The Medicaid Crisis

Medicaid is a large program. It serves the old, the poor and children. If you have read any of my past posts about this, you will know that I think that our American Civilization is defined by how we treat the old, the poor and, of course, children.

We are about to embark on an attack against these defenseless citizens. The same people that brought you multiple $100 Billion tax cuts and a $300 Billion War, are now going after the old, the poor and the children:

States Propose Sweeping Changes to Trim Medicaid by Billions
By ROBERT PEAR
WASHINGTON, May 8 - Governors and state legislators have devised proposals for sweeping changes in Medicaid to curb its rapid growth and save billions of dollars.

Under the proposals, some beneficiaries would have to pay more for care, and states would have more latitude to limit the scope of services.

Please tell me how taking money from children is "saving it?" Saving it for whom?

In order to do this draconian thing, States are going to have to change the law. Not that this ever impeded a Republican on the scent of easy money. The law currently insists that everyone be treated equal. That is, if the State is providing the money for medical care, the care should be the same as if it were in the private sector. They have farmed this task out to private, for profit, insurance companies, the famous Manage Care Organizations.

These MCO's are supposed to insure that the old, the poor and children receive the same care as the rich Republicans if they have Medicaid, no matter whether they are wealthy to begin with or not. Sounds like a good idea to me and one that would be compatible with a compassionate government. After all, the government should be there for all the people.

Of course, I am being cynical here. The MCO's make their big money, but do not provide equivalent care for the patient. Let me give you a quick example. One of the largest MCO's that manages State Children's Health Insurance (SCHIP) in Maryland is Priority Partners. A child comes into your office with a bad laceration. You spend 20-30 minutes sewing it up. You submit a charge of $150 which is reasonable and customary. Priority Partners pays you $13.25. No kidding. Now the child got the same care as any other, BUT, some day I am going to go broke. Then there won't be anyone to sew the cut up. There will be a two tier system. It is coming.

Recently in Oklahoma the two tier system was successfully challenged:

(Tulsa, March 23, 2005): Judge Eagan's ruling in the case of OKAAP et. al vs. Fogarty is a great victory for the children and families of Oklahoma. The Judge's ruling strongly affirms what Medicaid recipients, providers, and advocates have known and asserted for years - that the Oklahoma Health Care Authority (OHCA) has failed its obligations to ensure that low-income and disabled children in the Medicaid program have access to adequate medical care in a timely fashion. For those who have been frustrated and ill-served by the Medicaid program, this is a moment of real hope.

Not so fast there, Jackson. I was shocked, shocked I say, to read the following in the above cited article from the NYT:

John Adams Hurson, a member of the Maryland House of Delegates who is president of the National Conference of State Legislatures, said: "I am a Democrat, a liberal Democrat, but we can't sustain the current Medicaid program. It's fiscal madness. It doesn't guarantee good care, and it's a budget buster. We need to instill a greater sense of personal responsibility so people understand that this care is not free."

This man is not a liberal Democrat. He doesn't give two shakes about real people. (Incidentally, I can think of a list of someones who need a "greater sense of personal responsibility" that includes: George W. Bush, Thomas DeLay, Dick Cheney, Douglas Firth, Bill Frist, and includes John Adams Hurson.) Just because he has a sexy name doesn't mean that he speaks for the people. His District should let him know immediately that he is a jerk.

I think we are rapidly coming to a crisis point in this country. The poor really have no idea what the John Adams Hursons of the world are cooking up for them. But then, they voted these yo-yo's into power.

Again, the NYT:

Moreover, they say, states should not have to offer the same comprehensive set of benefits to all Medicaid recipients, but should be allowed to provide some people with more limited benefits, like those offered by commercial insurers and the Children's Health Insurance Program.

States should be able to establish "different benefit packages for different populations, or in different parts of the state," the governors say in a draft of their new policy.(emphasis added)

Limiting benefits for the old, the poor and children. Its what we are all about as Americans. Too bad we can't just bomb them back to the stone age.