Regarding the loss of 25,350 Medicaid patients: Even though the overall numbers are small, the percentages using a very gross estimate in our area, are very high. Also this only means we will not get paid for care. They are still our patients and we will sustain their costs of care.
A gross estimate is that 12% of the population in our area just lost their major if not only form of health insurance.
Before this happens again, we better work with Creighton and Clarkson and Indian Chicano and Charles Drew and Lincoln FP where medicaid is over 50% of the patient population. We need a coalition of Medicaid providers to be able to stand up to this kind of situation in the future as well as hold other providers accountable who have left the underserved behind.
This is not the first time. The state cut $30 million in mental health with the carve out a few years back. This was over 50% cut in a state that was already near last in percapita spending in the nation in mental health, public health, drug and alcohol expenditures, and teacher salaries.
Short term the state is hoping to save money, but we all know that this is a farce.
Long term it will be costing much more. Mental health, ER, and primary care visits alone are enormous. Health also impacts education, prison populations, the legal system, and other areas.
One perforated duodenal ulcer patient cost us $15,000 because his Medicaid expired a month before and he failed to come in for samples one time too many. How many more?
The $2 copay has mental patients out on the street not on their medicines. Is this something that Nebraska citizens want?
One stroke patient, more likely soon, will deplete the resources of hundreds or thousands with hypertension.
Drug restrictions: Why should we saddle the most educationally challenged kids with sedating antihistamines?
Why do we kick poor people back into poverty by lack of health insurance access, workers comp, and insurance bureaucracy? Even the ones who desire to escape and have good jobs can be right back at the bottom in a matter of days. Even my patients that have injuries and work for lawyers suffer.
Why should the physicians most devoted to caring for the underserved, suffer the most in this process?
None of these make sense. We need to make this known. We are physicians and have a responsibility to lead and inform.
Robert C. Bowman, M.D.
Family Medicine