Monday, May 04, 2015

Emergency Room Visits Increasing, Not Decreasing, Under ObamaCare

by JASmius



Yet another insistent ObamaCare promise bites the dust:

A survey of 2,098 emergency-room doctors conducted in March showed about three-quarters said visits had risen since January 2014. That was a significant uptick from a year earlier, when less than half of doctors surveyed reported an increase. The survey by the American College of Emergency Physicians is scheduled to be published Monday.

Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.

“There was a grand theory the law would reduce ER visits,” said Dr. Howard Mell, a spokesman for ACEP. “Well, guess what, it hasn’t happened. Visits are going up despite the [UCL]A, and in a lot of cases because of it.”

Entirely because of it.  That's what happens when the government makes a commodity - and yes, health care is a commodity just like everything else, not a "right," no matter what his infernal majesty pontificates - "free": with the price mechanism taken out of the equation, the only means left to the market to allocate resources is to restrict access to the product in question.  With the demand side of the equation off the scale by definition and no incentive for consumers not to overuse the product, long lines and wait times to see a PCP (primary care physician) are inevitable.  That's simply how economics works.

There's also the matter of doctors still having the option of choosing not to work for slave wages:

The American College of Emergency Physicians (ACEP), which conducted the survey, pointed to the shortage of primary care doctors and the low payment rates from Medicaid, which accounts for much of ObamaCare’s coverage expansion.

“America has severe primary care physician shortages, and many physicians will not accept Medicaid patients because Medicaid pays so inadequately,” Dr. Michael Gerardi, president of ACEP, said in a statement. “Just because people have health insurance does not mean they have access to timely medical care.”

The inability to get a timely appointment with a primary care doctor leaves people still relying on emergency rooms, he argues.

Because emergency rooms by law cannot deny patients medical care.  And with fewer PCPs, and longer lines to get in to see one, ERs are the only other alternative.  It follows as night follows day.

Are doctors "greedy" for not being willing to be low-balled on Medicaid payments?  Or course not; specialization is where the real money is, largely because medical insurance policies don't cover nearly as much of the cost of even office visits, whereas seeing a PCP is usually considered "preventative care" that is covered in full, which means docs can't charge as much because the carrier won't pay it.

But it doesn't take a vivid imagination to see the Regime depicted this as "doctor greed" and moving toward the physician draft I've long warned of, where new docs are conscripted and existing physicians are not allowed to retire but forced into the Obamunist Medical Collective as well.

This corrosive dynamic was never illustrated more blindingly than in Oregon in 2008:

Supporters of [Barack] Obama’s health care law had predicted that expanding insurance coverage for the poor would reduce costly emergency room visits because people would go to primary care doctors instead. But a rigorous new experiment in Oregon has raised questions about that assumption, finding that newly insured people actually went to the emergency room a good deal more often.

The study, published in the journal Science, compared thousands of low-income people in the Portland area who were randomly selected in a 2008 lottery to get Medicaid coverage with people who entered the lottery but remained uninsured. Those who gained coverage made 40% more visits to the emergency room than their uninsured counterparts during their first eighteen months with insurance. [emphasis added]

Why?  Because those with Medicaid coverage were even more brainwashed into believing that their healthcare would be "free," had no reason not to overuse it, and consequently used it to death.

In any market, no matter the product, the only way to avoid artificial shortages and distortions and dislocations is to let the market work.  Stop monkeying around with prices, get rid of public subsidies and government diktats, let suppliers supply and consumers demand according to a rational pricing mechanism, which incentivizes consumers not to be more circumspect and rational with their purchasing decisions and suppliers to offer the best possible product at the lowest possible cost, and get the hell out of the way.  Captain Ed cites Lasik and plastic surgery (the "Nip & Tuck" model), which I'm frankly surprised escaped the ObamaCare dragnet.

I'm sure The One will rectify that in his next Executive Decree.

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