If Doctors Won’t Treat Medi-Cal Patients, Then Obama’s Health Care Reform Won’t Work in California

By Willie Pelote No one is competing for low-income patients: that’s the unfortunate truth for those who depend on Medi-Cal for their health insurance. When national health care reform is fully implemented, one in four Californians will be eligible for Medi-Cal.  In concept, that should mean that more Californians will have improved access to doctors, but that isn’t the reality because most doctors – 70 percent of California’s doctors according to the California Medical Association – won’t accept Medi-Cal patients. Current California law limits employment options for doctors by prohibiting hospitals from hiring doctors.  Since doctors cannot afford to set up private practice in communities where most of the patients are Medi-Cal insured or uninsured, low-income and rural Californians are left without adequate access to medical care. This needs to change if we want national health care reform to fulfill its promise. The solution? Let hospitals and clinics in medically underserved communities directly hire doctors. By doing so, we could break down the financial barriers that keep doctors from treating nearly a quarter of California’s population – a majority of whom lives in urban centers. SB 726 (Ashburn) will break down those barriers to access by allowing healthcare facilities that treat the poor, uninsured and Medi-Cal insured employ needed doctors, offering them a stable salary, benefits and work conditions: very simply, allowing doctors to make a living while treating low-income and Medi-Cal patients. If health care facilities in lower-income urban communities can hire doctors, we can end the unfair practice of specialty hospitals in more affluent areas “cherry picking” patients with private insurance. The hospitals and clinics that would be allowed to hire doctors under SB 726 would treat any patient who comes through their doors. According to federal data, 3,000,000 Californians are medically underserved and most of those live in urban areas. Because they are largely Medi-Cal insured or uninsured, they don’t have access to primary care physicians and are forced to use emergency rooms for their medical care. California’s leading health care and social justice groups including Health Access, Catholic Healthcare West, AARP, California Church Impact, California Labor Federation, AFSCME and more than 50 others support this solution. All but five states in the nation allow direct physician hiring and see its benefits. However, the California Medical Association is standing in the way of SB 726. With millions facing severe barriers to getting medical care, we need to rethink the limitations we have put on physician hiring – limitations that are no longer relevant or necessary, and that accomplish nothing besides making it nearly impossible for doctors to work in low-income communities. Willie Pelote is California Political and Legislative Director of American Federation of State, County & Municipal Employees.