Politicians talk a good talk about the importance of primary care and preventive medicine.

They they go ahead and cut Medicaid payment rates to doctors and hospitals. They are likely to be across-the-board, with hospitals fearing “there’s no scalpel in any of this; it’s all whack, whack, whack.”

Physicians will be fine. More will simply join the majority that no longer accepts Medicaid.

Patient however, again lose. Although hospitals won’t like cut inpatient units or the emergency department, it will be the community-based clinics that will feel the brunt of the cuts.

These outpatient venues form the pillar of any proposed universal coverage plan, and have been shown to slow health care spending. It continues to amaze me that government continues to take a short-sighted approach to cost cutting that will cripple any chances of health reform success.