Friday, September 12, 2008

Gloom and Doom

Health reform is not an easy task. If it was it already  would have been accomplished, or at least begun.

The recent financial disasters,including bank failures in the wake of the subprime mortgage market fiasco and secondary consequences in it's wake now have impacted investor firms, and banks.  Even the backup organizations are being threatened and choices must now be made as to which institutions can or will be saved.  In any case you and I will pay for these events, regardless of who is at fault.

Our medical care system has not been immune from this instabilty, nor will it be now and in the future. There is a strong parallel in medical care.  Financial institutions have felt some level of protection by governmental safety-nets.  (Sound familar?)

Our health care financing system and insurers have had the ability to maintain profitabilty and sustainability by their ability to carve out profit each year by forcibly reducing their reimbursement to those providing the actual care, without concern for rising cost, nor deterioration of   care.  The safety nets of medicare and medi-cal are now stressed to the maximum.

Further statements of insurance coverage now belie the fact that even those with "insurance" are not covered. Many providers now are not accepting medicare and many more do not accept medi-caid.  Patients who "have" medicaid are in fact unable to find providers who will see them.  The recent budgetary crisis in California has now totally placed all medi-cal payments on hold.

Tens of thousands of patients in skilled nursing facilities are about to be 'evicted' since their  'homes" will be closed and shuttered.

Costs are being shifted by the surge of non covered patients on medi-cal to private payors because the hospitals have to offset these losses.

There is no doubt that patients are suffering and even dying. More will die if further cuts occur.

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