The Straight Dope

Go Back   Straight Dope Message Board > Main > Great Debates

Reply
 
Thread Tools Display Modes
  #1  
Old 12-14-2005, 02:55 PM
BrainGlutton BrainGlutton is offline
Member
 
Join Date: Mar 2003
Location: Tampa, Florida
Posts: 68,910
Do U.S. doctors give Medicaid patients the same care as commercially-insured ones?

Perhaps this belongs in GQ, but it's bound to turn into a debate at some point, and there might not be any clear factual answer anyway.

A friend of mine is on Medicaid and has a raft of medical problems, possibly even including cancer, some of them possibly treatable through surgery. He's been going from doctor to doctor for a couple of years now, sometimes getting diagnoses from the GP's that are not confirmed by the specialists to which he is referred. He is absolutely convinced he is getting screwed because he is a Medicaid patient and the doctors, if they give him the full treatment indicated, will not make as much money off it as they would from a commercially-insured patient. In particular, he says, Medicaid won't pay for surgery unless it is to treat an immediately life-threatening condition. Is there any truth to this? (I mean, of course, as a general rule, not in his particular case.)
Reply With Quote
Advertisements  
  #2  
Old 12-14-2005, 03:35 PM
Indyellen Indyellen is offline
Guest
 
Join Date: Dec 2004
Quote:
Originally Posted by BrainGlutton
A friend of mine is on Medicaid and has a raft of medical problems, possibly even including cancer, some of them possibly treatable through surgery. He's been going from doctor to doctor for a couple of years now, sometimes getting diagnoses from the GP's that are not confirmed by the specialists to which he is referred. He is absolutely convinced he is getting screwed because he is a Medicaid patient and the doctors, if they give him the full treatment indicated, will not make as much money off it as they would from a commercially-insured patient. In particular, he says, Medicaid won't pay for surgery unless it is to treat an immediately life-threatening condition. Is there any truth to this? (I mean, of course, as a general rule, not in his particular case.)
Well, I can't speak for anyone other than the practice I work for, but I'm the Medicaid billing specialist as well as handling most of the commercial insurances for the practice I work for. We're specialists and we deal with cancer among other things.

Unless there is a problem with the patient being in a managed care Medicaid that we are not network providers for, we treat our Medicaid patients exactly the same as any other patient.

I'm sure there are doctors out there who don't, and Og knows we don't make enough on our Medicaid patients usually to even cover the minimum costs of what we do, but that's not something you'll find here.

In my networking with other practices, I have yet to meet anyone who admits to treating Medicaid patients differently, either. But I'm sure it exists. Frankly, IMO, if it does, then those doctors should be reported to the State Board or the Medicaid office.
Reply With Quote
  #3  
Old 12-14-2005, 04:41 PM
DSeid DSeid is online now
Guest
 
Join Date: Sep 2001
Pediatrician here. Nearly the same. Some different paperwork required. Vaccines are through a state supplier and may be a slightly different schedule. Some problems getting to specialists- some don't do Public Aid.
Reply With Quote
  #4  
Old 12-14-2005, 04:47 PM
Alice The Goon Alice The Goon is offline
Guest
 
Join Date: Jul 2003
IME, Medicaid or, in this state, AHCCCS, patients, are not treated differently by doctors. Any medication that is not on the formulary or any treatments or surgeries that are recommended has to be approved by the health plan, and that's where any differences in treatment come from. The doctors will request things to be approved, but if they aren't, it's ultimately the patient's or the patient advocate's responsibility to appeal that decision. If treatment is denied, that's not coming from the doctor, that's coming from the health plan.
Reply With Quote
  #5  
Old 12-16-2005, 02:52 AM
chique chique is offline
Guest
 
Join Date: Feb 2000
Gonna start this one out with a big caveat, ok? The following is ONE person's word concerning HER experiences with ONE medical facility. Don't jump on me because you, personally, aren't like that.

That said...A former co-worker of mine had two children of her own and was also a foster parent. While all three children received the same medical care, the attitude of the staff varied depending on which insurance card (private in the case of her own children, Medicaid/Minnesota Care for the foster child) she presented at the ER - fine for her kids, rather more cynical and rude with the foster kid. Perhaps your friend is receiving bad attitudes but good medical care and can't quite put his finger on what he's feeling?
Reply With Quote
  #6  
Old 12-16-2005, 11:58 AM
Sal Ammoniac Sal Ammoniac is offline
Member
 
Join Date: Apr 2005
Location: Beans, Cod
Posts: 4,443
At a minimum, there are a fair number of doctors who won't even take Medicaid patients, so right there, a Medicaid patient has fewer choices. Whether this translates into worse care is arguable, and would depend, I suppose, on the nature of the condition.

It is absolutely the case that hospitals consider Medicaid patients a drag on the system, and will do everything in their power to improve what they call their payor mix -- ideally, to pull in more patients covered by commercial insurers that simply pay better. Most providers, in most instances, lose money on their Medicaid patients, and everyone in the business knows this. And really, I don't see how this wouldn't translate into worse care for patients. If you have two customers, one who pays well and one who pays badly, who's going to get better service?
Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 10:35 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@chicagoreader.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Publishers - interested in subscribing to the Straight Dope?
Write to: sdsubscriptions@chicagoreader.com.

Copyright 2013 Sun-Times Media, LLC.