“States in the South and Mountain West, which traditionally have the lowest rates of primary care physicians, could struggle to provide medical services to the surge of new patients expected to enroll in Medicaid under the health overhaul and federal incentives may not provide much help, according to a report issued today by a Washington health research group.”

“My critics say that I’m ‘cynical’ because I say that Medicaid’s reimbursement rates are too low, and yet oppose spending more money that we don’t have. This is a false dichotomy. There are a lot of things we can do to make Medicaid more cost-efficient: starting with converting the program into block grants for the states, and letting states focus on fully funding care for the truly needy.”

“Under the Patient Protection and Affordable Care Act (PPACA), Medicaid enrollment is expected to grow by 16 million people by 2019, an increase of more than 25 percent. Given the unwillingness of many primary care physicians (PCPs) to treat new Medicaid patients, policy makers and others are concerned about adequate primary care capacity to meet the increased demand. States with the smallest number of PCPs per capita overall—generally in the South and Mountain West—potentially will see the largest percentage increases in Medicaid enrollment, according to a new national study by the Center for Studying Health System Change (HSC). In contrast, states with the largest number of PCPs per capita—primarily in the Northeast—will see more modest increases in Medicaid enrollment. Moreover, geographic differences in PCP acceptance of new Medicaid patients reflect differences in overall PCP supply, not geographic differences in PCPs’ willingness to treat Medicaid patients.”

“Our current health care
arrangements have many
flaws, but we should not lose
sight of the many blessings
that come from the life
saving and life lengthening
technologies generated
by the U.S. health care system. Reforming the reforms is
our next task, one that I hope we will approach with more
sobriety and less partisanship than has been our recent
experience.”

“Among Obamacare’s hundreds of pages was tucked a new government-run long-term care program, the Community Living Assistance Services and Supports (CLASS) Program. CLASS was poorly designed, and actuaries criticized it as being unsustainable well before the passage of ObamaCare. It appears from three recent congressional appearances by Health and Human Services (HHS) Secretary Kathleen Sebelius that the Obama Administration has caught up with the actuarial analysis.”

“But over the past two years, ordinary Americans have come to realize that Washington’s political class—the politicians and their staffs and the armies of lawyers and lobbyists and consultants that intermingle with them routinely—really have become distant from them in mind and heart; they have become disconnected in so many ways. That mental and emotional distance had become glaringly evident on many topics, such as record spending and deficits, but none so clearly as in the long and bitter national debate on the Patient Protection and Affordable Care Act of 2010 (PPACA), the new national health care law.”