Healthcare Reform - better?

In 2007, legislation, promoted by Governor Pawlenty, was passed pointing towards privatization of our previously public mental health system. The proponents of this legislation say it will be "better". I guess that could be possible, but what scares me is that, no one has ever articulated a single, clear, compelling reason why we ought to privatize. I've heard lots of different reasons, but they are vague and ever changing. It kind of reminds me of when we invaded Iraq.



Privatization began this past spring when various private health care plans launched something called Special Needs Basic Care Plan, or SNIBS (don't ask). SNIBS are voluntary; consumers don't have to sign up for a SNIB. Preferred Integrated Networks (PINS) are scheduled to roll out January 2009 which will be less voluntary and eventually involuntary. SNIBS have begun soliciting (some more aggressively than others) people with serious mental illness to sign up. So far, the skeptics that we are, Tasks has been urging our clients to be cautious about giving up their Medicaid (M.A.) for private insurance.


But Tasks clients tend to be free thinkers, so one, Al (not real name), signed up with a SNIB, GreenCare (not real name), on 6/1/08. Al's troubles with getting medical care began immediately:

• Al is currently on medical leave due to a recent heart surgery but his surgeon is out of the SNIB network. Now, he has to find a new surgeon.
  
• Al receives case management from Tasks Unlimited (he is currently on medical leave recovering from heart surgery) and Tasks has a contract with GreenCare to provide Care Coordination for clients who enroll. We submitted the list of clients to GreenCare but did they check the list for Al's name? Nope.
  
• All routinely receives occupational therapy through M.A. The GreenCare rep told Al it would be covered. What he neglected to say was that Al's diagnosis excludes him from this coverage. Will he have to go without therapy?
  
• GreenCare promises free transportation to doctor appointments, and their Care Coordinator insists that this is true. But Al has been unable to navigate the automatic reservation system and the Care Coordinator suggests that "something is wrong with Al that he can't do it." A Tasks staff member has tried to navigate the automated system and even she found it difficult.
  
• SNIB rules allow dis-enrollment at any time. When we heard about Al's difficulties, we encouraged him to dis-enroll. He called his GreenCare coordinator on June 26 and submitted a request the paperwork. Oh, by the way, dis-enrollment is more difficult than enrollment so we assisted Al in completing the paperwork and mailed it back on July 3. But it turns out that Al can't dis-enroll until the end of the month, so he won't get his M.A back until Aug. 1. Meanwhile, Al goes without the medical care he needs. Tasks will provide Al a ride to see his psychiatrist, who, thankfully is in-network.
  

I had, optimistically, anticipated that some Tasks clients would have good luck with privatization, and others would experience various problems. I never imagined that our first, volunteer guinea pig would encounter every possible problem.


It may be early on but so far, privatization doesn't seem "better" to me. You know what scares me? Al will have to go without medical care. How many people will we lose to this health care reform?


Email me for more information or for ways you can help actually make the healthcare reform...well, better.