The state of Arizona’s medical problems.


Well, our senate, in its infinite wisdom, did not pass the hospital levy bill.  This is a bill that was basically a tax on hospitals, clinics, and doctors that would give 3% of their take back to the state.  It was a voluntary tax — and would end up being reimbursed as the parties would end up getting it back in the form of medical reimbursement from AHCCCS and Medicare.  Think of it as a circle — these entities pay in advance to start, but get paid back as they continue to pay the 3% for future reimbursement.

250,000 people will lose their AHCCCS benefits in July.  These people aren’t going to simply quit getting sick, and they’re not going to quit coming to the hospital.  Now the hospitals are just going to quit getting reimbursed for services rendered.

Rumor has it some hospitals are already actively laying staff off — respiratory therapists, techs, and nurses in anticipation of these cuts.  Others are simply not hiring for empty positions as people leave; every hospital I know of is running on short staffing.  Not that this is new; it is merely much worse than it used to be.  One hospital I have heard of is giving ICU nurses 3 and 4 patients; telemetry nurses are getting 6 at another.  These are NOT safe nurse to patient ratios.  And I can guarantee, when (not if) the shit hits the fan and a patient has a negative outcome, the facility will blame the nurse rather than take the responsibility for overloading them.   Whichever facility that might be.

I have even heard that patients who are admitted to one hospital are ending up spending their stay in the ER because the hospitalists (the doctors who take care of you while you’re admitted) refuse to accept care if the patients don’t have insurance.  This, friends, is what will end up happening on a grand scale state wide.  I can anticipate that within a few years, some rural hospitals may even close entirely.

All this, while the Centers for Medicare and Medicaid are reducing reimbursement to facilities nationwide based on patient satisfaction surveys.  Which by the way have nothing to do with the physical quality of care, nor the appropriateness of care rendered, but with the patient’s perception of how well their desires were catered to by the staff.

This is the beginning of an absolute nightmare for access to health care in general, and illness care in particular, in this state.

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