Thursday, July 13, 2006

Healthcare changes

Billmon writes of the event that may actually bring about changes in our healthcare structure, but with cynicism rampant predicts what the change will actually be. To summarize - healthcare industries are losing money when 'normal' predictions are they should be gaining. And the changes will be cut the loss points - specifically, either close the emergency rooms or (more likely) change the laws that require service to all that arriveand prevent gaming those requirements. (The payment of ambulance services to take the patient an extra 45 minutes away, or just rolling the bums out into the parking lot for 'later'.) And in his cynicism (and not so hidden hope he's wrong) he speaks of watching for the newest 'grassroots' program - say, "Consumers For Affordable Health Care" - to start up.

He missed. He missed the avenue, and he missed the fact that the assault is already underway. Why take the front door when the back door's standing open?

In this case the back door is the rage against illegal immigrants. Medicaid recipients are supposed to be asked point-blank if they are illegal immigrants, and required to provide proof they're not. The rules have been getting tighter and tighter since that 2003 addition, and there are discussions in several states of making such a requirement an across-the-board one. Come to the hospital and in addition to your proof of insurance or ability to pay and your proof of self you get a requirement for proof of citizenship or legal residency. That makes it more difficult to USE the emergency room - and there's plenty of evidence this works to reduce the load already. If further cuts are needed, increase the consequences. Failure to provide will result in an additional fee for investigation. Or multiple proofs, of which at least one must be photo ID.

Nothing so blatant as revoking the laws that Billmon saw passed. Nope, just taking advantage of fear and anger.


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