Nowadays, physicians are still not obliged to accept Medicaid patients that remains a controversial discussion point. In the United States, there are more than 85 billion beneficiaries of this governmental-state program, while 71% of caregivers are ready to deal with their health problems (Holgash & Heberlein, 2019). Even though such patients usually put enormous effort to find a physician promptly. In many cases, they hear a number of refusals until they ultimately reach a life-saving professional far from their home. Although there are many understandable reasons for refusal, to my mind, current practice is insurance-based discrimination, which is unfair towards poor masses and goes against medical ethics.
The primary blame is put on the inferior Medicaid payment in comparison to Medicare and private insurances. It was found to reimburse 72% of what Medicare compensated for physicians’ services in 2016 (Holgash & Heberlein, 2019). Although the majority of caregivers feel the duty to accept some Medicaid patients, they are reluctant to do that, taking into consideration the business element of their clinical practices. To maximize revenue, they have to reject such patients and prioritize those with private insurance. Other arguments for rejecting Medicaid claims include increased state reimbursement waiting time, onerous paperwork, higher social and behavioral demands of Medicaid patients that require more resources and time than the average patient. Although 84% of state-governmental assistance program’s beneficiaries successfully received the care they needed, they often structural inequities of the “separate but equal” policy (Agarwal, 2017). The Hippocratic oath in the modern world demands efforts to eliminate discrimination in health care based on various social categories.
The business argument should be overshadowed by professionals’ moral responsibility to address the health care disparities. Although physicians are able to reject Medicaid insurance, they are ethically obliged to contribute to the Medicaid program improvement. They must not only wait until the government fix insurance-based inequalities, but also do their part to help those most in need. Of course, it is not possible to accept every potential claim and maintain the business. However, every physician can decide on the number of such patients his/her practice can sustain. In that case, refusing to see all the poor people with Medicaid is a purely discriminative and unfair practice, at least in terms of medical ethics and their contract with society. The government also should increase the reimbursement level and initiate managed care programs following Medicaid expansion.
References
Agarwal, S. (2017). Physicians who refuse to accept Medicaid patients breach their contract with society. STAT.
Holgash, K., & Heberlein, M. (2019). Physician acceptance of new Medicaid patients: What matters and what doesn’t. Health Affairs.