Medi-Cal patients with cancer fare worse than those with other coverage

[KamaAina]

http://www.sacbee.com/news/local/article45080877.html

Cancer patients insured by California’s health plan for low-income people are less likely to get recommended treatment and also have lower survival rates than patients with other types of insurance, according to a new study by UC Davis researchers.

While other studies have linked Medicaid insurance status to worse cancer outcomes, the UC Davis study appears to be the first to examine the impact of various kinds of health insurance across more than one kind of cancer.

Understanding how well Medicaid (called Medi-Cal in California) serves cancer patients is crucial, experts say, because as much as 10 percent of California’s Medicaid expenditures go to cancer care. And Medi-Cal has grown to cover more than 12 million Californians – nearly a third of the state’s population.

“What’s striking is how similar the findings were for Medi-Cal members and the uninsured,” said Dr. Kenneth Kizer, director of UC Davis’ Institute for Population Health Improvement, which conducted the study. “If we weren’t spending billions of Medi-Cal dollars on cancer care perhaps that would not be surprising, but you’d think that the outcomes might be better when you’re spending that much money.”

[yeoman6987]

1. Ugh! Out most liberal state can't get it right.

We better improve some of these programs that the state use so when we do have single payer these problems are resolved.

[KamaAina]

2. I'm not really sure we're "our most liberal state" anymore.

Our most liberal state would certainly not have the highest rate of poverty (adjusted for cost of living), prisons so overcrowded they're under a consent decree, and so on.

[still_one]

4. We aren't. We are actually an independent state, though thankfully most LA and SF bay area

are solid blue which keeps some sanity, though with prop 187 and of course prop 8 we are sometimes a little slow. We eventually usually get it right

[Agnosticsherbet]

3. So what would the outcome be where medicaid (Medi-cal) not avaialable.

Those on medic aide/medi-cal are the poorest among us. They are less likely to have had regular care through their life, and even with medi-cal, often put off visits until they are very sick. The poor do not have the luxury of taking a sick day until they are very sick indeed.

Just comparing outcomes may not provide an accurate picture.

[SunSeeker]

5. Unfortunately, they did not study why the outcomes were comparable to being uninsured.

I suspect it is because the best doctors don't take Medi-Cal, and the working poor can't afford to take time off to see a doctor, so they wait until they're catastrophically sick and go to a place that won't give them the best care. That is how it was with my mom.

[daredtowork]

6. More studies like this need to be done!

Medi-Cal providers are horribly inefficient. That's the money-suck. Patients are deprived of time with their primary-care physician, and their medical record gets fragmented as they are passed between specialist providers. You just go in circles and circles and circles. If one treatment causes side-effects, you just have to live with it for months until your next appointment. During that time, you either get worse and seek (unnecessary) emergency room care or you get better - but there's no one there to build on that progress.

This system needs to be fixed, but the clinics seemed too focused on pursuing grant opportunities to look at the big picture.