NBC in Dallas notes the obvious – Docs pull out of Medicaid

When the government pays health care providers less than it costs the provider to provide the service, the providers will elect not to provide the service. I really tried hard to get another reference to provide in there…

Noting the obvious in Dallas; Doctors threaten to pull out of Texas Medicaid.

Cuts to fees paid doctors in the state health care program for low-income Texans is raising fears that already declining physician participation will fall further.

The Dallas Morning News reports the health care and insurance industries fear a 1 percent Medicaid fee cut scheduled for Sept. 1 will be the first in a series. That’s as state leaders order state agencies to cut their next two-year budgets by 10 percent because of an expected $18 billion revenue shortfall.

It’s been happening in Massachusetts and many other places around the country too. Did you expect anything different? Are the doctors being greedy? After all, they make money by providing services to other patients – like the ones who pay in cash, have their own insurance, or employer-sponsored insurance through private companies.

I’m not saying health care providers and hospitals accept all private insurance. The fact is, network negotiations between many insurers and many providers is an ongoing thing. Sometimes, parties do not come to an agreement and the contract is terminated. But participants in private or employer-sponsored programs almost always have an option be it a different doctor, hospital or insurance company.

With government sponsored entities like Medicare and Medicaid the customer generally has no other option if the program fails them. The program is falling apart as more and more doctors politely refuse to work with the system since they lose money all the time.

This is what a single payer systems like Medicare and Medicaid are destined for … failure.

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Steve McGough

Steve's a part-time conservative blogger. Steve grew up in Connecticut and has lived in Washington, D.C. and the Bahamas. He resides in Connecticut, where he’s comfortable six months of the year.


  1. sammy22 on July 12, 2010 at 7:38 am

    "This is what a single payer systems like Medicare and Medicaid are destined for … failure." Spoken like a true believer. Meanwhile the rest of the industrialized world is made up of fools who believe otherwise.

    • Steve McGough on July 12, 2010 at 8:18 am

      Single payer food. Single payer housing. Single payer education. Single payer energy … they all work so damn well in those Socialist countries…

    • Dimsdale on July 12, 2010 at 12:40 pm

      Just because the U.S. mainstream media doesn't tell you about something doesn't mean it isn't happening.

  2. sammy22 on July 12, 2010 at 10:40 am

    Does your list of "Socialist" countries include Australia, New Zealand, Japan, So. Korea, Brazil….? I think the "issue" is not WHO pays, but HOW the system is set up. I read/hear that we pay more for less than anybody else.

    • Dimsdale on July 12, 2010 at 12:39 pm

      We know the "who" and the "how", and it is pretty ugly.  Øbamacare was written by somebody, and it wasn't our elected "representatives", who probably know less about the bill than you.  I think SOS has outlined just some of the incredible failings of Øbamacare, and it is the tip of the socialist iceberg.


      How about the PIGS?  Their economies are in tatters (even without Øbama!)  And Canada?  The founder of Canada's vaunted system, Dr. Castonguay, as the chairman of a government committee reviewing Quebec health care this year, concluded that the system is in "crisis."

      "We thought we could resolve the system's problems by rationing services or injecting massive amounts of new money into it," says Castonguay. But now he prescribes a radical overhaul: "We are proposing to give a greater role to the private sector so that people can exercise freedom of choice."


      Sounds like we are going backwards.


      I looked up "problems in Australian health care" and came up with this (for one):


      One of the worldwide fallouts of September 11 has been escalating costs of insurance and re-insurance arrangements, and this has placed pressure on the medical malpractice insurance in Australia. The major medical malpractice insurer in New South Wales (pop. 6.5 million) and Queensland (pop. 3.6 million) has recently collapsed, leaving doctors without coverage in their private work (state governments provide coverage for public hospital care).

      Longer-term issues include concerns about the potential shortage of nurses in most states and the adequacy of equipment and capital funding, and general questioning about the level of financing of the system.

      The Australian healthcare system is in relatively good shape. Out-of-pocket costs are moderate and access to emergency care is good. However, there are a number of concerns for people without access to the pensioner-level subsidy for pharmaceuticals, especially for the chronically ill.

      There are also extensive waiting times for elective surgeries at public hospitals. Although waiting lists for the most urgent elective surgery for heart disease and cancer are almost nonexistent, there are long waiting lists for orthopedic surgery (median wait for total hip replacement is 88 days; 10% of patients waited over 345 days in 1999 to 2000), and cataract surgery (median is 73 days; 10% waited more than 316 days). One of the attractions of health insurance is the ability to bypass public hospital waiting lists.


      At best, we are trading known problems with potentially reasonable answers for a new set of very expensive "answers" to problems others are already dealing with.

  3. sammy22 on July 12, 2010 at 10:43 am

    And some of those countries have money for space exploration, remember?

    • Steve McGough on July 12, 2010 at 11:00 am

      Once again, you fail to get my point. Why not just provide housing, food and education across the board for everyone and have everyone chip in with their taxes? May as well take all the private companies and merge them with the government too! Why not? In your world, it solves all of the problems in the USA.

      This is the United States of America and we have a Constitution that is the baseline of our Democratic Republic. Everyone – mostly liberals – are tearing it to shreds. We are not like any other country and our economy, government or legal system can not just be compared apples to apples – it's not even close.

    • Dimsdale on July 12, 2010 at 12:17 pm

      It's easy to have money for space exploration when the bulk of your defense is handled (here it comes!) by the U.S.

  4. sammy22 on July 13, 2010 at 4:17 am

    Steve, once again you do not get my point: you say things that need lots of clarification. Your clarifications tend not to be to the point, and you assume a lot about what I say. The "in your world" phrase, is a shot in the dark.   And "we are not like any other country……" is another great generalization that has no teeth.

  5. sammy22 on July 13, 2010 at 4:23 am

    Dims, I thought you believed that those countries that have money for space exploration are bankrupt, with huge deficits and going down the toilet w/ their Socialist agendas. And they spend money on defense too: remember Bosnia, Kossovo and now Afghanistan? And yes the US spends more money than anybody else on defense.

    • Dimsdale on July 13, 2010 at 5:58 am

      The point is, we spend more money than anybody else on their defense, direct or indirect.  And they are bankrupt or just about there.  Even the MSM can't hide that fact.   The Euro is tanking, even worse than the dollar.


      My point stands.

  6. beekeeper925 on July 13, 2010 at 5:55 am

    To Sammy22

    If those other countries have such great systems that we should try to emulate, why don't you move to one and leave us, the great unwashed, to suffer here under our horrible capitalist system. We'll make do without you.

  7. sammy22 on July 13, 2010 at 6:09 am

    I am staying: the United States are perfect.

    • Dimsdale on July 13, 2010 at 8:30 am

      Then let's keep it that way rather than trying to emulate others with unsuccessful ideas.

  8. Dimsdale on July 13, 2010 at 5:44 pm

    Just as a humorous aside: when I read the title of this piece, "….Docs pull out of Medicaid", I could only think of Chevy Chase on the old SNL "Weekend Update" saying, "A frustrated Medicaid could not be reached for comment".


    Yes, I am going to hell……

  9. sammy22 on July 14, 2010 at 4:03 am

    Arrogance is bliss.

    • Dimsdale on July 14, 2010 at 7:58 am

      And ignorance is no excuse.


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