Why Reduce Access to Primary Care to ‘Supply and Demand’?

By Dennis Archambault

Sally C. Pipes, president and CEO of the Pacific Research Institute, criticized the Centers for Medicare and Medicaid’s regulation that beneficiaries should not wait more than 15 business days to get a primary care appointment.  In her article published in the June 17 Detroit News, “Limit Medicaid enrollment to alleviate wait times,” she confirms the acute need for more primary care providers, but her solution to the problem is to reduce Medicaid enrollment “and preserve the program for those who truly cannot take care of themselves.”

Limiting “demand” – reducing access – is contrary to humanitarian principles. The problem is on the supply side: We need more primary care providers, and more health centers which are available to receive people with Medicaid coverage in a timely manner. The regulation to limit wait times is more an issue for commercial providers of ambulatory care. Federally qualified health centers routinely leave appointments open each day to see patients who have a timely need.

Also, Pipes asserts that “the progressive approach to just about any policy challenge is to use public resources to stoke demand without addressing supply.” In fact, the government is addressing supply. In fact, it was the Affordable Care Act that enabled Teaching Health Center programs – such as Authority Health’s medical residency program – to increase training of primary care physicians and dentists with the goal of not only filling the primary care void, but to encourage placements in medically underserved areas throughout the nation.

Access to care through expanded Medicaid/Healthy Michigan has increased demand on primary care services – in large part because the population didn’t have access to primary care before. The answer is not to minimize access but to increase access and increase providers. Not only is that a humane approach, but it is also cost-effective, by minimizing the need for expensive secondary care and emergency hospital use.

Dennis Archambault is vice president of Public Affairs for Authority Health.

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