April 7, 2014

Expanding Medicaid Is a Step Backwards

Summary

As a practicing obstetrician-gynecologist in California, I have long been concerned with the failings of programs intended to help women in need access quality health care. I am increasingly concerned that the expansion of Medicaid through the new health care law, known as Obamacare, will exacerbate the system’s existing problems, and make it even more difficult to obtain medical care at reasonable rates as the strain on the program grows.

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As a practicing obstetrician-gynecologist in California, I have long been concerned with the failings of programs intended to help women in need access quality health care. I am increasingly concerned that the expansion of Medicaid through the new health care law, known as Obamacare, will exacerbate the system’s existing problems, and make it even more difficult to obtain medical care at reasonable rates as the strain on the program grows.

Expanding Medicaid is neither caring nor affordable. Despite the program’s high cost to taxpayers, it provides patients with inadequate care. There are a number of reasons it falls short, but one in particular stands out: low provider re-imbursement rates which discourage doctors from accepting Medicaid patients. This in turn leads to poor continuity and quality of care and increased fraud.

I’ve witnessed the problem first-hand while taking care of pregnant women covered by Medi-Cal, California's Medicaid program. I have sometimes felt alone in treating these high-need patients, since Medi-Cal, as it currently stands, covers only obstetrical aspects of medicine. My colleagues in other specialties do not take Medicaid, which often fails to cover the cost of care provided. Should one of my patients have a non-obstetrical problem, such as an abscess on her tonsils or recurrent loss of consciousness, it is unlikely she will find an appropriate provider that accepts Medi-Cal in a timely manner.

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