Tuesday, January 27, 2009

Is SCHIP the Answer?

Congress is set to introduce legislation, and the President is expected to sign, a plan to expand SCHIP to millions of children in homes where the income is $63,000. Some pundits believe the income threshold could be as high as $80,000.

This is not what most consider poor.

But is SCHIP really the answer?

Not so for Michelle. A single mom in Geneva, Illinois working 6 nights a week as a bartender. She has not signed up for All Kids (Illinois' SCHIP) for her 7 year old son.


many doctors in her area won’t see kids with this kind of coverage.

“I looked into All Kids and it’s affordable, but it seems to be seen as a kind of second-class insurance where I live,” she told me.

"Second-class insurance."

This is the reality behind the promise of universal access to health care for Illinois children. Payment rates are so low and state payment for services so slow that many providers, especially those in the suburbs, simply refuse to see kids with All Kids coverage.

Washington, we have a problem.

I asked Susan Phillips, director of marketing at the Dreyer Clinic, why these patients were turned away. She cited the state’s low reimbursement rates and tardy bill-paying practices as well as complicated administrative requirements associated with the program.

Low reimbursement, tardy payments, administrative red tape.

And this is supposed to be the answer to America's health care crisis?

Nearly 150 doctors at the for-profit Dreyer Clinic, an affiliate of Advocate Health Care, stopped accepting new patients with government-funded Medicaid coverage in 2006, Phillips said. Medicaid is part of All Kids.

Well there's your problem.

Dreyer is for profit and we all know that for profit operations are bad.

The lesson here is that true universal coverage depends on more than a promise of health insurance for all. It requires medical providers willing to serve those with coverage.

I don't like the word . . . "requires".
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