Medicaid Deserves More Respect
If you're on Medicaid and your child needs a pediatric specialist, good luck finding one. You are up to five times less likely to get an appointment than someone with private insurance.
Medicaid Deserves More Respect
Robert Field
If you’re on Medicaid and your child needs a pediatric specialist, good luck finding one. You are up to five times less likely to get an appointment than someone with private insurance.
That is the finding of a study just published in the New England Journal of Medicine . (See last Thursday’s Inquirer for a full description.)
This is not news to most Medicaid recipients. It is well known that many physicians, particularly specialists, avoid taking public insurance.
The attitude of physicians is understandable. Medicaid reimbursement tends to be extremely low, and payments are often delayed for months. For many, the economics of taking Medicaid just don’t work.
State governments, which run Medicaid, can’t really be blamed, either. The program accounts for over 20% of state budgets on average, even though the federal government picks up at least 50% of the bill. It is single largest expense for many states, and its costs continue to rise relentlessly.
Faced with budget crises, several states want to restrict Medicaid coverage by limiting eligibility. Further cutbacks in reimbursement for providers are also possible, which could make it even more difficult for beneficiaries to find one.
Budget negotiators in Congress may propose new cuts to the federal share of Medicaid. Republicans want to re-engineer it completely. They would eliminate most national standards and turn it into a set of block grants to states, which could then make drastic changes to coverage.
All of this is bad news for health reform. Obamacare relies on Medicaid to cover 16 million more people starting in 2014. That is half the number who will gain new coverage under the law. A shrunken Medicaid program would have difficulty shouldering this new burden.
Medicaid seems like an easy target for budget cutters. It’s nice to provide free health insurance for the poor, but generosity often fades when economic times are tight.
But much more is at stake. Medicaid is also a lifeline for many inner city and rural hospitals. Without it, indigent patients would have no coverage at all. Even meager Medicaid payments are better than nothing.
In the long-run, Medicaid may actually save money. Without it, states would need another, and possibly more expensive, way to keep hospitals in poor areas afloat. They would also face a range of consequences from more sickness and disability in their populations.
Medicaid’s problems spell trouble for all of us, even if we are not beneficiaries trying to get a doctor’s appointment. We owe the program much more than many seem to realize. We should keep that in mind as our representatives consider whether and how to change it.
To check out more Check Up items go to www.philly.com/checkup
too much generational welfare....why try to work when you can get food stamps, welfare, free healthcare for you and your kids. then this attitude gets passed on to the children who do the same. what happened to trying to getting ahead in life instead of just trying to do the minimum to survive. i understand the need for safety net programs but they've all just grown way too big.— davidm1886- o and not to mention you can get free or subsidized housing. free lunches for your kids at school......etc etc. where does personal responsibility kick in under this system— davidm1886
- I have read only the two comments posted. Both of the commentators equaled Medicaid with welfare or other subsidized programs. I work for a company that manages Medicaid benefits to ensure the recipients receive quality care. You people are under a misconception that only people on welfare receive Medicaid. Medicaid is a safety net for those who are poor to help them get healthcare. Many of the people who receive Medicaid are the working poor, the disabled etc. Without Medicaid these people would be going to hospitals because they were very ill, causing hospitals to give out more charity care. At least if people receive Medicaid, they can receive preventative care, obtain eyeglasses, and see a dentist. Another thing is that not everyone who is in the Medicaid program receives the same level of benefit. Medicaid beneficiaries also have access to prescription medications. I will agree that there are people who abuse the system, who would rather get benefits then earn a living, but not everyone who receives Medicaid benefits are like that. You who knock the system, be lucky you have some type of health insurance. Hope that you are never in need of health benefits and there is no Medicaid. Medicaid is the payer of last resort. I can speak from experience that Medicaid managed properly saves money, and without it healthcare costs would be even higher.— RandiRN
- Abington Memorial Hospital
- Agency for Healthcare Research and Quality
- American Medical Association
- Aria Health
- Centers for Disease Control and Prevention
- Centers for Medicare & Medicaid Services
- Consumer Medication Safety site from ISMP
- Cooper University Hospital
- Crozer-Keystone Health System
- ECRI Institute
- Inquirer Health & Science
- Institute for Safe Medication Practices
- Jefferson Health System
- Kaiser Health News
- Kennedy Health System
- Lourdes Health System
- Medical Society of New Jersey
- Mercy Health System
- New Jersey Department of Health and Senior Services
- New Jersey Hospital Association
- NPR.org Shots
- NYTimes.com: Well
- Penn Medicine
- Pennsylvania Department of Health
- Pennsylvania Health Care Cost Containment Council
- Pennsylvania Medical Society
- Pennsylvania Patient Safety Authority
- St. Mary Medical Center
- Temple University Health System
- Tenet Healthcare
- The ACP Advocate Blog by Bob Doherty
- The Chester County Hospital
- The Hospital & Healthsystem Association of Pennsylvania
- U.S. Department of Health and Human Services
- U.S. Food and Drug Administration
- Virtua
- WSJ.com Health
