One question that advocates of Medicaid expansion will never answer is: who will the newly-enrolled Medicaid patients see when they are sick?
I recently wrote about the harsh truth about North Carolina’s Medicaid system:
Medicaid rolls in North Carolina have ballooned from about 1 million in 2003 to roughly 2.1 million today. Adding another 630,000 would push the program over 2.7 million enrollees and mark more than 1.7 million new Medicaid patients in just fifteen years.
All this would take place when the number of physicians accepting Medicaid patients is dwindling.
The doctor shortage is especially acute in rural areas, where the concentration of Medicaid enrollees is even heavier, making for even lower doctor to population ratios.
Today from The Insider (subscription required) comes an article discussing the first meeting of North Carolina’s legislative Committee on Access to Healthcare in Rural North Carolina.
The committee didn’t take any formal action Monday but heard a series of presentations on this issue with some eye-catching statistics. North Carolina ranks 29th in the country in the number of active doctors per capita, 32 counties don’t have a psychiatrist, and 20 counties don’t have a pediatrician, according to a report from the Campbell University School of Medicine. Five rural hospitals have closed since 2010, and three counties — Camden, Gates and Tyrrell — have no primary care doctors at all, according to the Sheps Center at UNC-Chapel Hill.
This is not politics or ideology – this is simple math. Medicaid expansion in North Carolina would not provide access to medical care to the new enrollees, it would simply give them a Medicaid card with little to no hope of actually seeing a doctor when they are sick. Medicaid expansion advocates must be confronted with this reality.