Many states are cutting Medicaid due to the economic pressures this country is going through. Is this a good thing? It's tough to say. I have worked in a Federal Qualified Health Center for over 10 years. I recently switched hospitals but I can't say that I have seen less Medicaid patients. Without making any stereotypical comments, I don't think I am out of bounds by calling them a complicated collection of souls. Probably due to their socioeconomic status, they tend to have many medical problems which can suck up a lot of our time in the office. The low reimbursement from the government is legend and many physicians can no longer afford to see Medicaid patients. This brings us to the newest problem involving their care. According to a new article in the Washington Post, some states are lowering payments to hospitals and nursing homes, eliminating coverage for some treatments, and forcing some recipients out of the insurance program completely. The bottom line is that any optional services that states had added, to what the federal government mandated had to be covered, is now being targeted for removal.
This is just more proof that some new health care system needs to get put in play very soon. Medicaid is not a very palatable plan for hospitals and doctors as it is. Taking a broad brush and cutting huge swaths of coverage may leave a lot of people in trouble. That does not mean that states couldn't do a better job investigating who should and should not be on Medicaid in the first place. I cannot tell you how many patients who are in their 20's that I have seen on Mainecare (our version of Medicaid) for ridiculous reasons: dyslexia, asthma (though they take no meds and smoke), mild depression, etc. I am not saying that these people don't need care but they also need to work and contribute more to society and themselves. We physicians are not immune to some of the injustices that plague our medical system. It tugs at my heart to see a working poor patient who has to pay cash for his ER visit for a chainsaw accident while a 27 year-old bounces in and out of the same place for supposed lower back pain (even though he sits at home playing XBOX 360 all day).
This economy is going to force a lot of cuts by the state governments everywhere. Many of these cuts are long overdue. Some, however, will hurt our patients undeservedly. We are only seeing the tip of the iceberg. I hope our medical organizations get a whiff of this in order to advocate for our patients or a lot of good people are going to be in a world of hurt. Literally.