Monterey, CA Physician Shortage, Particularly For Those On Medi-Cal

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I wrote yesterday on my blog  about the tenuous state our Medi-Cal fund is in, a situation which will be exacerbated by health care reform laws which could add up to 17 mil. more people to the Medicaid (Medi-Cal in California) system nationwide, depending upon how many states opt out.  There is another major problem looming.  Even under the current system, it's difficult to find a doctor taking Medicare let alone Medi-Cal, which pays only a fraction of the reimbursement rates under the Medicare program.  The Sunday edition of the New York Times highlighted an issue which has been going on for many years, a shortage of physicians.  Once one of the most prestigious and highly paid professions in America, it's an industry that is going out of favor as Medi-Cal, Medicare and private insurance payments get cut and more and more doctors find it is difficult to make a living.  The Association of American Medical Colleges estimates that by 2015, the country will have 62,900 fewer doctors than they need.  That number is expected to more than double by 2024 as the expansion of insurance coverage continues and the aging of baby boomers increases demand for health care.  Even if the Affordable Care Act were not implemented, it's believed there would be a shortage of 100,000 doctors in the country by 2025 just due to the aging of America.  "We have a shortage of every kind of doctor except for plastic surgeons and dermatologists," Dr. G. Richard Olds, the dean of the medical school at University of California, Riverside, told the New York Times.  The issue results in more people driving longer to get to doctors, and turning towards emergency rooms for routine care.  I wrote recently on my blog about California implementing a $15/visit surcharge on Medi-Cal recipients who go to the hospital for routine care.  But many of them are doing it because they can't find a family doctor who will treat them for the scant payments they would receive from Medi-Cal.  This often leads to a decline in health because these people don't have a regular physician looking out for them.  "It results in delayed care and higher levels of acuity," Dustin Corcoran, the chief of the California Medical Association said, with people who "access the health care system through the emergency department, rather than establishing a relationship with a primary care physician who might keep them from getting sicker," he said.  In 2008, the last survey done on the matter, it was found that less than half of physicians were taking new Medicaid patients.  It's likely this number has increased dramatically since then due to the increasing financial pressure physicians are under.  At Alliance Home Health and Family inHome Caregiving, our two platinum sponsors which do in-home health and private duty caregiving, respectively, the problem is readily apparent when doing patient assessments.  Many patients aren't getting the care they need covered by insurance.  A limited number of visits from home health are covered under an order written by a physician, while private duty caregiving isn't covered by insurance at all unless the patient has long-term care insurance, which few people do.  Unfortunately, it's a catch 22 situation.  More people need insurance, but in order to expand the pool of Medi-Cal recipients it's likely to result in more cuts in reimbursement rates which will just cause more doctors to refuse to take Medi-Cal insurance. 

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Please note that this blog reflects my personal opinion and may or may not reflect the opinion of HandsTo Help Seniors and the individual members comprising the Board of Governors.