Discussing the impact of managed care on trans healthcare, access to procedures, discrimination, and barriers faced by trans individuals. Highlighting the complexities of inclusive coverage for gender-affirming care in California's State Medicaid program. Examining the role of healthcare in managing the socioeconomic status of trans individuals and the failures of managed care in improving access and quality of healthcare.
Managed care models in Medicaid have restricted access to gender-affirming care for trans individuals.
Managed care perpetuates a market-driven approach to healthcare, prioritizing profit over care.
Managed care diverts attention from ensuring equitable and accessible healthcare for all by prioritizing profit over meeting healthcare needs.
Deep dives
The Impact of Managed Care on Trans Care Access
Managed care models in Medicaid have led to restricted access to gender-affirming care for trans individuals. Despite having insurance coverage, many trans people struggle to find providers competent in trans care or face administrative burdens that limit their utilization of care. Even in states with supposedly inclusive coverage, such as California, restrictions on care still exist. Hair removal, a necessary component for certain surgeries, is often not covered or subject to stringent limits. Managed care rationalizes scarcity and commodifies services, prioritizing profit over care. This market approach obscures the structural failures in healthcare provisioning and exacerbates disparities in access.
The Ideological Foundation of Managed Care
Managed care models are rooted in the belief that healthcare consumption should be restricted to prevent unnecessary utilization and combat the so-called free rider problem. By tightly managing services, implementing rationing, and defining eligibility criteria, managed care aims to control costs and improve efficiency. However, these models perpetuate a market-driven approach to healthcare, prioritizing profit and maintaining the commodification of care. The focus on individual responsibility shifts the blame onto patients and diverts attention from broader structural issues in the healthcare system, such as accessibility and affordability.
Market Imperatives and Profit Generation
Managed care models in the Medicaid system have allowed for-profit insurance companies to generate profit by controlling public funds. These models extract surplus value from public funds and prioritize profit over meeting the healthcare needs of individuals. By rationing care, implementing administrative burdens, and limiting provider networks, managed care perpetuates barriers to accessing care and reinforces the commodification of health. The profit-driven approach of managed care diverts attention from the fundamental goal of ensuring equitable and accessible healthcare for all.
Outcomes of Managed Care and Restrictive Access
Managed care models result in restricted access to care, even for individuals with insurance coverage. Denials, administrative burdens, and limited provider networks create barriers to receiving necessary gender-affirming care. The efficiency and cost-containment measures of managed care prioritize the market economy over meeting the healthcare needs of individuals. These limitations often result in delays, financial hardship, and inadequate care for trans individuals seeking gender-affirming services. The impact of managed care highlights the urgent need to reevaluate and transform the commodification of healthcare to ensure equitable access for all.
Challenges with Trans Healthcare Access
The podcast explores the challenges surrounding trans healthcare access, particularly in the areas of hormone therapy and surgeries. The speaker highlights the high cost of hormone prescriptions offered by private subscription healthcare services and the limited availability of surgeons for gender-affirming surgeries, especially in countries with national healthcare programs. The discussion emphasizes the impact of managed care models and privatization schemes on trans healthcare, which often prioritize profit over comprehensive and equitable care.
The Global Impact of US Managed Care Model
The podcast delves into the global impact of the US managed care model. It highlights how privatization schemes and the expansion of private health insurance corporations have been advocated by global trade bodies and international financial institutions, such as the World Bank. The adoption of managed care models in Latin American countries, for example, was driven by conditions imposed by these institutions. The discussion also explores the implications of these models on gender-affirming healthcare, including the cost differentials and the challenges faced by trans people seeking affordable and quality surgeries. Overall, the podcast emphasizes the need to challenge the market ideology and strive for comprehensive healthcare systems that prioritize justice and well-being.
Today's episode was originally a patron exclusive. To support the show and get more episodes like this, become a patron at www.patreon.com/deathpanelpod
Bea and Jules discuss “managed care,” a seemingly innocuous term for a guiding principle in contemporary US healthcare that structures and incentivizes medical rationing and austerity. We also discuss how the use of managed care in state Medicaid programs leads to widespread denials for trans care, and tease Jules’ new book, “A Short History of Trans Misogyny,” coming in January from Verso.
Find our book Health Communism here: www.versobooks.com/books/4081-health-communism
Death Panel merch here (patrons get a discount code): www.deathpanel.net/merch
As always, support Death Panel at www.patreon.com/deathpanelpod
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