Medicaid SNAFU

SNAFU – Situation Normal – All Fouled Up.

Army Saying – World War II

Federal investigators have issued a report that says, in essence:

• Half of doctors could not offer appointments to Medicaid patients.

• One-third of doctors could not be found at locations listed in Medicaid managed care plans.

• 8 % properly listed were not accepting Medicaid patients.

This news comes in fact of what everyone knew already: overall, less than half of doctors across the nation accept Medicaid patients.

The reasons why are obvious: due to doctors shortages, practices are overloaded: reimbursements are as low as 60% of private pay; Medicaid regulations are fraught with bureaucratic hassles; only one fourth of physician groups are accepting Medicaid patients from health exchanges.
Add to these problems that fact that is almost impossible to find specialists who care for diabetes, asthma, sickle cell disease, and other chronic diseases and that Medicaid is exploding in growth, with 9 million beneficiaries added in 2013, a 16% increase.

Medicaid faces a five pronged problem:

• One, explosive growth

• Two, doctor shortages

• Three, overloaded practices

• Four, doctors not accepting new Medicaid patients

• Five, inaccurate government records listing where Medicaid doctor are located.

Medicaid is like a faulty five-pronged dull government fork, with half the prongs missing.

Coverage is not necessarily the same thing as care. What good is government coverage without private doctors to provide the promised care?

The situation is a reminder of a Casey Stengel story when he was manager of the New York Mets. The Mets had a hapless first basement named Marv Thornberry, who was constantly dropping throws and infield fly balls.

Casey went into the outfield and had batters hit Stengel fungo fly balls.

When Casey dropped the first fungo, he yelled, “Thornberry, you’ve got this position so fouled up, nobody can play it.”