A Critical Review of Medicaid/schip

A Critical Review of “Medicaid/SCHIP Program”

Medicaid/SCHIP is insurance coverage provided to families falling below poverty line. This program was designed by the Government to provide health care coverage with little or no co-payments or financial cost to the patients. The government is considering cuts and cost restraints. These cuts to the program will affect Emergency Rooms, Doctors and patients. The number of uninsured will also raise and overall individual health will suffer. In addition to those who will suffer, are the state and local officials which be burden with cost shifting. So, why does the government seems to think that cost repression is the answer or solution to the program? The answers can be found through the enable the paitents, stabilize the benefits for health care providers and individuls, and fix the wholes in the Medicaid program.

First, we must consider that cost shifting is only hurting everyone involved in healthcare. By taking health coverage away from families who need it, will only lead to uninsured individuals who exploit the Emergency Room as their primary care. Healthcare enables these individuals to seek routine care and prevenative care. These costs are much lower than the costs of frequent or major emergency room visits. This will also lead to the dependence of Physicians in E.R. This is clearly not what is wanted or needed by either parties.

One issue to consider is the fact that physicians are paid low reimbursement rates and therefore do not want to participate in the Medicaid/SCHIP Program so they opt not to see patients with such health coverage. Since there are a limited amount of doctors that will accept Medicaid patients. A result of this is patients not being able to find or access the limited doctor’s offices that will acccept Medicaid and end up not having a primary care provider (PCP). A reasonable solution is to fairly reimburset PCPs and not cut or cost shift. Taken as a whole, PCPs don’t want to see Medicaid patients because they are paid pennies on the dollar and ERs are becoming frustrated because emergency treatment is often delayed to other patients who might be in greater need of their services.

Another issue, is that cost containment will lead to a higher amount of uninsured people. This means that Emergency Rooms will not be compensated for providing care. The hospital will suffer financially and overuse of the E.R. will continue to grow by organizations that have to provide the medical care to patients. Patients will also no longer seek medical treatment for illnesses until they are extremely ill and again rely on the E.R. The tests and medications will end up costing more then if the patient had the coverage to seek medical treatment to begin with.

The biggest problem is that the program, Medicaid/SCHIP, was not designed to work. The government created this program but didn’t put much into structuring and ensuring that the program would function successfully. There was little responsibility put onto the insured and therefore abuse occurred. Patients have a small