- Welcome to socialized medicine
Obamacare fans wax utopian about how people would get the medical attention they need if only they have health insurance. Obamacare even tried to force people to buy health insurance, but the Supreme Court’s Obamacare decision gave people the choice to pay a tax instead. Still, the underlying assumption that health insurance means access to care lingers on.
But is that really true? Does having health insurance mean you will get the care you need?
Medicaid sheds some light on this question.
In 2010, about 42 million children from some low-income families obtained health insurance under two programs: Medicaid and Chip (Children’s Health Insurance Program). A study done by the General Accountability Office (GAO-11-624) in 2011 showed that fewer doctors and specialists accept children insured by Medicaid and CHIP as new patents than children covered by private health insurance.
Just how bad is it?
About 75 percent of primary care doctors and specialists throughout the U.S. are enrolled as Medicaid and CHIP providers. About 77 percent of these doctors accept all children covered by private insurers as new patients but only about 45 percent accept all children covered under Medicaid and CHIP. More rural primary care doctors accept Medicaid and CHIP insured children as new patients than urban primary care doctors.
Specialists are also less likely to accept Medicaid recipients as new patients. About 84 percent of specialists accept all children covered by private health insurance as new patients compared to only 51 percent who accept all children insured by Medicaid and CHIP.
Wyoming is a rural state. Are doctor’s here more willing to take on new Medicaid patients?
According to Dr. James Bush, Medicaid Medical Office for the State of Wyoming, virtually all primary care physicians in Wyoming are enrolled to accept Medicaid patients. Wyoming Medicaid does not have data on whether doctors refuse to accept new Medicaid patients but Dr. Bush said, “I have never heard of patients complaining that a doctor won’t accept them because of Medicaid.”
Medicaid patients in general seem to have the same access to doctors as everyone else in the state. The problem, Dr. Bush said, is a “paucity of providers.”
In Wyoming in 2011, the number of people enrolled in Medicaid at some point during the year was 90,000. Under Obamacare, that could increase by almost 50 per cent. According to Dr. Bush, “Access will continue to be a problem due to a lack of providers.”
Obamacare will increase the Medicaid reimbursement rate to 100 percent of Medicare reimbursement rates for 2013 and 2014, but Medicaid reimbursement rates in Wyoming are now close to 100 percent of Medicare rates and most doctors already take Medicaid patients, so a higher reimbursement rate will likely have no effect on doctor supply in Wyoming. Because Wyoming has a small population spread over a wide geographical area, the problem for many people needing health care, even those with private insurance, is that there are no doctors close by to see.
So it seems unlikely Obamacare will improve access to health care in Wyoming. If government gets even more involved in health care, will things get better? Probably not.
In the Canadian socialist health care paradise, government pays for everyone’s health care, not just for those whose income falls below some arbitrary level. In Canada, even fewer doctors take new patients compared to doctors enrolled as Medicaid providers. In 2004 in rural areas, only 38 percent of doctors accepted new patients and by 2007, only 36 percent accepted new patients. The situation is even worse in urban areas. In 2004, only 21 percent of doctors accepted new patients and by 2007, only 17.6 percent of doctors accepted new patients. In 2011, the median wait time to see a specialist once a condition had been diagnosed was 9.5 weeks. That ranges from 2.2 weeks for medical oncology (cancer) to 19.7 weeks for orthopedic surgery.
Why won’t doctors take new patients when government pays the bills? As the GAO study mentioned above shows, doctors don’t accept new Medicaid and CHIP patients primarily because of low reimbursement rates and the red tape and paperwork burden imposed by the health care bureaucracy.
Although some people might feel more secure with government-supplied health insurance, it doesn’t mean they will get the care they need. Instead of sticking with the Obamacare fiction, we need reform that increases access and lowers costs. To do this, we must stop the creeping socialization of health care system and put people back in control of their own health care decisions.