Another glaring example of why the ‘if you like your doctor, you can keep your doctor’ mantra President Obama and other ACA enthusiasts touted is simply false: An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state’s Obamacare health insurance exchange and won’t participate, the head of the state’s largest medical association said.
- “It doesn’t surprise me that there’s a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association. Thorp has been a primary care doctor for 38 years in a small town 90 miles north of Sacramento. The CMA represents 38,000 of the roughly 104,000 doctors in California.
- He called the exchange’s doctors list a “shell game” because “the vast majority” of his doctors are not participating. Why? Because when asking physicians to participate in the exchange, the memorandum of understanding failed to provide reimbursement rates. As expected, few physicians were willing to blindly agree to participate without knowing what the rates would be.
- “We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” he said.
- California offers one of the lowest government reimbursement rates in the country — 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower.
- In other states, Medicaid pays doctors $76 for return-office visits. But in California, Medi-Cal’s reimbursement is $24, according to Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor. In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160, Mazer added.
- Only in September did insurance companies disclose that their rates would be pegged to California’s Medi-Cal plan. That’s driven many doctors to just say no.
- Who would have guessed? Physicians, like I’m sure most working adults, would rather not be paid a fraction of what their services are worth, so are choosing not to participate. This in turn means the pool of doctors available to patients will be smaller. And worse yet, they’re currently being led to believe that more doctors are participating than actually are.
- “Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy. “They may be listed as actually participating, but not of their own volition,” said Donald Waters, executive director of the Alameda-Contra Costa Medical Association.
- Waters’ group represents 3,100 doctors in the East Bay area that includes Oakland, with an estimated 200,000 uninsured individuals. “This is a dirty little secret that is not really talked about as they promote Covered California,” Waters said.
- All of the changes and uncertainty in the health care industry are also, not surprisingly, leading many doctors to consider retiring early. “I just turned 55, and a lot of us are kind of going, ‘Maybe there’s something else we can do in the last 10 years,’ because this is just getting too onerous to keep on going,” said Dr. Theodore M. Mazer, the Washington Examiner reported.
- Once again, enrollment does not mean access to care. “[T]here aren’t enough doctors to take the low rates of Medicaid,” said Alex Briscoe, health director for Alameda County Health Care Services Agency, the Washington Examiner reported. “There aren’t enough primary care physicians, period.
Modified from a Townhall.com and a Washington Examiner article