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ObamaCare Clusterfuck: "Medical homelessness" in California

KPIX (CBS local) in San Francisco:

While open enrollment for coverage under the Affordable Care Act is closed, many of the newly insured are finding they can’t find doctors, landing them into a state described as “medical homelessness.”

Rotacare, a free clinic for the uninsured in Mountain View, is dealing with the problem firsthand.

Mirella Nguyen works at the clinic said staffers dutifully helped uninsured clients sign up for Obamacare[1] so they would no longer need the free clinic.

But months later, the clinic’s former patients are coming back to the clinic begging for help. “They’re coming back to us now and saying I can’t find a doctor, “said Nguyen.

Thinn Ong was thrilled to qualify for a subsidy on the health care exchange. She is paying $200 a month in premiums. But the single mother of two is asking, what for?

“Yeah, I sign it. I got it. But where’s my doctor? Who’s my doctor? I don’t know,” said a frustrated Ong.

Nguyen said the newly insured patients checked the physicians’ lists they were provided and were told they weren’t accepting new patients or they did not participate in the plan.

Now, to be fair, "many" is not a number. But since when have we gotten good numbers on ObamCare from the administration? And since California is a Democratic state, top to bottom, we're not likely to get any good numbers from Covered California, either.

Dr. Kevin Grumbach of UCSF called the phenomenon “medical homelessness,” where patients are caught adrift in a system woefully short of primary care doctors.

“Insurance coverage is a necessary but not a sufficient condition to assure that people get access to care when they need it,” Grumbach said.

Those who can’t find a doctor are supposed to lodge a complaint with state regulators, who have been denying the existence of a doctor shortage for months.

Meanwhile, the sick and insured can’t get appointments.

“What good is coverage if you can’t use it?” Nguyen said.

Experts said the magnitude of the problem is growing, and will soon be felt by all Californians. But those on the front lines, like the free clinic, are feeling it first.

More than 3 million Californians are newly insured. At the same time, a third of our primary care doctors are set to retire.

Well, of course they're going to retire. ObamaCare's ACOs are just HMOs all over again. And who wants to go in debt to for an M.D. to end up as an employee in a hospital, with some administrative drone making all the medical decisions? I don't think so.

NOTE [1] The latest category of good-hearted people Obama has betrayed.

NOTE Now that the "ZOMG!!! 8 million kinda sorta!!!" euphoria is over, we are coming to find out how ObamaCare actually delivers care. This story will be the first of many.

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mellon's picture
Submitted by mellon on

They can still sell other kinds of insurance, car insurance, homeowners insurance, renters insurance, business liability insurance, just not health insurance.

We have to do it soon because as soon as a multinational gets involved then we can never change it again. Forever. We'll be stuck like South Africa is now. With no workable solution and no way to fix it via the ballot box.

Even a revolution there wasn't able to fix it. Nothing like these free trade agreement entitlements has ever existed before.

paintedjaguar's picture
Submitted by paintedjaguar on

It won't make any difference, I know, but someone should point out that the U.S. has been breaking or disregarding treaties and international law for years. We only stick to agreements when our rulers find it convenient.

mellon's picture
Submitted by mellon on

>It won't make any difference, I know, but someone should point out that the
>U.S. has been breaking or disregarding treaties and international law for years.
>We only stick to agreements when our rulers find it convenient.

What could be more convenient than a get out of responsibility free card in the form of a trade agreement which you could blame on the WTO (an organization you started)

If the US had already had single payer when the agreement was signed we could keep it as long as no money was involved at all.

That is why the right in Canada keeps trying to sneak privatization in there somewhere, and the right in the US is trying to insert charter schools into education. The way the trade agreements are designed, they are designed to take the slightest privatization and ratchet each change in and then wholly privatize that segment then they start on the next one. That's how they are destroying the (UK) NHS bit by bit.

Submitted by lambert on

From IATP:

There is no definition for "services" in the agreement. It has often been said that a service is anything that cannot be dropped on your foot.

Alrighty then. (For example, Rolls Royce leases its jet engines and constantly monitors them via data transmissions, as we learn from MH 370. So, is a jet engine a product or a service?)

mellon's picture
Submitted by mellon on

You have to understand that although GATS hasn't gone away, the same people who brought us GATS have been churning out lots of other FTAs many of which cover services- they all overlap and involve different countries. Also now there is TISA, which is supposed to supplement, not replace GATS-

"Trading Health Care Away" is an essay on GATS in the UK context..

Also, Allyson Pollock has written extensively on how the FTAs are designed to tear apart- to privatize public health care in the UK context-

paintedjaguar's picture
Submitted by paintedjaguar on

You can't swing a stick these days without bumping into an Obot or Dem blogger crowing about the "success" of Obamacare -- it's like the Bush-lovers all over again. They must be aware of some of this stuff. "Reality based community" my ass.

You know what else? It isn't the Republicans I blame for the Medicaid screw-up. It's like the old fable -- do you give a scorpion the opening to sting? Then don't pretend to be surprised at what happens.

mellon's picture
Submitted by mellon on

online advocacy. At one point in 2009 it was reputed to be $700k a day. The people who are telling those stories are paid shills for the health insurance industry. They have sample scripts which they vary slightly but the gist of them is that (having insurance now) is SO much better than being medically indigent before. Of course, before the person with an illness who made $50k a year would have been a partial write off and now they get stuck with a $17,000-$22,000 extra every single year that they must pay. (the premium PLUS the OOP max which this year is around $12,600 but next year will undoubtably be a LOT higher)

That is more than most people with chronic illnesses are expecting and I doubt if they are going to be happy when they realize how it works. But they will be too busy trying to prevent their real homelessness. Not just medical homelessness.

But at least the free riding will end. They kept harping on that in the 2009 hearings. Lots of people can't pay hospital bills now and the 60% actuarial value coincidentally is the real cost to the hospital, the rest is teh markup. They can pay that to the bill collectors.

In Massachusetts many chronically ill people were caught in a bind, some trying to move out of the state, because suddenly they could not afford the drugs they needed to take because the insurance payment took it all.

Do people know that Michelle Obama is a hospital administrator?

Submitted by Dromaius on

Venting, since most of the loyal readership here already know.

The Democrats have prevented ANYONE from getting decent individual insurance, even people who had decent insurance before. The likely reason: They didn't want the "rateshock" claims. They wanted the CBO to say, "it cost less than we thought!" And because Wellpoint can report higher earnings now.

People are floundering and Democrats in states like California refuse to do anything because that would be admitting there's a problem.

And who reports these things? CBSLocal (which, from my observation, is a little like Faux News) and then of course, the rightie sites. But it's a rampant problem, see yours plus my own link and see the fact that my insurance commissioner has played lip service to fixing it, even enacted some "roooles" which of course I don't trust.

All the rightie sites have to do is state the facts and it slams Democrats. In turn, I see all over Facebook (because I don't visit DKOS type sites or I'm sure I'd see it there too) the meme that the good Obama supporters have been trying to put out there, that rightie sites NEVER make good points, even once in awhile. This, in an effort to keep the doubts away.

And soon, some Obot will be coming over here to tell you that any self-respecting "progressive" site shouldn't be talking about this.....No, actually any self-respecting "progressive site" SHOULD be talking about this....which gives you an idea of the ethics of most "progressive" sites.

This all represents the very worst any political party has done to me in my lifetime. No Republican has ever burned me as a citizen as badly as the Democrats have. And I was a welfare brat during Reagan. People will suffer and die while the Democrats cover it all up for as long as possible. And this festering mess is only going to get worse. I hope it destroys the Democratic party never to be revived in my lifetime. They and their minions and blind followers will deserve it. At least the right wing is honest about wanting to hurt people to benefit the corporate powers.

jo6pac's picture
Submitted by jo6pac on

I was at the Dr. office on Monday and he is still in love with aca and told me it will get better. He is convinced that it will become Medi-Care and when I told him Medi-Care will become aca he told me I was listening to Rush windbag R. to much. He did admit if he only had aca patiences he would be out of business. It doesn't pay. Only the first black demodog potus could do this.

From Ives just more of that privatizing of Amerika.

mellon's picture
Submitted by mellon on

They are making all sorts of hints but its all part of a cover up of the fact that with agreements like NAFTA and GATS, they have gradually been committing the US to a trade policy which bans public services from being expanded in countries that sign trade agreements with us, AND US.

That is the problem of having corruption, the assumption we make that they are acting in the public interest almost couldn't be more wrong-

So BEFORE we could expand Medicare we would have to withdraw from all those FTA's and SOON, we will have to pay trillions of dollars in compensation to any multinational corporation who is negatively impacted. See also the following:

GATS and Public Service Systems

TISA vs. Public Services

And dozens of other links Ive been posting-

jo6pac's picture
Submitted by jo6pac on

I told him Medi-Care will become aca

Medi Care will disappear and as you have pointed out citizens will have a form of aca or nothing other than the hurry up and die plan;) Who could have known Sarah P. was right even if she had any idea what she was talking about.

Submitted by Dromaius on

I think it's just nasty when your doctor gets political on you, no matter what side they're on. It's especially the case when they call you a Republican for stating the facts. Personally, I'd find myself a new doctor and tell this moron why..

And it cracks me up that he luuuurves himself some ACA, but wouldn't if all of his patients were ACA (because it doesn't pay). Wonder if he thinks Medicaid is great too...wonder if he accepts ANY Medicaid patients.

jo6pac's picture
Submitted by jo6pac on

No, I'm going to keep him over the yrs he has proved to me he does care about people it just hasn't sunk in that the govt. doesn't.

Then there is the note I have from him to the courts to drop me from jury duty:)

Submitted by Dromaius on

Yeah, I don't cut him any slack. He is a physician! He is supposed to be smart. At minimum, he shouldn't be insulting his patients. Accusing you of listening to Rush Limbaugh because you have a better grasp on what's happening with the "a"ca than he does? That's a personal insult.

mellon's picture
Submitted by mellon on

One big goal - it seems to me- not the main one- though - of the ACA is to keep the insurance companies in the game AT ALL COSTS,

Basically it seems to me that the system is totally unsustainable but they cannot admit that without admitting a large number of things they deny, so its completely built on fake assumptions. They claimed a great many things that it makes a big stink about doing save money, when hey don't at all- for example- The things that could save money it quite clearly does not do- as they are against neoliberal mantra- price controls, for example-

They will not be able to keep it going for very long, I suspect its main goal is to create a false sense of near hysteria over health insurance prices so they can start their "emergency measures" which are the REAL goal. The ACA is just a vehicle to that real goal. I suspect theiir real goal is INCREASING the cost of providing health care.

Short term, I can't see how they could do anything other than maintain the insurance and drug companies huge slice of a shrinking pie by screwing the sick and the doctors more and more.

Rainbow Girl's picture
Submitted by Rainbow Girl on

I guess he's not aware that only about 25% of Medicare-eligible people are able to afford the supplemental Medicare policies (for drugs, for covering the unlimited out of pockets and huge deductibles and copay, etc.) that make using Medicare "affordable." On the flip side, he seems unaware that huge numbers of Medicare-eligible Americans (especially the elderly) can't afford to use Medicare because it's too expensive and anyway so many doctors don't even accept it.

Does this doctor even know that you have to pay premiums for the privilege of being in Medicare Part B? And that once you pay those premiums you then face massive out of pocket costs unless you have lots of money to pay for supplemental policies?!

Yikes. Pretty high level of ignorance. Very Obotish (i.e., speaking out of his left fanny).

Rainbow Girl's picture
Submitted by Rainbow Girl on

So with ObamaCare exchange insurance (at least in California), you don't just pay good money every month for inferior care, you pay for non-existent care. (*) I guess we've already progressed from Skinny Networks to Phantom Networks.

I wish National Consumer Law Center would take Mrs. Ong as a client and sue the California Exchange and Mrs. Ong's insurer for a return of every penny of those $200/month that have been pretty much taken from her under false pretenses. There has to be a point where the representations of insurers -- e.g. "our list of providers" -- are actionable when they clearly result in collecting a lot of money for NOTHING in return. This is just plain consumer fraud and it's on the far end of the egregiousness meter.

(*) I'm of course of the view that if there's no doctors you don't have the care, because doctors are the deliverers of care. It would be interesting to hear from the WH or the California regulators when they come up with a talking-point that says, basically, "the unavailability of doctors is not a lack of medical care."

mellon's picture
Submitted by mellon on

Unless they get ahead of themselves in lowering the legal standard of care a little bit too quickly. That's why they are doing what they are doing with these groups, the way they are.

Eventually, we could see all modern medical treatments classified as "experimental" because they exceeded the mid to late 20th century standard of care as implemented in 21st century (shhhh!) America by the modern leeches, insurance companies.