Last week, I wrote about the malformation of health care financing that allows a federal judge to roll back Medi-Cal (Medicaid) fee reductions, which the governor and legislature had agreed to in order to buy some breathing room while they negotiate a budget to cover California's out-of-control deficit.

I don't blame the judge: She didn't write the law that created an vicious circle of federal and state governments picking our pockets to fund Medicaid programs whose costs are spiralling upwards.

Doctors and pharmacists are leading the legal charge against the state.  According to today's San Francisco Chronicle, they're now upset that the state's appeal has caused the judge to give the state more leeway.  Instead of owing "backpay" from July 1 (when the fee cutbacks took effect), the judge has moved the date forward to August 18 (when she made her initial decision).  This will save the state about $65 million.  Because of the (lack of) federal match, the cost to providers will be about $130 million in lost fees.

Needless to say, organized medicine and pharmacy are dissatisfied, and intend to overturn this latest ruling.  Unfortunately, they refuse to accept that Medi-Cal itself is the problem, not today's lack of money.  According to the California Medical Association: "It's a blow to providers' ability to take care of the Medi-Cal population.....and a blow to the effort to ensure that poor Californians have access to health care".

Well, that's a stigma! If you're dependent on the state for health care, you're part of the "Medi-Cal population", not a normal patient like everyone else.  The answer, of course, is to shrink the "Medi-Cal population" by taking health care dollars away from the state and giving it back to the patients who need it.

And you'd think that doctors and pharmacists would prefer to earn their incomes from patients, rather than having to go to federal judges to overcome the vicissitudes of political budgeting.