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Article published - April 23, 2008
Credit: PRESS DEMOCRAT
HIGH COST
Why it makes no sense to cut Medi-Cal spending
In a couple of weeks, Gov. Arnold Schwarzenegger will release a revised state budget plan. Californians should hope that, in one area in particular, the governor revises his slash-and-burn approach to spending cuts: Medi-Cal.
As Sunday's article by Staff Writer Martin Espinoza highlights, low reimbursement rates have already forced many local doctors to stop treating Medi-Cal patients.
Doctors can't be blamed for this decision. The money they receive per visit from the federal-state program comes nowhere close to covering the cost of providing services.
Cutting the program an additional 10 percent will result in more doctors rejecting these patients, who have few other options for treatment.
Dr. Bo Greaves, president of Primary Care Associates of Santa Rosa asks, "What's going to happen to the poor in Sonoma County? Where are they going to get care?"
It's a good question. More than 50,000 Sonoma County residents receive health care through the Medi-Cal program. Many clinics have long waiting lists (there is a 400-person waiting list at Southwest Community Clinic in Santa Rosa) and may not have access to the specialists that patients need. If they can't get into clinics, and their condition worsens, they will end up in emergency rooms. Treating Medi-Cal patients in the ER instead of a doctor's office costs government more and drains resources from hospitals. Most important, it's not good for the patient to wait until their condition deteriorates to the point where they need emergency services. This strategy also hurts insured Californians. According to information cited by the governor's office in 2007, private insurance premiums have risen 17 percent to cover the cost of uninsured patients and underpayments by Medi-Cal.
It may make immediate sense for the state to cut Medi-Cal reimbursement rates in order to save $500 million. Over time, those savings will be reduced by increased payments to hospitals for ER care, and, in the private sector, by rising insurance premiums. But the biggest toll will be paid by low-income Californians who won't receive the health care they need -- and deserve.Low reimbursement rates have already forced many local doctors to stop treating Medi-Cal patients.
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