You have to apply for the social benefits here, like you would apply for a job. It is when the state government says no, you don't get to benefit from social welfare programs. In this case, TennCare, a health insurance system for the poor and disabled.
This government denies those applications at around a 50% rate, iirc. With that decision taking around 4 months to a year Then an appeal is launched, with that decision generally taking 2+ years. A judge rules on that appeal eventually.
A panel is convened with a couple of lawyers, the judge, a vocational expert (job fitness person), a health care professional, and yourself. Who you are and what you are capable of is summed up and deliberated upon. If you are deemed indigent, you are given an insurance policy with TennCare.
This is well explained but its missing a key ingredient.
You are dealing with government. Its not a business like Instagram or a grocer like Costco. If IG crashes consistently or if Costco has long lines at chekout, you take your business elsewhere.
With Medicaid you dont have an option, and the govt program, unlike IG or Costco, will never go out of business due to poor business services
> You are dealing with government. Its not a business like Instagram or a grocer like Costco. If IG crashes consistently or if Costco has long lines at chekout, you take your business elsewhere.
In a democracy, when the government fails, you can vote it out and get a new one... and you get as many votes as a person with 100x your spending power. In the free market, a business that effectively serves a specific market can thrive despite absolutely abysmal performance for the rest of the market. It's not unusual for a business to be better off if they can get rid of certain customers, because they're a net cost to the business. So they have every incentive to be as hostile as possible to those "customers".
> With Medicaid you dont have an option, and the govt program, unlike IG or Costco, will never go out of business due to poor business services
It's not like the poor and indigent have a lot of influence over IG & Costco either. ;-)
You'll notice that Medicaid and Medicare have different levels of service. There's a reason for that (not a very pleasant one). There are different levels of service between Medicaid to discount private health insurance (particularly pre-ACA private health insurance), and the comparison makes Medicaid look pretty good. Go compare this case to the cases against private health insurers, and then tell me that private health insurance works out better.
That's a fine point. If you can't vote for each individual position in the government, then really you don't have the same influence you have over a multinational conglomerate's insurance division.
If this is supposed to be some argument for how the free market actually provides accountability, I would love if you could cite the last health insurance company that died because of their poor business service.
And some people want everyone to have to use this system. Our private insurance system in the USA is far from perfect but it's a lot better than the government system. I have never once had an issue with my employer provided insurance covering any care that a doctor feels is necessary.
The application process parent is talking about is Medicaid, not Medicare.
Medicare is pretty ironclad, because the recipients are elderly and vote. Medicaid recipients tend to be marginalized and high need, so they’re used as a punching bag by local governments in states where that’s a good way to score political points.
This particular system wasn't nationwide, it was a system that the state of Tennesee paid 400 million dollars to Deloitte for. Conveniently, Tennesee is one of those states filled with people who think "Government bad" and gets tons of tax dollars from states like California and New York at the end of the day.
You don't have to move to Medicare if you do not want to - you can continue with all the private insurance your employer offers or you can afford, or you can 'self insure'.
Not everyone qualifies for government assistance. The software Deloitte built was supposed to automatically determine if someone was eligible. It is now being alleged that the software did not function correctly and was denying people because of bugs and issues with the software, not because the person was ineligible.
