My Personal Experiences with Public Healthcare (Medicaid)
September 4th, 2009
My wife and I have been foster parents for over 11 years and have taken care of 75+ children for varying amounts of time. Roughly 5 years ago my wife quit her job and started doing full-time medical foster care. In addition to our own 3 biological children, at any point in time we could have 1-3 infants or toddlers with cerebral palsy, brittle bone disease, down syndrome, autism, feeding tubes, colostomy bags, prescription medications, etc. BTW, my wife is a saint and has the patience of Job.
As part of the foster case system, all of these children are covered under Medicaid. I want to state that my wife and I are both for medical insurance reform. We live with the medical system every day and see the massive amounts of problems. I’m not a doctor, economist or politician (God help me!), but parts of the reform bills in Congress, in my opinion, are not feasible. With all the debate regarding the “public option”, here are our experiences working daily with Medicaid.
Fewer Doctors – Over the past couple of years we have seen 2 of our favorite primary care physicians leave the Medicaid program. These are doctors that know our children, know us and that we trust. My wife spoke with their PAs and nurses and even though they love the kids and are committed to helping them, the “system” makes it unbearable. They complained about the low fees, late repayments and paperwork required for Medicaid. BTW, we are not seeing any new doctors entering the Medicaid system in our area.
Overcrowding & Longer Wait Times – Since there are fewer Medicaid doctors in our area, the ones that do accept Medicaid patients are becoming overcrowded and harder to get into. My wife routinely waits 1 1/2 – 4 hours in the waiting room before even seeing the Dr. or PA.
Increased Bureaucracy – My wife has to file her Medicaid claims on a weekly or biweekly basis. We’ve started to receive more requests for paper and more requirements for funding. There seems to be a “CYA” attitude with these requests. They may be trying to squeeze the fraud and waste from Medicaid but it translates directly to slower repayments and care for the children. If the government cannot even manage a small program like “cash for clunkers” how are they going to effectively service something that is 15%-20% of our economy?
Less Money – Eliminating waste and fraud is great but it relates directly to less services and benefits. We’ve seen the number of employees that man the Medicaid support lines decrease. My wife talks to the CSRs and they say there are fewer employees and that they are over worked. Many times if you cannot get to a CSR, we leave a message for a callback. We might not hear back from them for 3-5 days. When you need confirmation on paperwork or billings this can be a huge issue. Recently the Medicaid system switched from a VB6 program to an online system. My wife was so excited until she started using it. The website was essentially unusable for first 6-8 weeks. You couldn’t enter your claims, it crashed, gave cryptic error messages and drove my wife $&!@# crazy! I don’t know how many hours we both spent swearing, trying to use the website. And since the site didn’t work and people were not allowed to use the old VB6 program, the Medicaid phones were overloaded. We didn’t hear back from Medicaid for weeks!
Like I said, I’m not doctor or economist but I don’t see, based upon my experiences, that the public option would be anything but a disaster. How could lower fees to doctors resulting in few doctors and longer wait times be good? Also, with the influx of x million new patients who is going to treat them? We are not churning out that many new doctors. Again, overcrowding. I’m not sure exactly what need to be done to fix healthcare but a public option is not the answer.
Categories: Personal
The only thing the public option might not be worse than…is the NOTHING that 46 million of us are working with right now. The IF(sickness,bankruptcy)ELSE(fingers crossed).
Give me the forms. Make me wait a few weeks. Sounds like a huge improvement over the constant fear that if I get a twinge in my chest, I could be on the streets.
No one wants to take your healthcare and replace it with Medicaid. They want to take my NOTHING and replace it with…something.
And I would be most grateful.
You make very good anecdotal reasons against Medicaid as a public option, but what you would you have done for these children if Medicaid wasn’t available? Your foster care is truly saintly but no for-profit company is going to be willing to pay for the added medical coverage. That leaves our broader society to recognize that collectively we need to provide medical care for the most helpless amongst us.
As a proponent of Agile development, I know that sometimes it’s better to have something in place now that wait until the ideal (and unachievable) solution is ready to launch.
I should have said in my previous post: I appreciate your candor. No doubt dealing with Medicaid on a regular basis would make me doubt the possibility of extending it to everyone too!
Also worth noting: I like the blog a lot.
I feel with you. So far can’t offer a solution, but recommend reading this article about a comparison of health care systems: http://www.washingtonpost.com/wp-dyn/content/article/2009/08/21/AR2009082101778.html?nav=hcmodule I found it very interesting.
All the best from Germany,
Hannes
Jeff,
First thing, well done to yourself and your wife for the work you are doing. The world is a much better place because for it.
Like yourself I am not a doctor but I am working computers for a long time.
I spent a year working around Healthcare and IT advising the Irish government.
I spent a while researching the various systems worldwide to compare Ireland’s system (which is only OK to be generous) I was looking at the US system.
All systems (bar Denmark I think) have one main problem IMHO. They don’t understand that they are in a customer service business.
There seems to a lack of understanding in that industry around IT. They use specialist healthcare IT companies (like Cerner or iSoft). While these companies are quite large they are small when compared in size to the CRM companies which have had more time and resources to deliver customer service software.
This solution while cannot create more doctor (US has some of the lowest doctor & Nurse ratios in the western nations) it can focus on what the need is.
It could very effective in Primary and preventive care to start, first as just a means to reduce paperwork and keep everyone on the one page.
Later using techniques developed in Marketing to leverage the processes we use to sell people something into what they could be then next ailment and test earlier.
Jack
P.S. There must be something broken in the US Heathcare system when you go through the stats. While spending on Healthcare in the US is about 16% about half and half, public and private the US has some of the lowest per catia Doctors, Nurses and CT scanners..
I am not trying to anti-american truth be told all health systems have problems but maybe America is could see this an opportunity to do what they do best and innovative.