Tag Archives: coverage is not care

Government Buries Evidence of Poor Access to Care under Obamacare

From John R. Graham:

Thank providence for USA Today, which has given us yet another story describing how poor access to health care is under Obamacare.

People who fell for navigators’ sales pitches and signed up for Obamacare are discovering that it is junk insurance:

“The exchanges have become very much like Medicaid,” says Andrew Kleinman, a plastic surgeon and president of the Medical Society of the State of New York. “Physicians who are in solo practices have to be careful to not take too many patients reimbursed at lower rates or they’re not going to be in business very long.”

Kleinman says his members complain rates can be 50% lower than commercial plans.

“I definitely feel like a bad person who is leeching off the system when I call the doctors’ offices,” she says. Shawn Smith of Seymour, Ind., spent about five months trying to find a primary care doctor on the network who would take her with a new, subsidized silver-level ACA insurance plan.

Note: This person had a silver plan, not a bargain basement bronze plan.

More: Government Buries Evidence of Poor Access to Care under Obamacare | Health Policy Blog | NCPA.org.

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WSJ: “Patients Cram In Tests Before Health-Law Start”

From the Wall Street Journal:

Thousands of people are cramming in tests, elective procedures and specialist visits before year’s end, seeking out top research hospitals and physician groups that will be left out of some 2014 insurance plans under the new health law, health-care providers say.

Many insurers offering plans under the law are slimming down their networks of doctors and hospitals in a bid to lower the cost of policies, which begin coverage Wednesday.

Health insurers are especially focused on paring academic teaching and research hospitals from their networks because they generally charge more than community hospitals for similar services. …

Some 70% of new plans under the health law offer relatively narrow networks compared with many current plans, according to a recent McKinsey & Co. report.

Read more.

(Via NCPA)

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CNN: “Doctor shortage, increased demand could crash health care system”

CNN reports:

Obamacare is expected to increase patient demand for medical services. Combine that with a worsening shortage of doctors, and next year you may have to wait a little longer to get a doctor’s appointment. And the crowded emergency room may become even more so. …

What happened in Massachusetts in 2006 when the state’s mandated health insurance rules went into effect illustrates the impending national problem.

When the Massachusetts law kicked in, wait times to get an appointment at primary care physicians’ offices increased significantly, and they’ve remained high ever since, according to anannual survey from the Massachusetts Medical Society. And Massachusetts has the second highest physician-to-population ratio of any state.

When patients couldn’t get doctor’s appointments they once again turned to emergency rooms. A Harvard study found all 11 of the emergency rooms that researchers studied in Massachusetts became busier after the law went into effect.

Read more at CNN.com.

(via FIRM)

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How Colorado’s Medicaid expansion harms patients

Linda Gorman of the Independence Institute writes:

Medicaid expansion would limit access to care for the significant fraction of the currently uninsured who would otherwise be eligible for federal premium subsidies under ObamaCare. It raises costs for state taxpayers, increases costs for people who are hospitalized, and prevents state insurers from collecting millions of dollars in federal subsidy money.

Read more: How Colorado’s Medicaid expansion harms patients | Complete Colorado – Page Two.

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Should Colorado expand Medicaid per ObamaCare? No.

At Forbes, Grace-Marie Turner gives Colorado officials reason not to expand Medicaid:

One of the most tragic failings of ObamaCare is that it will make it harder for many of the most vulnerable citizens – patients with no option but Medicaid – to get care.

Medicaid is cumbersome, complex, and wasteful – already the worst health care program in the country. But rather than making changes to improve or modernize this program designed to finance care for the poor, the Obama administration is trying to convince states to add at least 16 million more people to Medicaid, including families making more than $30,000 a year. …

Studies consistently show that Medicaid patients have the worst health outcomes of any group in America, worse than those with private insurance and, in some cases, worse than those with no insurance. …

Despite these many problems, many states are tempted and are seriously considering whether to accept the generous 100 percent federal matching money ObamaCare initially offers if they expand eligibility for Medicaid up to 138 percent of poverty (more than $32,000 for a family of four).

But states should be warned:  It’s likely a loss leader.  There are no assurances that Washington would be able to keep its promise to continue the generous funding.

There already is evidence that could be the administration’s plan. …

There is a better way:  Allow people on Medicaid the option of private insurance so they can get coverage through private competing plans. Florida has a successful model underway. These plans could provide much better access to physicians, coordinate care for patients with multiple health problems, and allow patients to be seen in doctors’ offices rather than in expensive hospital emergency rooms.Patients would have the dignity of private coverage, and safety-net hospitals will be able to keep their doors open so they can continue their mission of caring for the poorest and neediest in our society.

via The Real Tragedy Of ObamaCare Has Yet To Be Felt By The Poor – Forbes.

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Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access

In the Atlantic, Avik Roy writes:

Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act–its expansion of Medicaid coverage to 16 million more Americans–may actually reduce those individuals’ access to health care. …

Believe it or not, physicians even do better caring for the uninsured than they do caring for Medicaid patients. Two MIT economists, Jonathan Gruber and David Rodriguez, have found that three-quarters of physicians receive lower fees for serving Medicaid patients than they do for the uninsured, because many people without health insurance are still able to pay out-of-pocket for routine health expenses.

How?  Medicaid notoriously underpays doctors, so Medicaid patients have trouble accessing them. When Medicaid eligibility expands, many newly eligible people drop “private” health plans to enroll.

Read the whole post: Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access – The Atlantic.

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Sickest Canadians Face the Highest Barriers to Care

CTV of Canada reports:

Canadians with chronic conditions are frequent users of the health-care system, but a new report shows many experience considerable difficulty getting the medical treatment they need.

Read more: ‘Sicker’ Canadians struggle to obtain treatment: report.

Via John Goodman’s blog & Medibid.

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Elderly patients condemned to early death by secret use of do not resuscitate orders

The Telegraph reports that in England:

Elderly patients are being condemned to an early death by hospitals making secret use of “do not resuscitate” orders, an investigation has found. …

Action on Elder Abuse, an independent charity, carried out its own analysis of the official watchdog’s inspection reports. The charity’s findings, published today, uncover widespread evidence that patients are being left to die, without families knowing that such decisions have been taken.

Read more: Elderly patients condemned to early death by secret use of do not resuscitate orders.

(Via FIRM, Health Care BS)

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England’s NHS ‘creaking at the seams’ as waiting lists rise

The Telegraph (UK) reminds us that single-payer “universal” health care is really universal misery:

A senior doctors’ leader has warned that the NHS is “creaking at the seams” as official figures showed almost a third more patients are waiting too long to be treated in hospital.

Read the whole article: NHS ‘creaking at the seams’ as waiting lists rise – Telegraph.
(via FIRM)

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Medicaid as a ghetto: poor access to medical care

Benjamin Domenech of the Heartland Institute writes:

“The Great Society,” as Ronald Reagan once said, “is great only in power, in size and in cost.”

[A] study conducted by Joanna Bisgaier and Karin V. Rhodes published in the New England Journal of Medicine, [shows] something that is already known by most in the field – and denied only by those ignorant of the truth or with a political motive to deny it: the level of access granted by Medicaid and CHIP is completely insufficient to meet the demands of the population it purports to serve.

As Kathryn Nix writes at The Foundry, drilling down to the essence of the study: “While specialists turned away 11 percent of privately insured children, 66 percent of children with Medicaid were unable to get an appointment. For those who did, the waiting time was 22 days longer than for other patients.”

Read more: The Great Society’s Lie.

See also Domenech’s “More Medicaid Delusion,” where the following graph came from:

Lastly, see: Expanding the Medicaid Ghetto for how “reform” puts more people on Medicaid.

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