Listening

We all should. Are they?

Listening

The Idaho Department of Health and Welfare is spending our taxpayer dollars to go around the state and “listen” to our concerns. Idaho is about to grant a multibillion-dollar contract, the biggest ever in state history. Is this a wise investment, this listening thing? Its peanuts compared to the contract.

Lord knows, the legislature, who decided these billions of our tax dollars should go this way don’t listen. They ignore testimony. My elected State Senator has rarely appeared in public forums in my district for his last six years. The last time he did, it made national news. So he has learned. Don’t listen.

But the IDHW is listening. Maybe.

I am wondering if this representative government can survive. It’s up to you.

In the meantime, our taxpayer funded IDHW has gone around the state asking folks what are their concerns as Idaho Medicaid moves to managed care.

Our legislature has required this change to managed care. It’s all the rage. Maybe you have experienced it. You must go to an “in network” provider or the insurance company repossess your car. It’s that kind of health care we love, don’t we? Now we can stick it to those lazy Medicaid patients.

The DHW is asking, what do you think we should do? Will they listen?

There was a “listening session” this last week in Lewiston. I am not currently a provider who gets Medicaid dollars, or an enrollee. I was conflicted about making the $20 drive.

But the sessions have been very well attended. The department has posted the anonymized comments online.

As I read through them, I see a recurrent issue from providers. Keep in mind, managed care is nothing new. Big insurance companies have used this technique for years to control their costs and thus maximize their profits. Providers know the routine.

The insurance companies restrict their “panels” to low-cost providers. You liked you doctor? Sorry, not in panel.

They deny coverage for a recommended treatment. You can appeal; the doctor can appeal. Do you have a few months? Years?

I was a low-cost provider. I didn’t order a lot of tests or recommend many stupid surgeries. Lots of patients went elsewhere. They chose. So did I. They could find a doctor that would do what they wanted. I kept doing what I thought was a good job for my patients.

In the end, we’re all paying. It’s insurance.

This scenario is playing out big time here in Idaho. Hospitals and doctors across the state are fighting for more money. Insurance companies fight back. Such is the nature of a normal healthy marketplace.

When will you folks realize healthcare is not a marketplace?

Except maybe plastic surgery. Is that what you need?

I guess the Idaho legislature believes private equity funded big insurance companies are better suited to protect the taxpayer dollar than our own government.

Will they listen?

One of the recurrent questions from providers was, what would be the appeal process? Who can we gripe to when the insurer denies what we say is appropriate care?

I assume the IDHW will include that in their contract they put out.

Or will they? So now, our representatives want to contract out listening?

Idaho receives about $3B from the federal deficit government to pay for our Medicaid health care. Don’t get me started on the amount of tax dollars we are spending on debt service. We are talking about health care spending here.

But the two biggest drivers of fixed federal spending, after Social Security, are Medicare and Medicaid.

So you see this as a solution?

I have told you before, it hasn’t worked. President Bush gave us privatized Medicare. It has been proven to be a big waste.

Maybe Idaho is just behind the curve.

We should be listening.