Medicaid: The Worst Medical Outcomes in America
Medicaid provides the worst healthcare outcomes compared to every other form of insurance in America. While Physicians for Reform seeks to extend healthcare coverage to those without insurance, adding patients to the program with by far the worst patient outcomes is the worst possible way to approach the problem.
Medicaid's Substandard Access to Healthcare
Minorities often suffer most from the poor quality of care Medicaid provides. According to the US Census Bureau, while blacks represented only 12.7% of the population, they comprised 21.9% of all Americans on Medicaid. Even more telling, an astounding 27% of blacks, and 26% of Hispanics, were covered by Medicaid as opposed to only 13.5% of whites.i
Many politicians sell this as government compassion. However, it really means minorities disproportionately receive the worst healthcare - and have the worst health outcomes - in America. Here is why:
In 2008, Ohio Medicaid paid primary care physicians 53% of private insurance. For states with larger programs such as California and New York reimbursement was even lower, 38% and 29% respectively.ii Because physicians often lose money caring for patients on Medicaid, studies reveal diagnosis and treatment are delayed.
A study published in the New England Journal of Medicine found mothers seeking specialty care for their children covered by Medicaid / S-CHIP were denied appointments 66% of the time. Mothers of children with private insurance were denied only 11% of the time.iii Even when children covered by Medicaid / S-CHIP were accepted, they experienced more than double the wait time, 42 days, rather than 20 days for children covered by private insurance.
A similar study evaluating access to a dentist revealed that children covered by Medicaid / S-CHIP were denied appointments 63.5% of the time; children covered by private insurance were rejected 4.6% of the time. A Government Accountability Office report revealed that children on Medicaid have worse access to physicians than children with no insurance at all.iv
Because minorities are disproportionately covered by Medicaid, each time you read of limited access and poor healthcare outcomes for patients on Medicaid, this really means limited access and poor healthcare outcomes for minorities. Physicians for Reform not only finds this unacceptable, we offer solutions to better care for these patients.
Medicaid's Poor Health Outcomes
Scott Gottlieb of the American Enterprise Institute cites several other major studies in his Wall Street Journal article, “Medicaid Is Worse Than No Coverage at All”:
- Head and neck cancer: A 2010 study of 1,231 patients with cancer of the throat, published in the medical journal Cancer, found that Medicaid patients and people lacking any health insurance were both 50% more likely to die when compared with privately insured patients—even after adjusting for factors that influence cancer outcomes. Medicaid patients were 80% more likely than those with private insurance to have tumors that spread to at least one lymph node. Recent studies show similar outcomes for breast and colon cancer.
- Poor outcomes after heart procedures: A 2011 study of 13,573 patients, published in the American Journal of Cardiology, found that people with Medicaid who underwent coronary angioplasty (a procedure to open clogged heart arteries) were 59% more likely to have "major adverse cardiac events," such as strokes and heart attacks, compared with privately insured patients. Medicaid patients were also more than twice as likely to have a major, subsequent heart attack after angioplasty as were patients who didn't have any health insurance at all.
- Lung transplants: A 2011 study of 11,385 patients undergoing lung transplants for pulmonary diseases, published in the Journal of Heart and Lung Transplantation, found that Medicaid patients were 8.1% less likely to survive 10 years after the surgery than their privately insured and uninsured counterparts. Medicaid insurance status was a significant, independent predictor of death after three years—even after controlling for other clinical factors that could increase someone's risk of poor outcomes.v
[i]United States Census Bureau, The 2012Statistical Abstract, Health & Nutrition: Medicare, Medicaid, Table 148. http://www.census.gov/compendia/statab/cats/health_nutrition/medicare_medicaid.html/
[ii] Avik Roy, “How Do Blue States Expand Medicaid? By Paying Doctors Less, Forbes, July 23, 2012. http://www.forbes.com/sites/aroy/2012/07/23/how-do-blue-states-expand-medicaid-by-paying-doctors-less/
[iii] Avik Roy, “New England Journal: Two-Thirds of Medicaid Children Denied a Doctor’s Appointment, vs. 11% for the Privately Insured,” Forbes, June 6, 2011. http://www.forbes.com/sites/aroy/2011/06/16/new-england-journal-two-thirds-of-medicaid-children-denied-a-doctors-appointment-vs-11-for-the-privately-insured/
[iv] U.S. Government Accountability Office, “Medicaid and CHIP: Most Physicians Serve Covered Children but have Difficulty Referring them for Specialty Care,” GAO-11-624 June 30, 2011. http://www.gao.gov/products/GAO-11-624?source=ra
[v] Scott Gottlieb, “Medicaid Is Worse Than No Coverage at All,” The Wall Street Journal, March 10, 2011, http://online.wsj.com/article/SB10001424052748704758904576188280858303612.html.