In some ways this helps: There is still a stigma that if you show a Medicaid or Medicare card you must be some poor failure/welfare queen, etc. But if you brandish a Blue Cross/Blue Shield card, though in reality it may be paid by Medicare all the same, you're once more a respectable citizen. It's the difference between presenting food stamps to pay for food, and actual cash. The latter is more respectable, the former shameful.
And many doctors refuse Medicare patients as a matter of policy (probably because the govt. is actually more of a stickler about paperwork and negotiating fair pay than many private insurers are); so having the private card could even open doors for the sick/elderly/poor/disabled.
On the other hand, that the stigma exists for a patient that being on Medicaid is bad, but, say Aetna, the former slave insurer, is good -- is total crap. The outsourcing of health plans also happens at the state level: When I lived in California for a brief period, where I lived I think a lot of the state's medical program, Medi-Cal was mostly managed by Blue Cross.
-B.
Doug Henwood wrote:
> Wall Street Journal - November 15, 2006
>
> Healthy Industry
>
> In Medicaid, Private HMOs
> Take a Big, and Profitable, Role
> Managing Care for the Poor,
> They Prosper by Cutting
> Beleaguered States' Costs
>
> Dr. Polack Seeks an Antibiotic
>
> By BARBARA MARTINEZ
>
> Some 55 million poor and disabled Americans are
covered by Medicaid. With an annual price tag topping
$300 billion, it's among the biggest government
programs around.
>
> It's also a lucrative business for some private
companies that act as middlemen between the government
and patients. Instead of directly paying the bills
when a Medicaid patient goes to the doctor, state
governments increasingly outsource the job to private
contractors. More than one in three Medicaid
beneficiaries now receive care through a private
insurer.