Increasingly, we are seeing stories about patients who have a Medicaid card, but cannot find a physician, particularly a specialist, that is taking Medicaid patients.  This is not a surprise as the law of supply and demand is called a 'law' after all.  We've written about this more extensively in one of Tim's Blog Posts: When Does the Law Kick In.

So we're trying to follow the logic here.

1. Healthcare costs are increasingly driven by the care required by those with chronic conditions.

2. We know that chronic conditions have a reasonable degree of correlation with lower economic means due to a variety of things from diet to getting regular preventative care.

3. Without access to the full scope of care (read:  physicians), patients end up accessing the system via the hospital, the most expensive method of care delivery.

4. But we've left the price point of providing ambulatory care for this group at a level that most providers will not pay.

5. Which means they are right back in the emergency room.

Giving people, even more and more people, a Medicaid or Medicaid-like card doesn't change anything. 

If we really want to deal with causes at the source, we've got to provide the right incentives for those who can do this type of work to do so.