So let the games begin with this article from the Miami Herald. Four years ago a class-action law suit was filed against the State of Florida on behalf of poor and disabled children. The lawyers for the children claim that their clients had to endure unconscionably long waits or long drives for medical or dental care or pay out of pocket (if their parents could scrape up the money) because no doctors or dentists would accept Medicaid. Federal law requires that states which accept Medicaid money must provide reasonably prompt care that is comparable to that provided to children in the same area who are covered by private plans. Evidently similar law suits had been filed, and won, in several other states. What rally burned me up was the Florida Attorney General's defense agains the claims: the State is merely required to PAY for the care not ensure it is actually provided. As I commented to Mom over our morning coffee as we listened to the news: one sure way to get me swearing a blue streak is a story like this one. We had several this morning all dealing with the political games going on with the health care reform debates in the senate.
Here is another entry for the health care games from my local newspaper. There are actually two stories both involving Blue Cross/Blue Shield/Anthem which demonstrates why we need to have a public option that is fully funded and includes everyone, provider and recipient alike. In the first the patient received a triple by-pass on an emergency basis and then treatment from a cosmetic surgeon (including skin grafts) when her wound became infected and wouldn't heal. Then she was hit with a $10k bill because the cosmetic surgeon was not in the network. She was in a network hospital, her heart surgeon was in network and he recommended the cosmetic surgeon who was associated with the (in-network, remember) hospital. The other story included in the article is similar. Patients at the Porter emergency room got a rude surprise when they were billed for the services of the ER doctors because, although the hospital and specialists were in network, the ER physicians were not. And Anthem suggests that it is the patients' duty to find out if the doctors are in network. Yeah.!! Right!! You are in an emergency room with a medical condition that needs to be treated NOW and you are going to say "Wait a minute, Doc. Are you in my network??' And what are you going to say if he isn't or worse if no doctor at that hospital (as happened at Porter) is in the damned network?? The ER doctors evidently are now having signed (under duress, they say) a contract with Anthem.