Trish Emig

Stillwater

To the editor:

I write in response to Stanley Hupfeld’s recent News Press column in which he argues that changes should be made in our state Medicaid program, a program that consistently ranks nationally in the top 10, one of the few categories in which we actually are a “top 10 state,” as our governor is fond of saying.

What Hupfeld recommends is that we take away the administration of the Oklahoma Medicaid program from our own currently serving, dedicated state employees and give it to third party, out-of-state managed care companies, thus creating a whole new layer of bureaucracy requiring oversight and additional costs. The bigger problem is that their success depends on profit, often at the expense of service. In order to make money, these Medicaid managed care companies will manipulate costs by writing exclusionary contracts, reducing services and denying care. In the health insurance industry, denial is the rule, not the exception. New Jersey is a good example. Up to 30% of low income families were denied claims for hospital care by managed care administrators. And poor people simply don’t have the resources to contest these decisions.

As for services, Hupfeld thinks, strangely enough, that a managed care company would actually increase the range of services. As evidence, he cites the example of a mother’s breast milk which is “stored for babies whose natural mother cannot produce her own milk.” If Medicaid does not cover this service, then address the problem locally. Why not fine-tune the good system you have rather than roll the dice on an alternative that appears to be failing in many parts of the country? Take Iowa for example. The Des Moines Register describes their transition from Medicare to managed care as “a slow motion train wreck.” To minimize reimbursements, managed care providers constantly challenge medical claims, to the extent that hospitals, nursing homes and other caregivers have had to cut services, reduce staff, or even close.

In the final analysis, I think we want to stay on our own track rather than ride Iowa’s rails into obliteration. Long live Oklahoma Medicaid.

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