Posts Tagged ‘medi-cal’

My Healthcare Story – Ed Schilling

July 29th, 2011

In the middle of September 2001, just after 9/11, my wife lost her job at Medtronic in Santa Rosa, California. Medtronic makes medical devices like stents and catheters, but the company at that time moved its production line work to India. My wife lost her medical insurance for herself and our family. Later that month, I had my appendix taken out.
I was extremely lucky – at least financially. After my wife lost her job, we applied for Medi-Cal. My appendix operation would have cost us $5,000 on my wife’s previous insurance with Medtronic – about half of our savings at the time. As it turned out, it ended up costing us just $500 as a share of cost with our Medi-Cal insurance. I was not so lucky with the operation itself.
When I went to the hospital in Santa Rosa, they were unable to confirm that I had insurance. They were also unable to make a definite diagnosis that my appendix was the problem. While I waited eight hours to get that diagnosis, my appendix finally burst, and I was then, finally, ordered to drink a pitcher of blue-colored water and given a cat scan. Strange, because for the whole eight hours previous to that, I was ordered not to drink any water. Well, they got their diagnosis when my appendix burst and I was rushed into surgery.
Whatever break I got financially was paid for in the flesh, so to speak. Why did they make me wait so long before confirming that I had appendicitis? Was it because they couldn’t confirm that I had insurance? Was it because they just wanted to wait, for some other reason, for the cat scan, which would have given clear confirmation that it was, in fact, the appendix?
Anyway, they made me wait. And they sent me home promptly the next day after the operation, with a gaping deep wound that I was told I’d have to just clean myself. I was given instructions on how to clean this very deep wound. I also found out later that my wife’s former insurance would have covered having a nurse come out to the house to clean the wound, but Medi-Cal didn’t cover that. So I paid the price of having insurance that only covered the operation – paid for it in the flesh by cleaning my own wound.
If the hospital had diagnosed my appendicitis in time, it would not have burst, and I wouldn’t have had to clean the wound myself with Q-tips at home (with the help of a small mirror at times). And to this day, I think they would have caught the appendicitis in time, before it burst, had I not been a low-priority patient, a patient who, presumably, did not have insurance.

Ed Schilling

Brown’s Budget Ax Comes Down on Healthcare Needy

March 30th, 2011

Gov. Jerry Brown’s first whack at California’s $26.6 billion budget deficit is going to hit low-income Californians hard, especially those who rely on the state to get health care. Last week, Brown signed a bill reducing the state’s deficit by $11.2 billion through cuts in social programs such as Medi-Cal and Healthy Families:

Details of the Cuts
Of the spending reductions signed on Thursday, about $5.8 billion came from trimming social services. For example, the measures cut:

  • $1.7 billion from Medi-Cal, California’s Medicaid program;
  • $1 billion from CalWORKs, California’s welfare-to-work program (Contra Costa Times, 3/24).
  • $1 billion from First 5 by shifting reserve funds from the early childhood health and education program to Medi-Cal children’s services;
  • $862 million from mental health services (Sacramento Bee, 3/25).

Health Program Changes
One of the bills (AB 97) signed Thursday outlines changes to health programs. For example, the bill:

  • Eliminates Medi-Cal coverage for adult day health care services;
  • Ends Medi-Cal coverage for nonprescription cold and cough medicine;
  • Limits Medi-Cal beneficiaries to seven physician visits annually in most cases;
  • Imposes a 10% reduction in reimbursement rates for doctors and hospitals that serve Medi-Cal beneficiaries;
  • Raises premiums for Healthy Families, California’s Children’s Health Insurance Program; and
  • Requires Medi-Cal beneficiaries to pay $5 copayments for doctor visits, $50 copays for emergency department visits and $100 daily copays for hospital stays up to a maximum of $200 (Weintraub, Healthy Cal, 3/24).

Read more: http://www.californiahealthline.org/articles/2011/3/25/brown-signs-budget-measures-involving-major-health-cuts.aspx#ixzz1I7GFsW3M

After weeks of fruitless haggling over how to slice the remaining $15.4 billion, Brown on Tuesday called off negotiations with Republicans, citing their refusal to allow voters to decide whether to extend income, vehicle and sales taxes. If Brown and the Democrats don’t come up with a way around the GOP roadblock, cuts to health care and other social programs are going to be even deeper. Brown made a promise during the gubernatorial campaign that he would seek the electorate’s opinion on whether to raise taxes, probably knowing full well that trying to get a 2/3 majority of the state legislature to approve a tax increase was virtually impossible. So right now, it doesn’t look good that lawmakers will be able to resolve the impasse.

So we’re left with millions of Californians who will suffer needlessly because they will have even less access to vital health services. No one would suffer if we had a statewide public insurance program, like SB 810, that spreads the burden and responsibility for taking care of the health of all Californians. Contrary to what many assert, our state is not broke. Just as it is the case across our nation, the wealth is concentrated in too few hands. We would not have a budget deficit if those with the ability to pay more in taxes would pay their fair share. We can well afford a public insurance program for all, and we must demand that our lawmakers make it happen.

Sylvia@californiaonecare.org

Don McCanne, MD: California financial crisis, health students, and single payer

January 14th, 2011

Brown Unveils Budget Plan With Extensive Spending Reductions

California Healthline
January 11, 2011

(Gov. Jerry) Brown’s proposed budget would reduce spending by about $135.7 million by enacting changes to Healthy Families, California’s Children’s Health Insurance Program.

Brown’s budget also proposes $1.7 billion in cuts to Medi-Cal, California’s Medicaid program.

http://www.californiahealthline.org/articles/2011/1/11/brown-unveils-budget-plan-with-extensive-spending-reductions.aspx

And…

Labor is out-organized at budget protest

By Michael J. Mishak
Los Angeles Times
January 10, 2011

If today’s budget protests are any indication, organized labor needs to get, well, organized.

After Gov. Jerry Brown unveiled his budget, a handful of labor leaders gathered on the north steps of the Capitol to talk about the concerns of workers and recipients of In-Home Supportive Services and other programs that would see steep cuts. They didn’t get very far.

George Popyack, of the American Federation of State, County and Municipal Employees, was explaining how shifting state services to local governments could compromise quality when he was drowned out by hundreds of students descending on the steps for a separate demonstration in support of single-payer healthcare. Reporters and a camera crew turned to observe the students, who were chanting through bullhorns and banging drums.

“Well, we just lost the camera,” Popyack said.

http://latimesblogs.latimes.com/california-politics/2011/01/if-todays-budget-protests-are-any-indication-organized-labor-needs-to-get-well-organized-after-gov-jerry-brown-unvei.html

For report on the single payer rally by Erica Mu of KALW (audio and transcript):
http://kalwnews.org/audio/2011/01/10/could-single-payer-be-future-healthcare-california_782712.html

California Health Professional Student Alliance (CaHPSA):
http://www.cahpsa.org/CaHPSA/Lobby_Day.html

Comment:

By Don McCanne, MD

California’s budget crisis is a disaster. The draconian budget cuts will especially impact the state’s health and human services programs, including Medi-Cal and the Children’s Health Insurance Program. The good news is that California’s health professional students are not going to put up with it. They showed up by the hundreds to demand the enactment of a single payer system.

The future of our health care system is in good hands.

Re-posted with permission from pnhp.org.

Don McCanne, MD: California and New York lessons for Medicaid expansion under PPACA

January 6th, 2011

Cuomo Targeting Medicaid Spending

By Jacob Gershman
The Wall Street Journal
January 4, 2011

Gov. Andrew Cuomo is aiming to reduce the state’s Medicaid spending by billions of dollars, exceeding the size of cuts to the program proposed in past years, according to individuals with knowledge of his budget.

The Cuomo administration is considering a cut of about $2.1 billion out of the state’s projected spending on Medicaid in the upcoming fiscal year. With federal matching funds, the cut comes to more than $4 billion.

http://online.wsj.com/article/SB10001424052748704111504576060280154691892.html

And…

Brown to propose broad list of budget cuts

By Kevin Yamamura
The Sacramento Bee
January 3, 2011

(Gov. Jerry Brown) will propose Medi-Cal (Medicaid) savings by requiring patients to provide co-payments for services, limiting doctor visits and reducing rates paid to health providers. In Healthy Families (CHIP), which provides subsidized care for low-income children, he wants participants to pay more in premiums and co-payments while eliminating vision care.

“These would be shocking cuts if we hadn’t seen them before, but we have seen them before,” said Anthony Wright, executive director of Health Access California. “This is what’s left to cut outside of the wholesale dismantling of core programs. These are bad cuts that will impact millions of Californians.”

http://www.sacbee.com/2011/01/03/3295079/brown-to-propose-broad-list-of.html

Comment:

By Don McCanne, MD

A substantial increase in eligibility qualification for the Medicaid program is a crucial measure in the Patient Protection and Affordable Care Act (PPACA), designed to decrease the numbers of Americans without insurance coverage. Now the newly-elected Democratic governors of the two most populous states in the nation intend to sharply reduce funding of their Medicaid programs. What does this say about the wisdom of the PPACA policy of using Medicaid to expand coverage?

Gov. Brown’s proposal to impose financial penalties for accessing care, placing caps on doctor visits, and further slashing payments in this already critically underfunded program can only be disastrous for the low-income patients enrolled.

Once again, this is not change we can believe in. We desperately need an improved Medicare that covers everyone.

Re-posted with permission from pnhp.org.