Many years back, shortly after graduating from college some buddies and I went out to a surf-bar themed club somewhere near Philly. I was wandering with my friend Maury and his buddy Parker1 when I came up with an ingenious idea. None of us had much money – I had just graduated while Maury and Parker were still in school. We wanted to do shots but since they’re relatively expensive I suggested that we each take turns buying a round, so at least with the other two rounds it would feel like getting a round for free. Maybe this wasn’t the smartest idea, but it seemed like a good idea at the time. Maybe I should have also informed Parker beforehand of my non-aggression pact with whiskey, as the round of Old Granddad that he bought ensured that my night would not end well. More importantly, while I remember enjoying the two “free” shots, the round that I had to pay for was quite painful. At least I learned my lesson, as I don’t recall ever repeating this ritual.
Now let’s take this story into some hypothetical territory. Let’s say the Surf Club learned of what we did and decided to make my idea into a mandatory program. All patrons of the Surf Club must now pay a $20 cover and will in turn be handed three drink tickets in return. You’d be foolish not to use all three drink tickets since you’re already paid into the system, right? But the deal is not as good as it might seem at first. You only get the three “free” drinks on your first three visits to the club. After that you’ll only get back 90% of the value (um, thanks for giving me my own money back?), with you having to pay the remaining 10% at the bar you go to. As for the various bars themselves within the clubs, it seems that the club introduced cost saving measures and is paying the bartenders who serve anyone with drink tickets far less. As a result many of the bartenders are refusing to see new drink ticket customers, and laws of supply and demand will tell us that your wait time to get to a bar is going to increase thanks to a growing scarcity of bartenders willing to accept tickets. Even worse, there is no guarantee that after your third visit that the club will continue it’s 90% match of your cover charge. If it ends of having financial troubles it could possibly reduce the drink benefits or cut them altogether. Or you could be possibly be forced to pay a cover charge for the privilege of having to shell out more cash to wait in long lines.
One other note about this surf club – it turns out they’ve been running a similar system for years for veterans who visit the club. It’s fans refer to it as the model for the “single drinker” system. Although veterans never have to pay extra for drinks service is spotty and known for some horrendously long lines. Stories have even emerged about veterans who have stood in line for an entire evening without seeing a bartender and are ultimately forced at last call to go home completely sober. Tragic, indeed.
Obviously my analogy is not a perfect one, and it’s certainly not my intention to make light of veterans dying while awaiting care. Virginia Governor Terry McAuliffe is pushing to expand Medicaid in this state. In their typically nonpartisan fashion, The Washington Post reported on the story with the objective, unbiased lead in their June 25th “Afternoon Buzz” email of “Va. House Republicans fire opening salvo in Medicaid fight”. Maybe it’s just me but whenever the left takes issue with people who don’t want Obamacare imposed on them their arguments all sound like that famous hockey quote, “Well it all started when the other guy hit me back.” The article is also laced with plenty of left wing bias that’s too extensive to detail here.
As I like to point out to all of my lefty pals who staunchly defend Obamacare, coverage and care are not the same thing. Having a piece of paper saying you’re insured isn’t worth much when you can’t get treatment in a timely manner.As Sally Pipes pointed out in The San Jose Mercury News:
That’s because fewer doctors are participating in the program. Between 2010 and 2011, a staggering 33 percent of doctors decided not to accept new Medicaid patients, chiefly because the program’s reimbursement rates are incredibly low — and often don’t cover the cost of treatment.
Last year, less than 70 percent of American doctors participated in Medicaid.Consequently, current beneficiaries have difficulty finding a physician who will accept their coverage. Once they do, they may have to wait a long time to see the doctor.
Expanding the program will only exacerbate this state of affairs. In Massachusetts, for instance, which launched an Obamacare-style expansion of Medicaid on its own several years ago, just 66 percent of internists and 70 percent of family physicians accepted the state’s Medicaid plan, according to a 2013 survey. In some counties, just 30 percent of family doctors take Medicaid.
What’s more, the care beneficiaries receive doesn’t substantially improve their health. A major analysis of Oregon’s Medicaid program found “no significant improvements” in health outcomes for many patients enrolled in the program. Researchers reported that Medicaid coverage had virtually no effect on blood pressure, cholesterol levels or blood sugar — risk factors for chronic conditions.
Of course, part of the reaction from the left is predicable anger at doctors who don’t want to get paid a pittance to be forced to jump through bureaucratic hoops, and never the politicians who pass the laws that cause these conditions. Of course, these problems all work themselves out in the long run. If we as a nation ultimately allow this law to stand and wind up with doctor shortages I am sure that there will be no shortage of IPAB reps ready to provide us with all of the care that we deserve.
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Cross posted from Brother Bob’s Blog
1 Not their real names
