In a Broder-esque column over the weekend, George Skelton took a little of this, a little of that, and a little Capitol craziness, and jammed them all together. If you get beyond his Capitol story time of arm wrestling, you see that there are some very real concerns that are being glossed over. In a discussion of Medical co-pays, this is very concerning
Maybe the $50 and $100 co-pays are a bit excessive for people living in poverty, officially defined at $10,800 a year for individuals and $14,600 for couples. But some co-pays are warranted. (LAT)
Except, as Anthony Wright later points out. It isn’t just the $5, for which Skelton dramatically underestimates the value of the money to those on MediCal, but the incentives. If we start requiring these co-pays, it deters people from seeing the doctor early, and encourages them to wait until they can no longer ignore the problem. This is a perverse incentive.
But Skelton gets to the point of choices. More specifically, that we are making extreme choices simply by sticking with the status quo. If we allow the corporate tax break from 2009 to set in, we are looking at $1.8 billion disappearing. And that makes the MediCal payments look like chump change:
Schwarzenegger had the right idea in January but since then has abandoned it. If things got bleak enough, he said then, the state should postpone roughly $1.8 billion in corporate tax breaks scheduled to begin in July.
Things are certifiably bleak. … {T}hey certainly shouldn’t take effect this July. Some things just make sense, regardless of which party you’re tied to.
We must understand that bumbling along is, in fact, making a choice. Let’s offer Californians a real choice, provide the state the services that we expect and require, and let the chips fall where they may.
I know two people who could really use state medical aid. Both are ill. Both are uninsured. Both are unemployed. Neither can get coverage from the state.
While one person did get county aid, that was only after the social worker initially told him he didn’t qualify for that either. After he confronted them with the qualification criteria from their own website, they agreed he qualified. But it turned out to be sort of useless anyway. They ran a bunch of tests, referred him to somebody outside the coverage area, and then refused to return his calls about getting another referral. The doctors he saw clearly just wanted to find nothing wrong with him and get him out of there–including the emergency-room physicians the county clinic kept sending him to.
Keep in mind that this is the level of care we’re talking about. It’s a waste of everybody’s money. The county clinics lack the facilities to do much. The emergency rooms are just doing triage. And the private physicians who take the patients aren’t that interested in treating them.
No matter how much or little they charge for co-pays, it’s a lousy system that covers very few people anyway–and fewer every year.
Please remember this is the level of care people are talking about when they blithely claim that everybody has access to health care in the U.S. today.