Tuesday, February 19, 2013

Medicaid Snafu: A Letter To Governor Scott Walker

Governor Walker,

I'm writing to voice my concern about the changes that have been happening in the healthcare system here  in Wisconsin over the past year, since your healthcare policies have been put in place. My brother has relied on Medicaid coverage for his healthcare needs. He is a cancer survivor, who 16 years later still struggles on a daily basis with his health due to the detrimental effects of the chemo and radiation treatments he needed to save his life.

His heart is totally dependent on a pacemaker and several medications to keep his heart beating and to prevent him from winding up in the hospital due to worsening cardiomyopathy, or to prevent him from dying prematurely. However, his Medicaid coverage was suddenly given to Physician's Plus  insurance last fall. This meant that he had to find a new cardiologist and pacemaker specialist at Meriter since he was no longer allowed to see the doctors who knew him very well at UW Health. After many hours trying to find new doctors for him, the coverage specialists finally concluded that Meriter could not provide the care he required and granted him a special dispensation to return to UW for his cardiac care.

At the same time, my brother requires oxygen at night and has significant breathing problems due to extensive scarring in his lungs. His pulmonologist at UW Health has been keeping him stable and prescribing his oxygen, but again this had to change. His Primary Care Provider who prescribes his other medications had to change also, again, as he was seen at a UW Health clinic. Meanwhile the private company contracted to process his Medicaid enrollment payment lost it. Thus, he was suddenly told that he had no healthcare coverage. This type of healthcare experience is unacceptable.

As a nursing professor and advanced practice nurse myself, I know the challenges of staying healthy on good days for people with chronic conditions such as my brother's. Why does this kind of incompetence, uncertainty and red tape need to compound these challenges? Most who are not fully invested in staying healthy like my brother is would give up.

I am also concerned about the cost to taxpayers and healthcare consumers that is being incurred by the time that the employees at companies and agencies such as Physician's Plus, Meriter, UW Health and DHS are spending trying to handle the claims and changes to implement these policies you have set in place. Privatization, refusing federal aid and trying to do things your way are not working. We need a better healthcare solution that will not jeopardize the health of our citizens.

Beth Fahlberg PhD, RN

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