Word: caring
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Dates: during 1980-1989
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POLICYMAKERS are trying to counteract the health system's bias towards institutional care. President Bush recently proposed increasing Medicaid coverage to 130 percent of the poverty line for pregnant women and infants. And Representative Mickey Leland (D-Tx.) and Senator Bill Bradley (D-N.J.) have introduced legislation which would expand this ceiling to 185% of the poverty line...
Unfortunately, these efforts threaten to replace a case study in the failure of the health care system with a case study in the failure of the political system. Expanding prenatal care through the means-tested Medicaid program would reinforce a second-class health care system for the poor--one which may often fail to deliver needed services...
...expansion of Medicaid would immediately expand financial access to prenatal care for many American mothers-to-be. But financial access is only one component of actual access to care. Pregnant women must first weave through a maze of Medicaid regulations to become covered by the program. OTA called this process "a formidable barrier to the receipt of timely care." But with the first few months of pregnancy being crucial to the health of the baby, pregnant women can scarcely afford to wait while overworked welfare bureaucrats process their applications...
Once mothers do find their way onto the Medicaid rolls, they must locate physicians willing to deliver care to Medicaid patients. But partly because of huge medical school debts and tremendous malpractice premiums, more than half of American obstetricians cannot afford to provide prenatal care at Medicaid rates. As a result, one-third of low-income women who received inadequate prenatal care last year attributed this failure to their inability to locate a health care provider, according to a study done by the General Accounting Office...
...problem with Medicaid as a health care program for the poor is that it is a health care program for the poor. Recipients are stigmatized and often embarrassed to participate in the system. Doctors, receiving lower rates of payment, often provide a lower quality of care. And the federal government has a ready-made whipping boy should the budget deficit need a trim. Very few speak out for Medicaid on Capitol Hill...