California Medical Association Applauds Obama's Push For Health Care Reform
Main Category: Public HealthArticle Date: 16 Jun 2009 - 3:00 PDT
The California Medical Association called on President Obama today to fix the flaws with Medi-Cal and Medicare, the government's two biggest health care programs, as part of efforts to reform health care and extend coverage to those who are uninsured.
"California's physicians are strong advocates of providing universal access to health care," said Dr. Dev A. GnanaDev, CMA president. "We believe President Obama's stated guiding principle - 'fix what's broken, build upon what works' - is the right idea, and we are glad he has made health reform a top priority this year.
"One primary objective must be removing the current barriers to care in Medi-Cal and Medicare and ensuring any 'public option' that is part of the reform plan gives patients true access to doctors, not a false promise of coverage."
Leading congressional proposals suggest expanding Medicare or Medicaid as part of the plan to cover the uninsured, but CMA believes the major problems in those two programs must be rectified before the government builds upon them or creates a complementary public insurance option.
Medi-Cal, the government health care program for the poor, serves 6 million Californians, but many have difficulty finding a doctor to see them. That's because chronic underfunding has forced doctors to quit taking Medi-Cal patients or drop out of the program altogether.
Medicare has similar issues. Both programs have onerous administrative requirements that discourage doctors from participating and delivering the care that California's seniors and poor need and deserve.
Medi-Cal reimbursement rates have not been increased since 2001, despite the fact that inflation has increased almost 20 percent in that time. The result is low physician participation and more Medi-Cal patients heading to expensive emergency rooms for treatment. According to a 2006 report by the California HealthCare Foundation, 31 percent of Medi-Cal recipients visited an emergency room within the previous 12 months, while only 18 percent of Californians who are uninsured visited an ER in the same period, suggesting that Medi-Cal enrollees may have even less access to primary and preventative care than the uninsured.
The California Medical Association represents more than 35,000 physicians in all modes of practice and specialties. CMA is dedicated to the health of all patients in California.
Source
California Medical Association
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Other Factors At Work In MediCal Seeking ED Care
posted by Thomas W. Brown on 8 Aug 2009 at 1:36 amAs a retired OB/GYN who practiced in California for 32 years in a high percentage medical area, I have some opinions about why the MediCal patients go to the ED twice as often as uninsured people. The Medical patients are very much aware of the system. They know if they go to Dr. X and are consistently late for appointments, repeatedly do not follow treatment instructions and they know the mountain of paperwork, frequent denials, the daily hassle of calling the Medical office to talk to a clerk about denial of a requested service, Dr. X is not interested. He is interested in patients that come to her for medical advice and follow it and follow up if needed.
For instance, MediCal denied one of my patients a planned C/Section! They REQUIRED her to go into labor and fail to deliver before they would authorize a C/Section! As ludicrous as this was, I could get no farther with them, and the hospital in our area (nearest other hospital about 12-15 miles )REFUSED to admit her since she had been denied by MediCal, i.e., they wouldn't pay the bill.This is a very dangerous practice. As a physician, you might resolve this by saying, "I will not bill MediCal for this and just go ahead." ALL doctors who treat MediCal patients do this frequently, despite what the public thinks. But there is still no hospital that will admit this patient, UNLESS SHE IS IN LABOR. So, these patients put themselves and their babies at risk by waiting.
As you can see, there are many factors leading to refusal to see MediCal patients:
--patients typically sleep late in the day, many preferring a nocturnal life.They generally can't get to an appointment by 2 PM. Many have no transportation.
--many MediCal patients have a giant "entitlement" chip on their shoulder that turns doctors and the staff "off"
--lots of red tape hassle to get procedures or meds approved, with long waits for poor payment months later.
I am definitely AGAINST OBAMACARE, but reform should be made in areas of mediCal eligibility, better research done on applications locally to effectively root out fraud and prosecute it. The federal government should also widen the door so these 36,000,000 citizens without insurance can get MediCare--they are actually trying. The other 10,000,000 uninsured or underinsured are illegal aliens (NO not "undocumented aliens). They need to go back to their own country immediately. The Federal Laws in place have to be followed and shored up. These people CANNOT stay and get benefits. Period.
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