What are we going to do about this health care system?\u00a0 Or this polyglot of programs we have instead of a system?<\/p>\n
That\u2019s one of America\u2019s big questions, of course.\u00a0 At the recent Domenici Institute conference in Las Cruces, Dr. Mario Molina of Molina Healthcare presented some sobering statistics that add focus to the issue.<\/p>\n
Molina talked about a category of people called \u201cdual eligibles.\u201d We have heard that people in their last months of life are the most expensive patients.\u00a0 Dual eligibles are next.<\/p>\n
Dual eligibles are people enrolled in both Medicare and Medicaid.\u00a0 They qualify for Medicare either by age or due to a qualifying disability and for Medicaid because of low income.<\/p>\n
And they cost a lot of money.\u00a0 Some numbers from Molina\u2019s presentation:<\/p>\n
We have heard about these people:\u00a0 the ones who don\u2019t keep their appointments but turn up in emergency rooms, costing way more money.\u00a0 According to Dr. Molina, that\u2019s not due to irresponsibility but results from no reliable transportation and other issues related to their lack of resources.\u00a0 So too, their chronic conditions may be made worse by poverty \u2013 limited access to good food, for example.\u00a0 They don\u2019t take their medications, sometimes because they can\u2019t get to a pharmacy, sometimes because they can\u2019t read and don\u2019t understand the instructions.<\/p>\n
Dr. Molina makes a powerful argument for an orderly managed care system for this population.\u00a0 Features like coordinated transportation and on-site pharmacies would make their lives easier.\u00a0 Overall, he says managed care would save an estimated $2 trillion over a decade.<\/p>\n
I remember when New Mexico\u2019s Legislature divided the general fund into roughly 50 percent for public schools, 17 percent for higher education, and the rest for general government.\u00a0 The arguments were over a few percentage points.\u00a0 Then Medicaid came along and changed everything.<\/p>\n
But as we see, everything is related to everything else:\u00a0 this expensive, inefficiently delivered health care is provided to people don\u2019t have what the rest us have that helps us to take care of our health \u2013 decent housing, food, sanitation, education, transportation.\u00a0 If you ever think your life is out of control, these folks are much worse off.<\/p>\n
The deeper question is what we really expect of our health care system, what we are willing to pay for, and how that relates to a larger social safety net.\u00a0 We don\u2019t know or even talk about the answers.\u00a0 Maybe that\u2019s one underlying reason we still have a mess of programs instead of a health care system.<\/p>\n
Triple Spaced Again, \u00a9 New Mexico News Services 2011<\/p>\n","protected":false},"excerpt":{"rendered":"
What are we going to do about this health care system?\u00a0 Or this polyglot of programs we have instead of a system? That\u2019s one of America\u2019s big questions, of course.\u00a0 At the recent Domenici Institute conference in Las Cruces, Dr. … Continue reading