A Funny Thing Happened On The Way To Expanding Medicaid


The paper edition of the WSJ says it all in the piece called Medicaid Expansion Drives Up Visits to ER.  Yeah, like no one saw that coming.  The reference study found that “a group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance”.   You can check out the article if you subscribe or find other ways on the internet (wink) but it really shouldn’t be an eye opener for anyone.  After the “keep your own insurance if you like it” fiasco, is anyone really be that blind or stupid to believe the administration on anything they say about the ACA anymore?   Medicaid expansion is a mistake.  Why?  Because these patients do not pay ANYTHING and EXPECT EVERYTHING and have no skin in the game.  Why not go to the ER if the doctor is busy that day?  So what if it is just sniffles for a few hours (seen this myself)?  And let’s not forget that the ACA did NOTHING to drive more medical students into primary care.  No family docs or internists means no one to see these patients.  Those states that expand their Medicaid rolls will go bankrupt as soon as the Feds pull out from paying in a few years.  You heard it here first.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “A Funny Thing Happened On The Way To Expanding Medicaid

  1. Kurt
    January 24, 2014 at 6:02 pm

    Stay out of primary care. Worst recommendation to give a student these days.

  2. Stella Fitzgibbons MD
    January 23, 2014 at 8:41 am

    In our area I doubt there would be much change…because the pathetic small change that Medicaid pays for an office visit has caused all the doctors in areas with lots of low-income people to stop accepting new Medicaid patients, and I guarantee that none of the Medicaid PCPs’ offices are open after 5 pm. So how ELSE are these folks supposed to get medical care? And frankly, what I’ve seen of Medicaid doctors makes me think the patients get far better care in an ER than they would from these guys.

  3. Pat
    January 21, 2014 at 8:11 am

    hahahhahaha…like a friend at work said the night Congress passed ObamaCare: “We’ve all got the ‘gold card’ now!”

  4. civisisus
    January 21, 2014 at 6:57 am

    Oregon’s Medicaid expansion caused the state’s ER visits to soar, all right – all the way up to THIRTY-NINTH in the nation, per capita: http://kff.org/other/state-indicator/emergency-room-visits/#table (Kaiser Family Foundation)

    What’s “funny” is that Ideologically straitjacketed morons like you are never, ever,ever, not ever, interested in this thing the rest of us call reality. You weren’t first to this realm of dead-ender lunacy; let’s hope you’re among the last

    • Doug Farrago
      January 21, 2014 at 8:34 am

      What are you talking about? What is your reality? Make a valid point, statement or argument. And if you don’t like what we say here then go somewhere else.

    • Pat
      January 21, 2014 at 9:22 am

      Hey Civ, let’s remember: back in 1993-94, the state of Oregon tried to get ahead of the Medicaid problem (I know, redundant) by setting 300 or so diagnoses that they would pay for, and disallowing the rest. The Clinton Administration halted their initiative, leaving them with cost overruns and a cookie-cutter inefficiency.

      Want some reality? Try actually working in an ER when every single damn shift includes welfare patients i.e. those on the dole aka Medicaid, that wander in (or call the ambulance) in no distress whatsoever, for trivial garbage. Got a baby with a 99.0 temp who sneezed once? Get to the ER! Did you opt not to get your FREE meds filled after your FREE doctor visit? No problem, hit the ER and pass an even bigger bill to the taxpayer.

      I don’t give a damn what ranking Oregon has – Medicaid has turned into a fiscal black hole, and it doesn’t make some one a straightjacketed moron to point out that we don’t have the cash.

      You don’t know what you’re talking about.

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