It’s one of the biggest warnings delivered by those who were opposed to Medicaid expansion…long wait times, and it’s been confirmed by HHS, Office of Inspector General in December 2014.
According to the 12/2014 report, “Access to Care: Provider Availability in Medicaid Managed Care,” OEI-02-13-00670, “…slightly more than half of providers could not offer appointments to enrollees.”
The proposed solution in the HHS Office of Inspector General report is three-fold, first, to improve the accuracy of provider lists, second to make sure the number of providers is “adequate” and third to determine whether plans are complying with State standards and determine whether additional standards are required.
The report finally moves beyond “enrollment” and identifies the real issue of health CARE rather than health insurance. It explains: “Examining access to care takes on heightened importance as enrollment grows in Medicaid managed care programs,”“Access to Care: Provider Availability in Medicaid Managed Care,” OEI-02-13-00670, 12/2014.
Currently, Healthcare.gov advises: “If you’re having trouble getting an appointment to see a doctor, call your state Medicaid or CHIP agency or your health plan’s member services department,” https://www.healthcare.gov/medicaid-chip/using-medicaid-or-chip-coverage/. That’s your recourse, start your endless arguing about why you should be able to see a physician.
The report should herald in a significant shift in the “conversation” about Obamacare, shelving the ridiculous obsession with the political focus on how many people are enrolled rather than the citizen urgency of whether people can get needed medical services and care in a timely way. The report highlights that having health insurance is NOT an automatic indicator of improved access to health CARE.
Yet still, there are those who unreasonably want to spin that everything’s going OK. As consumers we need to ask: Why? In my opinion, it may be another case of elitism, a little bit of access is good enough for “them.”
For example, writer Austin Frakt asserted in his November 10, 2014 article, “Shortage of Medicaid Doctors? Not If You Ask Patients,” 11/10/2014, THE NEW YORK TIMES, “The Upshot,” that access is “good enough” for Medicaid consumers by saying, “Medicaid enrollees may, in fact, have to work a bit harder to find a primary care doctor who will see them, but almost all are still able to find one.”
Mr. Frakt asserted a similar theme of what’s good enough for Medicaid folks in his blog, “The Incidental Economist,” last year, December 3, 2013 when he wrote, “Medicaid access is quite close to that for the privately insured and lots better than the uninsured,” http://theincidentaleconomist.com/wordpress/medicaid-and-access/.
Ridiculously, instead of considering the government’s report on the current and significant pitfalls of the Obamacare expansion of Medicaid on health CARE as a result of the government’s finding that more than half of the providers could not provide appointments, Mr. Frakt would rather argue that the government survey’s methods, the “secret shopper,” direct research method is flawed and the problem is really very small.
For me consumers lose with this kind of a flawed attitude that is so supportive of the idea of Obamacare that it loses sight of the law’s flaws because conclusions based on this kind of flawed reasoning tend to determine that there is very little real work needed to be done to fix the health CARE crisis and instead conclude like Mr. Frakt that “…modest improvements may be sufficient,” Austin Frakt, “Shortage of Medicaid Doctors? Not If You Ask Patients,” 11/10/2014, THE NEW YORK TIMES, “The Upshot.”
If you’re into being soothed, this type of rhetoric might soothe you. If you’re not part of the population of those hoping to gain access to health CARE through the expansion of Medicaid opportunity to obtain access to health INSURANCE this may soothe you.
But if you’re concerned that the blurring of the lines and somehow equating health insurance with better health CARE then like me, you’ve got no choice but to believe the government’s own assessment that this IS NOT TRUE for Medicaid enrollees hoping to have improved access to health CARE if as the government itself states, “…slightly more than half of providers could not offer appointments to enrollees,” “Access to Care: Provider Availability in Medicaid Managed Care,” OEI-02-13-00670, 12/2014.
It is apparent to me that like most Obamacare zealots, Mr. Frakt’s reasoning is frequently unclear and requires even more nuanced spin to support any even tenuous consistency of thought.
In June of this year Mr. Frakt recites the usual that “Access to health care is enhanced by health insurance,” then argues that it follows that, “…equal opportunity to obtain coverage is a necessary condition for equal access to health care,” JAMA Forum: The Moral Case for Affordable Coverage and How Obamacare Fails To Live Up to It,” Austin Frakt, PhD, 6/11/2014, http://newsatjama.jama.com/2014/06/11/jama-forum-the-moral-case-for-affordable-coverage-and-how-obamacare-fails-to-live-up-to-it/.
OK, so Medicaid expansion is good because it expands opportunity to obtain coverage which is a necessary condition for equal access to health care. EXCEPT, according to the government, access to health insurance coverage DOES NOT necessarily improve access to health CARE because the availability of care via an appointment is IMAGINARY over half the time.
Mr. Frakt then shows an example of how the problem, though “modest” in his opinion is being addressed by bragging that the Government has increased “…funding for primary care training and in Medicaid payments for primary care visits…” ignoring one of the key findings of the government itself which is that “…specialists tended to have longer wait times…” than primary care physicians.
Specifically, “…primary care providers were less likely to offer an appointment than specialists; however, specialists tended to have longer wait times,”“Access to Care: Provider Availability in Medicaid Managed Care,” OEI-02-13-00670.
This type of reporting prevents reasonable action to address the ideological inconsistencies between the justifications given for Obamacare and the real Obamacare that not only falls short in its defined goals but may in fact be based on an ideology that is less true than false and therefore can NEVER achieve its stated ideological goals.
