“Got’cha” Was Not What DHCS Wanted to Hear
Sacramento was well-served last week by the Assembly Subcommittee on Health and Human Services, chaired by Assembly Member Holly J. Mitchell. Her subcommittee put the California Department of Health Care Services (DHCS), specifically the director, Toby Douglas, on the spot when they were investigating several programs that the department had made decisions on that weren’t […]
Universal Healthcare – Will the providers choose to participate?
With a Democratic congressional majority behind him, President-elect Barack Obama is likely to make a universal health care program a reality.
What is universal healthcare? No one knows for sure. The idea is that every citizen has some kind of medical insurance coverage. But how is “some kind of” defined? Does that mean there will be coverage for catastrophes or acute problems that are life threatening and require trips to the emergency room? Or does that mean coverage for normal run of the mill physician diagnostic appointments for the flu which includes laboratory work and imagining like x-ray, ultrasound, CT scans and MRIs?
Once the extent of coverage is determined, the issue becomes how the health care system will operate. Will it work like Medicare or Medicaid? Will people be rolled into existing insurance plans that have different tiers of coverage? Will the plan be automatic for everyone with the option of having additional plans that the individual pays for to improve the kind of health care coverage they have? And then who will be responsible for paying for this?
The MediCal Meltdown
The MediCal system, which provides health care for the uninsured, is about to implode. I have been a medical provider for 30 plus years in California, and have seen the meltdown of the system first hand.
Of course, money is a big problem, but it is only one issue in a long list of difficulties: lack of reimbursement for services; non-timely payments to medical providers that extend over 2 years; administrative bureaucratic hassles; paperwork nightmares; medical management by non-medical people; and medical management by medical professionals who have never examined the patient. It is no wonder that so many medical and allied health professionals are stampeding out of the system.
Here’s just one example of the bureaucratic hassles. I moved to a different medical suite in the same complex and had to change my MediCal paperwork. That required filling out a form consisting of 32 pages and, even though I’m already in the system, I was denied four times over the course of a year-and-a-half because it was claimed that I didn’t fill in answers to the bureaucracy’s satisfaction. But my information was already in the system, except for the new address.