Wednesday, March 24, 2010

Say what? What about the new healthcare bill and special needs kids?

Let me begin by saying that my past experience of 30+ years in the healthcare field and owning a large medical billing company provide me with the qualifications, I believe, to express my personal opinion here.
In addition, I've been dealing with my granddaughter's healthcare issues for 12 years and, I might add, it's been a challenge from the start.

Some of you may think the new Obamacare plan will benefit disabled children and adults.
If it truly offers coverage for those with pre-existing conditions, this is the only benefit I can see.

We know that most private insurance companies, with the exception of premium plans, provide little, if any, long-term care for the disabled. Medicaid and Medicare plans only provide services when “approved and authorized”. Authorization is usually provided based on the end result or gain. If there is no gain, there is usually no service. We know what happens without therapy and other needed services. It becomes an unfortunate vicious cycle for all concerned.

Don’t be fooled by broad terms like "basic benefits" and "covered".  They are not the fine print. What is "covered" is not what is "approved" or; for that matter, even "allowed".  

Authorized, allowed and approved are the key words in fine print!

What if your child doesn’t walk, or talk? What then is the benefit of therapy? Is there a gain? What about premature babies and the cost of keeping them alive? What about children born with syndromes and severe disabilities? What about those that are institutionally deemed?  Where will it end?

What’s that you say? Counseling is a benefit of the new plan? Think about it.

Physicians providing care to Medicare and Medicaid patients are currently difficult to find because they cannot sustain their practices on the reduced reimbursement rates. What makes us think highly trained specialists will be available to us (all) in the future if reimbursements continue to drop by adding, still another government plan? How can they remain in practice?

This is truly a tragic and sad turn of events, at least to me. By rushing into a decision that should have been carefully evaluated, I believe our government as put the wheels in motion that signal the beginning of the end of the most wonderful healthcare delivery system in the world.

What do you think?

Best,
Julie

No comments:

Post a Comment