“A Useless Piece of Plastic”

Before we get too far along in the week, I didn’t want to miss the opportunity to highlight an article by Robert Pear of the New York Times that appeared in the newspaper’s Monday edition.  Mr. Pear went to Louisiana to see firsthand the scope, or lack thereof, of healthcare services available to Medicaid patients.  If you’re concerned about the ability of our healthcare system to adequately serve at least 15 million new Medicaid beneficiaries as a result of health reform, this article won’t alleviate your worries.

The thrust of the Pear article is that states are making cuts in their Medicaid programs in order to balance their budget, and that these cuts are making it more difficult for patients to get the services they need, particularly if they need to see a specialist of some kind. 

This is not a new problem, though, but an exacerbation of an already-existing one.  There were already a significant number of physicians that do not see Medicaid patients because of the program’s comparatively small provider payments, lower than Medicare and substantially lower than private insurance plans.

For his story, Mr. Pear interviewed a woman in Opelousas, LA because of three herniated discs in her neck that require surgery.  She can’t, however, find a surgeon that will take her because she is a Medicaid patient.  Holding up her Medicaid card, she said, “It’s a useless piece of plastic.  I can’t find an orthopedic surgeon or a pain management doctor who will accept Medicaid.”

The new health reform law allows states to cut their Medicaid budget, but they can’t touch eligibility for the program.  That means cuts are going to come either through further reductions in provider payments or by limiting the scope of services beneficiaries can receive.

A critical goal of health reform is to make certain that all Americans have access to quality healthcare.  The Medicaid issue is one that remains to be addressed if this objective is to be met.