Wednesday, January 19, 2011

Work, Slave!

There is an interesting legal case from California that has just been accepted by the U.S. Supreme Court for a hearing. As most people know, California has a horrendous budgetary problem; we have run out of money. The state budget currently has a $25 billion deficit. To help resolve this, the state government has made major cutbacks to nearly all programs, including Medi-Cal, the state's Medicaid program. Our new governor, Moonbeam Brown, has proposed another 10% cut to the program, or over $700 million. A group of doctors, including the California Medical Association, sued the state, saying state cutbacks will deny poor people access to health care, which is contrary to the mission of the federal Medicaid program. The state says the doctors do not have a right to bring legal action. They claim doctors have NO RIGHT to a particular reimbursement from the state. So far the doctors have won in the lower courts. However California is appealing on the basis of state sovereignty. They say federal courts are interfering with a state's individual right to set its own budget. The Obama administration has directed the U.S. to respect the lower courts' rulings and stay out of the debate.

This highlights the terrible dilemma doctors have in this country. Obamacare is inching ever closer to reality. Along with it will be a flood of over 30 million new patients who will get Medicare level health insurance. Doctors are expected to treat all these new patients but according to the state they will not be allowed to challenge the reimbursements they receive for the care. Instead the money, if it comes, will be set by fiat in legislative chambers filled with lawyers and insurance lobbyists. So let's see, we'll have more patients to treat, with possibly lower reimbursements, with no recourse for protesting the meager payments, while our business overhead like staffing, insurance, rent, and supplies continues to rise. Doesn't sound like a good business opportunity to me. I hear Government, I mean General, Motors is hiring again.

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