Monterey, CA Medi-Cal Experiment Might Not Have Been Thoroughly Thought Through

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One frustrating thing about switching insurance plans is that some doctors that you may have had for years suddenly become out of network, significantly raising the cost if you stick with your same physicians.  Some Medi-Cal recipients are now feeling the same pain following a revamp of the program last year which reassigned a number of those in the health plan to a managed-care-plan with a restricted network of doctors.  The program is a test, to see whether those with complex medical problems can be better served while saving money for the government by being in a managed-care-plan.  However, some feel this is a dangerous experiment.  "We have to think about the fact that people's lives are at stake," Attorney Kevin Prindville with the National Senior Citizens Law Center told USA Today.  Some experts argue that managed-care-plans are ill equipped to deal with the health needs of the elderly, mentally ill or disabled.  The paper profiled a woman who was no longer able to see her oncologist.  Managed-care-plans often don't have specialists who can care for those with rare diseases in their networks.  They also don't typically have home-health aides on staff, which can be a big problem for seniors.  The test program in California is about to move nationwide, which worries many.  Unlike the Medi-Cal plan, those in the national plan will be able to opt out.  However, not everyone feels that this plan, which will focus on dual eligibles (those which have both Medi-Cal or Medicaid as well as Medicare, which costs the government a significant amount of money) is a viable option.  "Fifty percent of duals either have cognitive impairments or serious mental illness.  How's that going to work?" Robert Bernson, a former vice chairman of the Medicare Payment Advisory Board asked USA Today rhetorically.  I hope these issues are ironed out before this program goes national, the idea does not seem fully baked to me.

Please note that this blog reflects my personal opinion and may or may not reflect the opinion of Hands To Help Seniors and the individual members comprising the Board of Governors.