Question about Medicaid health insurance

catsareniice1

Someone here wrote.... "A recent study showed that Medicaid patients are 50% more likely to die after surgery rather than privately insured patients." Why would Medicaid patients be treated differently? If someone can explain. Seems illegal to me.

My friend just received a Medicaid package as she falls into that category even though she works hard. I told her about the statement above and now she is nervous.

She is getting Medicaid through United Health. Does that make a difference?

vlagrl29

Is there any way for her to get a private plan instead?

catsareniice1

vlagrl29 said:

Is there any way for her to get a private plan instead?

No. My niece only works 20 hours a week in retail. She's broke. Is Medicaid through Neighborhood Health or United Health bad?

snp605

There are quite a few reasons that drive this statistic:

1. people with fewer resources tend to be in poorer health to begin with. They've not had all of the "maintenance" and "specialist" type of appointments over the years. They also frequently have to skip medicines or treatments when medicaid does not cover it or they go through periods of being uninsured due to making too much to qualify for medicaid but can't afford insurance. People with resources pay out of pocket what these folks can't.

2. Medicaid reimbursements are extremely low so many higher end/experienced doctors will not accept medicaid patients. Therefore they more frequently get doctors with little experience or less expertise on their particular condition.

3. Due to financial, transportation, lack of childcare and other resource based issues, these people tend to miss follow up appointments, treatments and medicines.

4. Because of the fewer number of doctors and facilities that accept medicaid they usually have longer wait times to see a health care professional for initial or follow up treatment. These health care providers tend to be overwhelmed and also probably have less time for patients than someone who is getting reimbursed through private insurance or through some sort of concierge arrangement.

eta: 5. Due to higher numbers of people on medicaid typically being less educated than those people with insurance, they or their families may not be able to advocate for themselves as well when they feel that their treatment is inappropriate or not effective. They simply accept the diagnosis/treatment given to them because they feel stuck with what medicaid provides or with the health care provider that accepts medicaid.

There are probably some others but these are the big ones.

vlagrl29

catsareniice1 said:

vlagrl29 said:

Is there any way for her to get a private plan instead?

No. My niece only works 20 hours a week in retail. She's broke. Is Medicaid through Neighborhood Health or United Health bad?

I'm not sure since I've never been on it.  When open enrollment for the ACA starts later this year, I would highly encourage her to get on it.  If there is a Blue Cross office in her area she can walk right on in and they have trained professionals to help her out.  Most likely she wouldn't even have a premium payment if she chose the bronze plan.

formerlyGDaisy09

snp605 said:

There are quite a few reasons that drive this statistic:

1. people with fewer resources tend to be in poorer health to begin with. They've not had all of the "maintenance" and "specialist" type of appointments over the years. They also frequently have to skip medicines or treatments when medicaid does not cover it or they go through periods of being uninsured due to making too much to qualify for medicaid but can't afford insurance. People with resources pay out of pocket what these folks can't.

2. Medicaid reimbursements are extremely low so many higher end/experienced doctors will not accept medicaid patients. Therefore they more frequently get doctors with little experience or less expertise on their particular condition.

3. Due to financial, transportation, lack of childcare and other resource based issues, these people tend to miss follow up appointments, treatments and medicines.

4. Because of the fewer number of doctors and facilities that accept medicaid they usually have longer wait times to see a health care professional for initial or follow up treatment. These health care providers tend to be overwhelmed and also probably have less time for patients than someone who is getting reimbursed through private insurance or through some sort of concierge arrangement.

eta: 5. Due to higher numbers of people on medicaid typically being less educated than those people with insurance, they or their families may not be able to advocate for themselves as well when they feel that their treatment is inappropriate or not effective. They simply accept the diagnosis/treatment given to them because they feel stuck with what medicaid provides or with the health care provider that accepts medicaid.

There are probably some others but these are the big ones.

This. 

Patients who use medicaid have more issues than just their insurance (in general). Lower SES has been linked with poorer outcomes as has lower education level...often because those factors lead patients to seek less care or wait longer to get care when they need it. 

the results of the study do not surprise me, nor do I think that Medicaid is a cause of the bad outcomes the study was measuring.  there are too many other significant confounders for that study to be meaningful.