Medicaid Health Care: Dollars spent unwisely

Medicaid Health Care: Dollars spent unwisely


Approximately 50 million Americans have Medicaid and Medicaid health insurance for children reimburse pediatricians only a third of what commercial insurance reimburses for the same care.  As the ranks of Medicaid insured swell, this inequity threatens to drive private practice pediatricians out of business at they can no longer afford practice overhead, malpractice insurance and provide employee healthcare.  Obamacare has invested staggering amounts of money to provide services for the “uninsured” (those whose jobs don’t provide insurance).

A wiser investment of funds should have involved bolstering the Medicaid reimbursements to physicians. Small or mid-size private pediatric practices have provided ideal “medical homes” for their patient for years. In private practice pediatrics, patients have virtually unlimited access to their primary care physicians and relatively few access overburdened Emergency Rooms needlessly.

Presently only Federally Qualified Health Centers receive adequate compensation on par with that provided by private payers (from the Fed) for services provided to those with Medicaid. Just as easily those outside of the FQHC system should have access to improved reimbursement by demonstrating that they can provide services on par with FQHC Health Centers. Medicaid patients should also learn to value their health coverage by paying an income adjusted co-payment necessary to access care. With healthcare at the crossroads it frustrates most physicians to see that the government “fix” as always  ignores the most obvious, and unfortunately is always the “path not taken!”


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