Magical Medicaid

I know that many liberals think that the answer to healthcare accesss is government plans. I actually had one in the office on Friday. He was mad that it took so long to get an appointment. As usual I claimed responsibility for the delay, said I was sorry and took care of him. He muttered that he had insurance (Medicaid) so he should have had to wait. This is what I really wanted to tell him.

All of us physicians have templates. These are the schedules that allow us to schedule patients. Right now, if a patient has Blue Cross we get paid three to four times as much as someone who has Medicaid. In fact, a patient who pays $40 out of pocket is paying us twice as much as someone who has Medicaid. If we want to maximise our payments we would see only Blue Cross, if we could not fill our schedule we would see lower reimbursed insured, we would then add self pay, and then if there are any openings left, we would see Medicaid. So, every physician has to decide if they are going to see any Medicaid at all. Since it pays worst of any other insurance if you do take it you put them to the back of the list. I hate to say it but Medicare is just infront of Medicaid. So, if you are going to take government insurance, those patients will be at the back of your waiting list. Our group has decided that it wants to help everyone as best as we can regardless, that being said, we still have to stay in business so we have placed in stone some Medicaid appointments in everyones schedule. I have to admit though, you will wait alot less if you have good insurance.

So, what is going to happen with this government option? It is going to put even more people at the bottom of the list. Face it, if you pay cash, you will get in sooner. This whole thing about preventive care? Medicaid pays $19 dollars for a 30 minute preventative care visit. Blue Cross pays five times that amount. If you are already full, why would you take less money and incur more liability to do preventative visits that aren't worth the money? Of course, there is no medical liability in the healthcare bill either!