My mother has been on Medicare since was eligible (she's 73 now) and has in the past 9 months been on Medicaid. I'd like to think that it wouldn't matter, but I can remember my mother stating something to that effect when she worked as the dietary manager in the nursing home.
I think my husband got sub-standard care each time he was hospitalized, both before and after being on Medicaid, and that is because our hospitals -- even great ones -- do a piss-poor job of taking care of those with dementia. It is lamentable, but a completely separate issue from who is doing the paying.
My mother is on Medicaid and is now in a nursing home, and on hospice (paid for by Medicare). I doubt very much if her aides and nurses know how her bills are being paid. I'm impressed with the care she is getting.
My daughter works in an Assisted Living Facility as a PTA. I asked her once how many of their residents are on Medicaid. She said she assumed that most of them who have been there a long time have run out of money and are on Medicaid, but that she doesn't know that for sure or which they are. Obviously she is not giving anybody any worse treatment.
I'm sure it is possible that some places that accept Medicaid are not great places. I suppose that some places that have both private-pay and Medicaid patients do discriminate in the levels of care they provide. I don't doubt the experiences of other posters. But I'm happy to say that I have never seen any of that with my husband or with my mother.
They did not give her the anti-anxiety meds she needs twice a day. She hallucinated for two days. Had some gosh awful stories I know weren't true.
They asked NUMEROUS times what meds she was on, but the stress was just too much I think. She was saying "I'm going to start breaking things if they don't let me go home." Fortunately, they had said she could go that day. That was my biggest complaint, the lack of meds.
My doctor is set up where he has a "referral girl" who he instructs to get a specialist for me when needed. She looks at my chart and does it all, making the appt to getting approval to preregistering. My mothers doctor says you have this insurance and I can send you to so and so. Well the so and so did nothing about mother's heart which was 80% blocked, said there was nothing he could do. Yet when she had her heart attack 3 weeks ago, I was able to get my heart surgeon who immediately put in a stent. Yep changing her doctors.
My opinion on the care that I get - it depends on the doctor. One specialist that I go to doesn't care what type of program I am in and gives me good care, but another specialist says that he cannot give me medicines that may work because Medicaid will not pay. Have heard horror stories about hospital care for elderly with Medicaid also. Really think it depends on the doctor - someone who is against government programs would not be a good doc to have!
The worst experience that I had was a clinic for people without health insurance. The doctors did not know as much about the illness as I did, and they acted like they were experimenting on you. And they acted like you should never ask questions.
BUT, another grandparent was self-pay, with Alzheimers. They had a gorgeous nursing home "suite". However, towards the end, when they required an immense amount of care (this was before they had "memory care", it was all just nursing home, 1980's), the administration switched them to a double room, very tiny, and STILL CHARGED them the full rate!!!! we were incensed at this, but they said the level of care required could only be accomplished in the double room. We are still mad at that.
In retrospect, For all the money the one grandparent saved the government, by not being on welfare (and they earned every penny they had) they should have had both my grandparents in really nice rooms.