A recent study showed that it takes too long before sick children under Medicaid or the Children’s Health Insurance Program get to see a specialist, if one is granted at all. Under private health insurance, the wait is shorter by 50%. The study was co-authored by University of Pennsylvania’s Dr. Karin Rhodes. She said they had an idea of the problem but not the magnitude of it. The June 16 issue of New England Journal of Medicine reported the study on a few hundred Illinois specialty clinics. Rhodes said the study reflected clear and convincing evidence the difference between public and private insurances and that it’s across the system. Federal law dictates that Medicaid recipients are entitled to care access just like everybody else.
Female callers posing as mothers of children with illnesses like diabetes or seizures contacted 273 specialty clinics in the 1st 5 months of 2010. They requested for an appointment saying they had private insurance, sometimes they’d say their insurance coverage is Medicaid or CHIP. Private insurance coverage received an 11% denial against 66% when the clinic was told of public insurance coverage. With the clinics that accepted Medicaid-CHIP insurance coverage, they were told wait at least 22 days longer compared to waiting time under private insurance coverage. Private coverage wait was 20 days against 42 days for Medicaid-CHIP. The same goes for other specialty clinics like orthopedics, psychiatry, asthma, neurology, endocrinology, otolaryngology and dermatology.
Rhodes, together with co-author Joanna Bisgaier of the same university, chose very common conditions to use in the study. There was evidence that specialty intervention can make a difference in long-term outcome. In one instance where the caller sought treatment for a child’s type 1 diabetes, the wait period given was one year. Rhodes said just having to wait three weeks with a kid with a new onset seizure, or diabetes, or poorly controlled asthma, or a fracture, is disturbing in itself. An extra 22 days added to that is disparities and discrimination purely based on insurance. Rhodes suggested that every state should be studying their access, particularly if they’re considering cuts to Medicaid. Because they’re cash-strapped and they think they’re going to take it out of their healthcare budget, she added. Disparities will increase if there will be continued whittling away at these programs, said Rhodes.