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Medi-Cal facing expensive boom

July 12, 2012

Medi-Cal patient numbers will expand dramatically over the next few years while more and more California physicians are curtailing their services to recipients of the state’s health care program. (San Jose Mercury News)

Many doctors already view Medi-Cal reimbursements as inadequate; the state ranks 47th of 50, one of the lowest reimbursement rates in the U.S. Medi-Cal pays a physician $15-20 for an office visit; Medicare reimburses $50 for the same service, and a private insurer ponies up as much as $70.

Recently state legislators eliminated the Healthy Families program, which provided low-cost medical insurance for children and teens. That alone will add at least 900,000 children to the Medi-Cal ranks, and 1.5 million or more adults will be enrolled when the national health plan takes effect in 2014.

And lawmakers last year shaved 10 percent more from the pay to Medi-Cal providers, a move now contested by physicians.

Medi-Cal, covering 7.7 million Californians, is expected to grow by 30 percent in two years, costing $9 billion more — financed primarily by federal funds.

UPDATED, 3:35 p.m. July 19 to add the following commentary from the Contra Costa Medical Association on the matter of the Healthy Families program’s fiscal woes.

“The California Legislature recently approved Governor Jerry Brown’s proposal to phase out the Healthy Families program entirely in 2013, forcing approximately 880,000 children into the Medi-Cal program instead. Fewer physicians are able to accept new Medi-Cal patients due to the inadequate reimbursement rates that generally do not cover the costs of medical practice.

“In fact, the Legislative Analyst’s Office estimates that only 25 per cent of physicians who are treating Healthy Families kids will be in a position to continue providing care once the program is eliminated in 2013. Because the Legislature once again did nothing to address the structural funding deficiencies in Medi-Cal that make it impossible for many physicians to participate, the Legislature’s decision will only further strain access to care for Medi-Cal patients.

“The California Medical Association (CMA) opposed efforts to eliminate the Healthy Families program, and along with other provider and children’s groups, has proposed a compromise effort to restructure Healthy Families by moving only the “bright line” children — those whose parents earn between 101 and 138 percent of the federal poverty level — into Medi-Cal. The state will be required to transition these children to Medi-Cal due to the requirement of federal health reform.”


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US: Poll reveals that 83% of doctors have considered leaving their practices over Obama’s healthcare law. [By 2020, there will be a shortage of 90,000 doctors due to increased demand and expanded coverage. It will be ‘free’, but you may have to wait months or years to get it.] Daily Caller 2012 Jul 9


http://dailycaller.com/2012/07/09/report-83-percent-of-doctors-have-considered-quitting-over-obamacare/


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Dailycaller is a shill rag by that weasel Tucker Carlson. They just make stuf up, like Faux.


And, any supposed doctors that would be so selfish to abandon their practice because of increased health care opportunities for more people should be forced out and never again allowed in any medical profession.


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Thank you for the 6 to 0 rating.


We know who the enemies of civilization are


Us ‘civilizationalists’ are patient. We learn to be so. This does not mean that we are weaklings.


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The whole idea of becoming wealthy off of healthcare is out of whack. It’s a profession that is needed throughout society and originally a humble profession that has morphed into way too may over paid providers, shady insurance companies and often a socially instigated rock star aura superimposed on many physicians.


Medical school should be provided to those with the aptitude and and natural drive to do good for society at a realistic fee. Back to basics and realistic compensation for healthcare and it’s infrastructure.


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“The whole idea of becoming wealthy off of healthcare is out of whack.”


Who says? Who is to say how much money anybody should make from a particular industry?


If what you say is true that it “has morphed into too may over-paid providers, shady insurance companies, and, often, a socially instigated rock star aura superimposed on many physicians,”


that is NO FAULT of the market. That is the fault of government interventionism.


“Medical school should be provided”?


By whom? The government (again)??? The government is the troublemaker which is ruining the medical industry!


“Back to basics and realistic compensation for healthcare and it’s infrastructure”?


I could not agree more. Get the government out of the medical business and we will all be better off!


“There are in the fabric of a market economy not sabotagedby the nostrums of governments and politicians no grandees and squires keeping the populace in submission, collecting tributes and imposts, and gaudily feasting while the villains must put up with the crumbs. The profit system makes those men prosper who have succeeded in filling the wants of the people in the best possible and cheapest way. Wealth can be acquired only by serving the consumers. The capitalists lose their funds as soon as they fail to invest them in those lines in which they satisfy best the demands of the public. In a daily repeated plebiscite in which every penny

gives a right to vote the consumers determine who should own and run the plants, shops and farms. The control of the material means of production is a social function, subject to the confirmation or revocation by the sovereign consumers.”


Ludwig von Mises, The Anti-Capitalistic Mentality, p. 2


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The Gimlet Eye says “Poll reveals that 83% of doctors have considered leaving their practices over Obama’s healthcare law.”


No. Of the 700 doctors that replied to a survey fax:

83% say they are thinking about QUITTING. (Obama not in the question)


Gimlet you are trying too hard, your spin is showing and dude redundant much?


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California has the largest gross domestic product of any State, by far. California has one of the highest cost of living indexes in the nation. California has the largest delegation in Congress.


Yet our Congressional delegation is so at war with itself [Issa vs Pelosi] that as a State we exercise no clout. If these folks representing us in Congress would pull together FOR Californians, instead of jostling to see who could make the biggest splash in “national” politics, California’s Medicare and Medi-Cal programs might actually provide the health care services we expect … and they all promise.


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You have the wrong construct…and it is not isolated or California specific.


We now have one organized political party that is against everything and everyone else, that is funded by extremely wealthy reactionaries, that exists only to obstruct and oppose any meaningful advancements or changes for societal purposes.

They have blocked and fought every program and legislation that would help ordinary Americans since the New Deal..


They are the American Nationalist Party : the Republicans.


“When fascism comes to America, it will be grossly obese and carrying a mis-spelled sign” – Sinclair Clemens


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The Old Right, which constituted the American right wing from approximately the mid-1930s to the mid-1950s, was, if nothing else, an Opposition movement. Hostility to the Establishment

was its hallmark, its very lifeblood. In fact, when in the 1950s the monthly newsletter RIGHT attempted to convey to its readers news of the right wing, it was of course forced to define the movement it would be writing about—and it found that it could define the right wing only in negative terms: in its total opposition to what it conceived to be the ruling trends of American life. In brief, the Old Right was born and had its being as the opposition movement to the New Deal, and to everything, foreign and domestic, that the New Deal encompassed: at first, to burgeoning New Deal statism at home, and then, later in the ’30s, to the drive for American global intervention abroad. Since the essence of the Old Right was a reaction against runaway Big Government at home and overseas, this meant that the Old Right was necessarily, even if not

always consciously, libertarian rather than statist, “radical” rather than traditional conservative apologists for the existing order.


Murray Rothbard, The Betrayal of the American Right, p. 2


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I disagree that our “Congressional delegation is so at war with itself.”


They “pulled together” a long time ago. All this “debate” between them about Obamacare is just for show. It is theatre. Don’t fall for it.


Their long-term plan is to build a police state. This is just a part of that plan.


They pretend to differ with each other over “controversial” issues, while really being preoccupied with other far more sinister plans.


They are obsessed with CONTROL.


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A true Christian perspective to save trillions on healthcare!


Seventy-five percent of this nation are Christians. Twenty-five percent are non-christian and are Hell bound. If we Christians actually follow the Gospels of Christ, we personally don’t need any healthcare whatsoever! Therefore, we can save the rest of the nation from exorbitant healthcare costs. This is because of the following passages stated by our Savior, Jesus the Christ.


Jesus stated; “And all things, whatsoever ye shall ask in prayer, believing, ye shall receive.” (Matthew 21:22) “What things soever ye desire, when ye pray, believe that ye receive them, and ye shall have them.” (Mark 11, 24)


With specificity, these passages state that if one “believes” ye shall receive what you asked for in prayer. Therefore, all we true Christians have to do is firstly believe in Jesus, and secondly, then pray that we’ll never get sick or injured. If we do get sick or injured, then we obviously weren’t believing enough and need to pray harder.


Who are we to argue with Jesus in that He states with direct specificity that if we really “believe” in Him, we shall receive our prayer requests, and in this case, of not getting sick or injured in any way to need healthcare. It’s just that simple.


Any Christian want to argue with the direct word of Jesus relative to receiving your prayer requests in this respect? No? I didn’t think so. Therefore, let us Christians lead the way in saving our nation with the healthcare problem, praise!


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You are an idiot.


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Fedup,


Blaspheme! Calling our Christian God an idiot! What is proposed is exact and biblically inspired doctrine that you obviously cannot refute and remain intelligent looking in the aftermath, other than to call the messenger an idiot! Therefore, who’s the idiot? You!


Your kind are a dime-a-dozen in this forum. How sad.


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Your both right/wrong, so go sit in the corner and put on the hat.


This is why we can’t have nice things.


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Brother Ted… as you are well aware, the Lord NEVER charged a co-pay !

I don’t think that he ever called anyone an idiot, but he may muttered ‘fools’ under his breath.


You and I can be satisfied that the hypocrites will be soon wearing concrete overcoats and swimming in the most obnoxious bile as per Jesu Ben Joseph’s prescription.


HALLELUJAH !


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So let’s blame insurance companies, let’s blame the drug companies, but the FACTS are that a family physician can not afford to treat people for $40-$80 an hour under medical… (15 minute/visit X 4) Add to this liability insurance alone being over $100,000. My auto mechanic has a flat rate of $90 an hour and didn’t have to spend $150,000+ for an education. One thing that is evident, when you put another twenty million + people on the medical rolls with the limited number of physicans in this country your medical care is going to change dramatically. Add to this, government boards that will govern what medical care a physician can perscribe (is this any different than the “evil” insurance companies everyone talks about) and you’ll be lucky to get any medical care. The system doesn’t work in Canada, that’s why thousands come to the US for medical care. They can’t afford to wait for the bureaucracy to run it’s course before seeing a doctor. For some reason insurance companies are limited to specific states where they can offer their insurance. This alone creates a monopoly. Allowing all insurance companies the right to offer their services in all 50 states would increase competition and lower overall rates.


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So true!! People don’t think about the fact that not only is there liability in that hourlly figure, so is overhead, employee’s pay, rent, supplies etc. And you still want to build in a little profit. When you think about it in those terms really not much left.


People like to typify anything or anybody that has to charge anything outside what they think is reasonable, as greed or unfair. Sometimes that is just life. I don’t like high prices either but when I see someone is being fair what I’m I to do? Ask them to work for free or lost wages because of what I think?


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Humans need healthcare. There is no time for partisan politics on this issue. We all will be paying one way or the other. Let’s get something done that makes sense and keep tweaking it even better as time goes on.


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http://crooksandliars.com/files/vfs/2012/07/lack-of-funds.jpg

thank you Franklin D. Roosevelt for the WPA.


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“The evaluation of any economic system must be made by careful analysis of its effects upon the welfare of people, not by an appeal to an arbitrary concept of justice which neglects to take these effects into full account.”


Ludwig von Mises.


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Step one: break the drug company cartels by allowing programs to aggressively negotiate prices. Introduce competition where needed.


Step two: break the AMA union. Increase the number of doctors x2 through expansion of medical school and recruitment of talented RAs and other medical personnel to medical school.


Step three: control costs. Use the Japanese or one of the European models that regulates prices that can be charged.


Step four: only fund best practices and “reasonable” testing and procedures for public program.


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A. From Step 1: “aggressively negotiate prices. Introduce competition where needed.”


B. From Step 3: “control costs. Use the Japanese or one of the European models that regulates prices that can be charged.”


Aren’t these two strategies at odds with each other?


C. From Step 4: Who decides what “best practices” and “reasonable testing” are and whether they will be “funded” or not? In a free market economy, it is none other than YOU, the consumer, who decides. In a socialist economy, it will be state bureaucrats who decide. Are you sure that you really want to give up making your own economic decisions?


Count me out!


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I’m fine with socialized medicine. We’ve been down this road before Gimlet. They have great healthcare in the UK, Sweden, Japan, Taiwan, Germany and spend way less than us. Some have more socialized models (UK) others less (Germany), but all more so than the US. So there is no reason to think that socialized medicine is bad.


A and B are compatible. Markets can work wonders when they are competitive and regulated. If Medicare and other large public insurers negotiated prices they could get much better prices. In cases where that was not enough, they could encouraged alternative manufactures and even go across borders. People’s health over corporate profits.


http://www.popjolly.com/why-america%E2%80%99s-health-care-sucks-infographic-2712


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“Markets can work wonders when they are competitive and regulated”?


LOL!


You have no idea what you are dealing with here!


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On Medicaid, but gets at the point:


Let’s try to stick to the real world when we talk about Medicaid, by Aaron Carroll: Tyler Cowen had a piece in the NYT this weekend on Medicaid. He doesn’t seem too thrilled with its use in the ACA’s coverage expansion. … I have to admit that his article set me off a bit. It could be that he didn’t have space in the NYT for more nuance. Perhaps he’ll provide it on his blog. In particular, I’d love him to address some of the points below…

I get a bit annoyed when people claim that we can’t “afford” more government intervention or, god-forbid, single-payer. That kind of statement willfully ignores the fact that every country that has MORE government intervention spends LESS.

I get a bit annoyed by the claim that an expansion of government insurance leads to lines and waiting when lots of countries have universal access and less of a wait-time problem than we do. Moreover, almost no one makes this argument when we expand private insurance, only government.

I get a bit annoyed by blanket claims that doctors won’t accept Medicaid. Such statements often ignore the fact that the majority of Medicaid beneficiaries are children and pregnant women. We don’t need all types of doctors to accept Medicaid patients in equal numbers. …

I get a bit annoyed when people just claim government programs are “unpopular”. Like Medicare? I don’t think so…, polling shows the opposite of what Tyler (and lots of others) suggest.

I get a bit annoyed at the blanket acceptance of the awesomeness of the free market in health care, when there is no phenomenal evidence of its success. And again, those countries with less free market are cheaper, universal, and often just as good. …

Look, I get that people may not like the political implications of those systems. They may not like the governments that produce them. They may not like the lack of choice inherent in such systems. They may not like the potential limitations within them for making money, and therefore for innovation. But we need to stop making stuff up about them.


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Certain business models are not compatible with civilization. Example: slavery. Our nation used to permit . Now, it doesn’t…but we needed to have a bloody Civil War to change. Some people are still fighting it..

So,


Step one: Do away with an archaic business model ; the for-profit sickness industry. Replace it with a not-for-profit wellness and health-care system.


Step two: Outlaw insurance companies from covering people and not things.


Step three: Streamline the drug patent and import process. Reduce the patent exclusivity to ten years or less for pharmaceuticals developed through teaching and study colleges.


Step four: States cannot ‘opt out’ of a national health system…just like they cannot opt out of not having slavery.


Or , do we need to have another Civil War ?


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A simple fix would be to take those small checks and spend them in Mexico. Who cares if you can’t talk their lingo, they can fix your eyes, teeth and re-plumb anything for a fraction of the Alta California price. Competition for the ER stuff might be good for the consumer.


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How about sending all the illegal aliens back to mexico so we can affort to help our own citizens.


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I agree, every little bit helps but if we sent back all the illegals, we might starve to death.


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Jorge,


One way or another, we’re going to pay for it in the long run. So what if we have $5.00 heads of lettuce, or $3.00 a piece oranges? We sent back those damn illegals, and that supercedes anything else and makes uf feel good!


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That’s nonsense. You are making up those figures just to be inflammatory.


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Alternatively, we might put to work millions of unemployed Americans. That beats starvation, doesn’t it?


That’s the nice thing about a free market economy; it doesn’t need slave labor to make it work!


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Jorge: I agree and have used Mexican doctors in the past, but haven’t crossed the border in about seven years because of the drug cartel violence. Any references to quality dentists who do implants?


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Maybe one of Big Brother’s strategies (among others): cut off that escape route and reduce people’s economic options. Kinda neat!


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http://www.ihtworld.com/


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I have a friend who works for a medical clinic and no way are they able to see anyone without insurance or cash. They can not afford to see anyone on any goverment program because of reimbursement costs. Today I read where the average wait for a referral in Canada (their fantastic free health care program) is now 19 WEEKS – that just for the referral. Welcome to Obamacare since we don;t have enough doctors nationally and California is even below the national average. Interesting situation!


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The Affordable Care Act is nothing like the single payer system in Canada. Just screaming Obamacare and spewing falsehoods doesn’t change the fact that here in the US insurance companies will still be the primary source of our medical payments.


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Well, since the AFFORDABLE (which as of today has now tripled in cost and it hasn’t even been implemented yet) Care Act only has to cover the employee and not the family and it would actually be cheaper for an employer to pay the $2,000 TAX instead of providing the health care I would suspect that other than the rich and government employees most of the general public will be put into co-op’s and now you are on government subsided insurance. It is for sure this program is not free and this will cost everyone.


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Again, spew lies until it gets believed It hasn’t tripled in fact the new estimates are lower than originally thought http://mediamatters.org/research/2012/03/16/right-wing-media-falsely-claim-cost-of-health-c/184978


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You are entitled to you opinion, but not to your own facts


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move to Cuba


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Hi Dan,


My daughter is still on Healthy Families and we’re still paying a monthly premium.


So, on our end, there has been no end to HF.


I know there WAS talk of eliminating the administrative offices up in Sacramento, and combining them w/ the MediCal offices, and thereby saving HF, but I don’t think that’s happened yet.


Who told you that HF is no more?


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Celeryclown: Please see updated article with more information on Healthy Families’ situation.


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The expansion and reauthorization of the State Children’s Health Insurance Program (SCHIP) was signed into law by President Obama on February 4, 2009. In California, the SCHIP is known as Healthy Families.


This law keeps nearly 900,000 California children in Healthy Families. It also gives thousands more children access to health care. It provides money for 4 ½ years and gives financial stability for Healthy Families. Federal funds provide 2/3 of the funding needed for states to run their SCHIPs.


Making sure Healthy Families has enough money to cover children is important to Governor Schwarzenegger. The Governor is grateful that President Obama shares the same thoughts. Children who need coverage will be able to receive it. The reauthorization will allow California children access to comprehensive health, dental and vision care that is crucial for their healthy growth and development.


Click the following link to read the official press release: http://www.mrmib.ca.gov/MRMIB/Press_Release_President_Signing_2009.pdf


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