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Jan 31, 2009

Healthcare: They will pretend to pay - We will pretend to treat

01/31/09 - ChicagoBoyz by Carl from Chicago

The people of the Soviet Union had a slogan about their government jobs. "They pretend to pay us, and we pretend to work". That is what is coming in health care. There is no free lunch. When the lunch is truly free, then there is no lunch.

[edited] In speech after speech Gov. Blagojevich hammered home the “fact” that he had granted insurance coverage to so many in Illinois, through various means. How has this actually been implemented? State payments to medical providers has been dramatically slowed.

I have personal experience with the State of Illinois delaying payments, but the situation is worse than ever for health care providers. Many legislators say that they intervened to expedite payments to some of their local hospitals on the verge of major financial distress.

Delaying payments has the same effect as reducing payments, since the state doesn’t catch up for a long time. The payment delays ensure that providers need to hold a big “rainy day” fund, since their employees want to be paid cash rather than IOU’s.

Medical providers can do little except complain to their local legislators. They can’t sue the State to speed up payments, and if they did, the state wouldn't care. Unlike insurance, which may be popularly perceived as unfair, there are no avenues of appeal if you feel the state is killing your business.

The US will likely move to a backwards program of medical socialism by increasing coverage and then squeezing providers with reduced and slowed payments. Federal transfers to states will not make up the cost for unfunded mandates.

A version of this will unfold in Illinois and other states that increase insurance coverage at state expense. Medical providers will begin to crumble financially and move away from treating state and federally insured patients, or do it in the most bare-bones and cheap manner possible.

Political Contributions for Medicare Reimbursement
Blogojevich withheld Medicaid reimbursement to Children's Memorial Hospital to get a campaign contribution from its CEO.

Crisis Is Building in Illinois Finances
10/06/09 - CBS2 Chicago - by Mike Flannery

What are the priorities in Illiniois? Clearly the poor and sick are not at the top of the list. It is not compassionate to promise more than you can deliver.

The state is not a good social insurance company. It makes no investments to pay off its future promises. Instead, it tends to spend whatever is available on whatever serves politicians at the moment.

[edited] Tax receipts are down, and Illinois is not paying its social wellfare bills. The typical creditor must now wait three months to be paid, compared to two months at this time last year.

A Chicago Meals on Wheels nutrition center can't purchase food and is facing eviction. A large Lake County disabled program can't make insurance or mortgage payments.

2,600 creditors call the state each week, desperate to be paid.

The General Assembly will reconvene next week in Springfield. No one is even pretending to offer a comprehensive solution to the unprecedented budget disaster. The governor and legislative leaders all insist that must wait until next year.

Never Events
Medicaid is already squeezing doctors by finding ways to avoid paying them.

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