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This is a terrible prospect if you have a loved one in long-term care who is on Medi-cal. You may have to place them far away. What a difference having your loved one near your home and work or somewhere far away.

Let;s agree on the fact that medical care, when taken as a whole, is far too expensive. However, the idea that you could just squeeze the cost out of the system from the top down never made any sense and that's why - not talk about death panels, etc. - the idea that you could do all this for nothing never made any sense. I am just tired of being lied to be 'our' national leadership.

The cost of medical care, like the cost of most things, is built up piecemeal. It consists of hundreds, perhaps thousands, of individual pieces many of which are not under the control of the entity that does the final delivery and billing. No one wants to do the leg work and analysis it takes to run down and fix all the cost drivers that have built up over decades.

Instead, too many people are just sitting in Washington, D.C. and Sacramento saying we'll just cut the reimbursement rate until little counties like yours can't afford it - good luck. We are not Los Angeles or San Francisco County, sparsely populated counties with limited incomes have special problems.

Marty Richman

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