Medicaid: Pros and Cons

Medicaid is a social welfare health and medical services program for low income individuals and families.  The program is headed by the federal government and managed by the individual states. Naturally, such a large social welfare program is not without its advantages and disadvantages.

Advantages

Since Medicaid caters to individuals and families who belong in the low income bracket, these people are provided health care coverage when they otherwise would have none. Those who cannot afford health care would no longer need to go without basic and specialized health care.

Children from disadvantaged families are given access to a continuing medical and special needs care because of Medicaid.

Medical practitioners who accept Medicaid members as patients are guaranteed of a continuous stream of customers. There would be no need for them to advertise their services since states provide members with a list of participating physicians.

Participating practitioners are also guaranteed that they will receive payment from the government for the care they provide for Medicaid members. In some cases, some states also offer rewarding incentives to medical practitioners who participate in Medicaid. The risk of nonpayment for bills incurred by patients is minimal as well.

Disadvantages

There are limitations as to the type of treatments covered by Medicaid. The program evaluates each treatment plan and may not cover a particular procedure that is deemed unnecessary or experimental, causing problems for the physician and ultimately affecting the health of a patient. Refusal of coverage of expenses for the procedure will leave the patient and his or her doctor with little to no choice.

In order to keep rates for the program down, Medicaid reimbursements are often lower compared to what doctors usually charge. The result is that this discourages doctors from accepting Medicaid patients. In addition to low reimbursement rates, Medicaid reimbursements typically take between 37 and 155 days. This is a sizeable amount of time, especially for those smaller medical practices that need cash for operating costs.

In some cases, Medicaid recipients have become targets for discrimination, especially in nursing homes.  There have been reports of elderly people being transferred to a different setting (e.g., from a private or semi-private room to a ward) upon switching from private pay to Medicaid. Another sign of discrimination against Medicaid recipients in nursing homes is the refusal to accept or admit them and informing them that its Medicaid quota has been met.

Many state governments have also expressed their view that federal fund matching is not appropriated properly, allowing wealthier states to get more money than poorer states with greater needs.


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