Medicaid as Bad as No Coverage?

[BLOG] By Farah Dosani –

Medicaid provides health insurance for low-income and high need populations. The federal-state program is supposed to serve as the health safety net for the community.

But this safety net may have some major holes.

In a recent Wall Street Journal editorial, Dr. Scott Gottlieb makes the case how those on Medicaid might as well be uninsured.

“Across the country, cash-strapped states are leveling blanket cuts on Medicaid providers that are turning the health program into an increasingly hollow benefit,” he writes.

Reimbursements to providers are so low among other reasons that many doctors refuse to take Medicaid patients. This makes access to health care very difficult for beneficiaries, despite the fact they’re technically insured.

Gottlieb says those on Medicaid ultimately suffer and cites recent studies to back it up:

Throat Cancer: Medicaid patients and those lacking health insurance were both 50% more likely to die when compared with privately insured patients. (Cancer, 2010)

Major Surgical Operations: Being on Medicaid was associated with the longest length of stay, the most total hospital costs, and the highest risk of death. (Annals of Surgery, 2010)

Outcomes after Coronary Angioplasty: People on Medicaid who underwent the procedure were 59% more likely to suffer strokes or heart attacks, compared with privately insured patients. (American Journal of Cardiology, 2010)

Lung Transplants: Medicaid patients were 8.1% less likely to survive 10 years after the surgery than their privately insured and uninsured counterparts. (Journal of Heart and Lung Transplantation, 2011)

Although the authors worked to control for socioeconomic and cultural factors, they do acknowledge the limitations of the studies. Americans often qualify for Medicaid when they’re poor and already very sick.

However, this will change under the federal health care law in 2014 when states lower eligibility requirements. By 2019, the law will bring an estimated 16 million more Americans into the program.

Gottlieb says this a mistake, but not everyone agrees with his case against Medicaid.

Dr. Eugene Usberghi is a family medicine practitioner in Lehigh Acres, FL who has accepted the insurance since he started his practice more than 30 years ago. Although he acknowledges its issues, he does give the program some credit.

“Medicaid does cover for the basic needs of the patient,” said Usberghi. “Having no insurance at all is a much more difficult situation.”

This reporter can be reached at fdosani@wgcu.org.