Dr. James M. Perrin makes important points about both the benefits seen for Medicaid recipients and the persistent structural racism that occurs with the current Medicaid system (“Structural racism infects how we pay for health care,” Letters, May 17). One of his points is that Medicaid-insured people face discrimination because they receive “care from providers who mainly treat low-income patients.” The potential implication that such providers provide lower-quality care does not stand up to any measure of scrutiny. There are no data to suggest that such providers rate lower or are less capable, less empathetic, or less effective.
One might alternatively argue that physicians who care for the most needy in large part are driven by wanting to serve patients regardless of socioeconomic standing and most often are care-focused, thoughtful, highly educated, and mission-driven and among the best physicians to graduate from medical school.
While low-income patients are not cared for by inferior providers, the providers who do care for them end up battling the intrinsic inequities of reimbursement that may limit which tests, medications, and treatments may be covered.
Dr. Karl Kuban
The writer is a professor of pediatrics and neurology at Boston University Medical Center.