I would really like to thank you for continuing to provide vital information regarding our spiraling health care crisis.

I just filed my story and will provide a link as soon as it's posted.

For more information on these cuts, read the blog post "Is health reform dead?" and The Californian story "State budget crisis: Lean Times."

Here are some quotes that didn't make it into the story.

From San Joaquin Community Hospital CEO Robert Beehler:

"The number of unemployed is going up. The number of uninsured people is going. And they are reducing the amount of money they are willing to spend on the more unfortunate population. All these things add up."

"Realistically, I don't think the hospital will close its doors, but it's going to make it that much more difficult to cover payroll and the interest and depreciation on this new building (referencing the hospital's new tower)."

"We’re all becoming more fragile, but I'm sure education and everyone else has an equally passionate story."

From Kern Medical Center CEO Paul Hensler:

"This is not a nuisance suit."

"Every percent increase in unemployment results in a fairly significant increase in both people becoming uninsured and becoming costly to us."

"Any one of them isn’t going to cause us to close programs (referencing the cuts, other changes to Medi-Cal and the economy). The combination of all of them could put KMC and its programs in jeopardy."

From Mercy Hospitals President Russell Judd:

"The overall impact is catastrophic."

"In general they (the cuts) will affect each hospital differently in our community."

"Another devastating blow to Kern Medical Center will not help our community."

"A very large portion of our emergency room visits are for Medi-Cal patients because they have difficulty getting access to preventative health care. The safety net is the emergency department."

"We’ve got enough cash in the bank that will get us through this."

"My personal philosophy is you don’t solve problems with lawsuits. But in this case, I hope this gets the governor’s attention."

From Ken Keller, vice president of physician and business development for Bakersfield Memorial Hospital, via e-mail:

"I really can’t comment on the lawsuit but obviously don’t agree with the cuts due to the overall $500 million impact to hospitals it will have."

What are your thoughts on these cuts and this lawsuit?

The story, which is on page A4 of today's Californian, is taking a little long to post, so I copied it here. I'll put up a link when I can.

Suit targets planned Medi-Cal cuts
From staff and wire report
Some local hospital leaders are applauding a lawsuit designed to stop the governor’s cuts to Medi-Cal, with one hospital president calling the potential shortfall “catastrophic” to Kern County.

“The impact on this is much bigger than Mercy,” said Mercy Hospitals President Russell Judd. “It’s affecting all of the community.”

Bakersfield hospitals, along with a broad coalition of health care groups, hope a lawsuit filed against the state Monday will stop the 10 percent cuts to Medi-Cal and Denti-Cal reimbursements from taking effect July 1.

The lawsuit, which seeks class-action status, was filed in Los Angeles County Superior Court on behalf of California health care providers.

If the cuts go through, it will cost Kern Medical Center $5 million per year in care for Medi-Cal patients and the uninsured, said KMC CEO Paul Hensler.

The groups filing the complaint include the California Medical Association, the California Hospital Association, the California Dental Association, the California Association for Adult Day Services and the American College of Emergency Physicians.

Hensler is on the board of the California Association of Public Hospitals and Health Systems and was involved in that group’s decision to join the lawsuit, he said.

“I don’t think this specific thing puts it in jeopardy of closing,” Hensler said of KMC. But combined with the rising unemployment rate pushing more people toward Medi-Cal and being uninsured and other changes to Medi-Cal, “this could bring the county to the point where it decides it’s better to not have a county hospital.”

Medi-Cal provides health care services for 6.7 million poor, elderly and disabled residents. It is projected to cost $38 billion next year.

As part of Gov. Arnold Schwarzenegger’s plan to trim a $16 billion budget deficit, in February the state Legislature approved the cuts to the Medi-Cal reimbursement rates paid to doctors.

“The governor fully understands the devastating impact of these cuts which is why he continues to push for comprehensive health care reform and structural budget reform,” said Lisa Page, a spokeswoman for Schwarzenegger. “Together these will bring stability to Medi-Cal budgeting and ensure that the state never has to make such drastic cuts again.”

Even if these cuts go through, Californians will still be footing a bill, Judd said. More people will seek regular medical care in the emergency rooms, which costs more and lengthens wait times.

“Either we reduce our service to Medi-Cal patients or the public ends up paying more for their health insurance all across California,” said San Joaquin Community Hospital CEO Robert Beehler. “You never know at what point the whole system implodes.”

If the planned cuts take effect, it will cost San Joaquin $2.5 million a year, which is “a big, big number.”

“We have an obligation to try everything we can to stop these cuts,” Beehler said.

Judd didn’t know how much this might cost Mercy.

The cuts will mean Bakersfield Memorial Hospital will lose $1.2 to $1.4 million annually, said Ken Keller, Memorial’s vice president of physician and business development, via e-mail.

KMC is evaluating its organization and looking toward new payer contracts and the closure of the Emergency Psychiatric Center as ways to make up some of these funds, Hensler said. Supervisors approved a plan to move the psychiatric center from the KMC ER to the Mary K. Shell Clinic in April.

Hensler also stressed that if KMC closed, it would mean the area would lose its only trauma center and physician residency program.

“Without Medi-Cal funding, public hospitals cannot survive. These specific cuts strike at the core of the safety net,” said Erica Murray, vice president of the California Association of Public Hospitals and Health Systems. “These are the trauma centers, the burn units, the places where people go not only when they don’t have insurance or they have Medi-Cal, but if they have an automobile accident, their house burns down or another tragic event.”

Staff reporter Emily Hagedorn contributed to this report.

We are in terrible shape as a nation, and particularly as a state here in California, regarding health care. A few basic facts regarding Medi-Cal and what a 10% cut across the board means. California already is near the bottom in the country for  the amount spent per benificiary at $5,257. The US average for state Medicaid expenditures per beneficiary is $7,188, and New York spends double what California spends per person. 46% of all births in the state of California are funded through Medi-Cal. Medicare and Medi-Cal account for 75% of all nursing home revenues in this state.There are only 46 primary care physicians per 100,000 Medi-Cal beneficiaries here in California. The federal minimum standard calls for 60 to 80 physicians per 100,000. The rates are substantially lower for specialists. California has 6.6 million people on Medi-Cal currently along with over 6 million totally unisured. Drug costs have tripled in the past six years for the six most expensive drug classes from $758 million to $2.3 billion. Some rosy picture.

Adam, those are interesting stats. Where did you find them?

And just to clarify, California is not near the bottom, it is the bottom. California is 51st, out of the 50 states and the District of Columbia, for the total Medicaid payments per enrollee.

www.statehealthfacts.org/comparetable.jsp?ind=183 &cat=4&sub=47&yr=28&typ=4&sor t=218

Emily, I found them at the California Health Care Foundation website. The stats are from the latest published report they have on their site, which was authored in May 2007. Here is the url address and I've linked it for your convenience:

Thanks again for all your efforts to engage the public regarding health care, and for your fine articles.