http://www.dailygazette.com

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CAPITOL
Better, cheaper health care is goal State seeks to steer patients out of ERs
BY VALERIE BAUMAN The Associated Press

    Instead of waiting for hours in an emergency room or landing in a nursing home, New Yorkers with government health coverage will soon have the opportunity to avoid those costly treatment venues by going to their own family doctor.
    In his State of the State address Wednesday, Gov. Eliot Spitzer proposed changing the way New York reimburses hospitals and doctors for services — part of overall changes aimed at making health care cheaper for taxpayers and better for patients.
    The current system for reimbursing doctors in the pay-per-visit Medicaid and Family Health Plus programs hasn’t been updated since 1981, said Dr. Richard Daines, the state health commissioner. When primary care doctors are paid a fee that reflects the service they deliver, patients will have more options, he said.
    While managed care programs tend to pay doctors about what private insurers pay, a doctor treating a Medicaid patient under the pay-per-visit system receives $67.50 per visit, whether it’s an expensive, complex treatment process or a simple booster shot, Daines said.
    “If we are able to pay higher rates to primary care doctors, it will be easier to find a family doctor,” Daines said.
    Patient advocates like the proposal.
    “The most serious and most expensive health care problems that New Yorkers face — asthma, diabetes, HIV/AIDS, hypertension, stroke — these are things that can be treated and sometimes prevented if you’ve got strong, community-based primary and preventive care,” said Michael Kink, legislative counsel for Housing Works, an organization serving low-income people and people with HIV/AIDS. “We shouldn’t be waiting until people get really sick and incur really kind of high-cost, high-complexity illnesses.”
    “If you’ve got a Medicaid card in your pocket, you’re going to see more primary care doctors in your neighborhood,” Kink said. “You may see doctors sooner.”
    It’s unclear what types of procedures and visits will start to reimburse doctors at a lower rate. Health officials said they won’t know until the state budget comes out later this month.
    Hospitals and health care providers tend to have very small profit margins, and changes in reim- bursements raise concerns that if primary care physicians are paid more, other specialties could be paid less, said William Van Slyke, spokesman for the Healthcare Association of New York State.
    “Any reduction, period, in health care reimbursement increases the challenge of providing community care,” Van Slyke said.
    Hospitals support providing preventive and outpatient care but are apprehensive about the transition.
    “It’s a necessary shift to a new way of the government funding of the health care,” Van Slyke said. “Our concern is that we have to get to this new system first before we pull the rug out from under the old one What we need is time to transition and financial support to keep the existing system viable while we move to the more outpatient-based system.”
    Officials at the state Health Department said data suggest some providers may not be thrilled with the changes, but most would fi nd a balance between procedures paying more and those paying less.
    “A year ago, I was one of those hospital executives waiting to hear what the budget would do, so I’ve been on that end of it,” Daines said. “So it’s a perspective that I’ve brought that there are rates of change that can be tolerated and there are bottom-line issues. We’re sensitive to those.”
    Chandler Ralph, CEO of Adirondack Medical Center, said she supports increasing the reimbursement rate for primary care physicians, but believes no payment should ever be less than the actual costs of the care.
    “You have to be sure the reimbursement system is fair to every physician,” she said. “I have physicians who are asking me to pay [them] to be on call in the emergency room. One of the key factors of that is when they get called in, in the middle of the night, to either a patient with no insurance or a patient with low reimbursement, that’s no longer sustainable.”
    If the reimbursements cut down on total income, the center will probably have to cut back on community services, Ralph said. That could eliminate diabetes classes, wellness classes at businesses and exercise classes for the elderly.

Maybe those getting Medicaid should have to start paying the types of deductibles and copays the rest of us have to.  That would cut down on costs.

Oh but if the medicaid recipients must pay a co-pay, that means their welfare checks will have to increase. It's just the nature of the beast! Don't ask for any medicaid or welfare recipient to pay for anything more, cause that means WE will be paying for it through higher taxes!!

We will get slapped in the face by the government with argument and complaining about paying for welfare and the like.....I think everyone should pay for themselves but allowing the government to take away our right to choose because of our fight over $$ is really gonna make it harder for our kids to be Pioneering Americans.....

http://www.timesunion.com

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State uses TV ads to tout child health program
$10M campaign part of Spitzer effort to expand subsidized care

By JOSEPH SPECTOR, Gannett News Service
First published: Saturday, March 8, 2008

ALBANY -- As Gov. Eliot Spitzer seeks to expand subsidized health care to all New York children, the state on Monday will launch television ads across the state as part of a $10 million campaign to encourage families to enroll children eligible for the program.
The state Health Department has produced television ads that are testimonials from families that are enrolled in Medicaid or the state's Child Health Plus insurance program.
     
One TV ad was filmed in Spanish and another in English; the campaign has also included radio, newspaper and billboard ads.
About 270,000 children who live in low- to moderate-income households are eligible to enroll in Medicaid, which provides medical care to the poor and disabled, or Child Health Plus, which provides discounted insurance premiums on a sliding scale.
In his 2008-09 budget proposal, Spitzer wants to spend $37 million to increase the income eligibility for the program from 250 percent to 400 percent of the federal poverty level.
The expansion would mean that a family of four making up to $82,000 a year would be eligible to enroll -- about 70,000 children statewide. A family with an $82,000-a-year income would pay about $1,400 a year in premiums for their children's health coverage, according to the state Health Department.
Republican and Democratic lawmakers have expressed support for expanding the eligibility of child-health insurance after the federal government last year rejected New York's request to increase the threshold.
States, including New York, are suing and arguing that the federal government unlawfully imposed new rules. But rather than engage in litigation, Spitzer said New York should just fund the $19 million the federal government was expected to pay for the expansion. About 396,000 children are already enrolled in the state's Child Health Plus program.
For more information about the state's Child Health Plus program, visit http://www.nyhealth.gov/nysdoh/chplus or call 1-800-698-4KIDS (4543).

I'm not in favor of this government medical coverage. But since it will be a reality whether we like it or not, I don't know why they just didn't raise the income eligibility for medicaid. It is an already existing government program and they would then be able to save $10 million in the advertising campaign.

It's just 'them' testing the waters....we vote with our money......if it is popular and cheap(right now of course) we will choose it....just like stores have 'leader sales' so does the government.....we vote with our money.....sub-prime is an example of how we vote.....I cant wait for this rollercoaster ride to hit the top of the first drop(tax increase for health care).....who are we kidding-the leaders should be asking themselves,,,and they can answer too--ALL THE SHEEPLE......