(Harvard School of Public Health/WBUR/Blue Cross Blue Shield of Massachusetts Foundation/Robert Wood Johnson Foundation)
Brecah Bollinger, a 42-year-old mother of three in Quincy, requires a lot of medical treatment. But, she says, she often feels like a critical element is missing from her health care: the caring part.
Diagnosed with an immune system disorder, sarcoidosis, Bollinger has near-constant joint pain, trouble breathing, deafness in one ear and a slew of other symptoms that prevent her from holding a job, she says.
She’s on MassHealth, the state’s subsidized Medicaid program for low-income residents. But Bollinger says that as soon as she steps into the doctor’s office, she enters a world in which she feels inferior — rushed, ignored and discounted at each step. “I call it assembly-line health care,” she says. Doctors have abruptly stopped her from talking by putting a hand in her face, suggested she’s addicted to painkillers and left her alone in an exam room in the middle of a medical history, seemingly too busy to take her myriad symptoms seriously, she says. Although Bollinger reports that she was assigned a primary care doctor five years ago, she’s never seen her: that doctor’s schedule is always full. So Bollinger says she just takes whichever provider happens to be free.
“I’m treated horribly,” she says. “I want my doctor to be thorough even if it takes more than five minutes. Frankly, I’m embarrassed to be on MassHealth — they think, ‘Oh, you’re poor, you must be a drug addict.’ Or, like, ‘Your insurance doesn’t pay me enough to be thorough.’ ”
Despite nearly universal health insurance coverage in Massachusetts, which has clearly helped residents, mainly the poor, gain access to medical care, disparities persist.
Bollinger says she has a friend with renal cell cancer who is covered by private insurance and experiences health care in an entirely different, more humane manner. “She has Blue Cross and they treat her like a queen,” Bollinger says. “They pay for her transportation, and her primary care doctor, on days off, calls her just to check in.”
It’s tough enough being sick, but when you’re sick and poor, you’re far more likely to experience long waits and care that leaves you unsatisfied and feeling discriminated against because you’re on Medicaid or other public insurance.
In our poll, Sick in Massachusetts, we asked residents who said they had a serious illness, medical condition, injury or disability requiring a lot of medical care, or spent at least one night in the hospital within the last year about their experiences. We found that sick people with lower incomes (under $25,000) are significantly less likely than middle-income (from $25,000 to $74,999) and higher-income folks (over $75,000) to say they are very satisfied with their care. And more than one-fourth of the lower-income sick report that they were treated worse than others because of their insurance status, a significantly higher proportion than for middle-income (13%) and higher-income (2%) sick. Continue reading