It’s a good story. George Skelton at the LA Times reported earlier this week about a Reagan-era arm-wrestling match to decide whether to implement a cut to Medi-Cal, specifically Medi-Cal co-pays.
Amusing anecdote, if a bit scary to learn how public policy is sometimes dictated. Skelton seems to think higher co-payments for people under the poverty level is acceptable enough to put it up to an arm-wrestle. I don’t think that is not a good process to decide policy–and not just because I’d probably lose that particular contest to Governor Schwarzenegger.
Skelton did at least quote me with some of the counter-arguments (to co-payments, not arm-wrestling): these are vulnerable populations who make less than $1000 a month, where cash can be scarce. But one main point that was not quoted: The issue of co-payments is really about denial of care: do we want to allow providers to deny care to a patient under the poverty level beause they don’t have $5? or $50? or $100? For those providers who take the patients anyway, it’s another provider rate cut. And yet that’s the best-case scenario. So we disagree.
Thankfully, the columnist comes out against the vast majority of health cuts proposed, including the hard caps on prescription drugs and doctor and clinic visits. He recognizes that $5o for an emergency room visit or $100 for a hospital day stay is way too much for poor people.
And he recognized the larger point about priorities and values: the Governor’s budget seeks to impose new costs on the very poor before even considering delaying corporate tax breaks or upper-income taxes. That’s as unfair as an arm-wrestling contest between me and a bodybuilding Governor.