Medicaid Is a Problem, Not a Solution, according to the President of the Association of American Physicians and Surgeons (AAPS)

TUCSON, Ariz., Sept. 07, 2017 -- The majority of Americans who gained coverage under the Affordable Care Act (ACA) did so through the expansion of Medicaid, and loss of additional Medicaid funding is a key concern about repealing ACA. However, Michael J. A. Robb, M.D., current president of the Association of American Physicians and Surgeons (AAPS), suggests that Medicaid is a problem rather than a solution, in the fall issue of the Journal of American Physicians and Surgeons. 

While the majority of licensed physicians are said to be enrolled in Medicaid, Dr. Robb points out that the number of physicians who have limited and/or stopped taking new Medicaid patients is unknown, as are average wait times, the number of patients seeing the actual doctor for the initial visit, the average length of consultation, and clinical outcomes.    

Other questions, Dr. Robb states, include: How much money goes to actual medical care for the patient vs. administrative overhead? How much is taken from taxpayers in poorer states? How much profit goes to stakeholders? How much is wasted on inefficient protocols?

He proposes that all states should undertake a forensic audit of their Medicaid programs, as the Arizona State Chapter of AAPS is doing. Arizona’s program, which is 100% managed care, is reputedly the most efficient in the nation. Preliminary results show that contractor-level administrative expenses exceeded $1 billion and pre-tax contractor profits were more than $228 million on about $10 billion of revenue in 2015 or 2016. Nearly $400 million was transferred from the Medicaid program to other state agencies during the period 2012–2016.

Another question raised by Dr. Robb is whether Medicaid enrollees may purchase services privately, or are they restricted to what the system allows and pays for, as in Canada. This is especially important for highly specialized care. It is difficult to obtain a clear answer to the question, Dr. Robb found, but it appears that patients are permitted to pay out of pocket for care, although Medicaid probably will not pay for tests, procedures, or prescriptions that the outside physician orders.

Dr. Robb concludes that as “influential forces are urging us to march down the road to single-payer socialized medicine,” physicians must fight to identify and secure wedges of freedom.

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

Contact: Michael J. A. Robb, M.D., (480) 303-1133, or Jane M. Orient, M.D., (520) 323-3110, [email protected]