Jens 'n' Frens
Idle thoughts of a relatively libertarian Republican in Cambridge, MA, and whomever he invites. Mostly political.

"A strong conviction that something must be done is the parent of many bad measures."
  -- Daniel Webster

Tuesday, October 30, 2007 :::

Within the national debate over healthcare reform, an assumption has been revealed in several proposals:
Healthcare decisions for poor Americans are best left to the U.S. government.
I'm increasingly sympathetic to that view, actually - it's too simplistic and too harsh to say that people don't get poor by making good decisions, but I'm going to leave it at that, at least for now - but a lot of the proposals don't just want the government to make decisions for those people the government pays for, a lot of the proposals want the government to pay for everybody.

If I'm ever in a situation where I can't afford my own healthcare, I'll take what the state gives me on the terms the state gives me and be gracious for it. And if someone has no options for basic health coverage because of their financial situation, I'm willing to pay - and even require other taxpayers to pay - for them to have one option. But as long as I do have options, I don't want the government to take them away from me without a really good reason.
In 2006, Medi-Cal (California’s version of Medicaid) denied payment for one of my patient’s breast cancer surgery due to "incorrect gender." She was as surprised as her doctor. After five appeals and nine months had elapsed, Medi-Cal finally paid me $253 for the two-hour cancer operation and 90 days of follow-up care.
My skeptical side wonders whether she used the wrong procedure code, but my limited knowledge of Medicaid systems (and even more limited knowledge of Medi-Cal specifically) leads me to give her the benefit of the doubt.

The author wants to buy high-deductible private insurance for most Medicaid patients. It's quite likely that that would be more efficient, hence cheaper without being lower-quality. It might require record-keeping skills of Medicaid patients. It is, at any rate, better than changing the system by expanding it to cover more people.

::: posted by Steven at 12:09 AM

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Idle thoughts of a relatively libertarian Republican in Cambridge, MA, and whomever he invites. Mostly political.

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