The Myth of Insurance Coverage Expansion as a Solution for Basic Health Access Continues

So despite the expansions we still have half enough generalists and general specialists for half of the US population and major barriers existing to prevent access in a number of the insurance plans. The myth of expansion as a fix for shortages of workforce and access barriers continues to be expanded - preventing the financial design solutions that are needed.

A recent study used health care coverage rates as a control - not realizing that health care coverage is not the problem for populations behind. They do not lack for % covered. They have concentrations of the worst insurance plans. This illustrates the problem of studies that seek to find what they want to find.

The 40.2% of the 2010 US Pop in 2621 counties lowest in health care workforce with arguably the worst access due to half enough generalists and general specialists had 40.6% of the uninsured. They never lacked more than others for insurance coverage. But

• they do have the worst Medicaid, Medicare, and private health insurance plans.
• They are in the states with the worst of these plans.
• They have worst employers in these counties that have the worst paychecks, benefits, and private health insurance plans.

Financial Solutions Are Required

In previous work there are only about 38 billion dollars going to the 60,000 physicians in primary care in 2621 counties lowest in health care workforce - in 2008. There is not much indication of improvement with stagnant revenue, increasing usual costs of delivery, and the HITECH to value based increased costs of delivery.

It would take 40 - 50 billion more dollars to move these counties from half enough primary care workforce and team members to approach sufficient levels. If you do not see this in some sort of legislation that is passed to force Medicaid, Medicare and private insurance to support generalist and general specialty services much more - then you will not see improvements in access.

Burn this on your brain - Flat Lined Primary Care Workforce from Flat Lined Primary Care Finances

Understand flat lined population growth where health care workforce and health care dollars are ever more concentrated. Understand flat lined finances in the counties most in need of health care dollars and access and workforce - where the American population is growing fastest in numbers, demand, and complexity.