What My Patient Taught Me about Medicaid

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By Alieta Eck, M.D. – http://ZHcenter.org/

Since ObamaCare’s newly insured are predominantly new Medicaid beneficiaries, it is important to be aware of what this can mean to patients. These are the lessons I learned from a patient—we’ll call her Debbie— who came to our non-government charity clinic.

  • Decisions are made by a person sitting in front of a computer 1,000 miles away.
  • Delays dictated by an impersonal protocol can have bizarre results, such as proper fracture treatment denied for more than 3 years.
  • Private physicians are the real safety net.
  • Medicaid cannot help with the social problems that trap people in the system.
  • Medicaid does not care; ordinary people do.

The Medicaid system is a prime illustration of Gammon’s Law of Bureaucratic Displacement. Dr. Max Gammon, a physician and gifted statistician, studied inputs and outputs in the British National Health System in which he worked. He concluded that an increase in government expenditure is matched by a fall in production. It is like a “black hole” that sucks in resources and shrinks in emitted production.

Milton Friedman wrote that Gammon’s law has been in full operation for U.S. hospitals since the end of World War II, and especially since the enactment of Medicare and Medicaid in 1965. Medicaid is a behemoth program costing one-third of the average state budget, and draining the entire economy. Yet the Affordable Care Act is working to double the Medicaid rolls.

Here is how it worked, or didn’t work, for Debbie, a 54 year old woman who fractured her leg in 2011 and did not have it repaired until 2014. Surgery was first delayed because of infections and blood clots. But then the “system” that insisted she go home while each separate issue was treated. She returned many times to the emergency room, when another fall and increased pain became unbearable.

Debbie was finally brought to our free clinic, where we found a local surgeon to replace her hip. The clinic’s charitable donations paid him a fair fee. She became something of a celebrity when her story was featured on the front page of the local newspaper. Local doctors and a local clinic accomplished what the mighty federal government could not.

Debbie might be one of those patients of whom Dr. Ezekiel Emanuel, one of the ObamaCare architects proclaimed: “To control costs, it’s vitally important that patients be kept well. So many providers have become focused on the 10 percent of chronically ill patients who cost the system the most.”

Debbie was a smoker and a perpetual student, unable to support herself when her father passed away. She often seemed to sabotage her own progress. Physicians could not keep her well. The system could not fix her underlying problems. She needed people to show her patience and kindness.

Tragically, 4 months after her long-delayed surgery she was diagnosed with lung cancer, and she died on New Year’s Eve of 2014.

Those who came in contact with Debbie will not easily forget her. I know I won’t. Those members of the transport company who spent their Thanksgiving holiday bringing her dinner and brightening her world, will always remember how happy and grateful she was that day—and how good that made THEM feel. During her life, many people were ennobled by helping her.

Non-medical talking heads tell us when they say that they know best. MIT economist Jonathan Gruber told us that government officials think the American people are stupid, and thus cannot be trusted to determine their own direction. But we need to understand that their budget busting Medicaid system, which is supposed to help the most vulnerable, is helping bureaucrats and administrators instead.

Physicians are now beginning to stand up and to fight for what matters–the unencumbered patient-physician relationship and a thriving economy where our families will have the means and capacity to show kindness and compassion to their neighbors.


Dr. Alieta Eck, MD, (New Jersey): Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis. MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses. Dr. Eck is a long time member of the Christian Medical Dental Associations and in 2009 joined the board of the AAPS. She served as its President in 2012. In addition, she serves on the board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children of which one is an ophthalmology resident in St. Louis, MO. Dr. Eck was a 2014 Republican candidate for US Congress in NJ CD-12.

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