I started talking about this long ago. Anyone who has ever tried to help someone on Medicaid get a doctor's appointment had an arduous time. Doctors simply do not want any more Medicaid patients than they already have.
So it's nice that prominent columnists are talking about it, too. See John Daniel Davidson at thefederalist.com: Let’s Stop Pretending Medicaid Saves Lives. Excerpts:
Proponents of the “thousands will die” argument cite evidence that health insurance is correlated to health outcomes, which is a fair point, as far as it goes. But they too often conflate health insurance with Medicaid coverage. That’s important for two reasons: 1) the majority of coverage gains under Obamacare have come from Medicaid expansion; and 2) Medicaid coverage isn’t the same as private insurance—not even close. When progressives talk about insurance under Obamacare, they’re mostly talking about Medicaid coverage, not private health insurance.
The distinction is important because research has shown that being on Medicaid produces no better health outcomes than being uninsured. This argument has been hammered home by conservative health care scholars like Avik Roy and others, much to the consternation of progressive health policy wonks, who insist on torturing otherwise decent studies for signs that Medicaid saves lives. ...
What accounts for these findings? Part of the answer brings us back to Deamonte Driver. Simply put, too few health care providers participate in Medicaid, so Medicaid patients often have an extremely narrow network of care—especially specialist care. That’s why they often end up in expensive and inefficient hospital ERs. ...
This flaw is built into Medicaid’s design. Like Medicare, Medicaid pays less than private insurance does, so doctors and dentists are often hesitant to take on more than a handful of Medicaid patients, which means there simply aren’t as many doctors and dentists available to see Medicaid patients as privately insured or self-paying patients. What’s more, Medicaid enrollees don’t even have the option of paying the difference between what Medicaid pays and what private insurance pays, or negotiating the kinds of payment plans most providers are happy to offer low-income patients. Federal Medicaid rules simply won’t allow it. It’s either all Medicaid, or nothing.
(Bold added by me.)
Mr. Davidson utilizes one of the tactics favored by progressive writers. He provides an anecdote that humanized the problem. The anecdote had an unhappy ending, by the way. People on the left do that all the time, and it must work because one story about someone's suffering often seems to counter a thousand statistics.
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2:40 PM 6/29/2017
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