Most of President Obama’s proposed economic stimulus package has been reserved for Medicaid enhancements. The federal government is promising to absorb a larger portion of the cost of welfare, reducing burdens of public health to the states, freeing local governments of fees associated with soaring healthcare rates.
It appears that the Obama administration has already lost faith in a full recovery and has decided to pull the plug on the concepts of free markets and private insurance. With nearly ten percent of America now unemployed, it is only a matter of time before the working poor find their way onto Medicaid rolls. We received our first shot of morphine yesterday. At least we will feel no pain as our nation crumbles.
Having worked in the health care billing industry for over a decade, I have obtained inside knowledge of how the Medicaid system bleeds our economy dry. If wasteful healthcare spending is not curbed as part of congress’s new stimulus package, America will be swindled by non-profit corporate healthcare giants that make Bernard Madoff seem honest.
At the Jewish Board of Family and Children’s Services (JBFCS), it was my responsibility to bill private insurances and Medicaid for mental health services. Adolescents who remained in treatment for more than one month at the clinic where I worked (The Youth Counseling League) were most often children with Medicaid coverage. Children insured privately could not afford the ongoing costs associated with decades- long psychotherapy.
Although the Youth Counseling League had a $12 million endowment and received grant funding through generous funders like the Douglas Kroll Family, co-pays for the privately insured were never waived. It was my job to hound the parents of mentally ill children for outstanding balances. I must admit, when I worked there, I wanted to slit my own wrists and I secretly wished that all the children who came to the Jewish Board clinic were Medicaid insured. My job would have been so much easier! Medicaid rarely disputed claims, unlike private insurance companies that rejected almost every claim submitted due to minor errors made on claims.
Children with parents who had private insurance never lasted more than a month or two in treatment at the Youth Counseling League. Either they were miraculously cured of their demons in just one or two sessions, or they could not afford it.
Privately insured children were required to pay a co-pay for their weekly therapy sessions. Most often, co-payments exceeded $30. Most plans had annual deductibles of more than $1,000. Kids received one-on-one counseling once each week and were often referred for group therapy which required payment of the co-pay as well. Some saw the quack– John Udarbe for medication. Those already suffering from depression, eating disorders or schizophrenia were tossed into a hopeless ponzi scheme of healthcare billing, where treatment became too costly for those without state subsidized health care plans.
Most working class families in New York were not able to afford their co-pays. Medicaid children were offered transportation money when they came to each session.
Although the Jewish Board could easily have offered its Medicaid clientele Metro Cards for use on the subway, a decision was made by Assistant Executive Director, Susan Bear, to give the kids cash– thus ensuring that the poor kids who often walked to the clinic, would return day after day to collect a never ending supply of what the kids viewed as their governmental allowance. It was my suspicion that most of the kids used this cash to buy crack.
The Jewish Board received $230 per session from Medicaid for each psychotherapy session held. Private insurances like Aetna paid just $60 per session.
I’m sure that the Jewish Board is not the only non-profit, charitable health organization boasting from the news of increased Medicaid rates. There is big money to be made in public welfare. The Obama administration and state Medicaid programs must establish guidelines for what is necessary medical treatment during these hard economic times.
Let us hope that agencies like the Jewish Board do their part in stimulating the economy. The president of the Jewish Board, Paul Levine makes $270,000 annually. Corporate Compliance Officer, Kathleen McGlade earns just under that. Certified social workers who work at the Youth Counseling League earn just over $40,000.
At least Bernard Madoff wasn’t crazy. He was just a thief of the system, like so many others.