A loser right out of the box
Quote of note:
...it relies on the generosity of doctors and hospitals to provide specialty services free of charge.
Really.
In America. Profit driven America with its for-profit hospitals.
Don't make me laugh. We are obviously a long way away from any serious reform.
Model in Utah May Be Future for Medicaid
By KIRK JOHNSON and REED ABELSON
SALT LAKE CITY - Anyone looking for clues as to how the Bush administration might overhaul the Medicaid system should come to Utah and read the fine print of Tony Martinez's health insurance plan.
Mr. Martinez, 56, was homeless and without any health coverage a year ago. Now, under an experimental plan of partial insurance devised under Michael O. Leavitt when he was governor of Utah, Mr. Martinez can see a doctor or go to the emergency room for only a small fee.
But he and his wife, Lisa, are not covered at all for the potentially catastrophic costs of extended hospitalization or specialty medical treatment, from dermatology to oncology. For those services, they must rely, as they did when they were homeless, on charity.
And that brings the story back to Mr. Leavitt, who as President Bush's new secretary of health and human services is now leading a drive to change how Medicaid works and often points to Utah as an illuminating example that other states might consider - although it is an innovation that policy experts, doctors and advocates for the poor are deeply ambivalent about.
In Utah, Mr. Leavitt's plan departs from the traditional Medicaid program on two main fronts. First, it spreads out a lower, more basic level of care to more people, and reduces coverage for some traditional beneficiaries by imposing co-payments for services. And second, it relies on the generosity of doctors and hospitals to provide specialty services free of charge.
In doing so, the state has in many ways reframed and reshaped the national debate over Medicaid and health care for the indigent, experts say, broadening the focus from the question of who does and does not have health insurance, to what constitutes basic health coverage.
Many academics and health care analysts say they also worry that substantial state-by-state Medicaid experiments could fracture and fragment a system that while never without its critics, has evolved into an anchor of health coverage for the poor since its introduction in the 1960's. Medicaid could create a landscape of winners and losers determined largely by whether they are lucky enough not to become seriously ill.
