Wednesday, March 17, 2010

Have Insurance, Where's The Care?

A great article in Monday's NYTimes (yes, the NYTimes, of all places) gives a glimpse into our collective future, if Obamacare makes it into law. The story, written by Kevin Sack, tells of a woman in Flint, Michigan who is covered by medicaid, but can no longer locate a doctor who accepts medicaid patients. The article then goes on to describe this as a growing problem nationwide. This is a problem, not only for medicaid, but for medicare as well.

Why can't a medicaid patient find a doctor? Because there is no funding. States have begun to pare back their medicaid spending (they are the federal "partners" on medicaid). Medicaid payments (reimbursements they call it) are pitifully small and doctors cannot make a living if they accept too many medicaid patients. As the Times article points out, doctors tend to lose money treating medicaid patients. The same is often true for medicare patients. If Obamacare passes, the $ 500 billion reduction in medicare reimbursements that are cited in the bill virtually guarantees that more and more doctors will quit accepting medicare patients as well.

It is now estimated that more than one-third of all public hospitals will be forced to close their doors if Obamacare passes.

This is our future. Everyone will be insured, but there will be no place to go to get care. This is the nature of public entitlements. Pass them, make big promises, and then callously let those promises collapse just when people really need them.

Read the article in the NYTimes by Kevin Sack. This is where social security, medicare and medicaid are headed. It is one thing to make promises; it is quite another thing to follow through on those promises.