June 22, 2015

The new conservative reformers in the Senate are proposing a significant fee increase for primary care doctors and obstetricians is a sign that a compromise is possible to tame the Medicaid monster eating the budget.

When ObamaCare passed, doctors treating Medicaid patients received a big fee increase from Washington. But Washington’s promise was written in disappearing ink and now the money for the increase is gone and the fees have been cut back.

The Senate proposes to use state money to restore the fees so doctors have more of an incentive to handle Medicaid cases.

But the conservatives are also proposing a big reform to change the system that sticks taxpayers with ever increasing bills. They want to allow managed care companies to compete with CCNC to manage Medicaid spending.

Why CCNC thinks they deserve a monopoly with no competition has always been a mystery. And the fact the so called “ACO’s”, groups of doctors and hospitals, haven’t saved any money for Medicare in North Carolina casts doubt on why anyone should think they are the solution to Medicaid.

Instead, we need competition between the CCNC/ACO’s and commercial managed care companies. Free market competition is always better than a closed shop monopoly.

And to encourage competition within the medical industry as a whole, the conservative reformers also want to get rid of the Certificate of Need (CON) law that requires any group trying to compete in the medical business to get an expensive state license before they can. In other words, if a group of doctors want to open a walk in clinic inside of Wal-Mart to compete against the Duke ER, they first need approval from NCDHHS. The CON system stifles competition and raises medical prices by 5% according to economists. (WSJ)

The conservatives in the Senate are offering the medical industry a fee increase. Is the medical industry going to respond by endorsing a more free market model that breaks the CCNC and CON monopolies? Stay tuned.