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Wednesday, 19 February 2014 14:55

Don’t fix what isn’t broken

Written by 

To the Editor:

We have heard much from GOP Gov. Pat McCrory and some leaders in the state legislature about our “failed” Medicaid program. This “fix” is despite the fact that Community Care of NC (CNCC), which manages care for 1.4 million of the 1.6 million state Medicaid patients, was recognized nationally in April 2013 as the model for delivery of Medicaid services. 

Sen. Richard Burr, R-N.C., presented an award to CNCC from the Healthcare Leadership Council, a national group of healthcare CEOs, for quality AND efficiency and in particular praised the high quality of care delivered to patients in rural areas.

However, Art Pope’s Civitas Institute has allocated funds to discredit the Medicaid program, the purpose seeming to be to further reduce funding to the program. 

So what are the governor’s plans? He wants to privatize Medicaid. He wants to take this award-winning, efficient, patient-centered program and turn those state dollars over to several mega insurance companies and managed care HMOs. It is his belief that a private business can better run such a large program and save our tax dollars.

However, as has been shown with Medicare, a much larger program, only 1 percent is spent on administration. In contrast, managed care HMOs take 15 percent of health care dollars as profits.

Even if the state saves a few bucks (not a certainty), where does the 15 percent come from? It comes from reduced services to patients and further reductions in reimbursement to providers. Rural hospitals, especially, and providers depend on Medicaid income, but with increases in overhead and reduction in payments, many will not be able to survive and continue to serve those who need it most.

Having been in private pediatric practice in Franklin for 37 years (and with a Medicaid population of about 60 percent), I have dealt with the current N.C. system as well as the managed care system in Georgia. Hands down, the current NC system much more efficiently serves the patients and is much more user friendly to the medical providers; there is far less red tape and fewer inexplicable denials of care than the managed care system in Georgia.

And there is that 15 percent profit going to insurance companies for performing a service the state can do for much less.

Please contact the governor, Sen. Jim Davis, R-Franklin, and Rep. Roger West, R-Marble, and tell them the system is not broken; don’t “fix” what is not broken.

Frederick A. Berger, M.D.

Franklin

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