My wife and I have been foster parents for over 11 years and have taken care of 75+ children for varying amounts of time. Roughly 5 years ago my wife quit her job and started doing full-time medical foster care. In addition to our own 3 biological children, at any point in time we could have 1-3 infants or toddlers with cerebral palsy, brittle bone disease, down syndrome, autism, feeding tubes, colostomy bags, prescription medications, etc. BTW, my wife is a saint and has the patience of Job.
As part of the foster case system, all of these children are covered under Medicaid. I want to state that my wife and I are both for medical insurance reform. We live with the medical system every day and see the massive amounts of problems. I'm not a doctor, economist or politician (God help me!), but parts of the reform bills in Congress, in my opinion, are not feasible. With all the debate regarding the "public option", here are our experiences working daily with Medicaid.
Fewer Doctors - Over the past couple of years we have seen 2 of our favorite primary care physicians leave the Medicaid program. These are doctors that know our children, know us and that we trust. My wife spoke with their PAs and nurses and even though they love the kids and are committed to helping them, the "system" makes it unbearable. They complained about the low fees, late repayments and paperwork required for Medicaid. BTW, we are not seeing any new doctors entering the Medicaid system in our area.
Overcrowding & Longer Wait Times - Since there are fewer Medicaid doctors in our area, the ones that do accept Medicaid patients are becoming overcrowded and harder to get into. My wife routinely waits 1 1/2 - 4 hours in the waiting room before even seeing the Dr. or PA.
Increased Bureaucracy - My wife has to file her Medicaid claims on a weekly or biweekly basis. We've started to receive more requests for paper and more requirements for funding. There seems to be a "CYA" attitude with these requests. They may be trying to squeeze the fraud and waste from Medicaid but it translates directly to slower repayments and care for the children. If the government cannot even manage a small program like "cash for clunkers" how are they going to effectively service something that is 15%-20% of our economy?
Less Money - Eliminating waste and fraud is great but it relates directly to less services and benefits. We've seen the number of employees that man the Medicaid support lines decrease. My wife talks to the CSRs and they say there are fewer employees and that they are over worked. Many times if you cannot get to a CSR, we leave a message for a callback. We might not hear back from them for 3-5 days. When you need confirmation on paperwork or billings this can be a huge issue. Recently the Medicaid system switched from a VB6 program to an online system. My wife was so excited until she started using it. The website was essentially unusable for first 6-8 weeks. You couldn't enter your claims, it crashed, gave cryptic error messages and drove my wife $&!@# crazy! I don't know how many hours we both spent swearing, trying to use the website. And since the site didn't work and people were not allowed to use the old VB6 program, the Medicaid phones were overloaded. We didn't hear back from Medicaid for weeks!
Like I said, I'm not doctor or economist but I don't see, based upon my experiences, that the public option would be anything but a disaster. How could lower fees to doctors resulting in few doctors and longer wait times be good? Also, with the influx of x million new patients who is going to treat them? We are not churning out that many new doctors. Again, overcrowding. I'm not sure exactly what need to be done to fix healthcare but a public option is not the answer.