The Common Good

The Medicaid Card: A Useless Piece of Plastic?

The other day I saw a quote from The New York Times that I found especially interesting: "My Medicaid card is useless for me right now. It's a useless piece of plastic. I can't find an orthopedic surgeon or a pain management doctor who will accept Medicaid," said Nicole R. Dardeau, a nurse in Opelousas, La., who needs surgery for herniated discs in her neck.

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I found this especially interesting since just the day before, I learned that the highest-salaried doctors in the United States are orthopedic surgeons who specialize in the spine.

The problem is not limited to orthopods, of course. As the article by Robert Pear, "Cuts Leave Patients with Medicaid Cards, but No Specialists to See," points out, physicians across the board are turning away patients enrolled in the Medicaid program, which is supposed to assure health care to our poorest citizens.

To compound the problem, as states cut Medicaid payment rates for doctors -- 20 states did so last year, 16 more states propose doing so in 2011 -- people are swarming onto the Medicaid rolls. "Medicaid will soon be the nation's largest insurer," Pear writes. "It accounts for almost half of the increase in coverage expected under Mr. Obama's health law."

It's easy to throw blame around for our country's health-care problems: We've been doing it for years, to no appreciable effect. Democrats blame Republicans for doing nothing, and Republicans blame Democrats for doing the wrong thing. Consumers blame greedy doctors, hospitals, insurance companies, and pharmaceutical companies. Doctors blame greedy lawyers, the high cost of medical education, and inadequate reimbursement.

Hold your blame, folks, no matter how certain you are of your opinions. Blame could justifiably be attached to any or all of the above. The underlying problem, though, is neither greed nor bad law nor a broken system.

The underlying problem is that the United States, unlike all other developed nations, has no system at all. Nor do we have the non-system of a genuinely free market with open pricing, vigorous competition, and informed consumers. And until we get some sort of unified approach to health care, prices will continue to rise, accessibility will continue to fall, and Americans will continue to die younger than we need to.

At last count, people of 27 other nations live longer than we do. All 27 pay considerably less per capita for health care.

portrait-lavonne-neffLaVonne Neff is an amateur theologian and cook; lover of language and travel; wife, mother, grandmother, godmother, dogmother; perpetual student, constant reader, and Christian contrarian. She blogs at Lively Dust and at The Neff Review.

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