An elderly Michigan woman died in October as the result of a severe dental infection after adult dental Medicaid benefits were cut in the state. Blanche D. LaVire, 76, had been diagnosed with abscesses earlier in the year and reportedly suffered from advanced periodontitis. Because LaVire was mentally challenged, she required special treatment. Her condition was such that her doctors felt it would be unwise to undergo treatment in a dentist’s office. Advised to have the necessary procedure performed in a hospital, LaVire was then scheduled for an oral surgery near the end of June. The procedure was delayed when LaVire contracted pneumonia. Once she had recovered from the pneumonia, doctors attempted to reschedule LaVire’s procedure, but discovered she was no longer covered by Medicaid. An executive order issued by Michigan’s Democratic Governor Jennifer Granholm had taken effect on July 1 that dramatically cut adult dental Medicaid benefits. All oral health services were eliminated by the order, with the exception of emergency services.---

Shortly before she was laid off, a cardiologist told Anne Johnson she needs her aortic valve replaced, but without insurance she can’t afford the surgery. She is supposed to get checkups every six months, but that is also too expensive – so she has put them off. Her last visit to the cardiologist was in January, so she is already three months overdue. “Right now I have no idea what type of condition I’m in,” Johnson said.

Pharmacy groups are suing California, New York and Washington, alleging the states' reimbursements for prescription drugs under the Medicaid program are too low. They warn that pharmacies may be forced to terminate their Medicaid contracts. A fourth lawsuit -- this one against Minnesota -- is expected to be filed soon. The states are accused of improperly reducing their reimbursement rates in response to the new Average Wholesale Prices (AWP) for prescription drugs -- the published benchmark of drug costs -- which were themselves reduced on Sept. 26. While the AWP varies for different drugs, it went down, on average, by 4 percent.

There are five medical schools in Philadelphia and at least two of the teaching hospitals are in the nation's Top 10. I can't even count how many hospitals we have - 20 or more. Out of all those experts, four doctors perform this reasonably common procedure - and it sounds like it's for insurance reasons. Now, picture this whole thing with single payer. You get hurt, you go get treated. They send you where you need to go - and there are no worries about whether or not they take your insurance. They order the MRI when you need it, and they locate the right specialist to do the surgery. They send someone to check you at home after the surgery, and they cover the physical therapy - without a copay. Oh no, Democratic Congress! No, President Obama! Please don't throw me in that briar patch of evil socialized medicine! I might die of happiness. [Note: This is the end of the story. The story is what sickens you because maybe at one time you were in this man's shoes.]

"Some disabled, ill and elderly Alaskans are suing over a temporary ban that prevents them from getting help in their home through Medicaid. The class action lawsuit targets a federal moratorium that bars new people from being admitted to certain Medicaid programs that offer help including nursing care in the home. The programs were started so that people don't have to live in nursing homes or be stuck in a hospital, but according to the suit, that's what is happening as a result of the moratorium."

It was created 40 years ago to provide health care for the poorest New Yorkers, offering a lifeline to those who could not afford to have a baby or a heart attack. But in the decades since, New York State's Medicaid program has also become a $44.5 billion target for the unscrupulous and the opportunistic. It has drawn dentists like Dr. Dolly Rosen, who within 12 months somehow built the state's biggest Medicaid dental practice out of a Brooklyn storefront, where she claimed to have performed as many as 991 procedures a day in 2003. After The New York Times discovered her extraordinary billings through a computer analysis and questioned the state about them, Dr. Rosen and two associates were indicted on charges of stealing more than $1 million from the program. It has drawn van services, intended as medical transportation for patients who cannot walk unaided, that regularly picked up scores of people who walked quite easily when a reporter was watching nearby. In cooperation with medical offices that order these services, the ambulettes typically cost the taxpayers more than $50 a round trip, adding up to $200 million a year. In some cases, the rides that the state paid for may never have taken place.

When it comes to reforming America’s disastrous health care “system,” there are two issues that need to be considered: access and cost. The so-called reform proposals being offered by the Obama White House, the House and the Senate, are failing on both counts, and deserve to die. No progressives should allow themselves to be suckered into promoting one or the other. Here’s the problem. As long as the health insurance industry is permitted to be the primary paymaster, the cost of medical care will continue to soar, not least because the insurance industry is so concerned about minimizing its own outlays that it is forcing the system to devote nearly 30% of every health care dollar spent to administrative costs (compared to 3-4 percent for Medicare, and even less for single-payer systems like Canada’s). That’s true whether there is a so-called “public option” government-run health insurance plan or not. Note that 30 percent of America’s $2.5-trillion health care bill per year is $750 billion a year, a sum which does absolutely nothing to make a single person more healthy or less ill.

Hmmmmm, according to this report, "the drug industry group PhRMA will announce a deal it has struck with the liberal advocacy group Families USA, backing increased government coverage under the Medicaid program for the poor. During the last, unsuccessful effort to remake the health system, the Pharmaceutical Research and Manufacturers of America were among the most powerful opponents...In an interview, PhRMA President and CEO Billy Tauzin said his group is ready to sign on to a campaign to bring insurance to more people — even if it means drug companies will have to take less for their products — because too many Americans simply can't afford the medications they need."

I am writing this essay because the average American has no idea of the inequities that exist in the Medicaid/Medicare system and the harm the Federal Drug Enforcement Administration has wrought upon the American public - especially those who are poor, disabled, and live in chronic pain. Where did the DEA get their medical training???

"Four hospitals in New York state paid kickbacks to get more patients into their drug treatment programs, which billed Medicaid for services that weren't standard or necessary and lacked state certification, lawsuits allege. Another hospital paid people to search homeless shelters and other places for patients to enter a three-day stay in detox in exchange for cigarettes, beer, food, and other items, according to the lawsuit brought by Attorney General Attorney General Andrew Cuomo and U.S. Attorney Benton Campbell. The lawsuits allege those five hospitals and two others fraudulently billed Medicaid for more than $50 million in more than 14,000 different claims."

"States from Rhode Island to California are being forced to curtail Medicaid, the government health insurance program for the poor, as they struggle to cope with the deteriorating economy. ... Already, 19 states — including Maryland and Virginia — and the District of Columbia have lowered payments to hospitals and nursing homes, eliminated coverage for some treatments, and forced some recipients out of the insurance program completely. Many are halting payments for health-care services not required by the federal government, such as physical therapy, eyeglasses, hearing aids and hospice care. A few states are requiring poor patients to chip in more toward their care."

States from Rhode Island to California are being forced to curtail Medicaid, the government health insurance program for the poor, as they struggle to cope with the deteriorating economy. With revenue falling at the same time that more people are losing their jobs and private health coverage, states already have pared their programs and many are looking at deeper cuts for the coming year. Already, 19 states -- including Maryland and Virginia -- and the District of Columbia have lowered payments to hospitals and nursing homes, eliminated coverage for some treatments, and forced some recipients out of the insurance program completely.

Taxpayers underwrite the legal dispensing of possibly thousands of drugs never approved by FDA. Medicaid patients (and others) are oblivious to the status of the drugs they receive. Worse, some patients have died as a result. The drugs were marketed before Congress ordered FDA-review all drugs. Suppliers claimed a “grandfather” waiver. Typically, doctors, pharmacists, and patients are unaware that these drugs lack FDA approval. According to a pharmacist who has studied the issue, “I think the presence of these drugs shows we have a false sense of security."

In the first of an expected avalanche of post-election regulations, the Bush administration on Friday narrowed the scope of services that can be provided to poor people under Medicaid’s outpatient hospital benefit. Public hospitals and state officials immediately protested the action, saying it would reduce Medicaid payments to many hospitals at a time of growing need. The new rule conflicts with efforts by Congressional leaders and governors to increase federal aid to the states for Medicaid as part of a new economic action plan.

"Economic troubles are forcing states to scale back safety-net health-coverage programs — even as they brace for more residents who will need help paying for care. Many cuts affect Medicaid, which pays for health coverage for 50 million low-income adults and children nationwide, including nearly half of all nursing home care."

"John McCain would pay for his health plan with major reductions to Medicare and Medicaid, a top aide said, in a move that independent analysts estimate could result in cuts of $1.3 trillion over 10 years to the government programs."

"Amerigroup Corp. has agreed to pay $225 million to settle claims that it defrauded the Illinois Medicaid program, state and federal prosecutors said Thursday. The federal government and the state of Illinois alleged that Amerigroup systematically avoided enrolling pregnant women and unhealthy patients in their Medicaid managed-care program in Illinois, which served low-income people. ... A former Amerigroup employee was the first to file charges against the company, alleging that, in a bid to maximize profits, Amerigroup engaged in a calculated plan to discriminate against Medicaid-eligible patients with expensive medical conditions."

Despite threats of a presidential veto and opposition of Republican leaders in the Senate, Democrats will attach wording to "must-pass" legislation such as the Iraq spending bill imposing a moratorium on new rules by the administration that will impose draconian cuts on emergency rooms, trauma centers, hospitals, school-based clinics and other core public health infrastructure. Includes senate contact info. Call your senator in support of the moratorium now!

John McCain visited Miami Children's Hospital April 28 where he no doubt scared some babies while attempting to kiss them. His main purpose for being there was to give an impression that he understands the health care issue, but he managed only to underscore the fact that he has no plan to solve America's health care crisis.

George Bush continues to support abstinence-only education despite evidence it doesn't work. At the same time, he's inclined to demonstrate his fiscal bonafides at the expense of those most in need. Apparently he believes science is optional and compassion is arbitrary.