A Real Concern – Coverage With No Providers

A few years ago in Racine county only one dentist accepted Medicaid and she was a pediatric dentist.  The payments to dentists were so low that they couldn’t justify accepting them as payment in full, they would lose money on every patient visit.  We’re seeing more and more of that in the rest of the medical world.  As states ad thousands and thousands of people to their Medicaid programs, they have to pay for their care from a fixed sized pot of money, meaning that payments per visit will continue to shrink.

This article points this out with an actual example of billed charges and paid in full payments from Medicaid.  I don’t think that this is from Wisconsin and I don’t know how that state’s Medicaid payments mirror those in Wisconsin.  But I do know that here in Wisconsin, primary care providers (family practice doctors, eye doctors, pediatricians) are being paid pennies on the dollar compared to even other heavily discounted health insurance plans such as Medicare.

So before we start patting ourselves on the back about how great it is to have more people covered by government insurance plans, we need to consider that having a Medicaid ID card may get them seen in 8-10 weeks for non-urgent visits.  And history has shown that when that happens, people head to the incorrect source for care, urgent care clinics and the hospital emergency department for colds, sore throats and skinned knees.  Driving up the cost of their care and clogging the segment of our health care system that’s supposed to deal with truly urgent and emergent problems.

I don’t claim to have an answer to fix all of our health care system’s problems, but I can guarantee that putting hundreds of thousands or millions of Americans on Medicaid or other government programs isn’t the answer.

Dr. Warren


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