Florida Legislature Passes Medicaid Reform | Sunshine State News

Florida's Medicaid program will likely undergo fundamental and historic changes in the coming years, as the state Legislature passed a comprehensive reform package Friday, the last day of the legislative session.

 

The bill shifts Medicaid recipients from the government-centered program that provides health care to low-income families by paying providers for services, and into managed-care companies that are contractually obligated to provide services and meet cost-reduction goals.

 

The bill is largely based on a five-year-old pilot program in Broward County and four other North Florida counties, but the statewide move to managed-care companies is unprecedented among the other states.

via sunshinestatenews.com

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In Defense Of Overhaul, Administration Says Preexisting Conditions Are Common : Shots - Health News Blog : NPR

Look at your friends and family. Look at yourself in the mirror.

Chances are good that quite a few people in your social circle have health trouble that would make it a lot more expensive or impossible to get health insurance, according to an analysis the Department of Health and Human Services released Tuesday morning.

Enlarge AP

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition.

AP

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition.

The report, timed to come out just as the Republican-controlled House moves ahead with a bill to repeal the federal health overhaul, estimates that as many as 129 million Americans younger than 65 have some sort of preexisting condition.

 

All told, 19 to 50 percent of those people have a health issue that would complicate the purchase of private health insurance. Asthma and high blood pressure could drive the costs up. More serious health problems could scotch private insurance altogether.

via npr.org

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When Insurers Put Profits Before People - NYTimes.com

Late in 2007 I found myself riveted by a case playing out at the University of California, Los Angeles, the medical center where I trained and had once worked as a transplant surgeon. A 17-year-old girl named Nataline Sarkisyan was in desperate need of a transplant after receiving aggressive treatment that cured her recurrent leukemia but caused her liver to fail. Without a new organ, she would die in a matter of a days; with one, she had a 65 percent chance of surviving. Her doctors placed her on the liver transplant waiting list.

Nataline’s case was not all that different from the more than 200 liver patients I had seen successfully transplanted every year at that institution. She was critically ill, as close to death as one could possibly be while technically still alive, and her fate was inextricably linked to another’s. Somewhere, someone with a compatible organ had to die in time for Nataline to live.

But even when the perfect liver became available a few days after she was put on the list, doctors could not operate. What made Nataline different from most transplant patients, and what eventually brought her case to the attention of much of the country, was that her survival did not depend on the availability of an organ or her clinicians or even the quality of care she received. It rested on her health insurance company.

via nytimes.com

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The Long and Winding Road to the Emergency Room - NYTimes.com

He was the first patient of the day, dropped off at the emergency room by the police or a family member — a man in his 50s, unshaved, stumbling, engulfed in the pungent aroma of alcohol.

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Joseph Daniel Fiedler

When he blew into the breathalyzer’s strawlike tube, the readout was 0.18, more than twice the legal limit.

“I get seizures,” he said, referring to the dangerous reaction some people experience when they abruptly stop drinking. Then, as if to prove it, he held out trembling hands. Each bore the nicks and scars of a hard-lived life.

I looked at the beads of sweat on his brow, then down at his vital signs. Heart rate 120; blood pressure pushing 170/90. Despite his high alcohol level he was already in withdrawal. A medical detoxification — with drugs to counteract the sudden absence of alcohol in his system — was the right first step.

“Let’s admit him,” I said to his nurse. Because it was still early, there was a good chance a hospital bed would be available.

Her reply was apologetic but resigned: “He’s out of network.” I winced at my own naïveté. “Out of network,” a euphemism for “insurance will not pay,” was a roadblock I should have anticipated. A nuisance for many patients and would-be providers, it is ubiquitous in the second-class world of substance-abuse treatment, where insurance companies contract with selected hospitals and doctors to deliver care at bargain rates.

We called the few in-network hospitals within a broad radius. One had a bed. But before accepting my patient, the receiving doctor wanted a battery of tests, including an electrocardiogram and laboratory work, to rule out other medical concerns. It would be a day or so before the tests came back.

But the patient was already in withdrawal, I told the doctor. He couldn’t wait a day.

“Sorry,” he said flatly. “He

via nytimes.com

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