Lessons From a 4-Year Old

a medicaid

Please read the following and watch the video in 4 Year-Old Hits Insurance Hurdle. Do any physicians still believe in the Hippocratic Oath they take upon completion of medical school? Our entire system is broken. The dysfunction is not limited to our for-profit private insurance system but also includes those who are already enrolled in Medicaid. With a truly universal health insurance system, there should be comprehensive and continuous coverage.

Unfortunately, as things currently stand and as evidenced by the above example, my staff and I are constantly trying to get Medicaid services reauthorized throughout the year for seniors and the disabled who clearly need health care services at home and were previously eligible for them. The State of Missouri is making it increasingly difficult for service providers to fulfill our obligations to them and to our clients by instituting policies which allow for 30 – 45 (sometimes 60) day lapses in Medicaid coverage.

This means that the State of Missouri, ultimately, does not care whether or not essential services are delivered to those who need them. They leave that decision up to providers who are not guaranteed payment for any services delivered to clients during periods of ineligibility. Some clients are so ill that they are incapable of performing the smallest personal care or homemaking tasks on their own with disabilities ranging from cerebral palsy to rheumatoid arthritis to chronic obstructive pulmonary disease to congestive heart failure to stroke to dementia, etc.

The current process for acquiring and maintaining eligibility for Medicaid services frequently leads to a form of rationed care and is predicated upon many clients dropping out of the eligibility loop for a certain period of time.

 

This is how our system should work: Another Personal Experience from Germany

The very day I delivered my son, my father was admitted to the same hospital for blood clots which he developed as a result of his flight from the U.S. to Germany and his chronic lymphatic lymphoma (CLL). He was treated for 10 days (3 in ICU) and received a full regimen of testing and treatment. During the course of his treatment, his physician who had graduated from a German medical school only a few years prior asked pointed questions of us and my father’s physician. She determined that the chemotherapy that he was receiving “should” be working and was puzzled by the fact that his CLL had progressed to the stage it had while under the correct treatment regimen. After a few days, my father said he couldn’t believe how well he felt. Upon discharge, my father said he hadn’t felt that well in years!

My father’s emergency occurred three years prior to my own life-saving surgery in Germany and proved three very important things to me and my family:

  1. When my father was admitted, one of my mother’s chief concerns was if their insurance would pay for it. If so, how much of the final bill would my parents have to cover on their own? After I spoke with a thoroughly lovely accounts representative in the billing department about our situation, I translated her response to my mother who was certain I had misunderstood. Upon my father’s discharge, my mother was sure that I had told her an untruth (she was scared to pick him up) so as not to unsettle her or my father and expected to be confronted with tons of paperwork and a horrific bill. It never happened. My father was discharged with only a $75.00 fee (for administrative costs) and the billing department refused to take my parent’s insurance card and said everything was, “A -O.K.” with smiles. Not only do German physicians take their Hippocratic Oath seriously but so does everyone involved in the system.
  2. Not only that, my father was released with nearly a month’s supply of medication at no cost. He also returned for a final follow-up the day before he flew home so that they could determine if it was safe for him to fly. His physician also gave my parents exact instructions on how my father’s treatment should proceed and sent explicit written recommendations to my father’s physician.  My mother was astounded and in shock. She remains so to this day! Germany does not ration health care for its citizens nor its tourists -whether they pay or not.
  3. In Germany, we discovered that something was wrong with my father’s chemotherapy and it wasn’t the prescribed treatment that was at fault. It wasn’t until 2001 that we discovered what. Robert Courtney. By then it was too late as my father’s cancer had entered into the last stages and there was little to no chance of remission. This taught us that our for-profit system fosters greed at all levels. And greed will always present an obstacle to quality care and the well-being of Americans.

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Filed under Education, General Socio-economic & Socio-political Issues, Health Care, Religion & Spirituality, Women's Empowerment

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