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<DIV><STRONG><FONT face=Arial>From Doctor ( M.D. ) Anne Scheetz who is with
the Illinois Single Payer Coalition, statement in regard to this
latest Medicaid </FONT></STRONG></DIV>
<DIV><STRONG><FONT face=Arial>" expansion " bill " Action Alert
" that Champaign County Healthcare Consumers sent out and that Jennifer
Cartwright forwarded to the list.</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=Arial></FONT></STRONG> </DIV>
<DIV><STRONG><FONT face=Arial>David Johnson</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=Arial></FONT></STRONG> </DIV>
<DIV>" The Kaiser Foundation, whose data are mentioned in the "fact" sheet, will
not give any grants to any single-payer organization. " <BR><BR></DIV>
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<DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV
style="FONT: 10pt arial; BACKGROUND: #e4e4e4; font-color: black"><B>From:</B>
<A title=annescheetz@gmail.com href="mailto:annescheetz@gmail.com">Anne
Scheetz</A> </DIV>
<DIV style="FONT: 10pt arial"><B>To:</B> <A
title=IllinoisSinglePayer@yahoogroups.com
href="mailto:IllinoisSinglePayer@yahoogroups.com">illinois single payer
coalition</A> ; <A title=chispan@googlegroups.com
href="mailto:chispan@googlegroups.com">chispan steer</A> ; <A
title=movetobetterhealthcare@googlegroups.com
href="mailto:movetobetterhealthcare@googlegroups.com">movetobetterhealthcare</A>
; <A title=GPChicago@yahoogroups.com
href="mailto:GPChicago@yahoogroups.com">GPChicago@yahoogroups.com</A> </DIV>
<DIV style="FONT: 10pt arial"><B>Sent:</B> Monday, February 11, 2013 7:41
PM</DIV>
<DIV style="FONT: 10pt arial"><B>Subject:</B> [IllinoisSinglePayer] ispc
position on medicaid expansion in il</DIV>
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<P>Someone asked the question: Based on the "Medicaid fact sheet" in the
attachment, should ISPC be supporting the Medicaid expansion? Below is my
reply.<BR><BR>The Medicaid "fact sheet" unfortunately leaves a lot of facts
out.<BR><BR>
<UL>
<LI>While Congress could have passed a simple Medicaid expansion, instead
they passed the Patient Protection and Affordable Care Act, whose real
purpose is to secure private and public money for the for-profit health
insurance industry. The Medicaid expansion is no exception.
<LI>Illinois and other states are forcing Medicaid recipients into
investor-owned-for-profit "managed care organizations" (HMO's; subsidiaries
of insurance companies) that are allowed to skim 15% of what they are paid
per patient; the remaining 85% is supposed to go to care, but the companies
have plenty of ways to cheat on that. So far in Illinois people with
disabilities have been targeted for this program. It requires people to
receive care from a very limited network of clinicians who sign contracts
with the insurance companies, which most clinicians refuse to do. Some of
the patients affected have to travel more than a hundred miles to see an
in-network provider; long-standing patient-physician relationships are
disrupted. The insurance companies have onerous pre-certification and
pre-authorization requirements; for instance, the physician has to submit
documentation before a particular drug or a particular test will be paid for
(rationing by provider inconvenience). Hundreds of thousands of decisions
are subject to this requirement; I don't know how many hours of physicians'
and staff time are consumed, but lots. This Medicaid privatization, like all
privatization of public services, is being sold as leading to greater
efficiency, higher quality, and lower cost; and will in fact lead to the
opposite.
<LI>The rules governing Medicaid expansion require the states to provide
certain benefits. Illinois used to provide some benefits that are not among
those required, and last year the state cut those benefits. They included
for instance adult dental care (only extractions are covered now). Elderly
people who have Medicare and Medicaid are now required to have pre-approval
for every drug greater than four, or they will not be paid for; and many
elderly people take far more than that. Again, an enormous burden that
discourages physicians from accepting Medicaid patients.
<LI>The Dept of Health and Human Services recently released a proposed
complex set of rules about Medicaid patients being charged co-pays for
services. There are complex rules about when patients may and may not be
refused services if they can't pay. These are really poor people!, so I say
that this rule is simply evil. The amounts of money collected will probably
not even pay for the cost of collecting it.<BR>
<LI>At best the Medicaid expansion will substitute unaffordable
under-insurance (set to become the universal standard for the country) for
no insurance; and it will be of some help to some institutions that take
care of poor people (hence the support of the Illinois Hospital Association)
and that represent a lot of poor people (like Access
Living).</LI></UL><BR>There are plenty of organizations with money and
influence to support the expansion, and very few that will explain or fight
the harms being done.<BR><BR>ISPC should not use any of our scarce resources
to argue or work for or against the Medicaid expansion. Rather we should
continue to work for our own proposal under which everyone would get all
necessary care free at the point of service.<BR><BR>The Kaiser Foundation,
whose data are mentioned in the "fact" sheet, will not give any grants to any
single-payer organization. <BR><BR>If you are interested, you can search for
"Illinois Medicaid," "Centene," "Medicaid managed care," and "privatization"
on the ISPC website to get more
information.<BR><BR>Anne<BR><BR><BR><BR><BR><BR><BR><BR clear=all><BR>--
<BR>Anne Scheetz, MD, FACP<BR>Chicago IL<BR>773-486-6276<BR><A
href="mailto:annescheetz@gmail.com"
target=_blank>annescheetz@gmail.com</A><BR>Organizer, Physicians for a
National Health Program (PNHP), Illinois Chapter <A
href="http://www.pnhp.org" target=_blank>www.pnhp.org</A><BR>Organizer,
Illinois Single-Payer Coalition (ISPC) <A
href="http://ilsinglepayercoalition.org"
target=_blank>ilsinglepayer.org</A><BR>Secretary, ISPC People with
Disabilities Committee<BR>Corresponding Secretary, ISPC Chicago<BR>Hope is the
belief in the plausibility of the possible, as opposed to the necessity of the
probable.--Maimonides<BR>
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