Opinion: Medicaid fails the poor

Americans should be worried about Medicaid, the $500 billion federal program that provides healthcare coverage to the nation's most vulnerable, according to Scott W. Atlas, MD, a senior fellow at Stanford (Calif.) University's Hoover Institution.

In an op-ed in The Wall Street Journal, Dr. Atlas, author of Restoring Quality Health Care: A Six Point Plan for Comprehensive Reform at Lower Cost, argues that Medicaid fails to provide adequate healthcare to its beneficiaries, most of whom (57 percent) are low-income minorities, calling the expansion of the program under the Affordable Care Act "one of the most misguided parts" of the health reform law, "shamefully expanding second-class healthcare for the poor."

Here are three thoughts from Dr. Atlas on Medicaid and how it fails the American poor.

1. Medicaid enrollees have a hard time getting physicians to see them. More than half of physicians — 55 percent —in major metropolitan areas refuse to take new Medicaid patients, Dr. Atlas wrote, citing a 2014 report from Merritt Hawkins. In the same year, HHS reported 56 percent of Medicaid primary care physicians and 43 percent of specialists wouldn't take on new patients.

2. They generally have worse outcomes. Medicaid patients have more in-hospital deaths, more post-surgical complications and longer hospital stays than privately insured patients with similar conditions, according to Dr. Atlas. He cited a randomized study by the Oregon Health Study Group that found having Medicaid coverage did not significantly improve patients' health compared with the uninsured as a result of Medicaid's limited access to drugs, specialists and technology.

3. Medicaid is in need of more ambitious reforms. Dr. Atlas argues current federal dollars should establish and begin funding for new Medicaid health savings accounts, which would incentivize beneficiaries to live healthy lifestyles. Medicaid reform should also link federal funding to states enrolling more citizens in private insurance.

"By changing Medicaid into a bridge to private insurance, Medicaid agencies would help beneficiaries shop for private plans," Dr. Atlas wrote. "Doctors and hospitals would receive payments from the same insurance that non-Medicaid patients receive. Second-class healthcare for the poor would be eliminated, and costs would come down. Shouldn't those be the goals of any administration's Medicaid reform?"

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