Misadventures in Medicaid Land

Have you ever had a really bad sore throat, which you figured was probably viral so there was nothing that could be done anyway, but you better go to the doctor just to be sure?

So you go to the doctor and the doctor tells you: "Yeah, your throat is really red and there's pus in there, and I'm worried it could be strep," and she then proceeds to tell you that she doesn't have one of those long cotton ball things on a stick to do a throat culture, so you'll have to go over to the hospital to be tested!?

Well, I hadn't either. Until yesterday. But that is exactly the crazy scenario that took place. From the time I took the baby to the sitter's (to keep her out of a waiting room full of sick people) until I got home from the pharmacy, the entire experience took four hours. For a strep test.

It's a crying shame I don't have a voice at the moment because shouting my incredulity would be much more satisfying than pounding it out on this keyboard...

The genesis of this story probably began five months ago, when I submitted a bunch of paperwork to get Adi onto the state's health insurance plan for children. Called CHIP, it is designed to make sure all children in the state have health insurance, and the premiums range from $0 to $50 a month depending on a family's income. Imagine my surprise, then, when Adi was denied enrollment in CHIP because we didn't make enough money (you know ... for the free state health insurance plan). Instead, both she and I were summarily placed on Medicaid.

In the case of her care, this hasn't really mattered one way or the other. The list of doctors who take children on Medicaid was long and lush, and both my first- and second-choice pediatriacians were on the list. Her care, including a delayed vaccination schedule and the prosthetics for her dislocated lips, has been nothing short of wonderful.

In my case, the list of doctors who take adults with Medicaid was noticably shorter. Neither of the two doctors I have used in Philly under my regular insurance plans, nor any of the doctors Aaron has ever used, accept Medicaid. I wound up picking the only doctor who was listed in my ZIP code. Yesterday was the first time I had reason to pay her a visit.

I must say, the whole experience leaves me scratching my head. It looked like a normal doctor's office. She also accepted regular insurance patients, so it wasn't some inner city clinic for indigents or anything. But she couldn't even do a simple strep test!

Sending me over to the hospital, however, was like sending me to an inner city clinic because it was the unit of the hospital for the uninsured. I had to wait over an hour to be "registered" and then I had to wait 45 minutes for the lab to do the throat swab. Then, because Medicaid only covers labwork at one particular chain of labs, they had to send the swab out of the hospital to have it tested elsewhere, even though they had the capacity to test it right then and there.

The results will come back today.

I'm 99% sure I don't have strep. I haven't actually had it since I was a kid. Mostly I was just being a worried mom, worried about giving something so contagious to my baby. But this whole thing felt like a fiasco worthy of a Michael Moore movie; a case of the cure killing you faster than the disease.