Friday, February 19, 2010

Medicaid Kaiser Soze

The whole Kaiser Soze situation has got much worse in the last few months. As the percentage of patients with goverment insurnace goes up, the number of docs who will actually see it is going way down. When I met with our Senator I explained this to him. He had some data that showed the number of docs who had signed up with Medicaid and was of the belief that this meant that those docs would see all the Medicaid patients. I had to set him straight on the Medicaid Kaiser Soze pricipal. When you have to take call, many docs will take Medicaid so they get something for having to see the patient in the ER on the basis of something is better than nothing. But when it comes to seeing them in the office, just try to get an appointment! The long and short of it, just because you have signed up for Medicaid does not mean you have to see them. In our area the pediatricians have been so devastated by Medicaid and SCHIP that they will say they take those insurances but they have so limited their office templates that they are basically not seeing any government payors.

I told the Senator, its like Kaiser Soze, Medicaid is everywhere but when you call and try to get an appointment, it is nowhere.


SeaSpray said...

Hey Throckmorton ..that's great that you presented that info to the senator! Hopefully more enlightened ...he will pass that info along and it will be in the considerations as they rework the health care bill. I hope more doctors get involved!

My mother had mdcr/mdcd and she was fortunate that her doc always took her in. Although ..I have to say ..that even in her 80s ..she rarely had to go to the doctor except for check-ups.

I do worry about keeping my docs with any new government health care plan.

I wasn't familiar with the movie and so googled it .. because LOL! ..I wasn't sure you weren't referring to a medical condition. I often times have a little home work to do when I read your posts. :)

Sounds like a good movie with major intensity. :)

PS have you ever heard of small companies giving their employees their ins premium money in there paycheck for the employee to open a health care account? Friend's husband works for a small propane company and they started it this year in anticipation of Obama's health Care plan. Supposedly this protects their money, but instead seems to leave them with substandard ins. If they don't use the deposited money for healthcare they can roll it over into the next year and let it build. All in family have thousand dollar deductibles. Husband recently put on bp meds costing 100 per month and so he is taking out of account to pay for it. Does not make sense if for premiums. The company no longer pats the premiums to ins company ..but friend says their money they deposit just sits in bank. How can that possibly be *insurance*? Insurance takes the premiums in exchange for payment of small claims and God forbid the large ones. You pay your insurance before you eat breakfast. Anyway ..wondering if you as a small business man ever heard of this type of plan?

SeaSpray said...
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SeaSpray said...

I'm curious to know your take on today's health care summit ..although it's on during working hours.

Just turned it on. Sen Coburn sounded good. Sen Hoyer said some good things.

I just don't trust all the other things they load the bill up with... and I worry when I hear about ins decisions based on person's age and condition. Who decides?

I like the idea of ins options based on pre-existing conditions being abolished. Hoyer said how the politicians have a group ins where they have all these good things and they want to do the same for the public ..a big group.

But reading your posts ..I admittedly have concerns about the quality of the public grp ins vs government official's ins.

Right now republican sen Baucus is talking about a shop act for sm businesses to pool and take advantage of competition and tax incentives. That sm businesses should have options like the government does. My husband gets a book every open season and he has a good selection of ins choices ..different companies and with hi or low options and in the book can go across the pages and make comparisons of coverage. But we stay with what we've got... and always hi option. But others might choose cheaper and others higher cost. he also said they should change how docs are reimbursed.. should be quality of care vs quantity. He also said they agree on a lot of things and have opportunity.

Anyway ..curious to know your take on it all. I recall one of your posts talking about how ins people put their kids on the free program and burdened the free program and so through your blog posts ..I understand the back side of these seemingly "good" ideas.

Thanks for the lessons. :)

This is interesting and they should've done it in the first place. I LOVE that instant media communications is forcing politicians to be more forthright in their dealings... AND the ins companies. One Dem ..Sen Miller speaking powerfully about pre-existing conditions and other ins ratings - interesting.