The Medicaid Shunt


Take a look at the ACA from a 30,000 foot level.  The administration was in cahoots with the insurers.  It is certainly not affordable.   Then look at the amount of NEW people getting Medicaid.  It looks good for the government because they pay so much less to providers for Medicaid patients and they can claim so many more people are covered.  Can anyone else see the next argument by the government?  They will come out and say, “We tried working with the insurers (yeah, right)  and they are still gouging people.  The answer is to put more on people on Medicaid.”  Think I am embellishing?  I am not the only one with these thoughts.  The Jeffery Singer, a general surgeon in Phoenix, did a piece in the WSJ called ObamaCare Shunts My Patients Into Medicaid and he basically thinks the same thing.  Here are some highlights:

  • Recently several of my patients who had been paying for their own individual health insurance informed me that they were forced off private insurance and placed into Medicaid when they signed up for health care at 
  • A recent Boston University/Harvard Medical School study suggests that up to 80% of people participating in ObamaCare’s Medicaid expansion have been shifted off their private insurance.
  • Only 45% of doctors are now accepting new Medicaid patients, according to a recent survey by the health-care company Merritt Hawkins.
  • Fewer doctors means long waits to see primary-care providers and even longer waits to see specialists. This invariably leads to worse health outcomes for those patients; that’s why numerous studies have shown Medicaid patients have significantly worse outcomes than those with private insurance.
  • Thanks to ObamaCare, they have been shunted into a second-class health-care system.
  • ObamaCare has shifted—and will continue to shift—people into substandard and often-delayed care, all in the name of increasing health-care “coverage.” 

To summarize, the government wants more and more people on Medicaid.   The result is that less and less doctors will take this payment.  How to fix that?  The next step is for the government to force doctors to take Medicaid patients by holding their licenses hostage.   As the AMA and AAFP sit on their thumbs there are attempts by politicians to do just that.   We are doomed unless we walk from government pay and hope to get grandfathered in from these new laws.

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 “The Medicaid Shunt

  1. Jerry Mazza
    October 31, 2014 at 7:01 am

    I saw a patient yesterday who said that they did not qualify for an Obamacare plan because their income was too low and they had to apply for Medicaid.

  2. Stella Fitzgibbons MD
    October 29, 2014 at 8:31 am

    What Dr. Fitzpatrick said…plus here in TX we have a ton of patients who can’t even get Medicaid thanks to Rick Perry. Obviously he doesn’t think Jesus meant all that stuff about helping the sick and poor.

    • Pat
      October 31, 2014 at 11:55 am

      Stella, please direct me to the Scripture wherein Jesus tells his followers to do good for others by taking their neighbor’s work and wealth to do it, under the sanction of government force.

  3. Dave Fitzpatrick MD
    October 27, 2014 at 10:49 am

    Please don’t tell me that we didn’t see this coming. There is no way that that doctors will NOT be enslaved unless we stand together. If we accept the lawyers forcing us to take At-A-Loss fees, we are truly lost. If we refuse, together, we can salvage our livelihoods.
    BTW, this type of licensure requirement is done in many countries. Those citizens accept that the medical system is two tiered. Docs are required to tend government clinics from 9-12 and “allowed” to see private patients outside that time. Folks accept that ‘basic, universal care is free’ but that advanced care is fee for service.
    Yes, there is an American Constitutional right to a lawyer. No, there is no ‘right’ to a physician. When we are beaten up with this lie, we must resist. The repeating of a lie does not make truth.
    If Americans want to admit that O.J. Simpson bought a very different legal team than Joe Citizen gate from his public defender, then we can admit that America has a two tiered legal system.
    Instead of the fantasy of “Everybody Gets Everything” medical care, perhaps we, as a nation need to put on our grown-up undies and have a sober conversation about what we can afford.

    • Pat
      October 27, 2014 at 3:17 pm

      Dave, forget it. The tumor bulk is so large that the public not only will accept a two-tiered system, but ultimately will embrace it. After decades of (1) pushing health care as a “right”, and (2) encouraging class warfare, politicians have largely developed physicians as the problem in the public eye. Unlike many, I don’t believe that most patients trust their doctor. I think the public regards physicians with mistrust and envy, and will turn on them with increasing anger, abetted by politicians who just want to help. With large insurance cowed, complicit, and ultimately removed, control of the physicians will simply be assumed by the government.

      • October 27, 2014 at 10:56 pm

        Except that we are “modernizing” our healthcare by “broadening the experience of primary care providers.” I expect that within several years, the PA’s will be screaming because Prescribing EMT’s and licenses masseur/masseuses are intruding on their turf. Like the West African countries, the average person’s ‘doctor’ will be someone who can use the internet. Prescribing pharmacists will shake your hand at the Wal-Mart door and handle your prescription antibiotics for sore throat and ear infection. Midwives will ‘feminize’ childbirth – and the numbers of C-sections will go down as fewer people know how to do them.
        It seems so callous to call it “Third World Healthcare.” Anyone have a better term?

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