Does Medicaid need more market-based reforms to better serve recipients?

No

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by Paul Wylie

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Murder By Medicaid

Every so often we are treated to the devastating visualization of exactly what the cuts to domestic programs are causing. Once in a while the lurid photographs or the stunning video makes it's way to the media showing just how far we have sunk as a people when it comes to the care and the treatment of the poor.

The murder of a mentally ill patient, and that's what it is, murder, at Brooklyn's Kings County Hospital is indicative of a larger problem when it comes to services for the poor and the mentally disabled. Video shows security guards and a doctor ignoring a woman who had been waiting for twenty four hours in an emergency room at the hospital, even after she collapsed to the floor. A nurse finally comes and kicks her like a dog to see if she is alive, but of course, by this time she was dead.

Kings County Hospital has long been the only place in Brooklyn where the poor could go when they were sick or injured with non life threatening illnesses and injuries. Long waits for service are nothing new there, but the deaths of patients who seek treatment at the facility are on the rise. A lawsuit brought by the parents of a twelve year old boy who died of MSRA, a super staph infection, alleges that doctors never diagnosed the extremely ill child properly and sent him home with an over the counter antibiotic. He died soon after being discharged. Another recent incident at Kings County shows a man taken to the emergency room by relatives, where after a long wait to be seen, he also died. The cause? Admitting doctors failed to detect a stab wound that was bleeding profusely in his abdomen.

All of these three victims have one thing in common. Poverty. And even worse, they were on Medicaid, the much maligned by extremists medical program designed to help the poor have access to medical care. Only it doesn't work that way any more. Medicaid cut after Medicaid cut by this monstrous President and the leeway handed over to the states to bring in private insurance companies has so decimated the program, that what taxpayers are getting when money goes towards Medicaid now is not what they think. The money is going straight into the pockets of HMO's such as Kaiser, Magellan, Blue Cross and others, who act as middle man between care providers and the patient. It also didn't help that in March of 2003, Governor George Pataki began a series of funding cuts of his own to Medicaid payments for 17 Brooklyn hospitals, to the tune of $134 million.

New York is not unique in the cuts made to Medicaid payments for the care of the poor. But none can match the outright chutzpah of the Nevada legislature's callous and cold new budget. Passing hefty pay raises for public employees, they paid for them by trimming almost $275 million more from services to the poor, when they had already passed $1 billion in slashed spending not too long ago. Las Vegas mental patients who are suicidal already have almost no services, sometimes waiting up to three days in emergency rooms before being released after being given a cursory inspection by a doctor.

How did this happen? By the Bush Administration's privatization of Medicaid. It used to be that when a poor person had Medicaid coverage, they could go to the doctor or emergency room with the expectation of being seen by a professional. Not so any more, and this is what they do not want the taxpayers to know. Now, Medicaid patients must get approval by their HMO provider to see a new doctor. If the doctor is not on the provider's list, then the patient MUST choose an 'approved' care provider. Encouraged to provide minimal care by lower and lower payments made through Medicaid, the savings are then handed to the HMO's for saving the government money. The largest theft in world history isn't going on at Halliburton. It's happening right here in America's medicaid system under Bush.

The HMO must also approve all prescriptions given by doctors, many times changing the ordered drug for something else, or outright denying the patient access to the prescribed medication by calling it 'experimental'. Also not known by the public at large, who see the Medicaid program as a free ride for the poor, is the fact that while costs are sky rocketing, actual services received are in decline. That's because of the brilliant idea of forcing the poorest of the poor to make co-payments for services rendered. So a person receiving Medicaid due to a disabling illness, and who has to see his or her doctor four times a month will have to pay up to $25.00 per office visit. Say that person is given five prescriptions for approved by the corporate world medicine. Another $10.00. And if the doctor says the sick person has to see a specialist, it can cost another $50.00 co-pay.

Factor in transportation in areas that don't provide it, and the person is looking at $200.00 per month in order to try to regain their health. Sounds reasonable until you realize that if that person is living on a fixed income or minimum wage, they now have to choose between health care, rent and food. Can't have all three so choose one over the other. Of course, food and shelter have to come first, and bingo, the HMO makes more because they just forced the sick to not see their doctor, saved the government more money, and that big fat bonus check is on it's way to Kaiser headquarters. And then the poor and the sick get sicker, overwhelming emergency rooms, themselves understaffed, under trained, and underfunded. And so they die.

But of course, we know by now that this has been the mindset put forth by the sociopaths of our society. The ones who could care less about the poor and the infirm. They have trained us to turn a blind eye to the suffering of our fellow citizens in order to turn a buck themselves. And we fell for it time and time again.

Kings County Hospital must be held responsible for not only the death of this woman, but should be held criminally liable for the falsification of medical records, as they reported that this poor, mentally ill woman was alert and sitting upright as she lie face down on the floor gasping out her last breaths.

And the Bush Administration must be held criminally liable for the untold misery they have caused by giving the taxpayers money to corporations while allowing for the needless suffering of our fellow citizens. Whatever political philosophy you believe in, whatever causes you seek to champion, and whether you consider yourself conservative, liberal, or in between, right is right and wrong is deadly. Murder by Medicaid is a reality that has been long swept under the rug and must be seen for what it is. The bilking of billions of dollars from the taxpayers in order to enrich the few on the dead bodies of the poor. we must all call for yet another reform in this system. One that cuts the middle man out of medical programs designed to help the poor and the middle class and gives the power back to the medical providers. Doctors should be making decisions regarding a patient's treatment and not some person who is sitting at a desk being paid extra to make sure that treatment isn't received.

Imagine this was your mother, your sister, your aunt, or just your neighbor. Write to Congress. Call your Representative. Vote for someone who will deliver this change. Demand that HMO's be cut out off of the Medicaid ATM, because it's not the poor that are bankrupting the nation, it's the policies of take from the poor and give it to the rich that are not only causing us to go broke, but as evidenced by this latest episode, they are actually killing people.

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