Abraham: Families Deserve Better Than Medicaid
I’ve spent more than 20 years practicing medicine in the delta of Northeast Louisiana. After looking into the face of poverty, I believe that every American should have access to quality health care regardless of how much money they’ve got in the bank.
That’s why I’m frustrated with politicians who point to the Affordable Care Act and its accompanying Medicaid expansion as the solution to treating the needy. They thump their chests in victory, but all they’ve done is enroll these patients into a second-rate program with limited access to physicians, an almost-empty stable of specialists, and a formulary so restrictive that it is an insult to my patients.
Elected leaders must have the courage to demand better for the people we serve, not cling to failed institutions out of a lack of ingenuity or for political expedience. By repealing and replacing Obamacare, we have the opportunity to finally give all American citizens the health care they deserve.
My biggest problem with Medicaid is the same problem I have with other ACA plans: The system puts Washington between doctors and patients. Patients trust their doctors with their lives, but our treatment plans for Medicaid patients are shackled by bureaucrats who demand the cheapest medicines, not the most effective.
About 70 percent of plans sold on Obamacare exchanges in 2014 consisted of narrow network. Studies show Obamacare networks offer access to 42 percent fewer specialists, like oncologists and cardiologists, and 32 percent fewer primary care physicians compared to commercial plans.
Medicaid patients’ access is no better. Some doctors take Medicaid patients in bulk to adjust for low reimbursement rates, lessening the quality of the doctor-patient interaction. Other doctors flatly refuse to see them because it isn’t profitable, and some see them anyway knowing they’ll take a loss.
Limited access to physicians and specialists causes patients to go to the emergency room for non-emergent care or be admitted to the hospital for routine medical exams; expensive trips that result in taxpayers holding a bigger bill and patients being exposed to a more unhealthy environment.
Obamacare defenders want to preserve this failed program, but we can do better.
Pay the doctors and specialists who see these patients more fairly and expand access by deepening the provider pool. Patients would have their choice of doctors, and taxpayers would pay for fewer non-emergency ER visits and hospital admissions.
Block granting current Medicaid funds would give state governments the flexibility to construct disbursement programs that work best for the people of that state while controlling taxpayer costs by encouraging states to reduce fraud and waste.
The Government Accountability Office estimates that taxpayers lose $50.6 billion each year from improper Medicaid payments. A recent report by the Louisiana Legislative Auditor’s Office found the state Department of Health and Hospitals spent $1 million on Medicaid patients who no longer live in the state, and possibly misspent an additional $1.5 million. Block grants would force states to be more vigilant with taxpayer dollars by keeping better tabs on the number of Medicaid enrollees, something the state admits needs improvements.
Every person who benefits from America’s health care system should feel invested. Small, minimum copayments ensure that all participants play an active role in supporting the system we all depend on.
Finally, let’s get government out of the exam room. Let doctors and patients, including those on Medicaid, make their health care decisions together. When a bureaucrat decides patients’ tests and medicines, that patient often suffers without the care the doctor preferred to prescribe. This results in wasted doctors visits, wasted prescription payments, wasted time and increased costs.
Every American deserves quality medical care. To provide that, we have to recognize that the ACA is a failure and that there is nothing compassionate about continuing to cram people into this failed system.
We have an opportunity to do better for those who live in poverty, and that opportunity begins with Obamacare repeal.