MINNEAPOLIS, March 24, 2008—An article in the Los Angeles Times details how California physicians are declining to see new Med-Cal patients, because they are losing money and see reimbursement rates going even lower.

After San Diego ear, nose and throat physician Ted Mazer, M.D., billed the state's medical insurance program for the poor for a tonsillectomy, he got a check for $168—not enough to cover the cost of surgery. Mazer paid the balance out of his own pocket, then took steps to shut his doors to new Medi-Cal patients.

According to The Times, nearly every otolaryngologist in the San Diego area has done the same.

Half the state's doctors were refusing Medi-Cal patients eight years ago, just after rates were last increased. Refusal rates were sharply higher among certain specialists. Medical costs have risen since then, but state officials have stopped assessing whether enough doctors are participating in the program.

Reimbursement rates are so low now, doctors say, that a patient office visit nets only $24. Some clinics say the numbers simply don't work anymore. The result: Thousands of patients guaranteed health care under state law can't get into a doctor's office.

Experts warn that costs to taxpayers could go up by substantially more than will be saved through the budget cuts, as patients turn to emergency rooms. In pushing the governor's unsuccessful universal health plan, administration officials had estimated the cost of treating people in the ER at three to four times that of treating people in a physician's office.

Complete Los Angeles Times story