Study: Specialty physicians turn away two-thirds of children with public insurance

Sixty-six percent of publicly-insured children were unable to get a doctor's appointment for medical conditions requiring outpatient specialty care including diabetes and seizures, while children with identical symptoms and private insurance were turned away only 11 percent of the time, according to an audit study of specialty physician practices in Cook County, Ill. conducted by researchers from the Perelman School of Medicine and the School of Social Policy and Practice at the University of Pennsylvania. The findings are published in the June 16 issue of the New England Journal of Medicine.

"We found disturbing disparities in specialty physicians' willingness to provide outpatient care for with public insurance -- even those with urgent and severe health problems," said senior author Karin V. Rhodes, MD, MS, director of Emergency Care Policy Research in Penn's department of Emergency Medicine and a senior fellow in the Leonard Davis Institute of . "This study shows a failure to care for our most ."

The study also found that Medicaid and Children's Health Insurance Program (CHIP)-insured children who received an appointment faced longer wait times to be seen. Their average wait to see a specialist was 44 days, while privately-insured children with similar urgent conditions waited 20 days. Federal law, however, requires that Medicaid recipients have the same access to medical care as the general population in their community.

In the study, research assistants posed as mothers of children with seven common health conditions. They made calls to a random sample of 273 clinics representing eight specialties in Cook County. Two calls, separated by one month, were placed to each clinic by the same person using a script that varied only by . Overall, only 34 percent of callers with Medicaid-insured children were able to get an appointment, as compared with 89 percent of callers reporting Blue Cross Blue Shield PPO insurance.

In more than half of the calls to clinics, the caller was asked for information about the child's insurance type before being told whether an appointment could be scheduled. In 52 percent of these calls, the type of insurance coverage was the first question asked.

The clinical conditions cited by the callers were common problems that impact large numbers of children and warrant timely specialty care. They included severe body rashes, obstructed breathing during sleep, Type 1 diabetes, uncontrolled asthma, severe depression, new onset seizures and a fracture that could affect bone growth.

Prior research has found that reimbursement amounts are a key factor influencing doctors' decisions about whether to accept patients with . However, the authors suggest that incentives and mission of the health systems in which the doctors work may play an even larger role. Their findings underscore the need to identify policy interventions that will end the disparities identified in the study.

"We studied the health system, not individual providers," Rhodes said. "To reduce disparities, we may need to restructure reimbursement strategies and reorganize the manner in which our health system provides specialty care. We can fix this problem, but it will not happen unless we are willing to make the health of American children a national priority."

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dogbert
not rated yet Jun 15, 2011
Just wait until all insurance is public insurance ...
Vendicar_Decarian
3.7 / 5 (3) Jun 15, 2011
Very true Dogbert.

With a fixed price in a single payer system, there will be no incentive for doctors to discriminate against lower paying customers, since the price for everyone will be the same.

Yooze one Genius Dogbert. You must spend your daze hanging out at the Apple Genius bar or somefink.
dogbert
1 / 5 (1) Jun 16, 2011
You miss the point. Everyone will have long waiting times and those waiting times will be longer still because there will be fewer doctors available.
Vendicar_Decarian
1 / 5 (2) Jun 16, 2011
No DogbeTard, your point was that doctors under a single payer system would refuse to treat more patients than they do now, discriminating against those with lower incomes.

And now having been caught making a clearly stupid claim, you have decided to change the subject to wait times.

Now as to wait times, your claim is that there will be fewer doctors available. That is nothing more than presumption on your part.

In fact given the reduction in paperwork that accompanies a single payer system, there may actually be an increase in doctors available.

How many doctors will be available will in part be a function of how much money they can make and that will be set by the fees they charge to the payer system.

Now presuming that the payer system is Da Evils Gubderment, then it will be a function of how much the American people are willing to pay in taxes for such a system.

Cont...
Vendicar_Decarian
1 / 5 (1) Jun 16, 2011
If you are a nation of fools, then you will whine and complain and demand that your taxes be lower and the service you get will be like the service you get now...

Generally Inferior, and growing ever more inferior.
dogbert
1 / 5 (1) Jun 16, 2011
After cutting out your misrepresentations and ranting, you finally get the point about Obama's plan to subsume all health care into a public system:

Generally Inferior, and growing ever more inferior.


Yep.

ironjustice
not rated yet Jun 19, 2011
The doctors shouldn't worry because they are 'creative'. A doctor here was JUST 'caught' for questionable practices because he was found to have been seeing one hundred a fifty patients per day PLUS some of them had been dead for quite some time.
dogbert
not rated yet Jun 19, 2011
ironjustice,

I don't know where your "here" is, but of course, you can find examples of fraud in any endeavor.

Public insurance is rejected outright by many physicians and avoided as much as possible by many others because of billing issues and payment issues. That is a fact which the article reveals. That there may be a physician somewhere who has engaged in fraud is not really relevant to the discussion.
ironjustice
not rated yet Jun 19, 2011
Quote: That there may be a physician somewhere who has engaged in fraud is not really relevant to the discussion.
Answer: Here is Canada. As to relevance. I 'think' refusal of service to people on Medicare is against the law. Fraud is against the law. Crime is a psychopathetic trait. The majority of doctors are atheists. Atheists are known to be primarily psychopaths. Pick one of the 'relevances'.
dogbert
not rated yet Jun 19, 2011
You have made the statement multiple times that atheists are psychopaths. Care to support that statement?

It is not against the law for a medical practitioner to limit his practice. It is obviously not possible for him/her to work, for example, 24 hours per day every day.

It is also not a requirement that any medical practitioner participate in Medicaid or Medicare. In fact, obtaining certification to treat Medicaid or Medicare recipients is a difficult process in itself.
Vendicar_Decarian
1 / 5 (1) Jun 19, 2011
"It is also not a requirement that any medical practitioner participate in Medicaid or Medicare." - DogBertTard

But in a single payer system, their choice is limited to work and get paid or don't work and not get paid.

I think the vast majority of doctors will decide to work and get paid. The others aren't taking their oath seriously and have no business being doctors. They are easily replaced by the legion of students who wish to be doctors.

The fact is... Single payer produces better results overall at substantially lower costs than the failure that is the American system.
Vendicar_Decarian
1 / 5 (1) Jun 19, 2011
Now presuming that the payer system is Da Evils Gubderment, then it will be a function of how much the American people are willing to pay in taxes for such a system.

If you are a nation of fools, then you will whine and complain and demand that your taxes be lower and the service you get will be like the service you get now...

Generally Inferior, and growing ever more inferior.