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Marples: Why is Longview abandoned by Medicaid specialists?

Over the past few years I have became very familiar with a Longview resident who’s struggling with health insurance hurdles.

Sadly, it’s me.

Our city has two hospitals. One thing stands out: If you have a “Cadillac plan” of good medical insurance, specialists are available. If you don’t have top-of-the-line health insurance or, through no fault of your own are a Medicaid patient, those local specialists often won’t accept your “referral.”

I had a recent hospital stay and talked with a hospital administrative worker. She was candid and lambasted Texas law for being “so pitiful” and “so full of loopholes which the average citizen doesn’t know about until they may hit the pitfalls themselves.” She said that many local doctors, especially doctors of foreign nationality. confuse “Medicare” with “Medicaid.”

My foreign-born doctor knew I had a monthly disability check from Social Security, but made a bad assumption about my accompanying health insurance. The hospital worker said she felt it her duty to counsel patients before they made an awful mistake — not just physically, but financially. She advised the doctor, after which it seemed I was no longer a bar-code number on a hospital wristband but a human being again in his eyes.

I can understand why many Longview, Tyler, and even Dallas specialists refuse to take on Medicaid patients: It’s low financial reimbursement.

There are so many acronyms — HMO, PPO and the like. If a physician’s billing department sees the wrong mix of what I call alphabet soup, you’re rejected before they even see your face.

I’m not referring to affordable health care. I’m talking about access by specialists who would come occasionally to Longview. Medicaid recipients are not allowed to get care across state lines.

Longview has good neurologists (albeit few in a city of 81,000 people) who treat patients once a firm diagnosis is made. The rub is that difficult cases are usually initially diagnosed in Houston or Dallas.

As long as specialists and surgeons can pick and choose who has the fattest billfold (in terms of insurance) we will all pay one way or another. Merely rejecting a referral can be easy camouflage for financial discrimination.

Taxpayers shouldn’t scoff, because somebody has to pay the tab ultimately. I am an independent voter with conservative leanings. I had cancer at age 20 and couldn’t even buy health insurance for years. I once had money and had a farm, yet incidents occurred. I was scrupulously prudent. I was never on Medicaid 17 months ago. I was a good steward of my then-savings for decades. Even I was leery of Medicaid, but I’d like any patient healed and returned to a productive life.

Rest assured, I am not condoning supporting able-bodied freeloaders who can dance, spin, sport expensive things and milk the system. I deplore that. However, I fear legitimate people are being under-served in Longview.

I realize not all insurance companies can be embraced by all doctors. This is different than so-called socialized medicine. I’m trying to end what I call handcuffed Medicine by picayunish Providers. That part can be amended with honorable negotiation.

Many other people are in the same dilemma. Somebody needs to speak up that specialists across Texas (and Longview) should not decline referrals as an easy way to discriminate to wealthy and away from poor patients.

I am fair-minded. I know surgeons or specialists have a right to earn a living. By the same token, patients have a right to get healed, if possible. Longview shouldn’t be so isolated in a few medical fields.

I commend specialists who come to Longview Cancer Clinic. I just wish that would be the case in other specialties such as neurology, reaching people who can’t get to Dallas, Houston, etc.

I’d love to be healthier and productive again. I’d gladly let any big city expert neurologist see my records and I’d be thrilled to get treatment in Longview by them.

— James A. Marples, a Longview resident, is a regular contributor to the Saturday Forum.

Today's Bible verse

“Keep your lives free from the love of money and be content with what you have, because God has said, ‘Never will I leave you; never will I forsake you.’ ”

Hebrews 13:5

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