U.S. Specialty Physicians Turn Away Two-Thirds of Children With Public Insurance, Study Shows

U.S. Specialty Physicians Turn Away Two-Thirds of Children With Public Insurance, Study Shows

www.sciencedaily.com

Sixty-six percent of publicly-insured children were unable to get a doctor's appointment for medical conditions requiring outpatient specialty care including diabetes and seizures, while children with identical symptoms and private insurance were turned away only 11 percent of the time, according to an audit study of specialty physician practices in Cook County, Ill. conducted by researchers from the Perelman School of Medicine and the School of Social Policy and Practice at the University of Pennsylvania.

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This study was limited in it's scope, but it has me kind of worried...

After all, the way things are now, we are under a new regime of institutionalized health care; and it's supposed to be much better - pat of something to be proud of, according to some prominent political citizens.

The study also found that Medicaid and Children's Health Insurance Program (CHIP)-insured children who received an appointment faced longer wait times to be seen. Their average wait to see a specialist was 44 days, while privately-insured children with similar urgent conditions waited 20 days. Federal law, however, requires that Medicaid recipients have the same access to medical care as the general population in their community

I find myself wondering how much of the disparity is driven by commerce factors, and how much is by something more 'personal.'

In more than half of the calls to clinics, the caller was asked for information about the child's insurance type before being told whether an appointment could be scheduled. In 52 percent of these calls, the type of insurance coverage was the first question asked.

I am not one to advocate for the elimination of profit-based medical service models, but if this is typical of the 'compromise' that the industry and the government worked out, I may have to reconsider my position.

Prior research has found that reimbursement amounts are a key factor influencing doctors' decisions about whether to accept patients with public insurance. However, the authors suggest that incentives and mission of the health systems in which the doctors work may play an even larger role. Their findings underscore the need to identify policy interventions that will end the disparities identified in the study.

"We studied the health system, not individual providers," Rhodes said. "To reduce disparities, we may need to restructure reimbursement strategies and reorganize the manner in which our health system provides specialty care. We can fix this problem, but it will not happen unless we are willing to make the health of American children a national priority."

www.sciencedaily.com
(visit the link for the full news article)

This does illustrate one serious weakness with medicine. It is now a business. These businessmen must make a profit in order to pay their employees, feed their families, pay their student loans and their various types of insurance. Then they also deserve to be compensated for the sacrifices they made to go to med school and residency. Private insurance pays better, and these doctors only have so many hours in a day.

You can just smell the for-profit goodness... I'd like to find a specialty doctor that provides more of a benefit than the open-source internet. I've diagnosed and cured two of my own ailments over the last decade or so. One where I lost a considerable amount of weight. After a 12k tab I actually determined both were food allergies. Guess they didn't see it coming. You can imagine what else they miss on the first, second, third, or fourth visit.


Turning away kids... I can't wait for karma to kick in.

When people go through six years of school, they expect to make per hour, what us peons make per day. Just the way it is I guess....

Originally posted by TKDRL
When people go through six years of school, they expect to make per hour than what us peons make per day. Just the way it is I guess....

edit on Thu, 16 Jun 2011 16:01:40 -0500 by TKDRL because: (no reason given)

You don't believe doctors should make more than ditch diggers? How much is that 8+ years of schooling and training worth?

Originally posted by TKDRL
When people go through six years of school, they expect to make per hour, what us peons make per day. Just the way it is I guess....

edit on Thu, 16 Jun 2011 16:02:18 -0500 by TKDRL because: (no reason given)

It's alot more than six and knowing what I have to pay for student loans I can only imagine their monthly bills.

Not sure what people expect them to do. Work for free?

Make more than a ditch digger sure why not... I am not a ditch digger, I am a craftsman, I had to work my way up over 8 years myself. I don't think a doctor should make per hour, what I make in a day no. That is insane....
Then again liars charge about the same, what can I do about it?

reply to post by Americanist


I'm sure the internet will sue your wounds shut and cut tumors out of you when you have cancer.

What ignorance.

Originally posted by TKDRL
Make more than a ditch digger sure why not... I am not a ditch digger, I am a craftsman, I had to work my way up over 8 years myself. I don't think a doctor should make per hour, what I make in a day no. That is insane....
Then again liars charge about the same, what can I do about it?

So, why didn't you go through med school, residency, and specialized training like these doctors? Even as a craftsman, you do not have the same responsibility and exposure that they do. Even if you opened your own business, your insurance costs would be nowhere near as high as theirs. You would not get as many nuisance suits as they get. If you want equal rewards, make an equal investment.

reply to post by sonofliberty1776


I really don't care at this point, I got "free healthcare" now, you can have your overpaid doctors if you want. It sucked back when I used to live in NY, only go to the doctor when I was so sick I couldn't work. Couldn't afford to take the day off, plus lose a day pay on top of that under other than dire circumstances.

To turn away any children is just despicable. Not enough doctors go into medicine for the right reasons, which used to be to help people get healthy.

The costs of education is too high, it isn't sustainable, if in the end, people cannot afford the services the doctors went to school for.

Originally posted by snowspirit
To turn away any children is just despicable. Not enough doctors go into medicine for the right reasons, which used to be to help people get healthy.

They are not turning them away, they do wait longer though. Isn't that normal for socialized medicine?

The costs of education is too high, it isn't sustainable, if in the end, people cannot afford the services the doctors went to school for.

It is not just the cost of the school. What about the 8 years of scrimping and scraping by? If you are not getting an exceptional reward for that sacrifice, why do it?Why not just go be a used car salesman? Or a postal carrier? They require virtually no sacrifice and offer above average pay. What happens when the smart people who can become doctors say that the reward is not worth the sacrifice? Who loses then?

Between malpractice insurance and paying their student loan debt back, the doctors can probably not afford to take many people with Medicaid given the reimbursement rates.

i hate to break it to you all

but private healthcare will always better better than public

and i am an advocate for a profit based system because if they are not making money they cant provide the goods and services and to pay and give that pro bono stuff.

every single day the healthcare industry is being told what to do and how to do and their costs rise daily.

if they are not making any money that cant provide those goods and services or hire quality doctors.

medicare and medicaid suck because they are public it stinks but thats the way it is.


turning away children does stink but in my opinion thats out of fear of the government or not having what they need to render care.

the healthcare industry is just like any other industry competition the more people competting to bring those goods and services to the market lower prices and increase the quality of what your buying constrasted by what those people get from government care.

everyone has a heart just get government out of it and stop creating the heartlessness that leads to studys like these.

my 2 cents.

Originally posted by sonofliberty1776
So, why didn't you go through med school, residency, and specialized training like these doctors?

A master craftsman spends about 10 - 15 years to get there. Apprenticeship, journeyman and even when you make master you are still not finished.

Why are you so enamored with sit down schooling that was instituted to create good little workers in the industrial age. It was never intended to actually 'educate'.

Doesn't really surprise me that they would prefer private insurance over a public form. Probably easier to work with and get treatments paid for.

reply to post by sonofliberty1776

Originally posted by sonofliberty1776
They are not turning them away, they do wait longer though.

Which part of this didn't you get?

Sixty-six percent of publicly-insured children were unable to get a doctor's appointment for medical conditions requiring outpatient specialty care including diabetes and seizures, while children with identical symptoms and private insurance were turned away only 11 percent of the time, according to an audit study of specialty physician practices in Cook County, Ill.

or this

Overall, only 34 percent of callers with Medicaid-insured children were able to get an appointment, as compared with 89 percent of callers reporting Blue Cross Blue Shield PPO insurance.

or this

In more than half of the calls to clinics, the caller was asked for information about the child's insurance type before being told whether an appointment could be scheduled. In 52 percent of these calls, the type of insurance coverage was the first question asked.

Turned away, as in couldn't get an appointment. Looks like they might need to make the Education system for profit down there too to help with the reading comprehension.

Originally posted by ..5..

Originally posted by sonofliberty1776
So, why didn't you go through med school, residency, and specialized training like these doctors?

A master craftsman spends about 10 - 15 years to get there. Apprenticeship, journeyman and even when you make master you are still not finished.

Why are you so enamored with sit down schooling that was instituted to create good little workers in the industrial age. It was never intended to actually 'educate'.

Dude you don't know me. My "sit down schooling" consists of 3 technology based AAS degrees and a BA in History. I am well aware of what the various types of craftsmen do and what they go through. However 15 years to make "master"? Bull. I am a Master automobile tech, a licensed Journeyman electrician, and a journeyman HVAC tech, and a trained EOD tech. I currently work in an entirely unrelated field though(well they do have concurrent application). My best friend is a master mason and a master carpenter. It did not take him 15 years to become a master at both trades. If it takes you 15 years to reach master level in a trade, that really sounds like your issue.

reply to post by Maxmars


Personally, to solve this dilemma I would advocate for those that wish to become doctors should be allowed to have education free of expenses. Then following their education they should be required to work off their debt by providing medical services to the public. Once their debts are repaid they can proceed to make profits; although, I would speculate many doctors get in the business because their is great pay and not because their sole reason is to help people in need. Much like lawyers now days. They want your money first, then they will help you.

Gouging is also another area that seems crazy. When one day in the hospital can fund rent for 4 years in a common rent neighborhood, something needs to done. I personally am in favor of services that are necessities to live, liberty or the pursuit thereof to operate not for any profit. It would eliminate much of the greed associated with these large organizations.