what we learn about TX healthcare beyond how FDA putting lead in M&Ms in the TX Sen HHS interim hearing?
- new minted HHSC Commissioner Charles Smith still has that new car smell! he still has that, “seriously, who doesn’t mix up MedicAID and MediCARE all the gosh darned time?! both sides duet, y’all!” about him. it won’t last long, so let’s let him get his gollies where he can.
Healthcare Management AssociatesHMA (some things just need to stay abbreviated because they’re a think tank) has estimated that Texas would only net $358 million for accepting Medicaid expansion which is about 4% of the Medicaid budget. (ignore for a moment that the HMA analysis is totally HORSE APPLES!) IRL doctor person and CommitteeeChair Schwertner thinks this is a bad deal and WILL NOT SETTLE! this is hilarious because a) the net gain he’s referring to is only from hospital care and not all the other services covered by Medicaid and b) because we are an oil state and are facing a shortfall (though we are still doing better than Yokelhoma and Sad Dorkota), to cope with said budget shortfall we are asking all agencies which receive General Revenue funding to VERY KINDLY find 4% in cost reductions, Medicaid gets beaucoup GR, and so that 4% reduction is looking like a very nice thing right about now. bonus: it would continue in years when the Saudis aren’t screwing with the price of oil.
- Sen. “No Relation” Perry had a smart and that’s not a common occurrence for him so give him a hand! oh, you want to know how? he noticed that TX banks overtime for CPS caseworkers and those caseworkers do not receive any of that overtime pay until 2 weeks after they say, “FUCK YOU! I QUIT!” he feels that this incentivizes people to do exactly that. you’d think we would have learned our lesson when this strategy did not work out well in 2011, but of course not. Sen. Perry closed with a pointed, “Common sense has left the building!” all the hands and laughs for him because otherwise he’s usually pretty worthless to me. but today he did a good.
- newly-ish DFPS Commissioner Hank Whitman (who does not have a new car smell because he used to run the TX Rangers and so he kinda smells like old leather) has a public service announcement: Big Boys DO SO CRY! and he is a Big Boy who cries! sometimes with CPS caseworkers who are sad about life and how shitty CPS is. he also thinks the lege should quit pretending like he’s cleaning up Judge Specia’s mess because Judge Specia is a great guy (he is) and they never gave him enough funding.
- in most states, if an MCO recovers wrongly disbursed Medicaid funds, they get to keep it. in most states, if the Office of the Inspector General recovers wrongly disbursed Medicaid funds, then, because the MCO has to cooperate, the two groups split it equally. in TX, if the OIG recovers wrongly disbursed Medicaid funds, all of the funds go back to the MCO. chew on that for a minute, taxpayers.
- Sen. Van Taylor used his “FU” powers for good. it turns out that part of the problem with getting kids who enter the CPS system their physical and mental healthcare screenings within 30 days is because the MCO (Superior) is required to make sure that they are getting an appointment on time (which 90% are), but they aren’t required to do any followup as to whether they actually make it to the appointment (only 62% are). he was all, “your job is to make sure kids DON’T DIE. not that they got an appointment and its someone else’s job to make sure they don’t die.” to which Sen. Uresti added a fine, “CPS IS EVERYONE’S PROBLEM!” because it really is.
- Commissioner Smith said the Healthy Texas Women Program could help you find a doctor OR provider. kinda putting up front that not all providers have medical staff. that was a glorious Freudian slip that one!
- Lesley French talked about how nice-like the Heatlhy Texas Women Program (preceded by the Texas Women’s Health Program which was preceded by the Women’s Health Program) is!–though it still doesn’t know WTF is going on with the maternal mortality rate–just that it spiked in 2011 and has been trending down since then *fingers crossed*. but Ms. French says we are now covering as many ladies as it was back in the dark days of 2010 before the massive budget cuts in 2011. then Sen. Rodriguez had to spoil Ms. French’s party with facts and was all, “FUNNY THAT YOU MENTION IT BECAUSE: you are covering 57 thousand women now, but I have numbers from 2010 (212 thousand) and 2012 (86 thousand) and 2014 (63 thousand)! maybe you should think in terms of women served instead of providers–we’ve. been. over. this.–a place that can take on 5 HTWP patients is NOT the same thing as PP and neither is a dentist’s office. when you get your annual pelvic from a pediatrician, I’ll believe it’s a valid option. by the way, if you don’t mind, could you please explain why there have been a total of 0 HIV screenings in Harris Co. since you kicked PP Gulf Coast out of the HIV screening, prevention and treatment program, that would be also to very good.” I love it when Sen. Rodriguez goes all prosecutor mode.
- and then we got to the Heidi Group which is a CPC. CPCs are those organizations with membership in the “guilt women ’bout the ‘bortions” club. the Heidi Group received got the 2nd largest grant from the HTWP which strikes a lot of people as odd seeing as it has 0 medical staff. apparently they were already approved as a Medicaid provider despite having 0 medical staff because they, wait for it: CONTRACT. (which is a dirty word around the Pink Dome parts because we outsource somewhere in the neighborhood of 40% of state services which are not fit for public viewing so they tell them to PUT SOME CLOTHES ON, but not a burka.) and, no, we are not allowed to review those subcontracts to make sure they are with real doctor people like Sen. Schwertner (who can’t decide whether he hates ‘bortions or rising Medicaid costs more). did I forget to mention that 53% of Lone Star births are paid for by Medicaid? well, FIFTY THREE PERCENT OF BIRTHS IN TX ARE PAID FOR BY MEDICAID! and why can’t we see them? PROPRIETARY INFORMATION. which is why contracts are so fucking dirty to begin with. so the lovely people who learned their medicine from the Holey Babel and [PROPRIETARY INFORMATION] Institutes of Health get their $1.65 million whether we like it or not.
- and then it was time for public testimony. I will spare us all from that, except for the last guy who I cited in the headline. you’ve been good. you deserve this cookie:
after 10 hours, the hearing ended strong with a tinfoil hat on. the witness alleged that FDC was probably lead and that the FDA was trying to poison us with it by putting it in the perfect Trojan Horse: M&Ms. the witness alleged the FDA, FBI, CIA, NSA and other acronyms were also killing us with the magic words: “fluoride” and “chem trails”. and before we could all turn into pumpkins, Chair Schwertner cut him off with, “you know who you should really talk to about all this? you should talk to TCEQ. I will give you their phone number!” which is probably the best dismissal of a crazy person I’ve seen in a while at the legislative level. especially since TCEQ isn’t doing its job anyway, so they might as well get inundated with the GUANOS!
now it the point in the post where I tell you: