Earsy Campbell is a mother of nine and a grandmother of 27. She has 13 great grandchildren, and many of her family members live close by in Oakland. She’s had several jobs in her life, including being a caregiver.
But now, at 77, she needs care herself. Earsy has high blood pressure and diabetes, which led to a stroke 12 years ago that left her paralyzed on her right side. She uses a wheelchair because of the stroke.
“My right arm is paralyzed. I can’t use it at all. I was a right-handed person, and I can’t do any writing now,” she says.
Earsy is one of more than a million Californians known as dual eligible beneficiaries, people who receive benefits through the federal Medicare program and state-run Medi-Cal program. And like other duals eligible beneficiaries, her health care needs are complex. She needs help with many activities of daily living, such as getting in and out of bed, bathing, dressing, and meal preparation.
Earsy has help at home from her daughter, who gives Earsy her breakfast and daily insulin shot – as well as assistance from a paid caregiver, whom Earsy has known for more than 30 years.
The two women form her support team and are paid by Medi-Cal’s In-Home Supportive Services (IHSS). Medicare pays for prescription drugs, doctor’s visits and any hospital stays.
Recently, Earsy enrolled in a managed care health plan through which she now receives both her Medicare and Medi-Cal services. That means, now she has just one medical benefit card and she no longer has to pay co-pays for her medications. Also, the managed care plan offers extra benefits of dental and vision services, which were cut recently from the Medi-Cal program due to state budget shortfalls.
Right now, Earsy’s primary medical needs are dental work and new glasses. “I can hardly see out of these,” she says. “The way I understand they’re giving you glasses every two or three years.”
The managed care program make money by cutting cost therefore very limited in giving any authorization. If you have any medical condition, instead of finding out the root cause to treat the problem to the root, they just barely stabilize your condition enough so you don’t complain for a while. That’s it. people who work for managed care company usually get bonus at end of year from the “cut cost” that they were trying to harm patients. Managed care NEVER benefit patients rather benefit the “managed care” company.