Like sending a restaurant reviewer who doesn’t want to be noticed in disguise to a fine dining establishment, the US government plans to recruit “mystery shoppers” to pose as patients, to determine policies for health access.

The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.

Federal officials predict that more than 30 million Americans will gain coverage under the health care law passed last year. “These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem” of a shortage of such physicians in the United States, the Department of Health and Human Services said in a description of the project prepared for the White House.

Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.

“I don’t like the idea of the government snooping,” said Dr. Raymond Scalettar, an internist in Washington. “It’s a pernicious practice — Big Brother tactics, which should be opposed.”

You can call it Big Brother tactics, or you can call it data gathering. Unless there’s some kind of entrapment, where the shoppers goad the doctors into not taking Medicare, I don’t really see the problem.

There is one thing, however. Wouldn’t the mystery shoppers have to be actual sick people? A restaurant reviewer and a patron have few differences. But a sick patient and a healthy mystery shopper actually do. So wouldn’t recruitment for this position have to come from the sick?

Perhaps this is a stealth way to end the problem of the uninsured in America. If enough uninsured people just become government contractors to test the health care system, suddenly the ranks of the uninsured go away! Perfect!

On a more serious note, this does seem to be nothing more than government officials calling hospitals, asking how long it would take to get an appointment, and whether the provider accepts Medicare or Medicaid. That literally happens hundreds of thousands of times a day in America. You could probably get at the same data with a survey of patients.

But I do think it’s an important area to probe. Republicans are the ones who think that government-run health care leads to long wait times and denial of care. The fact that it happens right now in America should be of some interest to them.

Before this becomes a hissy fit on the right, by the way, it should be noted that George W. Bush’s Administration did something very similar.

David Dayen

David Dayen

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