Off the top of my head, I can't think of a better solution to handling the State Medicaid program other than turning to managed care. If you've got a better idea (other than spending tons of money we don't have) I"d love to hear it.
Haven't we already been through this? Here?
Without a DoctorThere’s been a lot of talk in our state about health care reform, Medicare, Medicaid and so on. There’s one side who believes health care is a right, and another believes government intervention in health care is wrong.
We are seeing the penultimate example of why health care reform is so urgently needed in our country. For six years, I witnessed first-hand the rape of Medicaid and Ryan White funding at the hands of Florida’s Republican governors Jeb Bush and Charlie Crist. What were once viable programs providing health care to people in need became bureaucratic jungles of unpaid claims and unmanageable care based upon rigid guidelines designed not to provide the best health care possible, but to deny payment for health care.
Faced with decreasing payments caused by further cuts to these programs, physicians have been forced to quit seeing patients they care for, thanks to political appointees bogging down the system to “save taxpayers money.”
Ten years ago, this area had five physicians handling HIV patients. Today there are none. Now that Dr. Daniel J. Warner has been booted as “the area’s only certified HIV doctor,” can someone out there explain where the hundreds of patients he’s seen over the years are supposed to go? Many of these patients lack the funds and transportation to go out of our area to see a capable physician. Will they have to see a physician who (most likely) is overwhelmed already? A physician untrained in the complex and ever-changing scope of care these patients need? How does the Health Planning Council of Northeast Florida plan on ensuring proper care for these patients?
Here’s a message to Jim L. Mayo, chairman of the Health Planning Council: Instead of donating money to Republican political candidates and health insurance PACs, how about spearheading real reform to health care by supporting our president? Or will Mayo be content with the knowledge that his actions might very well lead to the death of so many patients?
The Rape of Florida MedicaidIn 1965, President Johnson signed the law establishing Medicare and Medicaid. The original purpose of the Medicaid program was:
The Medicaid program, authorized under Title XIX of the Social Security Act, was enacted to provide health care services to low-income children deprived of parental support, their caretaker relatives, the elderly, the blind, and individuals with disabilities.
Going way back to the days of Gov. Claude Kirk (whom I had the pleasure to know personally, regardless of his political leanings), Medicaid has been a prime target of Republican Death Squads.
Gov. Bob Martinez (whom I worked under while with the Florida Board of Nursing) cut, sliced, and pared Medicaid at an alarming rate, especially with regards to our elderly.
But it wasn’t until the reign of Jeb Bush (for whom I billed Medicaid and Medicare at a home health agency) that Medicaid in this state went under the greatest change.
One of Jeb’s first actions upon taking office was to kill his predecessor’s, Lawton Chiles (the only Florida governor in recent history to actually care about health care for children, the disabled and the poor) health care initiative for individuals and small businesses, the Florida Health Care Purchasing Alliance.
But that wasn’t Jeb’s first foray into the rape of Medicaid. In 2003:
Governor Bush is proposing to drop health care and long-term care coverage for about 26,000 seniors and people with disabilities, although they would retain prescription drug coverage. The governor also is proposing steep increases in co-payments for prescription drugs, which likely would make it harder for some poor patients to afford their medications. The state already implemented modest cuts in the Medicaid eligibility of elderly and disabled people last year.
In 2005, Jeb had the bright idea (not!) to be among the first to follow his brother George’s edict to make state Medicaid coverage over modeling it like (get this!) a health insurance company, complete with limits on coverage:
Gov. Jeb Bush of Florida and Gov. Mark Sanford of South Carolina, both Republicans, have proposed radical changes intended to inject market forces and competition into Medicaid. Under their proposals, the state would give Medicaid recipients a fixed amount of money to buy health care or private insurance.
Under Governor Bush’s proposal, Florida would contribute a fixed amount toward coverage for each Medicaid beneficiary. Patients could use the money to “opt out of Medicaid altogether and purchase health care insurance in the private market,” Mr. Bush said.
(Ironically, today Jeb is on the board of Tenet Healthcare, the same company required to repay the government over 900 million dollars in Medicare and Medicaid overpayments and is plagued by scandal after scandal.)
Even today, Jeb Bush’s failed Medicaid managed care decisions are affecting the State negatively:
”We’ve done the experiment. It has failed,” said Durell Peaden, the Senate’s health care budget chief. “The reports are unsettling. People couldn’t get to specialists, couldn’t get adequate care. And they couldn’t do it cheaply.”
I’m sure Lawton Chiles, the only Florida governor in 40 years to care about it’s citizens, is rolling in his grave right now…
The son of Gov. Lawton Chiles said today Gov. Charlie Crist has “betrayed” needy children and old people by raiding a tobacco-funded trust fund for $700 million needed to balance Florida’s budget.
The "fix" to Medicaid obviously does not involve turning it over to managed care.
As much as you hate Alan Grayson, he had the answer:
Let’s face it. Health insurance companies charge as much money as possible, and they provide as little care as possible. The difference is called profit. You can’t blame them for it; that’s what a corporation does. Birds got to fly, fish got to swim, health insurers got to rip you off. And if you get really expensive, they’ve got to pull the plug on you. So for those of us who would like to stay alive, we need a public option.
In many areas of the country, one or two insurers have over 80% of the market. They can charge anything they want. And when you get sick, they can flip the bird at you. So we need a public option.
And they face no real competition because it costs billions of dollars just to set up a national health care network. In fact, the only one that’s nationwide is . . . Medicare. And we limit that to one-eight of the population. It’s like saying that only seniors can drive on federal highways. We really need a public option.
And to the right-wing loons who call it socialism, we say, “if you want to be a slave to the insurance companies, that’s fine. If you want 30% of your premiums to go to ‘administrative costs’ and billion-dollar bonuses for insurance CEOs who figure out new and creative ways to deny you the care you need to stay healthy and alive, that’s fine. But don’t you try to dictate to me that I can’t have a public option!”
