DEMOCRATS, in designing the Affordable Care Act, extended Medicaid coverage to an additional 17 million people. The theory is that if uninsured people get insurance, they will not be as sick and cost as much in the long run.
The success of this grand stroke rests on the assumption that doctors will take Medicaid patients, which they have long been undercompensated for seeing.
But Democrats had the cure: Raise doctors' pay.
Starting Jan. 1, reports Kaiser Health News, primary care physicians who treat Medicaid patients will get the same rates they are paid when they care for seniors in the Medicare program.
The Centers for Medicare and Medicaid Services explained the move with this insight: "Studies show that when states pay physicians higher rates under their Medicaid programs, more physicians participate."
This approach works with lawn services, too. So, problem solved - sort of.
A federal government that is $16 trillion in debt will pay $11 billion to cover the total cost of the change. According to an analysis by the Urban Institute of 2010 data, that would mean a 64 percent average pay increase for physicians.
Ah, but there's a catch: Washington will pick up the tab only for two years. After that it must be presumed that the costs would be shifted to state taxpayers.
There are a couple of other problems with the Jan. 1 start date as well. The federal government hasn't published the Medicare rates for 2013, so states don't know what the increase will be for Medicaid either.
Nor has the federal government, from whence cometh thy help, said what kinds of doctors it will pay more. Just family physicians, internists and pediatricians? No specialists? Some specialists? All specialists?
"Will we see physicians running to sign up for Medicaid because of potential for making money?" asked Rebecca O'Hara, a vice president of the Florida Medical Association.
"I would say that's unlikely."
Probably in West Virginia, too.