The situation could easily lead Oklahoma officials to water down health care standards, just as California is considering. While Oklahoma ranks 49th for primary care physicians, California ranks 20th.
Even if doctor access weren't an issue, Medicaid expansion is still unlikely to improve health outcomes. Cline notes the OU Health Sciences Center in Oklahoma City provides the highest concentration of health care in Oklahoma with much of it offered free through the teaching hospital. Despite that “free access to the highest concentration” of health care, he notes that within a few blocks of the center are some of the “worst health outcomes in the entire state.”
Cline said research shows just 10 percent of health outcomes are the result of access; 40 percent are driven by personal behaviors such as diet and exercise. “If you simply expand Medicaid, cover more people and have fewer people who are uninsured, but you have the same system, that's not going to solve the health challenges of our state,” Cline said.
The health care challenges facing Oklahoma are significant. But they won't be solved by simply dumping people into Medicaid. Without true health care reform, that's simply a plan to increase state costs and water down health standards — and still fail to significantly improve citizens' health status.