A cart without a horse?

cartJan Moller of The Times-Picayune reports on Louisiana Governor Bobby Jindal’s plan to help reform the state’s collapsing Medicaid program:

Jindal’s plan calls for pilot programs in four regions — New Orleans, Baton Rouge, Shreveport and Lake Charles — where most Medicaid recipients would be required to choose between competing managed-care networks. The state would provide “choice counselors” to help people pick between the plans, and people who don’t choose would be automatically enrolled in a plan.

 And who will be seeing these patients?

In the current system anyone who qualifies for Medicaid by virtue of age, income or disability can go to any health-care provider willing to treat them and the state will pay the bill. The problem, critics say, is that there aren’t enough doctors willing to treat Medicaid patients…

As I’ve posted before, if you want a functional health care system you’ve got to have a standing army of primary care physicians.  And you’ve got to pay that army enough to keep people interested in joining up.  Not only do we not have that army, but what few front line soldiers in the war on disease we do have are increasingly failing to re-enlist.  And we’re failing to recruit replacements.

Some people believe government-run health care is the solution.  Others, like Governor Jindal, think market-based reforms are what’s needed.  Unfortunately, it won’t make much difference whether you show up at your family doctor’s office with a Medicare or Medicaid card, a private insurance card, or a debit card from your health savings account if you are greeted with a “closed” sign or a “for sale or lease” sign.

Hat tip: Catron at Health Care BS
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