Look past the mess of the Cover Oregon website and it's easy to find another Oregon health care mess.
We've all heard about patients being upset they can't keep their doctors. But some of neediest Oregonians are finding it hard to find a doctor. Bulletin reporter Tara Bannow explored the issue in an article on Thursday.
Getting doctors to see Medicaid patients was a problem long before the recent health care reforms. Doctors worry about being fairly compensated for their work just like everybody else. And when they knew they would have to subsidize Medicaid patients with patients on private insurance, it put them in a bind.
Then came the health care reforms. Thousands more people were added to Medicaid. In Oregon, those people are served by the Oregon Health Plan.
The Central Oregon Coordinated Care Organization responsible for the patients was expected to get some 8,000 new patients. It has seen at least 14,000 more.
And while efforts have been made to increase Medicaid compensation, the flood of patients and the compensation issue have led to some Central Oregon doctors declining to take new OHP patients and even sending existing ones away. It's hard to know how widespread the issue is from anecdotal reports, but the CCOs in Lane and Klamath counties have closed to new members.
Health care reformers knew something like this might happen. When more people suddenly get insurance, it's only logical that there would be capacity problems. Patients who have not had coverage before may need treatment for longstanding problems.
The shortage of primary-care physicians is also nothing new. It's been a policy worry for years.
When we spoke to Gov. John Kitzhaber the other day about the federal reforms and Oregon's experiment with CCOs, he said he is hopeful they will improve care and hold down costs. But while those reforms did not create the capacity problems, they reinforced them and have not done enough to solve them.