This is NOT to suggest that African-American maternal mortality and Medicaid maternal mortality are mutually synonymous. There is some overlap, however.
The Medicaid administration freely admits that one of the major issues with delivering healthcare to their clientele is that recipients are more likely to "blow-off" appointments than people who receive private healthcare insurance. More than a third of Medicaid recipients showed up for five-or-fewer of nine-recommended well-baby visits.
One factor is that people with private insurance are usually held responsible for the cost of the appointment if they do not show up at the required time. At more than $120 per appointment that is a very strong incentive to either show up or call more than 24 hours in advance. People on Medicaid have very little monetary skin-in-the-game.
Transportation to appointments can also be a problem. Most doctors choose to have their offices in swanky, low-crime areas. Some people on Medicaid live in higher crime areas distant from the doctor's office. Bus rides are long. Uber drivers not always thrilled to pick up clients in areas they perceive as dangerous.
Dilution of Responsibility
A third factor, one that advocates-for-the-poor NEVER want to talk about is that some mothers on Medicaid have children by multiple fathers and do not attend scheduled pre-and-postpartum appointments because they have nobody to watch their children.
Where-as a married couple has two sets of grandparents and aunts to pull on for emergency childcare, the mother with children from multiple fathers lacks that second set of family.
Many factors come into play. The grandmother of an ex-boyfriend is unlikely to take all of the other kids even if she is willing to watch her own grandchild.
The mother of the current boyfriend might consider the current liaison to be temporary at best and be resentful of the probability that the mother-to-be will break up with their son and then ding him for child-support for the next 18 years. After all, she has a history if she already has at least one kid from a different father.
In some cases, the second set of grandparents do not even know about the grandchild spawned by their son.
One man, one woman, till death do us part...
Still the best plan.
Correlation versus causation? What demographic uses Medicaid again?
ReplyDeleteIt reminds me of the whole “Poor people have more health problems. Therefore being poor causes illness and ‘we’ (meaning you) need to give ‘us’ (meaning me) more money to tackle the problem (2% of which we'll pass on, administrative charges/costs you understand - we really need to attend the global symposium in the Maldives and my Mercedes is a year old)” argument. Maybe, just maybe, they’re poor because they make poor life choices. Poor life choices that include those that will affect their health. Poverty isn’t the issue, it’s bad choices across the board, but we’ll gloss over that inconvenient truth.
I well remember the “smoking causes everything from alopecia to zits” propaganda, (conveniently) forgetting that those they use as examples/evidence for this are those who have made (euphemistically) less beneficial choices their entire lives. Eating cr*p, never exercising, living in filth, using drugs could, maybe, just maybe, also have something to do with it, yah think? (smoking is the least of their health worries, but cigarettes are such an easy, and lucrative, target).
Cui Bono?
Amazingly, purely coincidentally yet again, it is the very people making the spurious claims (and certainly not those ‘benighted’ African-American women and their self-inflicted, and grossly over-exagerated woes) who will gather money (from you at the point of a gun) to solve an irrelevant ‘problem’ whilst ignoring the real ones.
Freedom, when you get down to the nitty-gritty basics, is responsibility. You accept responsibility for actions, behaviours, choices and outcomes/consequences (good or bad) for yourself. No wonder so many clamour against it in defence of their actual (in all but name) slavery. (It’s so much ‘easier’ to do/say/think as you’re told, accept the bread and circuses, and always, but always have somebody else to blame for your failings).
My sister found herself jobless, broke, without reliable transportation and on medicaid 10-15 years ago. Part of the medicaid package included transportation to appointments. They might tell her they would pick her up 3 hours before the appointment then drive all around Wayne county picking others up. It was very much a “ghetto taxi”. They were sometimes “ no call, no show” . My sister felt that as a MA recipient she was treated with less respect and consideration than when she had private insurance. I worked in the Foster Care/ juvenile justice system for almost 3 decades and can confirm outcomes follow choices, however, your upbringing colors your perception of choice…… If you are a kid growing up in a 3rd generation welfare home with absolutely no positive role models showing you how initiative can succeed your choices are effectively constrained. Another note, over the years as a foster care worker and manager. I dealt with hundreds of families. I can remember only a handful of cases where the kids coming into care were from a family with mom and dad married to each other and raising their own kids. In most of those cases both parents had serious drug or mental health problems and were without support systems. The other 98% were single parents, ill educated and unemployed. Where there were multiple kids there usually were multiple daddy’s. Its darn near impossible to get an adult “on track” who has no experience with life other than the life they are living.
ReplyDeleteSee above. I agree with both previous posts.
ReplyDeleteAfter our oldest kid raised her kids her and her hubby wanted to buy a little ten acre patch down the road and build a big fancy new place which they did . We bought her place and have rented it since . It has opened my eyes to a different world . I learned that fiancé means live in baby daddy and has nothing to do with reality . Of the dozen or so misfits that have lived there on this hill with us Only one couple had a kid that belonged to them both and they were actually married . Sigh!
ReplyDeleteI suspect that if you looked at poor white families you'd see higher mortality and Illness than middle class.
ReplyDeleteI also suspect the upper class is almost un measurable with their hookups, drug use, and assorted other stupidity.
I wager that the strongest correlation is "poor life choices" and "poor outcomes" ("Hunter Biden! Please take the call on the red courtesy phone! Hunter Biden!") Wealth only provides an insulative benefit, just like good insulation means that your house takes longer (does not avoid) approaching outdoor temp, once your furnace fails.
ReplyDelete