Medi-Cal: The $0 Copay Plan

Katy Grimes: If you didn’t already believe that there is a concerted effort underway to force socialized health care on all Americans, perhaps it is time to change your mind.

California sought permission recently from the federal Centers for Medicare & Medicaid Services to collect co-pays from Medi-Cal recipients – the class of people in California who pay no income tax, but receive free health care. The Obama Administration rejected the state’s request.

Medicare recipients were lumped into the request, but are different because they paid into the system for decades with Social Security taxes – California’s eight million Medi-Cal recipients did not, do not, and apparently will not.

Federal officials told California that the request violates the Social Security Act, proving that we have several generations of government employees and welfare recipients who believe they are entitled to government care at no personal cost.

But the state only requested permission to charge for co-pays of $5 for a doctor’s visit, $50 for an emergency room visit, $3-$5 for medications, and $100 per day for hospitalization, up to a maximum of $200. What I wouldn’t give for a health plan with those co-pays.


It looks as if we all may get the same health plan soon, but with a reduction in care and services, unless ObamaCare can be stopped. The centerpiece of ObamaCare is the individual mandate, the provision that makes it mandatory for every citizen to purchase private health insurance. The mandate is currently under review by the U.S. Supreme Court.

While private sector, employed Americans pay exorbitant health insurance premiums for less and less medical coverage, public employees and welfare recipients receive comprehensive gold plans, with very low contributions, and low or no co-pays.

The argument from the Obama administration is, that for welfare recipients and the retired, people “struggling to make ends meet,” a $50 copay for an emergency room visit, or $5 for a doctor visit, could prevent people from seeking necessary care.

Middle class and working class people have lived with the same dilemma for years. Ironically, in private sector, we assume that actuaries plan on higher co-pays making people think twice about seeking medical care. But with most welfare mothers running to the doctor for every runny nose and cough, Medi-Cal should have a co-pay.

The people in government making up this drivel must not share doctors with Medi-Cal patients the way the rest of us do. Even with my private health insurance, every time I go to the doctor, for which I am charged a $40 co-pay, the waiting room is filled with Medi-Cal patients, who appear to use trips to the doctor as a social outlet.

They brag about how they  don’t have to pay for anything when they go to the doctor. They compare medications, illnesses and conditions, and talk about medical issues with the confidence of a nurse practitioner, while sick people taking time off of work, come and go.

After four back surgeries and rehabilitation therapies, I’ve seen the inside of too many doctor’s offices, and been around too many fakers with time on their hands.

This will only get worse, and is where we are headed. According to the people who brought you ObamaCare, asking welfare recipients to pay $5 is considered “a much bigger chunk out of their budget” than it is for working people.

I’d like to know what “budget” they are talking about. I have a budget because I work and earn an income. Those who receive government assistance as a vocation, don’t have “budgets.” Apparently asking them to pony-up money for a visit to the doctor doesn’t fit into the big social plan for liberals.

The Public Vs. Private Divide

For 20 years, I was responsible for purchasing health insurance plans for a large, private sector manufacturing company. I have seen the erosion in private sector benefits first hand, while watching premiums increase every year. And every year insurance brokers talked about the expanding “Cadillac” medical and dental plans the state, city and county employees were enjoying, while Cadillac health plans weren’t even being offered anymore to small group private sector employers. According to many brokers, insurance companies couldn’t make as much money from the private sector plans as they could from selling insurance to governments.

While government regulators hammered away for years at insurance companies, they’ve driven health insurers right into the outstretched arms of ObamaCare – and they are dragging us with them, kicking and screaming.

A new report commissioned by America’s Health Insurance Plans, examines the impact of the health reform law’s premium tax on the cost of health insurance coverage. (Beware the phrase “health reform” – it is a plan to expand coverage to more people, and charge insurance companies a hefty excise tax to accomplish this)

The report shows that the premium tax:

Will increase premiums by an average of 1.9 – 2.3 percent in 2014.

Will increase premiums by an average of 2.8 – 3.7 percent by 2023.

In the small group market, of which most private sector health insurance is, this translates into an average increase of $2,800 for individuals and $6,800 for families over a 10-year period.

The premium tax also applies to Medicare Advantage, Medicare Part D and Medicaid managed care plans.

While the middle and working class are being disproportionately squeezed with higher taxes, higher utility costs, higher food bills, higher education bills, and getting regulated, taxed and fee’d to death in small business, the only class of people that government seems to care to protect anymore is the welfare class. If only the same care was shown to the people who create jobs and work…

FEB. 7, 2012

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