Parents’ Perspectives on Medicaid Changes

During tough economic times, state governments often make drastic cuts to health programs, specifically Medicaid, in order to balance budgets. A recent study in the Journal of the National Medical Association investigated the opinions of Medicaid parents regarding federally-mandated changes to the Medicaid program following the Deficit Reduction Act of 2005. A total of 49 patients completed ethnographic interviews surveying their attitudes toward the institution of premiums and co-payments in the Medicaid program.

Respondents for the study were parents of children who attended a pediatric clinic in Milwaukee, Wisconsin. Ninety percent were African American. Sixty-four percent of parents had graduated high school. Most parents were unaware of the changes to the Medicaid program.

Some poignant comments of these parents include the following:

“[If] I have to get charge $10 every time I come, I probably would be here. I would just go run and buy some over the counter drug and see if it works for the baby.”

“If I was able to afford it in the first place, I wouldn’t be applying for Medicaid.”

“I’d rather take him to the ER [than pay a $10 co-pay].”

“You got some people [that] just might take a gun and go put it to somebody’s head and say give me $10, I need to get my baby to the hospital.”

Commentary:

This interesting study explores the opinions of the care-takers for children on Medicaid. Some findings are completely expected; parents would rather decrease  health care utilization than spend out-of-pocket for care. Other responses, particularly the one suggesting that parents might turn to violent crime in order to provide health care for their children, are utterly shocking. Policy makers ought to consider the potential effects such policies – enacted typically for budgetary reasons – might have on health and society.

JNMA. 2009; 101 (3): 213-222.

by

Cedric K. Dark, MD, MPH