Anyone who has seriously studied Medicaid, the insurance program for low-income Americans, understands that there is a huge difference between possessing health insurance and having access to health care. Until late yesterday afternoon, the Obama administration seemed bent on spending $350,000 to spy on doctors and rediscover this well-known fact. Although those plans were finally scratched, doctors should expect to see similar government intrusions in the future thanks to Obamacare. The Department of Health and Human Services’ “mystery shopper” program would have called 4,185 primary care physicians in nine states, twice. On one call, they were to request an appointment while posing as a privately insured patient; on the other call, they were to pose as a patient with government insurance. Just this month, a similar study was published in the New England Journal of Medicine, which found that two-thirds of Medicaid patients were denied doctors’ appointments, compared with just 11 percent of those with private insurance. The government’s study would have merely duplicated the results of this and other private studies
The American Medical Association voiced displeasure at the proposed waste of time and money, and at the prospect of government spying on its members. “The government should be working to address [the doctor] shortage so all patients can have access to the health care they need, rather than using mystery shoppers to tell us what we already know,” said AMA spokesman Cecil Wilson, M.D. Other doctors contacted by the New York Times were less cordial, invoking “Big Brother.” We agree, but what did Dr. Wilson, and the rest of the AMA, think was going to happen when they threw their organization’s significant prestige behind Obamacare? By helping expand federal government control of our nation’s medical system to unprecedented levels, they have virtually guaranteed that bureaucrats will be looking over their shoulders regularly from now on.
Over half of all new health coverage obtained by Americans thanks to Obamacare will be through Medicaid. Obamacare’s authors specifically chose Medicaid as the vehicle for most of the coverage expansion because it is “cheaper” than Medicare and private insurance. But Medicaid isn’t cheaper because government is somehow better than the private sector at controlling health care costs. Rather, Medicaid is cheaper because it pays doctors less for the same services.
That is why Medicaid patients are turned down by doctors: Government price controls decrease the supply of doctor labor. When a government’s price control regime fails, the next step typically is to find other means of coercion in order to keep economic actors in line. The “mystery shopper” program represented one bad idea toward this bad end, but the government will find another way. Doctors should expect more such interference until Obamacare is repealed.
