California Touts Universal Coverage, Reduces Care

 CalMatters, California Governor Gavin Newson’s political publication, just announced that “nearly all” – 94 percent – of Golden State residents have health insurance. The majority are enrolled in MediCal, the state’s Medicaid program.

Newsom emulates the great magician, Harry Houdini, by diverting attention from what he doesn’t want us to see to what he does. Newsom wants the world to see “universal access to care.” He doesn’t want people to see that his insurance does not lead to care. 

CalMatters repeatedly conflates coverage with care, making readers believe that having insurance gets you the medical care you need when you need it. Just because someone has a health insurance policy, especially no-charge Medicaid, does not mean care is available. In California, only 60 percent of physicians accept new Medicaid patients. Second, the combination of too few doctors with constantly increasing numbers of enrollees has lengthened wait times to see a primary physician to medically hazardous levels, viz., 132 days to see a primary care physician.

The result is death-by-queue, especially for Medicaid patients: people dying while waiting in line (a queue) for care that doesn’t come in time to save them. What good is having insurance for 94 percent of Californians if 40 percent of them don’t have a doctor?

Doctors give two reasons for refusal to see new Medicaid patients: low payments, often below cost-of-doing-business; and the regulatory/administrative burden. Newsom’s expansion of Medicaid, now enrolling illegals, will further increase the regulatory burden. More important, Newsom’s insurance expansion will divert more healthcare spending from care providers to pay for bureaucracy. 

Newsom pledges to raise taxes, increase federal contributions to MediCal, and use that money to pay more to physicians. There are three problems with his promise.

Any increase in taxes will drive even more doctors to out-migrate. Second, he plays a shell game with hospitals to increase – effectively embezzle – federal Medicaid funds (taxpayer dollars) and has in the past used additional revenue for crony capitalism rather than the intended purpose. Third, attempting to defray part of his state’s $45 billion budget deficit, he has announced plans to take money away from paying care providers. So much for his promise to pay more for care.

The fundamental flaw in Newsom’s actions is the damage to patients caused by the seesaw effect. As more people are given no-charge Medicaid insurance, access to care goes down. Fewer doctors for more patients. Wait times increase. More death-by-queue.

The seesaw effect is magnified by adding illegal immigrants to Medicaid rolls. Across the country, from San Francisco to Chicago and New York, people in sanctuary cities are bitter that social and particularly medical services are being given to illegals while taking these services away from legal residents. Newsom doesn’t merely seem to give preference to one group, illegals, over another, citizens: he is.

The last thing Americans need is more divisiveness and less medical care. Newsom accomplishes both.

Deane Waldman, M.D., MBA is Professor Emeritus of Pediatrics, Pathology, and Decision Science; former Director of Center for Healthcare Policy at Texas Public Policy Foundation; former Director of New Mexico Health Insurance Exchange; and author of 12 books, including multi-award winning, Curing the Cancer in U.S. Healthcare: StatesCare and Market-Based Medicine.  Contact him at www.deanewaldman.com.

https://www.realclearhealth.com/blog/2024/09/09/california_touts_universal_coverage_reduces_care_1057024.html