Health Insurance does not equal Health Care

Particularly when you shift people from private insurance to public insurance. This, of course is obvious to anyone who lives in the UK or Canada.  But Obamacare is premised on making this obvious mistake.  And our totally unbiased press reports expansion of government health insurance as an expansion of health care.  Which is a lie.

Roy For McArdle: "Health INSURANCE Is Not The Same As Health CARE"
Avik S. A. Roy, blogging at TheAtlantic.com's space that was Megan McArdle's, writes:

Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act--its expansion of Medicaid coverage to 16 million more Americans--may actually reduce those individuals' access to health care.White's report comes on the heels of numerous studies that show that patients on Medicaid, our national government-run health-care program for the poor, do far worse on health outcomes than do those on private insurance, and in some cases, worse than those with no insurance at all. (For an extremely deep dive into these studies, see my three-part series on the topic.) 

1) Medicaid underpays doctors for their expenses
Why does this occur? The main reason is that Medicaid underpays doctors and hospitals to care for Medicaid beneficiaries. Medicaid's reimbursement rates are around half of those paid by private insurers. In many cases, Medicaid pays doctors less than it costs to care for Medicaid patients, meaning that doctors face the choice of caring for the poor, and going broke, or shutting their doors to Medicaid patients. One survey found that internists were 8.5 times as likely to accept no Medicaid patients at all, relative to those with private insurance. Another found that two-thirds of kids on Medicaid were denied a doctor's appointment for a serious condition, relatively to only 11 percent for the privately-insured. 

Believe it or not, physicians even do better caring for the uninsured than they do caring for Medicaid patients. Two MIT economists, Jonathan Gruber and David Rodriguez, have found that three-quarters of physicians receive lower fees for serving Medicaid patients than they do for the uninsured, because many people without health insurance are still able to pay out-of-pocket for routine health expenses. (Gruber was the intellectual father of Obamacare, and remains an outspoken advocate of the law.)

And #2 and #3:

2) Overall, Medicaid expansions do not lead to more doctor visits3) Obamacare's Medicaid expansion could worsen physician access