One of the effects of Obamacare was the expansion of Medicaid, which in Oregon is referred to as the Oregon Health Plan (OHP). In Lane County alone, over 96,000 people are now on OHP, at the very time when Primary Care Physicians (PCP) are in short supply. This is precisely the opposite of what Obamacare would supposedly do: it was peddled as something that would lower healthcare costs by providing more people with affordable preventive care so that there would be fewer people clotting up the emergency rooms and urgent care facilities.
Instead, more people than ever are heading to the ER or urgent care - thousands of them in Lane County alone. It's particularly ironic that, with television ads flooding the airwaves telling people to "talk to your doctor" about this or that medication, few people actually have a "your doctor" with whom to talk in the first place.
The days of having a PCP who actually knows a patient are long gone, for many people.
So instead of receiving the preventive services that Oregon’s coordinated care organizations were supposed to provide to boost health care quality for Medicaid patients and drive down costs, OHP patients in Lane County are crowding area emergency rooms and urgent care centers, or putting off seeing a doctor entirely.
At Trillium, which is the CCO in Lane County, people get put on a waiting list, with the promise that at some point in the future, a PCP will be assigned to them. There's just no way of knowing when that will be, who it might be, or whether the two of you will even "hit it off". And if the latter fails to happen, good luck finding a new one who might be a better fit for you.
Peggy, a Trillium member who asked that her last name not be used, is one of them.
She said she has gone three months without a primary care doctor after the doctor she had seen for more than 20 years retired.
“You can’t get a doctor,” Peggy said. “Nobody is taking Trillium patients because Trillium doesn’t reimburse doctors enough to take us.
“We’re clogging up the urgent care and ER,” she said.
Peggy said she must take antibiotics and narcotic pain medication for her arthritis and a bone disease. But doctors at the ER and urgent cares won’t prescribe narcotics.
And so people such as "Peggy" find themselves in a Catch-22 situation: she needs pain medication, but the doctors she's able to see won't prescribe it because they don't do follow-up work, and so there's no way to identify potential abusers. Since it can't be determined conclusively that she uses the medication appropriately, they won't give it to her at all.
The end result, for many, is that they hit the streets to find a dealer in the illegal drug trade.
Welcome to the real Obamacare.