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- เผยแพร่เมื่อ 24 เม.ย. 2013
- "Most physicians can't afford to accept Medicaid" patients, says Dr. Alieta Eck, a primary-care physician based in Piscataway, New Jersey. "If you're getting paid about $17 per visit, it won't be long before you can't pay your staff or pay your rent."
Medicaid is the nation's health care system for the poor. It's funded jointly by the federal government and the states. Medicaid is either the first- or second-largest budget item in all 50 states and the program is slated for a massive expansion under President Obama's health-care reform law. Despite the program's huge and growing overall cost, reimbursements to medical providers are so low that many practices refuse to accept Medicaid patients, causing long waiting periods for treatment.
Eck and her husband, Dr. John Eck, are the founders of Zarephath Health Center, a free health care clinic in Somerset, New Jersey, where they each volunteers six hours per week taking care of poor patients. While the Ecks don't accept Medicaid in their private practice, some of the patients that show up at their free clinic are Medicaid recipients who can't find a regular doctor.
"The hardest thing for a Medicaid patient to do is get a doctor's appointment," says Avik Roy, who writes a health care blog at Forbes.com and is a senior fellow at the Manhattan Institute. One consequence is that Medicaid recipients show up at emergency rooms at nearly double the rate of the privately insured, often with accute problems that could have been addressed earlier in a doctor's office. They're also more likely than both the privately insured and the uninsured to have late-stage cancer at first diagnosis.
After they've been diagnosed, it's also difficult for Medicaid patients to find qualified surgeons who will treat them. A University of Virginia study found that Medicaid patients were about twice as likely as the privately insured to die in the hospital after surgery. Even the uninsured were more likely to make it out of the hospital alive than Medicaid patients.
Despite the program's failings, in 2014 Obamacare will add millions of new patients to the program's rolls. "All too often, people who claim to care for the poor say, 'I'm going to give you a card that says you have health insurance and my work is done,'" says Roy. "But the hard part is making sure that person gets treated."
Obamacare was designed to expand Medicaid by about 17 million enrollees by 2021, but it likely won't meet that goal because the Supreme Court ruled that states don't have to participate in this component of the law in order to keep current levels of funding. So far, the governors of 19 states have come out against expanding Medicaid in their states.
So what's the best way to provide quality health care to the poor without spending more money that we don't have? Roy says the federal government should take the same money it spends on Medicaid and block grant it to the states so they can experiment with health care plans in which the patient is in control.
"Let them spend it on the doctor of their choice," says Roy. "Let people take the money and get the bureaucrats out of the way, and you'll find there's suddenly a lot more efficiency in the way people actually get health care."
Eck believes charity care could be a big part of the solution, if only the government made it easier for doctors to volunteer their time. She has worked with state Sen. Robert Singer (R-N.J.), who has co-sponsored a bill in New Jersey that would allow the state to cover physicians for malpractice in their private practices as a way of compensating them for volunteering. The bill is currently awaiting consideration by the state senate's health care committee.
"Every doctor I talk to says, 'I would do that in a heartbeat,'" says Eck.
In the meantime, when Obamacare takes full effect next year, charitable clinics like Eck's will be more essential than ever to pick up the slack for a social safety net that's already not working.
"I've been doing this for nine years," says Eck, "and I can honestly say that I come away feeling good that I was able to make a difference."
About 5 minutes.
Produced, shot, edited, and narrated by Jim Epstein.
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"A Card that says you have health insurance is not health care." 1:27
"A card that says you have health insurance is not health care"
Here in Illinois my girlfriend recently got a job with health insurance and had to come off of Medicaid. She lost her fantastic primary care doctor because of it. The doctor accepted medicaid but wasn't in the private health insurance's small network. Medicaid isn't great but maybe we try Medicare for all, get rid of all the overhead staffing necessary to deal with all the private insurance companies that inflate prices. I know it would mean less payout for doctors but as a medical student myself I would gladly take the pay decrease if it meant 1) I never had to dedicate 10-30% of my time haggling with insurance companies, 2) everyone could have access to good care, 3) our patients could stop paying so much more for their care compared to citizens of other developed countries. I know most of my peers feel the same way.
"Symbolism over Substance" the Obama tagline
I honestly don’t want help from government but I’m sick with possible chrohns disease, deviated septum that affects my breathing through my nose, loss of hearing that I’m eligible for surgery , long face syndrome, , malabsorption syndrome. I work but ask my job if I could work 3 days to get back on medicaid so I can have all these things fixed the medical billing would be impossible to pay
I TO AM ON MEDICAID. LOOKING FOR SOMEONE WHO WILL DO SURGERY ON 5 BULGING DISCS. PAIN, NUMBNESS WIDESPREAD THROUGH BODY. BED RIDDEN 23 HRS A DAY. THE POOR ALWAYS GET THE SHORT END OF THE STICK. SUCKS TO HAVE HEALTH INSURANCE THAT REALLY DOES NOTHING FOR THE SYSTEM. EASY WAY OUT BARRACK OBAMA...
The reason they earn so much is because the AMA limited the supply of doctors through licensing. Putting a cap on salaries will just make the problem worse.
Volunteering is one thing, involuntary servitude is another!
Yes Ma'am Doctor you care !Thank you 💋
I was told by a fellow primary care provider years ago, a doctor should be able to see a patient in 8 minutes if the doctor has the staff to complete the orders are directed by the nurse & other staff members. In this case that comes to $127.50 dollars/hour minus your costs. Time for insurance sounds like a fair exchange to me.
$17? like most physicians mine bills at a rate that allows for them receive payment and remain a viable business. When I first met my physician he allowed people to pay in cash the amount he receives from medicaid if you have zero insurance. My physician charges about $150 per visit (it has changed since I first started coming), and medicaid sends him almost $60. Now, I have seen the amount medicaid pays for other services like a endoscopy charging over $600 and getting about 20% of that reimbursed and this is why procedures and hospital visits are so ridiculously high. I know it may be different for some insurance/medicare but wtf this has to do with obamacare? medicaid is medicaid it hasn't changed a bit since obamacare started because I have been on it before then. What I find funny is the similarity between this and social security. Everyone was against it, but then it caught on. Now the sad part is everyone hates it again, but for a different reason...congress looted the crap out of social security funds. That doesn't make it a bad program only congress members who should have been slapped with term limits decades ago. I once was a child and wondered why anyone would want to be a politician. Well, that is a no brainer when you find out how much these guys make on the side and even when they retire are paid back from lobbyists with well paid jobs in the industries they aided. might as well be fudging communism.
Here's an idea. What if the government treated health insurance for poor just like food stamps. You apply, they give you a specialized bank card just to spend just on health insurance, treatments, and prescriptions.
It won't be a lot so you still have to be frugal so prices won't inflate faster plus you can afford basic insurance to cover emergency room visits which is by far the largest cost problem.
That was very well put. Thank you for existing.
Good, Good video.
Thank you Reason
once years ago i lived in a middle class town and i went to a dentist in the neighborhood and i said do u except medicaid and he said no but ill make an exception for u if he did not except it i could have found another dentist very easily that does but since he was close by i went to him medicaid is fantastic i love my medicaid also in my program if u r on ssi with medicad u are entitled to a free fridgerator other people with mentall illness who worked in the past and get ssd are not entitled to free refridgerators
Here in Louisiana I applied for Medicaid about 10 years ago and I was told I had to be disabled for at least a year to qualify so I got denied. However, I had a family member who has never worked and she had to go to the hospital and she got Medicaid on the spot. I have a feeling what she is getting is emergency, temporary Medicaid that will eventually end. She has a husband also that doesn't work, but I don't think he is disabled, but pretends to be.
Medicaid doesn't cover adequate dental & vision treatment.....& that is why you see toothless seniors on Medicaid/Medicare.
Either you are in or you are out. If you are in, you are going to contribute like everybody else. If you want everything to yourself than no more schools, no roads, no police or fire protection, and no healthcare. Go live as a hermit so next time one of your friends gets terribly ill and loses their job that you don't have to look at them. Its your money so live all by yourself!
So what you’re saying is that we should increase our spending on individual medicaid visits and we will be ok
Multitude of companies competing, and not forcing anyone, but dependent on the rules of free markets. is what I am talking about. The fact that employees have to follow rules, doesnt mean there is no individualism, as the very same individual has the power to leave any company, nothing is forced.