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The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Friday, January 23, 2015

Maybe the health care supply curve slopes upwards and more ACA bait and switch

See here for a review of a recent NEJM article that supplied data indicating that the temporary increase in Medicaid fees which was part of ACA  may have increased access to medical care.So as Medicaid professional fees increase more services are supplied.

From Nov 2012 to July 2014,

" [t]he availability of primary care appointments in the Medicaid group increased by 7.7 percentage points, from 58.7% to 66.4%, between the two time periods. The states with the largest increases in availability tended to be those with the largest increases in reimbursements, with an estimated increase of 1.25 percentage points in availability per 10% increase in Medicaid reimbursements (P = 0.03). No such association was observed in the private-insurance group. During the same periods, waiting times to a scheduled new-patient appointment remained stable over time in the two study groups."

So now that the Medicaid fee increase has elapsed and fees will be cut should we not see a decrease in availability? The specter of more folks on Medicaid and fewer docs likely to see Medicaid patients is part of why this article talks about the great bait and switch of ACA.We see more of a distorted version of social justice emerging from Obamacare.

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