I’ve been getting literature in the mail about new managed care plans available to people with disabilities on Minnesota’s Medical Assistance program. These voluntary plans tout their ability to offer care coordination, quick access to specialists, and all of the other basic Medicaid services. Enrollees would not have to pay the usual Medicaid co-pays for prescription drugs, which might make this option particularly attractive for people with low incomes.

The disability community has a longstanding suspicion of managed care that is rooted in the fear that managed care organizations will restrict choice and access to services, particularly personal care assistance. These plans sidestep those concerns by excluding personal care and private duty nursing services in the traditional fee-for-service (FFS) sphere. My wonkish instincts tell me that managed care is becoming the preferred model for administering public health care programs and home care services will eventually be included in future versions of these plans. But it’s going to be some time before the FFS model is even partially abandoned.

I don’t mind managing my own care, but I could see myself choosing one of these plans if my medical needs became more complex.

I need to renew the disability parking tag for my van. I understand the bureaucracy’s need to periodically verify eligibility for things like this, but it seems like I’m wasting a lot of people’s time and resources to prove that my disability still exists. I would be willing to subject myself to a week’s worth of humiliatingly invasive medical exams in exchange for some kind of documentation giving me Gimp-for-Life status. Said documentation would be electronically available to any person or entity wishing to confirm my gimpness, saving me substantial amounts of both time and postage. After all, it’s not exactly a secret. Maybe I could also get some kind of laser-engraved holographic identification card to carry around in my wallet. In glossy black, of course.

A few months ago, I wrote that AT&T was planning on offering a data-only plan for deaf iPhone users. The Text Accessibility Plan (TAP) is now available for $40 per month. The only hoop for potential customers is completing an eligibility application to verify one’s deafness, hearing impairment, or speech impairment.

On a completely unrelated note, the warmed brie on Kincaid’s menu in St. Paul is, like, the best appetizer ever. Its melty goodness is enough to make me weep just a little bit.

Once again, I need to recruit another nurse. This kind of reshuffling is to be expected after several years of stability and I’m fortunate that I don’t have to do it more often. I’m posting ads on places like Craigslist because placing a classified in the Strib is exorbitantly expensive. If anyone has other ideas on recruiting methods, let me hear them.

I got around to watching the recent Frontline episode that profiled health care systems in other wealthy democracies. In short, places like the U.K., Taiwan, and Germany make us look like a banana republic when it comes to providing access to health care. This doesn’t exactly come as a surprise, but the success of other national health care systems only highlights the tone-deafness of our own elected leaders on this issue. The narrator makes it clear that, once implemented, universal health care systems are tremendously popular with citizens. If Republicans could overcome their slavish devotion to free-market absolutism and pass meaningful health care reform, such a move would likely reap them huge political rewards. I suspect McCain understands this and could be persuaded to endorse a health care system that is a public/private hybrid, but that isn’t going to happen while the GOP is beholden to Grover Norquist and his acolytes.