Monday, April 23, 2012

It Sucks To Be Poor

It sucks to be poor. It is nobody’s goal in life to be poor, to wonder how you are going to feed your family, keep a roof over your head, or to be unable to afford the most basic of needs or wants. I’ve been poor, not homeless or destitute, but close enough to appreciate the fear and uncertainty that comes with an overdrawn back account and a baloney and tater tot dinner.

I’ve never received government assistance, not even unemployment compensation. So I have never had to check in with a government employee, told where I could live, or what groceries I could buy. And when I needed to take my children to the doctor, I’ve always had my choice of all of the pediatricians in town.

The poor have Medicaid.

Medicaid. Fraud ravaged. Doctor hated. Taxpayer resented. Medicaid. And no one likes Medicaid less than the people it was designed to help.

There are 1.7 million Ohioans receiving state funded medical assistance. Ohio is revamping Medicaid, again.

Eleven companies recently participated in a complex bidding process to win a piece of this action. Five won the opportunity to provide coverage. Five lost and are filing appeals. One, Anthem Blue Cross the #1 insurer of Ohioans, shrugged off its loss and walked away.

Medicaid, the State of Ohio’s single payer health care system for the poor, appears to be mired in controversy. As reported in the Columbus Dispatch, there are charges of more than just irregularities, mistakes, and a shocking lack of transparency. There may have been actual fraud and false statements on the applications.

Some of the companies that were shut out contacted London based Barclays to analyze the process. They found “Scoring results indicate considerable inconsistencies among bidders…Scoring processes are always complex, especially in markets this large, but typically not to this degree.”

In a rush to save $1.5 Billion (real or imagined) in the next two years, the state may have selected up to three vendors thanks to applications enhanced with inflated statistics. Though the process was supposed to “improve the coordination of care for 1.7 million recipients and improve health”, it may, instead, have been just one more arbitrarily awarded government contract.

It is one thing to entrust your children’s health to the lowest bidder. It is even worse to be herded to a facility or provider that lacks the integrity to compete fairly. But when you are a football, when you are tossed from one player to another, you don’t have much say in the process.

But then again, it sucks to be poor.


1 comment:

  1. From our friend Ellen J.

    Boomers, this is a wakeup call.
    Fact 1: Baby Boomers have been the primary funders of Medicare and Medicaid.
    Fact 2: In 10 years, who will be the primary group(s) in need of Medicare/Medicaid in order to sustain their lives and well-being, when a host of companies will have been forced to drop out of bidding to fund them, due to the sheer cost of providing services? Boomers. Fact 3: In 10 years, the likelihood of Medicare/Medicaid benefits available to you will be minimal, if non-existent (esp. if Romney and his cronies have their way.)

    If Dave doesn't (I don't know if he does or not) sell Long Term care, he should, because the government is not planning for "us" to be able to afford, with its assistance, healthcare, nursing homes, etc. And, the number of companies offering LTC is dwindling at an astronomic rate; those still offering LTC are increasing rates at an astronomical rate.
    If you are not concerned, you should be.
    DAVE -- what is your recommendation????