But since about a million or so people did exactly that, I’m going do so here.
After San Diego ear, nose and throat physician Ted Mazer recently billed the state’s medical insurance program for the poor for a tonsillectomy, he got a check for $168, too little to cover surgical costs. The balance came out of his pocket.
Now legislators have cut the rates even further, leaving Mazer resolved to shut his doors to new Medi-Cal patients. Almost every other specialist in his field countywide has already done the same, he said.
When you make something “freeâ€, it has a tendency to get very expensive. Continuing.
Half the state’s doctors were refusing Medi-Cal patients eight years ago, just after rates were last increased. Refusal rates were sharply higher among certain specialists. Medical costs have risen since then, but state officials have stopped assessing whether enough doctors are participating in the program.
Reimbursement rates, doctors say, already are so low that a patient office visit nets only $24. Some clinics say the numbers simply don’t work anymore. The result: Thousands of patients guaranteed healthcare under state law can’t get in to a doctor’s office, so they don’t go or they sit for hours in an emergency room.
Experts warn that things may get much worse.
Chris Perrone, an analyst who tracks Medi-Cal issues for the California Healthcare Foundation, said Medi-Cal risks are becoming so unattractive to doctors that the program could soon “fall off the edge.”
When lawmakers began to address the state’s multibillion-dollar budget shortfall, Medi-Cal was the first program to be targeted with major cuts because of its size.
Funded jointly by the state and federal government, Medi-Cal is California’s second-biggest expenditure after education. It is projected to cost $38 billion next year, with about $15 billion drawn from the state’s general fund. The program serves 6.7 million poor, elderly and disabled people.
After doing the math, the State of California taxpayers are paying $5671.64 per person, per year on healthcare. Not a bad number, until you look at private healthcare costs.
We’ll use mine for example: With my payments, plus that of my employer, we gave $1973.40 to our provider last year.
So far, according to the extensive amount of paper my insurance company sends me every time I use their services, from March 07 to March 08 they have had to pay for four office visits, x-rays on two different occasions, a recent CT scan, 3 three different prescriptions and 14 physical therapy appointments for a total of $3116.36. Add in $680 worth of co-pays out of my wallet and the grand total is $3796.36.
Just what are they covering here? I’ve got a dislocated AC joint and probable Sarcoidosis. Even adding up the money I sent them and my expenditures, the total cost is $5769.76.
But that is not the way the math should be done. Not counting any of the money they made off investments from the payments my employer and I sent them, which what with the amount of cash they take in on just a weekly basis could be a significant amount, I cost them $1142.96.
I’m thinking that, just like in all things government, there needs to be some administrative thinning. Supposedly, if you listen to pro-government health care folks, private insurance companies have large numbers of people sitting around thinking of creative ways to deny coverage. They must be paying those people in cheap Canuck Meds or something if they can keep costs lower than the Great State of California
I recently had some surgery and during the office visits I took the opportunity to talk about our healthcare system with my saw bones. From his viewpoint and mine we see that the problem is administrative costs and insurance company procedures. He admits that he bills three times the cost at which he would make a satisfactory profit. He has to in order to cover the insurance discount or to makeup for Medicare reductions.
I asked him about the unlucky individual that didn’t have insurance but could afford to pay the bill? He stated that if the patient asked for a discount, he would readily give him 66% off, but the doctor could not initiate a discount without the patient asking for one. Otherwise the poor smuck pays the full boat.
Bottom line is always ask for some relief even if your just holding up your end of co-pays, you never know what might happen.
I believe that the State will attempt to insert Third World or other unlicensed-in-the-USA physicians into this gap when real, American-educated, private-practice MD’s refuse to continue with the State co-payment charade.
I believe the State will, unfortunately, prevail.
Many States and the Federal government have been using unlicensed veterinarians to fill positions in food inspection and safety, animal disease control, and diagnostic laboratories for years.
I believe the same is true with other medical professionals.
As long as there is a body in the chair, qualifications are flexible in goverment work.
Phil, you ignored the 900# gorilla: illegal aliens receiving Medi-Cal. I’d like to see the percentage of the Medi-Cal budget the illegals use up.