INSURANCE COMMISSIONER JOHN GARAMENDI CALLS FOR REFORM OF STATE’S BROKEN HEALTH CARE SYSTEM IN WEEKLY RADIO ADDRESS

A message for John Garamendi:

This may be like putting a message in a bottle and throwing it into the ocean...but, I feel I'm on a deserted island here in Sonoma County when it comes to finding people who share our values and understand the forces shaping current health care policy.

You are right. There is much more we could be doing with the health care resources we already have in our counties...to expand universal access to health care....short of single payor. I have been promoting a network of "safety net" providers made up of FQHCs, district hospitals, primary care physicians, the Sonoma County public health department and anyone else that shares our values and goals. Such a network could create medical homes for the uninsured and MediCal beneficiaries because it can better manage MediCal payments (in fact only a network of such providers can.

The San Francisco Health Plan and the Santa Clara County Health Access Plan are beginning models for such a network.

I would like to discuss the strenghts of this approach/this model with Mr. Garamendi. Any chance of that? I would be happy to come to Sacramento or meet elsewhere. I've been working in health care policy and reform initiatives at the federal and local level for over 30 years.

Geza Kadar, Jr.
Health Care Attorney
Board Member, Southwest Community Health Center
Santa Rosa, CA
707-575-4151

This is an excerpt from an e-mail I received from a friend. She is 50 years old and was diagnosed with breast cancer in April of this year. It is now almost the end of July and she is STILL WAITING for approval from Cigna (Chino Hills, CA) to approve treatment!!!!! This is inexcusable!!! Cigna needs to be held accountable and explain WHY they are refusing to approve treatment for a woman with breast cancer!!!

Nope, no MRI yet, it's still under review. They did approve a bone
scan to be done locally so I will do that next Monday. There was also
supposed to be a biopsy to get a tissue sample to test, we have no idea
what happened to the paperwork on that, and the CT scan and MRI are
still not approved. So much for their 3 to 5 business day turnaround.
Not to mention Kimmie failed to mark any of this stuff as STAT so it
didn't get the 24 hr turnaround. I have an okay to see Dr. G again,
but there's no new test results for him to discuss and they didn't
approve the one for Dr. Chung, who could actually go over the bone scan
results with me if they were in by then. Doesn't matter since we might
as well wait for the biopsy too, she wanted the scans and the biopsy to
give her a complete picture.

What really pisses me off to no end
is that worst case scenario stage 4 patients have a life expectancy of
18 to 36 months following diagnosis. Now I don't plan to be one of the
worst case folks, but if I were, I have now spent 4 month of those 18 to
36 months waiting for diagnostic tests so my treatment can START.
I would love to go see Kimmie in person and lay those stats on her, plus
a few other thoughts: Like, imagine it's your mom, or sister or
grandmother, or YOU in this situation. And you're waiting. And you
don't know how bad it is. But the clock is ticking and you know it
is. So every time you get a headache, a little voice asks you: has it
spread to my brain? Your back kind of aches because you sat too long in
your chair, normally you wouldn't give it a second thought, but there's
that voice: has it metastasized to my spine? You cough a little bit,
dust probably...or is it in my lungs now? But because you're waiting
for approval, YOU DON'T KNOW, so you imagine the worst. All day, every
day, it's there, in the back of your mind, nagging away at you. The
cancer is in there, it's growing, unchallenged, unchecked, unimpeded.
And those cells could be loose in your bloodstream right now, looking
for somewhere to set up camp next. But we can't do ANYTHING about it
yet because we are waiting on your frigging diagnostic tests. Now do
you know why I want you to mark them STAT?

Is there ANYTHING that can be done??????

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