Cuts in Medicaid services

by: Eric B.

Fri Jul 03, 2009 at 10:25:51 AM EDT

This Jack Lessenberry column is something you should have already read.  If you haven't, please go read it before going on.  You will take a short quiz at the end of this post.

I’m not sure what the weather is where you are. But it is a bleak day for thousands of Michigan adults who have been managing their vision, hearing and dental problems with the help of Medicaid.

Due to our budget problems, the state, as of today, is no longer paying for a number of formerly covered services. This includes routine eye and dental exams, glasses and fillings.

That's actually as of July 1. I noticed the deadline, mostly because I work in a group home in a system of group homes where all of the residents are entirely dependent on Medicaid.

One of the residents in that system (when you work in such a thing, you tend to get to know residents in a number of the homes), was rushing up against the July 1 deadline to get fitted for dentures.  There was real danger that the dentures might not be ready by July 1 and this person would spend the rest of his or her life without anything in his mouth, and not by any choice or his or her own.

That is not all.  This particular person also lost funding for one of the medications he or she takes to help him or her swallow food.  I won't go into the particulars of the specific health problem, but suffice to say that in this person's case, the medical decision wasn't made by the doctor and patient, but by way of no funding for Medicaid.

Those of us familiar with the rightwing shouting line on this, that something akin to universal health care would prevent them from seeing the heart specialist of their choice, understand that this is really an argument from selfishness.  The current system deprives poor people of choice.  The right wing is concerned with choice only so long as it is extended to them.

This is the very real extension of the health care system as it currently is.  If you have Medicaid here in mid-Michigan, you're going to Cadillac for dental care, since no dentist within an hour's drive accepts Medicaid patients.  The reason?  Medicaid reimbursements are to the point where doctors and medical professionals treat those patients at a loss.  If you're wealthy and are one of the last remaining people blessed with good private insurance, you have plenty of choice today.  If you're poor, or lost health insurance when you were laid off (i.e. me) you're screwed.

The cuts in service Lessenberry wrote about are also the extension of this. Now, if you have Medicaid and live in mid-Michigan, you may as well skip the drive to Cadillac, 'cause the state isn't going to pay for your dental care.  On the other hand, I know someone who last year took his kids out of school for an entire day so he could drive them all down to U of M and a cheap-o clinic there.  Regardless, before July 1, there was a health care desert here in mid-Michigan that if you had Medicaid you had to travel outside for dental care.  That desert now encompasses the entire state.