Klair Carroll
2/23/2013
Medicaid a good idea gone bad
Private health insurance in the United States has reached an all-time high in costs making it entirely impossible for poor families to afford private health insurance. Medicaid began in 1965 and became the main way for the poorest families in the United States of America to finally get medical care without paying the outrageous costs of medical care without insurance. Medicaid has changed many times since its birth in 1965 mainly by expanding its eligibility so that more people can be covered. In 2014 the affordable care act once again will expand the eligibility of Medicaid making even more people eligible for this health insurance. Though Medicaid has provided some part of medical coverage for the poorest families it is by far the most flawed health insurance plan in the United States and maybe even the worst in any developed country. Enrolling more of the poor into Medicaid won’t help them but actually hurt them because patients on Medicaid have little or no dental coverage, have an unbelievably difficult time finding a healthcare provider that will treat them, and the treatment the receive is well below the treatment people on private insurance receives.
Avik Roy is the founder of Roy Healthcare Research and a person who has extensive research in Medicaid wrote an article about a boy named Deamonte Driver who lived in Prince George’s County, Md. This boy lived with his single mother and was an African-American child on welfare who died at age twelve but not by a drive-by shooting or drug bust but by your average toothache. He went to the hospital because of a headache and the doctors found that his brain got infected due to a severe dental abscess, they conducted surgery and his condition improved but twelve days later Deamonte passed away. Avik continues to say that Deamonte Driver didn’t die because he was uninsured he died because he was on Medicaid. See Deamonte would have lived if he would have had routine dental care but at the time only 16 percent of dentists in Maryland accepted Medicaid. A study was done by the SC Rural Health Research Center about dental health in poor children and they found that dental caries affect poor children at twice the rate of their peers and are more likely to go untreated. They also found that 80 percent of caries are found in only 25 percent of children. Many people ask why.Why to poor children have so many more cavities? Why do so few dentists accept Medicaid? The answer is simple Medicaid pays so much less to the healthcare provider that private insurers. If we put more poor people on Medicaid sadly we’ll have many more complications similar toDeamonte’s.
Another reason Medicaid has become so bad is because so few health care providers accept it. This also is largely due to the surprisingly low reimbursement rate in comparison to private health insurance. The 2011 Nation Ambulatory Medical Care Survey showed that 31 percent of doctors were no longer accepting new patients on Medicaid. In comparison only 19 percent of new privately-insured patients were no longer being accepted. This could become an even bigger issue when more people become enrolled in 2014 due to the Affordable Care Act. More people will be enrolling and less doctors will accept them making the care for Medicaid patients very difficult to obtain or even impossible. This study found that the main cause of this is the low reimbursement rates. New Jersey had the lowest reimbursement to healthcare providers and 70 percent of those providers weren’t accepting new patients. One can just imagine the frustration of a Medicaid patient that has fallen ill and can’t find a doctor or have do drive over 50 miles just to see a doctor that would treat them.
Lastly because Medicaid pays so little to healthcare providers the quality of care that Medicaid patients receive is sub-par at best. Studies have shown that Medicaid patients are far less likely to survive serious health conditions than other Americans. The University of Virginia conducted a study of over one million patients and found that surgical patients on Medicaid were 97 percent more likely to die in the hospital that those with private insurance, and 13 percent more likely to die than those with no insurance at all. These results are scary, to think that the uninsured even get better medical treatment than those on Medicaid. The reason is because in many instances Medicaid doesn’t even cover the costs for providing treatment so healthcare professionals know they are losing money every time they treat a Medicaid and instead of going bankrupt and having to shut down they would rather focus their attention on patients that can keep their establishment afloat by paying what their healthcare is actually worth.
There is no arguing though that Medicaid has helped many poor families and some lives have been saved because of Medicaid. The way in which it is being handled just can’t be sustained and is detrimental to the health and well-being of all of the poor people who are enrolled in the program. We need to find a way to make healthcare more attainable to these already burdened less fortunate individuals by reimbursing healthcare providers at least what they are actually worth not reduce it further (something that is being proposed during the fiscal cliff talks). By increasing reimbursements to healthcare providers they will be much more willing to accept new Medicaid patients making it more possible for Medicaid patients to find treatment.Healthcare providers will also pay much more attention and provide better care to patients that are on Medicaid if they know that they will receive the compensation they deserve. Lastly if we reimburse healthcare providers more dental care will be much more available for Medicaid patients allowing them to get the preventative dental care they need to avoid major health complications in the future. It will be a very difficult task to do this because of the financial strain Medicaid already puts on the government but if we really care about the overall health of the less fortunate in our country we will find a way to improve Medicaid.