- I’ll just start this with a disclaimer. I’m not claiming to be tackling the subject of Medicaid. That’s a vast topic, with many differing opinions, some quite heated I’m sure. I have decided to simply address one side of Medicaid and the people who receive it. This post is my opinion. Some are going to disagree with me. That’s wonderful. Freedom of speech and the right to your opinion is what makes America so great. Some things about America need work though, such as healthcare. I am not claiming in any way to be an expert on the subject. I also sadly don’t have the answers on what we should do to improve things. I do hope this will bring some biases to light, and perhaps awareness may foster future change. I have had experiences and am choosing to share them to make a central point, one point amongst many available I assure you, in this post. The purpose of this particular post and this specific problem I’m confronting is to bring awareness that it exists and maybe, just maybe change a few people’s opinions and how they react to others. Feel free to comment and share. I encourage a good debate, but there’s no need to be hateful to try and change my mind on how I see things.
- When I was pregnant with my first child I was working as a Registered Nurse. The small company I worked for offered private insurance. It wasn’t bad, but I had carried better elsewhere, at larger corporations. The small business was also experiencing financial troubles and all full-time employees had been cut-down to part-time hours. It was mandatory, but supposedly temporary until the company could get back on its feet. I loved my job so I hung in there with everyone else. At this point I was naive and became aware of the inherent medical costs of having a baby. I was not able to pay the outrageous deductible my insurance required, and realized the entire hospital stay would be out of pocket for me. My husband was also temporarily unemployed at the time. It was suggested by a friend to look into pregnancy Medicaid. Even though I was a nurse, my income at the time was low enough that I was eligible. I had been paying into Medicaid faithfully for over 15 years, and I felt it was my only option to afford the costs of having a baby. After being on pregnancy Medicaid your baby is automatically enrolled into Medicaid at birth up until one year. If you want Medicaid after that, your income must be reevaluated. With my second pregnancy I was working for a larger company, full-time, and with excellent health insurance. My husband was also working full-time. So I have had the opportunity to experience my own healthcare and that of my child with Medicaid versus with private insurance. I’ve noticed a few things that are really disappointing. These are my personal experiences. If you are on Medicaid you experience different treatment versus your treatment with private insurance. My first child never saw a physician her first year of life other than as a newborn in the hospital. Every time she was seen it was by a Nurse Practitioner. I have nothing against Nurse Practitioners. Some of my best friends and most trusted colleagues are Practitioners, and they’re very capable. The point is I was told quite plainly by the clinic that the Pediatrician there did not see Medicaid babies. I had no choice but to have my child seen by a Nurse Practitioner. My second child, on private insurance, has seen the Pediatrician every single time. I see big differences in the way I was treated during both my pregnancies. I got appointments sooner and much easier with private insurance. My treatment in the hospital was far superior the second time around. This is no fault of the hospital. I think people just treat you differently when you’re on Medicaid. The first time the woman helping me fill out the birth certificate actually assumed I was not married. When I corrected her she was visibly embarrassed. A few other examples I have experienced personally follow:
I was pregnant at the same time as another female I’m extremely close with. She had Medicaid. I had private insurance. We were both in our second trimester. We both had colds with almost exact symptoms. I made an appointment on a Saturday at an acute care clinic. I suggested she give them a call as well. She called me back and told me they had refused to see her stating since she was pregnant she really needed to address this with her OB-GYN on the following Monday. They certainly didn’t think that was the case with me. I was seen and treated same day.
I have a close friend with a baby similar in age to my youngest. My baby has private insurance. Her child has Medicaid. Not too long ago our babies had very similar symptoms. Again this occurred on a weekend. My child was seen immediately. Her child was not. She was instructed to follow-up with his regular pediatrician. With our children having the same exact symptoms here’s what occurred at my child’s visit.
- Blood tests, nasal swab, throat swab, full assessment of baby. Prescriptions called into pharmacy of choice.
Here’s what her son got.
- Pediatrician looked into his ears and throat. That’s it. She didn’t even listen to him with her stethoscope. She suggested some nebulizers, but didn’t call any into the pharmacy. No blood work or any other tests for that matter.
- There’s a thousand reasons I’m sure someone could come up with for why these children were treated differently. Maybe you could think of a couple reasons why the adult women were treated differently too. And that’s fine. You could even be correct. But I personally believe they were treated differently because of their payer source. I have experienced both resources and I personally feel I had better treatment, better access to care, and better outcomes with private insurance. Occasionally I get frustrated at my rising cost of insurance. I work what’s called part-time eligible, meaning I work part-time hours, but am eligible to purchase insurance from my employer. It is definitely more expensive as a part-time employee. And I’ve experienced rising co-pays and deductibles recently. I’m still paying on my portion of the hospital bill with my second child. It’s hard when both kids get sick. That’s at least $50 in co-pays and never mind what the prescriptions will cost for two! I sometimes miss no co-pay and free prescriptions with Medicaid. But, I wouldn’t have it any other way. I feel my children get better healthcare on my private insurance. I feel blessed that I’m able to afford healthcare for them and that my husband and I are in a place financially where we don’t need to place the children on Medicaid. They get treated differently. Statistics prove that outcomes are worse with Medicaid patients. I have worked in Case Management in the past and have seen this to be true.
I believe there’s a bias to people on Medicaid. I believe they are treated as if they are deadbeats who sit around and drink beer, abuse prescription pain meds, and procreate for the sheer fun of it. People wrongly assume that everyone on Medicaid is abusing the system, laying around on their lazy butts eating their free cheese and not paying taxes. They think women on Medicaid are promiscuous, unmarried, and have several baby daddies. This prejudice, this wrongful assumption of character makes the people who really need government assistance shameful of their position. A lot of people on Medicaid just can’t afford healthcare. They are working full-time or two or three jobs trying to make ends meet. They may not have access to insurance or it may not be offered where they do work. Here in the South there are a lot of small businesses where insurance either isn’t offered or is simply too costly for a family to afford. Some people have children with disabilities and the cost of care is too high of a burden, making government assistance the only plausible option they have.
Point being; good people are on Medicaid. A lot of them may be people you know but they’re too ashamed to mention around you that their children are on Medicaid. They don’t want to see the undeserved disgust in your eyes, so they don’t tell you. This prejudice and judgement have bled into the healthcare system. Yes, Medicaid does generally not reimburse as well as private insurance, and this has a lot to do with biases in care, but I’m afraid a lot of it is personal also. People see Medicaid and they often think: poor, trash, unemployed, degenerate, addicted. Perhaps this is the case sometimes. Perhaps some people abuse the system, but should good people receive bad treatment because of it? Not everyone on disability is lazy, or an alcoholic, or a drug user. Did I come up with that on my own? No. I see the bias in healthcare all around me. Some people experience illness, injury, bad circumstances. You can’t lump everyone into the same negative pool. They don’t deserve it. Next time you think of judging someone, or treating them different, please remember that you don’t know their story. You haven’t walked in their shoes.
I would like to add that I received good healthcare with Medicaid. We live in a wonderful country with some of the best healthcare available. I just felt it was better with private insurance.
That is all 🙂