On Tue, May 12, 2009 at 3:38 PM, Chuck Grimes <cgrimes at rawbw.com> wrote:
>
> I am no fan of SEIU, but this story and the implication that SEIU is to
> blame for the feds taking back or withholding Medicaid funding is mostly
> nonsense. The Medicaid or rather MediCal system has build-in share of cost
> formulas across the board. The SEIU wage deals with the counties is just one
> part. The same problem of state and country contributions mandated by
> federal guidelines has been an on-going battle for years.
>
> MediCal reimbursements and their documentation requirements for claims have
> become the worst of the worst in a systemic denial of service. Many doctors
> and private hospitals who have a choice will not take MediCal patients
> because the fee schedules are so low, the paper work so high, and the
> likelihood of a denial so high. The average time between between providing
> service and getting paid runs above 120 days. More progressive counties like
> Alameda have made up the state budget contribution difference for years, and
> slowly the counties have had their own budget problems, partly because of
> it. Every year since I can't remember when, California Republicans have held
> up state budgets on the starve the beast line of reasoning. From about
> mid-May to about October MediCal claims are stalled out and dribble through,
> while the legislature and governor battle over the budget.
>
> I have absolutely no doubt the, ``bill includes a `maintenance of effort'
> clause to prevent states from using the new federal dollars to lower their
> spending on healthcare at counties' expense. The SEIU argued that
> California's cuts violated that clause...''
>
> ``That stance is unreasonable, and Washington should drop its threat to
> rescind the extra Medicaid dollars.'' Nonsense. If the feds let California
> off the hook, they will likely face a sea of state level complaints around
> the country about the same problem. Several states don't even subscribe to
> the Medicaid system because they don't like the share of cost guidelines.
> The states, counties, and feds have been cost shifting for decades under
> endless battles over taxation. This is one of those battles. And so now,
> it's the union and working class demands for higher wages that is the
> problem?
>
> No. It's the public policy of `starving the beast' by cutting taxes and
> cutting public service support that is the problem.
>
> All of this is very similar sounding to the banks that complain about
> regulation but want the money anyhow. And it also smacks of the forced wage
> cutbacks in the auto industry.
>
> The whole state system is on the verge of collapse exactly because it will
> not raise the appropriate tax levels in a progressive system so it can no
> longer afford any social safety net. It is the wage demands from the lowest
> level of labor that is to blame for the crisis? I don't think so.
>
> CG
>
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