Expanding Medicaid Will Decrease Access to Care

| January 19 2012

By Alieta Eck, MD

“The purpose of profit is to encourage competition,” said NJ gubernatorial candidate Bret Schundler. Too bad he didn’t win in 2001, as his free market approach to our economy would have dramatically enhanced prosperity in NJ. Instead, as private enterprise has declined, one in seven New Jerseyans is now on food stamps and Medicaid, dependent on the government for basic needs. Every NJ governor since 2001, including the current GOP darling Chris Christie, has cooperated with the federal government, accepting federal tax money and expanding Medicaid as prescribed.

Profit causes more people to supply a service or product. Increased supply causes competition, and the one who provides the best quality at the lowest price wins. This is the free market. The only impediment to a free market in medical care is government intervention.

The Affordable Care Act will prove this point dramatically, as demand will skyrocket and prices will be fixed. Once the physician realizes that he cannot turn a profit, or recoup his educational costs and overhead, he will slow down and retire early. Only the wealthy who are willing pay the going market price will be able to avail themselves of the best medical care in the world.

The Affordable Care Act will expand the ranks of those covered under Medicaid, the program designed to “pay for” medical care for the poor. But Medicaid simply provides a huge bureaucracy to sign people up and shuffle papers. The payments to physicians are about 10 cents on the dollar, so most physicians do not enroll in Medicaid. The Medicaid program amounts to a fraud on the American taxpayer, squandering his hard-earned dollars for ¼ to ⅓ of the average state budget. If this expenditure results in a healthy population and true access to care, one might argue it is money well spent. But it is not.

We can see what ObamaCare will bring to the nation by looking at the results of RomneyCare, its prototype in Massachusetts. Romney promised that people would all be “insured” enabling everyone to see the doctor in his office, sparing the taxpayer from having to pay a more expensive emergency room bill. But as more people attempt to avail themselves of their new found “coverage,” they find that they cannot find a physician who is willing and able to see them. The average wait is now two months, so they still go to the emergency room.

This is not the worst of it. In an extraordinary study from Ohio, Medicaid recipients had worse cancer survival rates than people with no insurance at all. Could it be that the bureaucratic paperwork and low Medicaid fee schedule provides a barrier rather than access to care? An uninsured person who is willing to set up a payment plan, or who expresses true gratitude for donated services, does better than a patient with a Medicaid card.

The purpose of insurance is to protect one’s assets from sudden depletion in the event of a major loss. The poor presumably do not have assets to protect. So instead of insurance, they need a place to go when they find themselves ill and without funds to pay. In 1965, before Medicaid was enacted, hospitals had clinics where physicians donated their time to help the poor.

If we restore the free market to medicine, more primary care physicians will be able to set up practices where patients can pay a fair price for medical care. Philanthropy, hospitals and churches can set up non-government free clinics where the poor is able to access medical care when they become ill. Retiring baby boomers can form an army of volunteers in their communities.  An innovative plan can be for the state to provide true medical malpractice protection for the entire practice of the physician who volunteers four hours a week in such a clinic. This will change everything and result in a booming economy as Medicaid will diminish and those huge sums will revert back to the taxpayers.

New Jersey and Kansas are preparing to draft laws that will make this happen. The states might need to defy the new federal legislation and may be forced to decline federal funds. But state budgets will be balanced and prosperity will result.

We simply must not allow Government Healthcare to expand the failed Medicaid program.

 

Author:

Dr. Alieta Eck, MD, President of AAPS  graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988.  She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. 

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