Advertise Here

Deliver your message to thousands of readers every day.

Our readers are influential opinion makers - politicians, journalists and activists.

Learn more about ads.

About Us

David Greenwald, Editor. (Contact David.)
CFC Education Foundation, Publisher. (Contact us.)

Got a news tip? Want to write a guest column?
Contact David here.

About California Progress Report.

Founded by Frank D. Russo (Publisher and Editor, 2006-08).

Sponsors

Books

Patient Protest Marks First Cuts To Medi-Cal

MediCalprotest5.jpg

By Dan Aiello
California Progress Report

A protest by approximately 250 Medi-Cal enrollees and healthcare providers Tuesday, one of four demonstrations to besiege the state capitol steps, marked the death knell for the first eight Medi-Cal services slated for elimination, even as legislators struggle to reconcile new budget woes.

The crowd of mostly Medi-Cal enrollees included elderly, young mothers with infants, homeless and indigent, who chanted “sí, te puede (yes, you can),” while holding signs that read “health care is a human right.”

The services set for elimination, the first of many cuts to be felt by Medi-Cal enrollees, include dental, podiatry, optometry and five other services the federal government does not require state Medicaid programs to provide. Because the programs are not federally mandated, they were termed “optional” services during the earlier budget negotiations and were eventually cut from the Medi-Cal program as legislators reached agreement in February.

The program services end today for approximately 2.8 million Medi-Cal enrollees, 120 service providers and 500 clinical sites throughout the state, according to rally sponsor, California Primary Care Association (CPCA), which represents most of the affected clinical service providers.

The cut to benefits will save California approximately $115 million dollars, according to the Department of Finance, though savings may be less for fiscal year 2009/10. Advocates acknowledge a marked increase in patient services that followed the announcement of the cuts as providers worked overtime especially to get dental patients cared for before the cuts took effect.

Federal matching funds that will be lost for these services is estimated to be $134 million dollars. Of the $115 million dollars saved by the state, $109 million comprised adult dental care while the remaining eight benefits cost taxpayers approximately $6 million dollars. California receives approximately $1.60 per dollar spent on Medi-Cal services.

On April 29, CPCA had filed suit in the State Superior Court of Sacramento along with two of its member clinics, Clinicas Del Camino Real, Ventura, and Southern Trinity Health Services in Trinity. The Lawsuit contended that the State could not legally eliminate Medi-Cal adult dental, chiropractic, optometry and podiatry services in federally-qualified health centers (FQHCs) or rural health centers (RHCs) on the grounds that they are included in the definition of these clinic’s services under both state and federal law, and are therefore mandated benefits.

The court disagreed with the plaintiff’s argument, ruling the state was not required to provide the services. CPCA claimed that most clinical providers will now make drastic staff cuts and that some clinics, “like Trinity Health Services, are in jeopardy of closing altogether,” according to CPCA spokesperson Chris Patterson.

“[The court’s] decision will adversely impact not just adult Medi-Cal beneficiaries, which the legislature targeted by eliminating critical Medi-Cal services for this population, but low income children and the uninsured,” stated Carmela Castellano-Garcia, President and CEO of CPCA, one of the event speakers.

Dr. Carla Docharthy, representing the California Podiatric Association, warned of impending increases in emergency room visits as enrollees have no where else to turn for care. Docharthy used an elderly diabetic patient who she recently treated, as an example. The female patient presented herself with multiple skin ulcers on her feet. “I successfully treated her in three visits. The total cost to Medi-Cal was $400 dollars. That patient will now have to go to already crowded emergency rooms,” claimed Docharthy, who believes the chronically ill patient will receive less care at increased risk for a far greater cost.

Patterson told California Progress Report he believes these patients will still require care, but the cuts will force Medi-Cal enrollees to substitute the less expensive preventative treatments with more expensive, mostly emergency room, acute-care services.

“They will go to the emergency room for a toothache,” said Patterson. “We would have been able to treat them for far less.” Patterson believes where the Denti-Cal clinic would have saved the tooth, the emergency room, not equipped to provide dental care, “will most likely pull the tooth.” In the end, Patterson believes the patient will receive worse care that will cost government more and patients will delay seeking treatment, further adding to program expenses.

Despite the current budget crisis, Patterson said CPCA will continue to fight for restoration of these services he sees as essential. “[CPCA] will be working closely with our coalition partners to seek either a partial or full restoration of these benefits.”

Other speakers at the rally included former Assemblymember Wilma Chan, representing Children Now, Dr. Jan Cooper, representing the California Optometric AssociationDr. Carla Docharthy, Edith Halberg, representing the California Alliance for Retired Americans, John Iversen, ACT Up/East Bay and Berkeley Needle Exchange, Rev. Tom Lewis, DDS, Unitarian Universalist Minister, and Dr. Ariane Terlet,representing La Clinica de La Raza.

Posted on July 01, 2009

Comments

I have spinal problems and I need regular chiropractic care. I am here legally, work, pay over $340 a month for my health care, yet for me chiropatric is not a covered benefit. Hard for me to feel sympathy for illegal immigrants who complain that now they will not get free chriopractic care. It is a question of fairness, folks.

Posted by: Larry at July 1, 2009 08:00 AM

I have spinal problems and I need regular chiropractic care. I am here legally, work, pay over $340 a month for my health care, yet for me chiropatric is not a covered benefit. Hard for me to feel sympathy for illegal immigrants who complain that now they will not get free chriopractic care. It is a question of fairness, folks.

Posted by: Larry at July 1, 2009 08:02 AM

I have spinal problems and I need regular chiropractic care. I am here legally, work, pay over $340 a month for my health care, yet for me chiropatric is not a covered benefit. Hard for me to feel sympathy for illegal immigrants who complain that now they will not get free chriopractic care. It is a question of fairness, folks.

Posted by: Larry at July 1, 2009 08:05 AM

John Iversen, ACT Up/East Bay and Berkeley Needle Exchange

Ah yes, the 'progressive' belief that they have an inalienable right to engage in self-destructive behavior and then present us with the option of either paying for their fresh needles or paying for their AIDS treatment.

You know, our forefathers never intended for those to be the options. They believed that their obligation was to provide these people with the FREEDOM to act as they desired, but the RESPONSIBILITY to live with the consequences of their actions without being a burden to the rest of us.

Perhaps it's time we returned to this more basic understanding of the expectations of citizenship.

Posted by: George Hanshaw at July 1, 2009 08:17 AM

I have spinal problems and I need regular chiropractic care. I am here legally, work, pay over $340 a month for my health care, yet for me chiropatric is not a covered benefit. Hard for me to feel sympathy for illegal immigrants who complain that now they will not get free chriopractic care.

The question really is one of whether or not you feel healthcare should be only for the rich, or as you suggest, only for U.S. citizens, or whether you believe our society should not differentiate between people and define the "inalienable right to life" to include medical care to make those words meaningful.

While you draw the conclusion others should not have healthcare you don't have, I would conclude that you should have chiropractic care - and not only because you need it, but because without it you may become disabled and a ward of this state.

Posted by: terran at July 1, 2009 08:52 AM

Ah yes, the 'progressive' belief that they have an inalienable right to engage in self-destructive behavior and then present us with the option of either paying for their fresh needles or paying for their AIDS treatment.

I think the goal of that program is to reduce HIV, not increase it. And as for our forefathers, I believe they wanted a society where all men are created equal - if not in ability to make fortune, surely, in the right to life.

Do you really believe people willingly choose addiction or a life of poverty? Not all are born into the circumstances of a George W. Bush. The hardest workers I've known have been gardeners, day laborers, field workers, housekeepers and motel maids. They work hard for little pay. They contribute greatly to our society, doing the work the educated won't. Surely you can agree they at least deserve the chance to heal when they are injured.

Posted by: Terran at July 1, 2009 09:04 AM

The reality is more expensive care will replace these services, by way of the state's emergency rooms. And laughably, GOP state legislators today are claiming a federal universal healthcare program intrudes on the state's rights to care for its citizens. So, while they are trying to cut to the bone health coverage at the state level they are in Washington complaining they want to provide healthcare at the state level. What a bunch of .... well, you know.

Posted by: walter at July 1, 2009 10:34 AM

Do you really believe people willingly choose addiction or a life of poverty?
Absolutely not. But the overwhelming majority of addicts and poor have that condition because they have made repeated poor choices.

I'm willing to give my effort and money - even my life - to defend their rights to make those poor choices, but I don't feel in the least obliged to pay for them.

Posted by: George Hanshaw at July 1, 2009 10:53 AM

Surely you can agree they at least deserve the chance to heal when they are injured.

I have no objection to them healing. I hope they do. But I no more feel an OBLIGATION to support them because they have impoverished themselves with poor choices than I feel an OBLIGATION to offer one of my two good lungs as a transplant to someone whose own lungs have been destroyed by COPD after 30 years of two-pack-a-day smoking.

They have NO CLAIM on people who made better choices than they did.

Posted by: George Hanshaw at July 1, 2009 10:57 AM

They contribute greatly to our society,

There are 37 million people in California. The state budget - exclusive of all the county budgets - federal budget, local taxing districts, etc., is roughly $100 billion. You seriously think that they contribute $2700 apiece to the state coffers? That would be their pro rata share.

Posted by: George Hanshaw at July 1, 2009 11:02 AM

I work with individuals with developmental disabilities. They attend day programs and work 30 hours a week. They earn anywhere from $80.00-$400.00 a month based on their ability. Almost half of their earnings are deducted from their SSI payments. They contribute as much as they are able to our society. Those in our supported living service program pay for their own rent, bills, food, and all their other living expenses out of their limited SSI income and work income. They supplement their food needs through food banks and other generic resources.

Individuals with diabetes need podiatrists for foot care and to cut their toenails so they don't risk infection and possibly lose their limbs. Most of the individuals I work with are unable to cut their own toenails. If they do they usually cut them wrong and it results in ingrown toenails, which requires surgery to correct. Since they can no longer see a podiatrist they will be forced to go to the emergency room for treatment and possibly be admitted for infections and complications. We are not permitted to assist them since it is considered a medical procedure and we offer non-medical training and assistance.

Individuals with diabetes also need yearly eye screenings and treatment to prevent blindness.

These are serious issues. Making blanket cuts to Medi-cal without considering those with special health care needs is irresponsible and will end up costing the state much more in ER and hospital care.

We will now have to make emergency room visits for toothaches. Our consumers will lose their teeth and will not be able to afford dentures.

I would be willing to pay extra taxes if it means saving limbs, eyesight, and the lives of dependent adults who will suffer great harm from these cuts.

Posted by: Robin at July 1, 2009 11:24 AM

I would be willing to pay extra taxes if it means saving limbs, eyesight, and the lives of dependent adults who will suffer great harm from these cuts.

Absolutely no one is trying to stop you from making additional contributions to these people from your own resources. You can certainly do that - regardless of what the legislature or governor does.

The debate, I believe, is whether or not to use the police power of the state to extract resources involuntarily from people who may not wish to make such contributions.

Is that a difficult concept for you to understand?

Posted by: George Hanshaw at July 1, 2009 11:37 AM

One should understand that the chiropractor only gets 17.00 a visit for medi-cal patients and its limited to 2 times a month. The most he will get in a year is 400.00. Every visit has to be authorized, billed in , stamps, deposited into their accounts. The over all profit is around 10.00 a visit or less. Its not like the chiropractor is getting rich on the system. The main money makers are the hospitals and drug companies.

Posted by: craig armstrong at July 1, 2009 01:06 PM

The debate, I believe, is whether or not to use the police power of the state to extract resources involuntarily from people who may not wish to make such contributions.

That is not the debate, at all. The Democrats only asked that California finally join every other, EVERY OTHER oil producing state (and nation for that matter) and have an oil extraction tax. These multi-national corporations make billions but aren't located in the state and hire few Californians to work for them, yet profit greatly from the lack of this tax. Who can defend the governor and gop legislator's position to continue to protect these companies. They already gave $2.5 billion in corporate giveaways, including enterprise zones that don't work, to businesses. Shared sacrifice should truly be shared.

And Mr. Hanshaw, I must further disagree with your generalization about the working poor, like day laborers, motel maids, housekeepers, etc. Sometimes circumstance, not choice, lack of education, not addiction, place people in untenable situations.

You and I may have been born into stable families that were able to pay for higher education, but you cannot tell me that migrant farmworking children chose a life of sloth. These people work very hard, and yes, contribute well to our society. Can you tell me a maid or farm worker does less for society than an educated, middle management supervisor, or a basketball player or, oh I don't know, let's say an AIG investment banker or vice president of Chase? I'd argue these educated people have fleeced society, yet they've been rewarded for this.

Please consider the possibility that there are elderly who can no longer work, who rely on Medi-Care and Medi-Cal, disabled, children, people who can't, not won't, contribute to society. For you to suggest that they chose to be on Medi-Cal shows an inability to feel empathy for others. If you actually knew any of these people, I don't think you would still feel the way you do.

Posted by: Walter at July 1, 2009 01:29 PM

Just think how many of these folks could be getting medical care if the adult children of california had not wasted 5 billion dollars on a hand out to stem cell special interest groups that is unlikly to ever cure anyone of anything. No wonder CA is an international laughing stock.

Just think how much medical care CA could pay for if it didnt drive away companies by excessive taxation or how much it could do if it grew up and drilled for oil off its coast.

Posted by: michael at July 1, 2009 03:18 PM

The only way to save CA is a massive purge of the incompetent, corrupt liberals that have been in charge for way to long. The midterms in 2010 would be a good time to start.

Posted by: michael ellison at July 1, 2009 03:24 PM

It is obvious by now that Republicans have a different definition of what it means to be "in charge" than normal people.

In order to pass the budget in California one needs to get it approved by two-thirds of the legislature and SIGNED by the Governor.

So now let's look at how many years the "Democrats" have been in charge.

Let's go back to 1983. Since that time Republicans have held the Governor's mansion with the exception from 1999 until 2003.

At no point even from 1999 to 2003 did the Democrats have two-thirds majority in either house of the legislature, let alone both.

Thus from this math exercise, the Democrats have never been in charge.

The problem is that no one is in charge and thus there is no accountability.

Posted by: More Civics Lessons at July 1, 2009 03:57 PM

Where is it written that health care is a right? There are acknowledged rights, constitutional rights, legislated rights, and there are legislated privileges.
Our founders acknowledged certain inalienable rights, one of which is the right to life, by which they meant that the state should protect people from mortal harm by others, especially from such harm by the state. They did not mean that others should save them from harm. It is well settled law in this country that no one, except appointed caretakers, has a duty to come to the aid of another in peril.

Posted by: Erik Kengaard at July 1, 2009 04:24 PM

Wiki has a decent discussion of rights at
http://en.wikipedia.org/wiki/Natural_right

Posted by: Erik Kengaard at July 1, 2009 04:30 PM

The debate, I believe, is whether or not to use the police power of the state to extract resources involuntarily from people who may not wish to make such contributions.
That is not the debate, at all.

That was PRECISELY the debate. I indicated that I had NO PROBLEM with the poster giving more money to causes he believed in, from his own resources. The issue is to whether or not to lay additional taxes on those who don't want them. As for an oil-extraction tax, I have repeatedly said that I had no objection to that as long as it is used to develop a funding stream - as Norway did - rather than a one-time increase in revenue that will disappear when the oil is exhausted. It is not prudent to get the legislature addicted to revenue that is finite, and they aren't making anymore dinosaurs...

And Mr. Hanshaw, I must further disagree with your generalization about the working poor, like day laborers, motel maids, housekeepers, etc. Sometimes circumstance, not choice, lack of education, not addiction, place people in untenable situations.
And SOMETIMES when you hear hoofbeats running across the horse pasture it's zebras too I imagine, but that's not the way to place your bets. I stand by my characterization that most people in the US in poor circumstances are that way because they have not only made mistakes, but have a pattern of REPEATEDLY making mistakes. Frankly, I have way too many successful immigrant friends to believe it's all that hard to be successful in the USA. And if you don't believe addiction plays a significant role in that, you haven't been working with homeless people, I can guarantee that.

You and I may have been born into stable families that were able to pay for higher education, but you cannot tell me that migrant farmworking children chose a life of sloth.
Perhaps you were. My roots are bluecollar as can be - and I paid for my own first college degree, my wife paid for the next before quitting work to raise our kids, and the military paid for my third degree.

Can you tell me a maid or farm worker does less for society than an educated, middle management supervisor, or a basketball player or, oh I don't know, let's say an AIG investment banker or vice president of Chase?
Yes.

I'd argue these educated people have fleeced society, yet they've been rewarded for this. Perhaps you'd be brighter if you'd paid for your degree yourself rather than having your parent pay for it. Perhaps bright enough not to make such a ridiculous argument. Do I think, for example, that the basketball player is overpaid? No I don't. His value is determined by the market. Would I pay that much for his services? Hell no, but no one is COMPELLING ME to pay for his services, are they?

Please consider the possibility that there are elderly who can no longer work, who rely on Medi-Care and Medi-Cal, disabled, children, people who can't, not won't, contribute to society. OK, I've considered the possibility. See the hoofbeat and zebra argument above. SOMETIMES that happens. Now are you happy?

If you actually knew any of these people, I don't think you would still feel the way you do.
a. I do know some of these people. I know a lot of these people. A few just had enormously bad luck, like being struck by lightning. The vast majority have made repeated bad decision that have put themselves in these circumstances and more bad decisions that keep themselves there.
b. How the hell do you think you know "the way I feel"?

Posted by: George Hanshaw at July 1, 2009 06:04 PM

Just think how many of these folks could be getting medical care if the adult children of california had not wasted 5 billion dollars on a hand out to stem cell special interest groups that is unlikly to ever cure anyone of anything.

An excellent point. The stupidity of wasting state money on embryonic stem cell research to make a point about abortion when you look at the advances in adult stem-cell research - where we don't have to worry about graft versus host reaction - goes beyond belief. And the very 'progressives' who were behind this appalling waste of taxpayer resources are the ones screaming the loudest when we are short today.

A pox on these idiots....

Posted by: George Hanshaw at July 1, 2009 06:27 PM

Why does California keep giving CASH for SSI's with that SSP Cash portion instead of FOOD STAMPS like almost ALL the other states?
Cut the Cash from the SSP and let them EAT FOOD. That way they will at least use some of the EBT-Dignity cards for food instead of at Dive Bars and on Crank/Meth.
That would save ALOT of money.
And if they would ever get real before it's just too late and there is just NOT going to be any money anywhere, not even the Federal Government, not even China or a printing press, they would get real and CUT the Illegals benefits.
I have not been to a Dentist in 20 years, and I work full time. I cannot afford the super expensive insurance costs.
I have needed Chiropractic care, and I don't have coverage for that, so I DON'T GET TO GO!
This is all so dumb and stupid.
Don't pay people so much money if they are NOT a legal citizen.
Don't give people more money than other states.
If they DID cut Illegal cash benefits, they would GO HOME, and Cut Costs for the Legal citizens.
How dumb the DemoGRANTS are in California.

Posted by: Make the Cuts at July 1, 2009 09:52 PM

This is all very disturbing. When did the citizens of California get the opportunity to vote in or out any of the social services?
It's a case of obvious abuse by immigrants,
legal and illegal, and transplants from other states. But whose fault is that! The legislature and Governors. There are far too many clinics, agencies etc, on the states back. It's called, create your own job. These need to go period. Medi-Cal should not have any cuts nor SSI. SSP cuts should be replaced by food stamps. Stem cell research was passed because of Nancy Reagan and is a bunch of B.S. The government of California needs a major overhaul including J. Chiang.They are arguing like children at taxpayer expense. They get $173 dollars a day for expenses when they are in Sacto. What? A fifty dollar lunch.

Posted by: Janice at July 2, 2009 09:02 AM

Being that state cant' afford it right, all medi-cal coverage should be eliminated regardless if it's optional or not. Let federal government pay them self for all of the stuff that they say state must pay.

Posted by: stevie at July 2, 2009 01:22 PM

I agree with erik kengaard. I am a retired Medi-Cal eligibility tech. More than half of my clients were illegal aliens. Most were totally irresponsible, many were completely dishonest, and some had an attitude that their culture/home country was superior to the U.S.

So why don't they go home? Because they are too busy milking and fleecing the U.S. taxpayer.

Also, I feel for Americans who have lost their health insurance but I would prefer to see NO NEW TAXES either state or federal to pay for it. I would prefer that CHARITIES step in to help. I donate to American Cancer Society and the Arthritis Foundation myself.

If the Feds were to give a dollar for dollar credit for donations to medical type charities, the American public could decide for themselves what services they want to provide and for whom.

Posted by: jsc at July 22, 2009 05:17 PM

Sorry, comments are temporarily disabled. We're doing a bit of server maintenance on the commenting area. We'll be back up and running shortly. Thank you for your patience.

Get email updates!

Get Email Updates

Want the California Progress Report by email? Once a week, we'll send you the latest and greatest headlines.



© 2008 California Progress Report Our copyright and fair use policy.
Powered by Mandate Media. Logo design by Jane Norling.

RSS

Stat tracker