NY trying to use Medicaid funds for housing

[glenn1]

Why don't New Yorkers use their own fucking money to solve their own fucking problems for once rather than trying to get middle class taxpayers from other states to do it for them? I hope all federal Medicaid funds are pulled if they keep this up. Your homeless problem is not a federal problem and you're being blatantly unethical trying to make it so.

http://www.npr.org/blogs/health/201...ign=npr&utm_term=nprnews&utm_content=20140728

<snip>Brenda Rosen, the director of Common Ground, the organization that manages the building, says The Brook offers a full range of services to keep its residents healthy: social workers, security, a doctor and even an event planner.

And while these services don't come without a cost — an apartment at The Brook runs at about $24,000 a year — Rosen says they are cheaper than the estimated $56,000 per year that the city spends on the emergency room visits and stays at shelters and jails, where many people with severe mental illness end up.

"You know, we as a society are paying for somebody to be on the streets," says Rosen.

Few people would dispute that Lissette Encarnacion is better off in her studio apartment than she was when she was living under the bridge. And it's far cheaper if she has a doctor downstairs than if she has to show up regularly in the ER.

The question is, who pays for this kind of housing?

New York now has about 47,000 supportive housing units, and the state intends to invest $260 million Medicaid dollars over the next two years. But the federal government won't match it.

At the crux of this debate is the question of whether housing qualifies as health care.

<snip>

 

[fskimospy]

So wait, just so we're clear, you're ok with it if the state spends $56,000 of "middle class taxpayer's money" on various emergency services and shelters, but will be enraged if instead $24,000 is spent on housing.

That's awesome. I never want to hear you complain about government efficiency again.

 

[Genx87]

My Grandma in her last two years of life lived in an assisted living facility. Medicare\Medicaid helped pay for her housing.

This article seems to be discussing people with health issues living within an assisted living facility. I think that is blurring the lines between housing and health care. It isnt like they are paying for some healthy person that is working. Their example had a traumatic brain injury and was living in the streets suffering from seizures.

 

[Jaepheth]

Housing is one of the best prophylaxis for hypothermia.

 

[glenn1]

So wait, just so we're clear, you're ok with it if the state spends $56,000 of "middle class taxpayer's money" on various emergency services and shelters, but will be enraged if instead $24,000 is spent on housing.

That's awesome. I never want to hear you complain about government efficiency again.

No, I object to NYS asking the federal government and taxpayers to assume $24k in housing costs that should be borne by the state and fraudulently conflating it with "medical" costs. You can't argue cost savings to redirect the burden to the feds for an expense that should belong to the state. What next, asking the feds to pay the costs for your elementary school program because more educated populations have higher incomes thus "saving" Medicaid money?

 

[fskimospy]

No, I object to NYS asking the federal government and taxpayers to assume $24k in housing costs that should be borne by the state and fraudulently conflating it with "medical" costs. You can't argue cost savings to redirect the burden to the feds for an expense that should belong to the state. What next, asking the feds to pay the costs for your elementary school program because more educated populations have higher incomes thus "saving" Medicaid money?

That wouldn't make any sense.

The availability of adequate shelter has a direct impact on someone's health.

 

[Hayabusa Rider]

So wait, just so we're clear, you're ok with it earmarked forte spends $56,000 of "middle class taxpayer's money" on various emergency services and shelters, but will be enraged if instead $24,000 is spent on housing.

That's awesome. I never want to hear you complain about government efficiency again.

I pay the highest rate for property taxes in the nation. Supposedly that's earmarked for education but much is diverted to pay for medicaid. Now you add even more cost to the most expensive program in the nation. OK if you want it fine. I propose an income tax on NYC to fully fund it.

 

[fskimospy]

I pay the highest rate for property taxes in the nation. Supposedly that's earmarked for education but much is diverted to pay for medicaid. Now you add even more cost to the most expensive program in the nation. OK if you want it fine. I propose an income tax on NYC to fully fund it.

I pay the same property taxes you do.

You did not read the article well; this is projected to cost you half as much tax money as you would pay otherwise.

I propose reducing the income tax in NYC with the savings.

 

[glenn1]

That wouldn't make any sense.

The availability of adequate shelter has a direct impact on someone's health.

So do most other public services and utilities. Should Medicaid pay for NYS costs to maintain water supply and sewer systems also? Trash pickup? Restaurant inspections? I just want to see what you think your state is actually responsible for and what federal taxpayers should cover.

 

[TerryMathews]

I drive an unsafe car - model year 2003 so it doesn't have side curtain air bags for my kids.

When can I pick up my new medicare car?

 

[fskimospy]

So do most other public services and utilities. Should Medicaid pay for NYS costs to maintain water supply and sewer systems also? Trash pickup? Restaurant inspections? I just want to see what you think your state is actually responsible for and what federal taxpayers should cover.

Those are all statewide programs for all citizens, most of whom are not Medicaid recipients.

This is using Medicaid dollars to provide something to a Medicaid recipient that we (presumably) all agree improves the health of the individual and costs less money to do so.

You are arguing that it is better to spend twice as much money and are enraged by the fact that a state is using Medicaid funds in an innovative and cost-effective way. Like I said, never complain to me about government waste ever again.

 

[glenn1]

Those are all statewide programs for all citizens, most of whom are not Medicaid recipients.

This is using Medicaid dollars to provide something to a Medicaid recipient that we (presumably) all agree improves the health of the individual and costs less money to do so.

You are arguing that it is better to spend twice as much money and are enraged by the fact that a state is using Medicaid funds in an innovative and cost-effective way. Like I said, never complain to me about government waste ever again.

Oh, so it's another one of those famous progressive "collective action" problems. The ones where you identify a problem but aren't willing to pay for it unless everyone else is forced to first. Even if they have no relation to the problem whatsoever. I guess you'd just let the people freeze if NYS or city taxpayers had to foot the bill alone rather than trying to pawn it off to Uncle Sam.

 

[fskimospy]

Oh, so it's another one of those famous progressive "collective action" problems. The ones where you identify a problem but aren't willing to pay for it unless everyone else is forced to first. Even if they have no relation to the problem whatsoever. I guess you'd just let the people freeze if NYS or city taxpayers had to foot the bill alone rather than trying to pawn it off to Uncle Sam.

It's really hard to see how this relates to my post in any way.

You are complaining about the use of Medicaid dollars to help Medicaid recipients get shelter that will improve your health outcomes. You questioned why we wouldn't use federal dollars to improve those other services, and my answer was that Medicaid dollars are to help Medicaid recipients, not to help society as a whole.

I have no idea where you got a collective action problem from, as it doesn't apply here.

Again, you are enraged by the state using Medicaid funds to improve people's health at a lower overall cost. I'm not. The fact that you're furiously arguing for an approach that costs twice as much tells me that you are much more concerned with ideological warfare than you actually are about good government.

 

[Hayabusa Rider]

I pay the same property taxes you do.

You did not read the artisocle well; this is projected to cost you half as much tax money as you would pay otherwise.

I propose reducing the income tax in NYC with the savings.

We're paying 56 billion now. Whenever something new comes along things still cost more. So my question would be this- do you guarantee that the costs will be reduced by the claimed amount and the old programs discontinued and not merely renamed?

Edit- you do not pay the same as I do since property taxes are county based. I live in the highest tax rate county in all 50 states.

 

[fskimospy]

We're paying 56 billion now. Whenever something new comes along things still cost more. So my question would be this- do you guarantee that the costs will be reduced by the claimed amount and the old programs discontinued and not merely renamed?

This is silliness, you don't know the exact cost until you do it. If the projected savings don't materialize, you reassess what you're doing.

As for the old programs being discontinued, that makes no sense. The other programs they are using are the emergency room, prison, and homeless shelters. All of those will continue to exist. The amount we have to pay for them can most certainly decrease though.

So presumably you're ok with that income tax cut for NYC if it saves money, right? I mean if you were wanting to tax NYC if it cost more it only makes sense that you would want to give the savings back as well, right?

 

[fskimospy]

Edit- you do not pay the same as I do since property taxes are county based. I live in the highest tax rate county in all 50 states.

What county is this? I bet taxation as a percentage of income (all things inclusive, sales, income, property, etc) is higher where I am than where you are.

 

[JockoJohnson]

Oh ya, I bet my penis size is bigger than both of yours combined....oh, we aren't talking about that here?

 

[glenn1]

It's really hard to see how this relates to my post in any way.

You are complaining about the use of Medicaid dollars to help Medicaid recipients get shelter that will improve your health outcomes. You questioned why we wouldn't use federal dollars to improve those other services, and my answer was that Medicaid dollars are to help Medicaid recipients, not to help society as a whole.

I have no idea where you got a collective action problem from, as it doesn't apply here.

Again, you are enraged by the state using Medicaid funds to improve people's health at a lower overall cost. I'm not. The fact that you're furiously arguing for an approach that costs twice as much tells me that you are much more concerned with ideological warfare than you actually are about good government.

No, I'm arguing for an approach that says NYS should pay for the costs of housing its own homeless rather than pawning the costs off on the feds as a "medical cost." The state can't shirk those responsibilities then say it's "saving money on Medicaid costs" if they get Medicaid to pay their housing instead. Any monies paid by Medicaid to pay for housing of this type should be directly deducted from any other federal housing assistance programs to NYS. The state is double-dipping or even more from federal funds to pay for what is a state and city responsibility.

 

[realibrad]

This is silliness, you don't know the exact cost until you do it. If the projected savings don't materialize, you reassess what you're doing.

As for the old programs being discontinued, that makes no sense. The other programs they are using are the emergency room, prison, and homeless shelters. All of those will continue to exist. The amount we have to pay for them can most certainly decrease though.

So presumably you're ok with that income tax cut for NYC if it saves money, right? I mean if you were wanting to tax NYC if it cost more it only makes sense that you would want to give the savings back as well, right?

To be fair though, how many programs do you know of that are ended because they were not giving a return greater than the cost? I personally cannot think of a program removed because it was not working.

I think Glenn brings up a good point. NY is now going to use money collected around the nation, and only use it for the good of their own people. Using others money for the benefit of the few seems quite unfair when the people funding it had little to no say.

If the state cannot pay for this new program through taxes on its own people, it means that this system cannot fund itself. That then means that this does not scale, and that means others cannot get the benefit that NY gets. That seems quite unfair.

 

[Anubis]

What county is this? I bet taxation as a percentage of income (all things inclusive, sales, income, property, etc) is higher where I am than where you are.

I bet he is in Westchester county NY which has the highest property tax rate in the country. something like 9k a year. that's JUST property tax, the rest of his taxes wont be much different than yours in NYC

 

[bshole]

What county is this? I bet taxation as a percentage of income (all things inclusive, sales, income, property, etc) is higher where I am than where you are.

Plus the quality of life in New York City is about zero. Seriously why would anybody want to live there?

 

[fskimospy]

To be fair though, how many programs do you know of that are ended because they were not giving a return greater than the cost? I personally cannot think of a program removed because it was not working.

It happens all the time, regardless this isn't a program being begun or ended this is a particular "treatment" that would be covered by Medicaid dollars. What products and services are covered change frequently.

I think Glenn brings up a good point. NY is now going to use money collected around the nation, and only use it for the good of their own people. Using others money for the benefit of the few seems quite unfair when the people funding it had little to no say.

That's true for Medicaid money regardless of how it is spent.

If the state cannot pay for this new program through taxes on its own people, it means that this system cannot fund itself. That then means that this does not scale, and that means others cannot get the benefit that NY gets. That seems quite unfair.

This isn't a new program, this is spending Medicaid money more efficiently than it was being spent before. It is very interesting to see so many people who are so conservative arguing in favor of a massive waste of taxpayer money.

 

[fskimospy]

Plus the quality of life in New York City is about zero. Seriously why would anybody want to live there?

Beats me. The housing and rental prices are probably among the highest in the country because nobody wants to live here.

 

[fskimospy]

No, I'm arguing for an approach that says NYS should pay for the costs of housing its own homeless rather than pawning the costs off on the feds as a "medical cost." The state can't shirk those responsibilities then say it's "saving money on Medicaid costs" if they get Medicaid to pay their housing instead. Any monies paid by Medicaid to pay for housing of this type should be directly deducted from any other federal housing assistance programs to NYS. The state is double-dipping or even more from federal funds to pay for what is a state and city responsibility.

So just that we're clear, you want to deliberately waste taxpayer money. Good to know.

Back to my original reply, never complain about government waste again.

 

[fskimospy]

I bet he is in Westchester county NY which has the highest property tax rate in the country. something like 9k a year. that's JUST property tax, the rest of his taxes wont be much different than yours in NYC

I'm pretty sure he doesn't live in Westchester. From what he has said before I've gotten the impression that he's more upstate than that. I guess we'll see!