How do they sleep?

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I am one of those people who believes that if you have something that isn’t working as it should be, then we should try to fix it, not toss it into the waste bin unless we have a better working replacement. I say this in response to the Commonwealth Foundation’s Elizabeth Stelle and her letter “Medicaid Is High Cost for Low Quality” (Dec. 2), in which she trashes Medicaid health care for the poor.

I am not so sure that her baseline assumptions about the program’s lack of success are totally on target. 

When she states that adult Medicaid patients, as contrasted with the uninsured, are three times more likely to go to an emergency room for care, perhaps part of the reason is her earlier statement that one out of three doctors won’t take new Medicaid patients. If they can’t find a primary care doctor to see them and they are ill, and if Medicaid will cover an ER visit, what choice would they have?

If uninsured, they may wait longer to go, worrying about how they will possibly pay the bill. As a policy analyst, why isn’t she trying to craft a policy that will benefit patients and not be a detriment for physicians, so both can be served?

Also, as a practicing pediatrician, I find insulting the view that the care the patients with Medicaid receive is “limited and low-quality.” The care that I and my fellow practitioners give to our patients is by no means predicated on what insurance they carry or if they are insured at all — though I sincerely wish that they all were covered.

The only time or reason I check what insurance they carry is when I need to know which vaccine “pool” to use for immunizations, that provided to us by the Vaccines for Children program or those we have purchased. 

We provide the same level of care to all of our patients. I could not sleep well at night if that were not the case. I wonder how well they sleep in Harrisburg.


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