Dr. James Schroeder on Medicaid

The November 18, 2007 Grand Junction Daily Sentinel printed the following LTE by Dr. James Schroeder:

Expanding Medicaid eligibility will mean fewer docs accept it

The dilemma faced by Dr. Glen Dean and his patients as outlined in the Nov. 11 article, “Tied up in red tape,” is nearly universal for those of us who provide medical care for children. Unfortunately, too many policymakers seem unwilling to accept some simple facts.

Rep. Buescher is quoted as saying, “If we expand eligibility without working on the reimbursement rates, any proposal is ineffective.” At the same time, he and his colleagues in the Legislature are considering several proposals that call for expanding Medicaid or the state Child Health Plan Plus, known as CHP+.

Apply some simple math. If you think the price tag for health-care reform is steep as currently projected, consider how much it costs when lawmakers think they can promise expanded coverage and increased physician reimbursement.

The truth of the matter is that expanding coverage will not ensure improved access. Rest assured that expanding Medicaid will result in a decrease in doctors who accept Medicaid.

Rather than expanding the current Medicaid and CHP+ system in Colorado, we should seriously look at fundamentally restructuring the nature of charity health care.

Instead of perpetuating Medicaid as a state-run charity with an iron-fisted lock on the charity market, we should encourage doctors to provide charity care outside of the Medicaid framework, allowing them to openly compete with Medicaid.

Eligibility for these private charity services could be determined on a need basis and incentives could be provided in the form of tax credits for providers who philosophically choose to provide specified services. In addition, individual donors who prefer to give money to a tangible local entity by choice rather than by coercion to an inefficient governmental bureaucracy could receive tax credits.

How many times must we hear that “the current system is broken,” so “let’s expand it”? That is purely nonsensical. I urge citizens to contact their state representatives today and tell them they oppose expanded government mismanagement of your health care.

JAMES SCHROEDER
Grand Junction