All Kids Already Dealt With

11:42 pm, 7/11/06

All Kids Already Dealt With
Governor Blagojevich's latest healthcare innovation, "All Kids", is a huge success:

A spokeswoman for the state Department of Healthcare and Family Services says so far about 45,000 kids have signed up.

That includes 40,000 who already qualified for state coverage but hadn't signed up and 5,000 kids who didn't qualify until All Kids was created.

So, the State of Illinois hasn't actually done much, they've just spent huge amounts of money creating a new program because they weren't competent to properly promote awareness of the pre-existing ones.

The state has now teamed up with the Chicago White Sox to get the word out. This is almost as great as the wildly promoted ISave-RX program, which, despite being projected to attract 1,500,000 senior citizens to buy Canadian drugs, had, months later, an actual enrollment of less than 1% of that number.

Physicians remain not just skeptical, but scared:

"We are extremely, extremely worried about whether the program will run smoothly enough to allow access to care," said Dr. Peter Eupierre, president of the Illinois State Medical Society, a physicians group.

...Many experts question whether Illinois is ready to make good on its promise of health care for all children while simultaneously implementing two major new programs affecting most of the state's nearly 2 million Medicaid recipients.

Along with All Kids, the state [rolled out] a new disease management program Saturday for 160,000 Medicaid members with costly chronic conditions such as diabetes and asthma. Beginning next year, it will make a form of managed medical care known as primary-care case management mandatory for 1.2 million members.

"We're pretty well-prepared. We know how to do expansions," said Anne Marie Murphy, head of the Illinois Medicaid program, noting that Blagojevich has added 450,000 people to government-sponsored health plans in Illinois since he took office.

It should be pointed out that since most state medical assistance programs target the poor, a significant number of people "added" to the plans are likely to be people who have been driven to poverty by Blagojevich's policies. The public would be better served by policies that eliminate the need for 450,000 people to be on government-sponsored health plans.

More importantly, though, they really seem to not know how to do expansions, because they apparently haven't bothered to clue in their most important partners, the doctors themselves:

"There are still a lot of things we don't know and a lot of questions we have," Eupierre said. On Wednesday, the chairman of his organization's board of directors sent a letter to Barry Maram, director of Illinois' Department of Healthcare and Family Services, asking for more detailed information.

"We would like to know, if we need to make a referral, how will that work?" Eupierre said "What number will we have to call? Will we have to fax documents? Will we have to discuss the case with someone from the state? How long will that take? Or can we do this online? None of those details are available yet, and that's frustrating."

Illinois health care will soon run almost as smoothly as Canada's.

Leading the list of concerns is whether the state can persuade doctors to participate in All Kids and the other changes it is making. Without a large network of participating physicians, access to medical care will be compromised and new medical management strategies for Medicaid won't work, experts note.

The problem is, doctors across Illinois are increasingly reluctant to work with Medicaid because of the state's long delays in paying medical bills, said Vince Keenan, executive director of the Illinois Academy of Family Physicians...

The state has tried to ease concerns by assuring pediatricians treating All Kids patients that it will pay them in 30 days. But doubts are widespread.

"The state has promised providers time and time again that it will pay our bills promptly, and they just don't do it," Pescatore said.

The state currently owes providers in excess of 1.5 billion dollars.

Question: When doctors refuse the Governor's "insurance" and angry families want their money back, how will that work? What number will they have to call? Will they have to fax documents? Will they have to discuss the case with someone from the state? How long will that take? Or can they do that online?