The first one would impact me  the most followed by the fourth.  There are still several clinics, not private offices that see mainly and majority medi-cal patients. The E.R.s should direct them to the Clinica Sierra Vista offices as well as Dr. Fox's offices. He has 2 offices and both see mostly medi-cal.  Budget Medical also takes alot of medi-cal.  You should not be able to go to the ER for a simple cough, runny nose, lice problems, sports physicals  or a pregnancy test.  People like that used to really drive me up a wall.

Private insurance rates WILL go up, they normally do when medicare and/or medi-cal rates are cut back. The insurance companies use those reimbursement rates as a guideline.  

Would increased private insurance rates go for all providers, or just the local ones? 

Why don't people take care of themselves and get a J-o-b so they can pay for the health care they all feel they are so entitled to. I have bills every month for medical care... and I have both medical insurance and a job. It is my responsibility to take care of myself, and my family. NO one else.

getalife - it's a bit more complicated than that, I fear.  What about the college student who is not only tackling a full course load at school but also works part time, yet cannot afford an insurance plan?  Would you rather they sacrifice their higher education all because as you claim, it's "their" responsibility to provide health coverage for themselves?  Or, would it be best to give them government funds for a short time until they're finished with their education and are now contributing even more to society than they would have had they not gone to school?

What about the single parents who have low-wage jobs without benefits?  Many of them are trying to do the right things but still find it extremely difficult to afford proper healthcare.

If we really want everyone to work for their health coverage, we need to completely change the current system, because right now it is extremely difficult for many hard working Americans to afford coverage. I just spoke with a Lead Security Guard at one of the oil fields recently.  He's an intelligent and capable man married to a woman who suffers from Diabetes.  Both of them work, yet they still cannot afford health insurance.  Now, I don't know all the facts, but I'm pretty sure that a top priority would be to get insured considering the costs they are incurring on a weekly or monthly basis just to purchase blood test kits!  In fact, he told me that his wife is forced to test her blood 50% less so that they can make the test kits last longer before having to purchase more.

There's absolutely no reason why any hard working American should not have equal access to healthcare.

I once was a college student with no health care, and I paid as I went, and I want to Urgent care when I was sick, not the ER.  I did everything I could before I would go, because I knew I didn't have the money. I would have qualified for services, but I have pride in being a self sustaining person.  I understand that Diabetes is a serous illness and is a financial  drain on ones resources, but there a plenty of other people out the who have medi -cal who should be out there working. The only reason my family has medical insurance is because I have a job and pay for it.  I shouldn't have to pay for my own medical and still pay for the dead beats to have it too

Your absolutely right, FloridaState, it is quite a bit more complicated than what most can imagine. I am one of those people that have medi-cal. I also, have medicare...but that doesn't mean I get equal care as someone who has private insurance. I wish I could pay for better insurance because I believe I wouldn't have the health issues I have today if I'd not been treated with "standard practice" policies.

That's part of what's become one of the biggest problems in America. People who are low income usually see doctors who are payed lower salaries. They tend to have routine standard practices for each and every patient, even if it doesn't apply to the patients medical complaint. They run test that are not nessasary, because they are sure to get payed for them, leaving potential illnesses to go undetected for undetermined amounts of time. Alot of test and proceedures need to be approved through what's called a TAR, and weather people want to believe it or not, medi-cal doctors will do everything else before having to get approval for something they know should probably be checked into. 

That's just a fraction of what's wrong. But hey, without all those low income medical patients to practice on, all you privately insured folks wouldn't have such good care. Look at it this way, getalife, you never have to worry about being one of us lab rats, now do you. Who else are the Interns gonna practice on??

Intrigued by your thoughts on unemployment and Medi-Cal enrollment, I looked into it some more.

Of all non-disabled adults 18- to 65-years-old enrolled in Medi-Cal:

• 44.7 percent work full time
• 7 percent work part time
• 11.3 percent are unemployed and looking for work
• 37 percent are unemployed and not looking for work

This is according to UCLA's 2005 California Health Interview Survey. (I've attached the Excel spreadsheet from CHIS to this post.)

Almost half of the enrollees are children, according to the California HealthCare Foundation (PDF).

Also from CHCF:

Contrary to common misperception, many Medi-Cal recipients are not on welfare. In addition to covering individuals who receive cash assistance from the government, Medi-Cal offers health care coverage to individuals and families who have incomes too high to qualify for welfare, but too low to cover health care costs. Medi-Cal requires some of these recipients to contribute to their health care by paying a share of the cost of the services they receive.

Good point FSG, it is a very complicated system with too many loop holes.

Emily brought up the share of cost medi-cal program. That is for people who have income too high to get medi-cal. Quite frankly, from the patients I've seen, that program is a joke.  The patient, for example may have a 500.0 share of cost, well that must be paid before medi-cal picks up any cost. Once that is met each month, medi-cal picks up the rest.  The share of cost changes each month depending on what the persons income is for that month. It's almost like you don't have insurance and not everyone even qualifies for this.  It is no different from being a person without insurance.  I can see this program beneficial if you are a sickly person who receives alot of care in a month but at that point you'd almost be disabled.

One more thing Emily shows us:  37% of non-disabled adults receiving medi-cal are not working and not looking to work.  Take away their medi-cal benefits. Put them in the welfare to work program.  Why should they receive health care when they are doing nothing?

I once was a college student with no health care, and I paid as I went, and I want to Urgent care when I was sick, not the ER.  I did everything I could before I would go, because I knew I didn't have the money. I would have qualified for services, but I have pride in being a self sustaining person.  I understand that Diabetes is a serous illness and is a financial  drain on ones resources, but there a plenty of other people out the who have medi -cal who should be out there working. The only reason my family has medical insurance is because I have a job and pay for it.  I shouldn't have to pay for my own medical and still pay for the dead beats to have it too

I agree that there are some people who take advantage of the system, but it is unfair to peg every recipient of medi-cal as deadbeat and lazy.

Here's a true story for you:

My wife and I were living in LA last year.  I was working a full time job with a decent salary for someone only a few years out of college, while my wife worked part-time and worked on her Master's degree full time.  We had just been married only a few months when she had a major medical crisis, but unfortunately I hadn't been able to get her insured yet because of all the "enrollment" rules that companies have set up with their benefit's packages.  We now have thousands of dollars in medical bills, which could have been even more astronomical had my wife not qualified for a version of Medi-Cal.  We're lucky to have such government programs that can be extremely beneficial in an event when hard-working Americans need some assistance.

Obviously we live in Bakersfield now, and with my new career I was able to obtain insurance for both of us.  My wife was only a short-term user of Government assistance.

In general, I like the idea of the government (or taxpayers if you want to look at it that way) offering some type of minimal coverage to all citizens (or at least children). My wife had to have her gall bladder removed and almost died during a period when we had no insurance. Luckilly, Med-Cal picked up the tab because there was no way we could afford it at the time. I've had some health insurance coverage that wasn't all that great but my insurance with the Army (Tricare) is the best.

Minimal coverage is available for children of families that do not qualify for medi-cal or they can't afford insurance through the employer.  It is called Healthy Families.  Depending on your family size and income, determines what you pay monthly, the costs can range from 6.00 to 12.00 a month.  The co-pays for Dr visits and prescriptions are 5.00.  Immunizations are free.

I'm familiar with that and I think it's a pretty good program. I just wish it was nationwide.

Yes, making that program nationwide, if not already, would help the un-insured kids.  Immunizations and well child physicals are free to any child under the age of 18 at the local Health Dept. 

FSD, you bring up a good question about the college student that's trying to put her/himself through school and working part time. If they can't afford to pay for insurance, then they sure can't afford the doctor bill.... they are just plain out of luck if they get sick. Hardly a doctor will see them without some way to pay.  These are the people who care enough about the future to get an education, yet there is nothing in place to help insure they stay well enough to achieve their goals. 

My daughter is one of those students who happens to have health issues. Her accomplishments have been much more of a challenge than other students, as she has not always been well enough to stay in school. But she keeps on going because she has a dream.

There should be government suppliments for everyone in America...across the board. Something that would help take care of the basics and then some kind of sliding scale for each as an individual. All for the sake of keeping our nation a healthy one.

Healthy families only covers kids, that I know of. That is, unless they were lying to us when we tried to sign up. 

It's a sad time we live in, when you can lose everything you have just because you get sick or injured. I get so tired of people refusing to even try a single payer healthcare system because they have this hairbrained idea that they are paying for so called deadbeats. We as a society are only as strong as the weakest link. At this point, we aren't all that strong.

twwann - it becomes even more of a problem when a college student is no longer a dependant of their parents.  Both my wife and I were lucky enough to have health insurance through our parents during our undergrad (even though the state of FL does offer a student health program through the Universities), however, when we moved to LA and she started her Grad program, my wife no longer qualified for her parent's insurance, and CA doesn't offer the same healthcare options for students.  Since we weren't married when I landed my job, I couldn't put her on my insurance until after the wedding, but because insurance companies have strict guidelines on the deadlines, we failed to get her insured.

ProgressivePete- You weren't lied to, they were correct, Healthy Families is for ages 18 and under.

They shouldn't call it healthy families then. It's great that they give kids affordable health care, but what happens when the parents get sick or injured? 

Speaking of healthy families, they've cancelled my kids twice (so far) because they said they never got the paperwork that my wife faxed them. She even confirmed that they got it, yet a few months later they claim to have not received it. It's way beyond infuriating to have to babysit their administrators and to have to speak with managers to get them to do their jobs. 

ProgressivePete-My children had healthy families before as well. I know what you mean about the paper work, mine was lost once after being faxed to them 2 times. I figured the fax was better than the mail and I was wrong. 

About  the name, you're right about that too. Should be called healthy children or healthy kids.

I doubt the mail would have been any better. At least with a fax you still have the originals.

Certified mail is an option.

Well, I can tell you what happens when the parent (I am a single parent) gets sick. I was never so dependent on the government for medical needs until 1991 when i was diagnosed with cancer. Prior to that I had a sucsessful dog grooming business and a nice home that was 4 years away from being free and clear. I had health insurance but nowhere near what i needed to take care of all our needs...food, house payments, utilities....and, in this state, one must have nothing before they can receive help. So, because of the nature of my illness, we (my daughter and I) lost everything.

Now the state pays me not to work...that's the way I see it....they won't pay for me to do anything towards a career and frankly at age 52 I really don't want to start over. Though my cancer has come and gone, everyday is a struggle just trying to make ends meet. This is hardly worth the mention, though, compared to what my daughter faces trying to make her way through life. There is absolutely zero help for her in the health care system we have. As a mother I feel terrible for not being able to help her with her medical needs...especially when it was my responsibility to help set her up in life. 

But that is what can happen when a parent gets sick. 

Just FYI on the college student front, many campuses are now requiring health insurance for their students. Those that do not have insurance are enrolled in a campus plan, with the premiums rolled into the tution and fees (and thus can be paid by financial aid if need be). Now, the campus plans may not be the best in the world, but they are better than nothing. If you or anyone in your family is considering going to college or grad school, this is something else to consider when choosing a campus.

The campus plans are not health insurance plans. This is what Bakersfield college states on it's web site. "The student health fee covers consultations with all heath center staff. The mandatory student health fee does not incude medical insurance coverage.  Referrals to community medical services at the student's expense are available for health services not provided on campus."

It's a health and wellness fee that covers things like diabetes screening, blood pressure monoriting, over the counter medications, pregnancy test and hearing/vision screening.

Twann-how old is your daughter?? (if you don't mind me asking)

When I was enrolled at CSUB I didn't have insurance and used the medical center there.  It cost me $50 per quarter and I DID see a doctor.  He gave me a prescription for the meds I'd been taking and I got them filled at the campus pharmacy for a fraction of the cost at a drug store.  When my grandson was enrolled there he used the clinic for sinus infections and the like and also got prescriptions filled.  In addition, they do have a lot of OTC meds and yes, they are cheaper.

Like Shwain said, it isn't full coverage insurance but it beats having no care at all.  I don't know what BC offers but I had to pay a medical fee there too.

In addition, when my daughter (a single mom) had to have emergency surgery and couldn't work for a long time, (no insurance) She used a clinic in her area that I believe was part of Sierra Vista for herself and her daughter.  Because she couldn't work, there was no charge to her.  I know it isn't ideal and people don't get to choose who they get to see, but it IS health care and took very good care of them.  She didn't own a home and had no resources so had little to lose so maybe that makes a difference.

Single payer or universal health care isn't going to pay your bills either, or make your house and car payment so I fail to see how it will be an improvement other than the health care itself.  You probably wouldn't get to see the doctor of your choice with that system either.

Clinica Sierra Vista uses a sliding fee scale fro medical and dental services. Some of there clinics are open late hours and Mon-Sat.  If an adult is very ill (diabetes, kidneys, back, etc) with no health insurance KMC has a MIA program but you must request this service while you are actually seeing the DR in the ER. 

Upon qualifying you are able to use the clinic services at KMC, for free or a small fee.  My mother HAD no health insurance and started having heart problems.  We faced a big problem knowing my dad would be responsible.  She went to KMC and was admitted for 4 days,  we did request the MIA.  However, my mom was denied because my dad owns a business and some other things.  When it was determined they didn't qualify, the lady settled with them the  total amount due.  I don't know the percentage they had to pay ( i do know what they paid though)but it was no where near the actual cost.

The only problem I see with clinics as Nancy said, you don't pick who you see but who cares.  Also the waiting game in those clinics.  Most of them are walk-ins, so it's first come first serve, but they WILL see you.

There are many clinics will see you if you have no insurance and the fees aren't that bad.  If you have no insurance and need birth control, the state has a program for that.  It will cover you annual women's exam and birth control for 1yr. 

Incorrect twwann. Not all campuses have full-fledged plans, but there are campuses which do. I went to graduate school at UC Davis and it had mandatory health insurance plans for both graduates and undergraduates issued by Blue Cross. The only difference between the campus plan and a regular Blue Cross PPO plan was that everything had to be rubber stamped by the campus health center (so it was somewhat like an HMO in that respect) before Blue Cross would cover it. It even had a stop-loss clause that if you paid more than a certain dollar amount out of pocket in a year, the insurance would cover 100% of all approved health costs for the remainder of the year.

Granted, the local colleges do not have mandatory health insurance plans, but, as I said, it is something to consider when choosing a college. I would hope that not all of our college-bound folks would be limiting their search to the region. And as Nancy pointed out, CSUB does have the on-campus medical clinic with actual doctors and a pharmacy.