At this point the judiciary is pretty much the only government entity in this state I have a modicum of belief in; they aren’t hamstrung by ridiculous rules that make it impossible to function, so they can simply follow the law. State agencies, when properly run, also can exhibit some independence. Lately, there have been several cases ruled in favor of reformers at the expense of malign protectors of the health care status quo.
After a series of investigations from the California Department of Public Health, 18 hospitals have been fined for substandard care.
Violations included an improperly inserted catheter, a ventilator that was not turned on and surgical tools left inside patients after operations […]
The hospitals were fined $25,000 for each violation – the latest of dozens of penalties the state has issued in recent years to more than 40 hospitals.
“The number of penalties will decrease and the quality of care will dramatically improve as hospitals take action to improve,” said Kathleen Billingsley, director of the health department’s Center for Healthcare Quality. “The entire intent of these fines is to improve the overall quality of care in California.”
As care is improved, so must access for treatment. The proposed cuts to Medi-Cal by the governor would have decimated the ability for the poor to find a doctor. The cuts never made it through district court.
A federal judge has ordered a temporary halt in the state’s 10 percent reduction in Medi-Cal reimbursement rates, improving access to care for 6.5 million low-income patients but throwing a new wrench in already difficult budget negotiations.
The U.S. District Court decision forces the state to reimburse most Medi-Cal providers at rates prior to the 10 percent cut, which lawmakers and Gov. Arnold Schwarzenegger made effective July 1 as a cost-cutting measure to help resolve a $15.2 billion budget shortfall this year.
The move increases reimbursement rates the state pays to doctors, dentists, pharmacists, adult day-care centers and other providers who serve Medi-Cal patients. It excludes some hospitals who do not contract with the state and do not provide emergency care.
This just shows the fallacy of a cuts-only budget, which runs into all kinds of voter mandates and constitutional demands. The good news here is that reimbursement rates will be sustained, albeit at a level low enough that half of the state’s doctors will still probably reject Medi-Cal patients. The Democratic budget would also have rescinded the Medi-Cal rate cuts.
In a separate decision in the State Supreme Court, the justices ruled that doctors cannot deny care to gays and lesbians based on moral objections.
Justice Joyce Kennard wrote that two Christian fertility doctors who refused to artificially inseminate a lesbian have neither a free speech right nor a religious exemption from the state’s law, which “imposes on business establishments certain antidiscrimination obligations.”
In the lawsuit that led to the ruling, Guadalupe Benitez, 36, of Oceanside said that the doctors treated her with fertility drugs and instructed her how to inseminate herself at home but told her their beliefs prevented them from inseminating her. One of the doctors referred her to another fertility specialist without moral objections, and Benitez has since given birth to three children.
Nevertheless, Benitez in 2001 sued the Vista-based North Coast Women’s Care Medical Group. She and her lawyers successfully argued that a state law prohibiting businesses from discriminating based on sexual orientation applies to doctors.
Of course, we cannot rely on the courts to shape public policy. But they set the boundaries – the lines that lawmakers cannot cross. And those boundaries are leading to increased access and improved care.
