The Illusion of Health Insurance

Earl K. Long Hospital…in Baton Rouge, La….[is] a provider of last resort, the state-run hospital’s principal mission is serving those who cannot get access or pay for care anywhere else… But its physical plant is in disrepair. For inpatient care, four patients typically share a single room and bathroom. Asbestos limits major renovations. The main entrance once went months with only one of its double doors, giving the hospital’s facade a gap-toothed steel and concrete smile.

Those with health insurance do not go to Earl K. Long Hospital.

Why then do more than half of the patients I see when I’m teaching medical residents there have Medicaid?… My Medicaid patients do not choose Earl K. Long Hospital. Medicaid chooses Earl K. Long for them, because it does not provide access to health care anywhere else.

Full article on the dangers of the Medicaid illusion.

Comments (9)

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  1. Vicki says:

    This is a very troubling article. Especially considering that Obama Care is going to consign about 16 million new people to Medicaid and they will not be allowed to enroll in (subsidized) private plans in the health insurance exchanges.

  2. Nancy says:

    Everyone should read this article. It is written by a dcotor who is also a member of Congress. He is describing what the advocates of Obama Care apparently think is an essential part of “universal coverage.”

  3. Tom H. says:

    Good article at Poitico and good post here. I hope lots of people read it.

  4. Joe S. says:

    I agree with the previous posts and would add that this article should be passed around the White House the way Gwande’s article was passed around. The staff would learn more from this one, however.

  5. Ken says:

    This is what health care for the elderly is going to look like if Obama Care is not replealed. Remember, within ten years, Medicare payment rates are going to be below Medicaid’s.

  6. artk says:

    Reading that article is like hearing about someone who kills his parents and then complains about being a orphan. The problem with Medicaid is the funding levels don’t allow for adequate reimbursements. The Republican congressman who wrote the article belongs to a party that has constantly lobbied for lower Medicaid funding levels. The fix for Medicaid is simple, decide that the poor deserve the same access to medical care as the elderly, raise Medicaid funding levels to Medicare funding levels.

  7. Joe S. says:

    artk, if we’re going to change the system, your proposal is a strange one. Wouldn’t it be better to allow Medicaid enrollees to take their portion (whatever it happens to be) and enroll in the same plans the rest of America has access to. Or at least have that option. Don’t know why your picking on Republicans today, but quite a few have endorsed what I just proposed.

  8. Devon Herrick says:

    I fear this is a condition that will be increasingly common for both Medicaid and Medicare enrollees. As provider reimbursements are ratcheted down to save money, fewer and fewer doctors and hospitals will want these patients. Over time the quality will suffer as public institutions become the provider of last resort.

  9. It drives me crazy that when I read an article in a health-policy or medical journal, or from the Kaiser Family Foundation, or from the Commonwealth Fund, or many other sources, they usually divide subjects into “insured” versus “uninsured”. “Insured” includes privately insured, Medicare beneficiaries, and Medicaid dependents.

    It’s completely wrongheaded. It’s as if I divided a sample into “employed” and “unemployed”; and the “employed” included those with jobs, those receiving Social Security, and those on welfare!