Fixing Part of the States Medicaid Nightmare

Posted: August 8, 2016 in Politics, Societal Attitudes, Uncategorized
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I know my  next sentence will mostly be repeating what many have already stated before; this is, after all, an ongoing, nationwide, nightmare. Then why do I feel compelled to say any more?  Because my most recent experience only highlighted, again, the additional burden placed on the state medicaid system.  It’s all very well for the federal government to mandate that everybody gets insured for medical coverage, but the manner and method of the coverage they mandated, has created the most costly and inefficient medical coverage any of us have ever seen, or felt.  Lest you get too discouraged about this subject up front, and stop reading; let me just reassure you, dear reader, that I will make a small suggestion that could help alleviate some of the wholly unnecessary burden the state is carrying, once I’ve outlined what happened in the most recent incident.

I recently wrote in one of my other sites , an article called “Fried Eggs” about a stop in the emergency room.  This stop was necessitated, not by a true emergency, but by a combination of ridiculous employer requirement, and a non-working medical card.  My daughter had come down with a summer cold, and her nose was running, and she was sneezing, and when she woke up, unusually, she couldn’t breath well.  A sort of choking sensation was occurring.  Naturally, being a waitress, she called in to work, to say she was ill, and wouldn’t be coming in.  Now, she had come down with this cold a few days before, so she had already been exhibiting the signs of the cold the previous day, and her manager knew this; however, the manager still required my daughter to get a note from the Dr. to prove she was ill, for the company records.

A little history here, about the medical card.  I used to have a full time job, before my required college course schedule began to interfere with getting there on time, and since the company wouldn’t adjust my hours, not even to make them part-time (how unusual), I was forced to choose between the call-center work, and finishing my education.  Being that I really want to finish getting a degree, I chose the education.  Now, I don’t have a full-time job, just a part-time one, and so, no insurance; however, the system was having a hard time getting updated to reflect the new status.  I had been trying for four months to get it updated, but there  was always some new hang-up.

On this particular day,  we tried to go in to the immediate care center, but the card was still not working, so we went down to the local medicaid update center, and tried again.  We were told, that we did indeed have coverage, but that the insurance company system where the main body of the coverage resided, needed to update itself. Under the circumstances, we still couldn’t go to the immediate care center, or the Dr’s. office, as they required the card to be working already.  We were sent to the emergency room for the required visit to the Dr. for the note.  Now, this makes getting that note a very expensive proposition.  An emergency room visit is at least three times, and often five times more expensive than a Dr’s office visit.

Imagine, if you will, how many other people may be going there for similar purposes, as it’s unlikely that we are the only ones who have difficulty with our medical coverage status.  Now understand, this coverage is being provided through both the federal government, and your local state government. They are both paying out a share  for these completely unnecessary visits. They get their money from the taxpaying citizens; from you.  In one recent article, I read that medicaid accounts for 25% of the state budget… I’m not sure which state it was referring to, but any state that is covering all these unnecessary trips to the Dr., and unnecessary emergency  room visits, is bound to be bogged down in an overblown medicaid budget.

Now, maybe you are mad about this expense, and you should be; but at least, in our case, I drove my daughter to the emergency room.  In many cases, the visit is made by ambulance, because it is being used as transportation; not because the trip is for a life threatening emergency, but because the traveler can’t afford a taxi, and has no other means of getting there.  The ambulance ride also gets billed to the state.  This is a really expensive ride to the Dr’s office.  These are all unexpected expenses in the state budget.  The real cost of covering all medical expenses lies not just in the actual medical issue, but in the combination of working, and non-working computer updates, human error of inputs, and availability of other resources.

In my daughter’s case, we did finally get seen, and she got a whole new health designation, due to having developed bronchial spasms, which had never occurred before.  She also got her required note for work, so she can keep her job; low paying though it is, it’s part of what we live on.  As I’m sure everyone already knows, part-time work doesn’t have required medical coverage for the employees, not that we could afford it if it did.

This is where I make my suggestion for cost savings to the state.  I know, I’m about to suggest that another government requirement be met by businesses, but, under the circumstances, I believe it’s necessary.  Here goes: Any time an employer requires an employee to get a note from the Dr’s., in order to prove an illness, or an injury exists, the employer should foot the bill.  I’m sure they could make an arrangement with a local immediate care to do this service, at a reasonable cost to all, in the same way that many employers arrange for lab work for drug tests.  Seriously, if a company can’t trust its employees to tell the truth about being ill when they call in, they have other issues that shouldn’t be burdening the taxpayers.

As for the transportation issue; the state should arrange with local cab companies, or with the ride sharing services, to allow them to bill the state for rides to the Dr.’s office, or immediate care centers, or even to the emergency room, where it isn’t a life or death ride, to save the cost of unnecessary ambulance services being billed to the state.  I’m fairly certain, that even if there were some billing done that wasn’t legitimate, it would still save the state money over the present system. And since there are GPS trackers in some of the cabs, the state could even cross check on the locations, and patient information being billed, to help keep companies, and rides legitimate.


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