Readers had a lot to say about Badger Cab's decision to ditch a contract with Logisticare, the Atlanta-based organization that took over the coordination of non-emergency rides for state Medicaid patients on July 1. One of those readers was Robert Harrison, Logisticare's chief of operations and the guy responsible for launching the move to privatization here in Wisconsin (previously counties had handled ride coordination themselves). Harrison claims things are going much better than Badger Cab would have you believe. In my story reporting the rift, an official with Badger Cab and several people with local health care providers talked about serious problems here in Madison on the first days of the switch, as local cab drivers were given incorrect names and addresses and patients were sometimes left stranded, unable to get timely and important medical care like dialysis. Badger Cab walked away from the contract after just one day on the job, fearing the chaos it says ensued would cause it to lose other customers. But Harrison says that Logisticare arranged 4,290 rides in Wisconsin on July 1 alone, and that 99 percent of those trips were handled "free of a complaint." That claim matches the company's oft-repeated assertion, both in interviews and on publicity materials, that its complaint rate is less than one percent in the 37 other states where Logisticare has similar contracts. Many trips on the first day, including some sent to Badger Cab, Harrison says, were for "same day" and "next day" rides, despite a requirement that routine trips be called in with at least two days notice. "That may have contributed to their decision," he writes. Harrison seems to be suggesting that a flood of such calls from Medicaid members who didn't give sufficient notice, rather than any fault with Logisticare operations, explains mix ups. He also makes a point to thank the 120 other transportation providers in the state he says are still working with Logisticare. "Most transportation providers, like other types of businesses, understand a start up and likely would have granted more than a 24 hour test period," he writes. Other reader comments veered from a complaint about the alleged tendency of Badger Cab drivers to honk their horns too often to a critique of the trend toward privatization. (Those of you who noted that the decision to hire Logisticare got going under the Doyle administration are correct.) "Sadly, this is what people vote for when they want smaller government and private businesses taking over," writes "Binary." When you finally put the wheels in motion the company that decides the fate of your least influential people who just need a timely ride to health care treatment are put up against the most powerful item -- the dollar." And from someone who claims to be a scheduler for two local health care clinics: "I only schedule a miniscule percentage of the appointments in this area ... yet in two days, I've already heard or dealt personally with three issues regarding these rides. Two resulted in missed appointments. It hurts the patients, the doctor, and those patients that could have been seen if the original patient had been notified they would need to cancel the appointment due to lack of transportation. But hey, we are saving someone money. I'm just curious who in the long run." The state health department has estimated that the contract with Logisticare will save Wisconsin $5 million over three years. Logisticare is earning $60 million from the three-year deal.
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