Okay, so maybe it’s not breaking news: the type of insurance you have may affect whether or not you can get in to see a doctor. In particular, if you have Medicaid-Chidren’s Health Insurance Program (CHIP) insurance (sometimes called “Public Aid”), you might have trouble finding a doctor who will see you.
In a study published in the June 16th New England Journal of Medicine, women posing as mothers of children with common health conditions called 273 pediatric specialist clinics throughout Cook County, Illinois. They made two calls, one month apart, to each clinic, trying to get appointments for their purported children. The calls were identical, except that one time the callers said they had Medicaid-CHIP insurance; the other time, they said they had Blue Cross Blue Shield, a “good” private insurance. The results are unsurprising but sobering: 66% of the callers reporting Medicaid-CHIP coverage were denied an appointment, compared with 11% of those reporting private insurance coverage. For those Medicaid-CHIP patients who did get appointments, the average wait for the appointment was 42 days, compared to 20 days for the privately insured.
On the surface, one might attribute these inequalities to a bunch of bad, greedy doctors. The reality, however, is more complex. In Illinois, Medicaid-CHIP pays about 20 cents on the dollar (when it finally gets around to paying, which is sometimes six months after the fact). Because of this, physicians may actually be spending more money than they take in for each Medicaid patient they see. One can only do that for so long and still keep the doors open and the lights on. No, the inequalities do not merely stem from the behaviors of individual, money-hungry doctors; the inequalities are built into a disastrously flawed system.
I am looking forward greatly to the upcoming CBHD conference examining the “Scandal” of Christian influence on bioethics. Christians are perceived as being very concerned about issues like abortion, physician-assisted suicide, and embryonic stem cell research, which threaten human dignity by estimating a person’s worth based on their age, appearance, or utility to society. But it seems that we are perceived as being less concerned about the structural, systemic factors built into our health care “system” which daily lead to insults to human dignity by estimating a person’s worth based on their pre-existing conditions, income, or occupation (i.e., their ability to get insurance). I wonder, if we Christians really stood out in society because of our concern for the latter as well as for our concern for the former, whether we might not have a greater hearing and make a greater difference in all areas of bioethics. (Remember Mother Theresa?)
Hope to see you at the Conference!