Ounce of prevention

December 12, 1991

On the heels of a state directive making welfare recipients more accountable for benefits they receive, Maryland this week applied the same rationale to Medicaid recipients. Under the new rules, recipients will be required to enroll with a private doctor and get regular preventive care rather than rely on hospital emergency rooms when they are sick.

The change appears to be part of a larger trend to encourage recipients of public assistance to be more responsible as a condition for continued benefits. Officials say the requirement will save the state about $24 million in the short run, but won't make a major dent in Maryland's $1.5 billion health care bill. Over the long run, however, it should result in better health care for the poor, who suffer disproportionately from illnesses that could be prevented through early intervention and treatment.

When Governor Schaefer first proposed the idea some months back, we questioned whether private physicians would be willing to accept Medicaid patients. Though a final answer probably won't be known for several months, it now appears that in most parts of the state, including Baltimore city, sufficient numbers of private doctors -- mostly general practitioners and family physicians -- have indicated they will participate in the program hTC to make it work. But it will still be up to the state to ensure that the transition runs smoothly and that those unlucky enough already to require medical assistance will not have their misfortune compounded by bureaucratic ineptitude.

Still, there is a better way...

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