American Elephants


We’ll Reduce Costs by Insuring Another 32 Million Patients, Won’t We? by The Elephant's Child
April 2, 2010, 8:55 pm
Filed under: Economy, Health Care, Law, Statism | Tags: , ,

Now that ObamaCare the Patient Protection and Affordable Care Act is law, will the uninsured really stop going to the emergency room for their basic health care?  A basic assumption about ObamaCare is that once people have insurance, they will stop going to the emergency room and make appointments with their doctors instead.

According to Stanley Goldfarb writing in the Weekly Standard,  there are several assumptions involved here.

  1. Insurance payments to primary care physicians will change the habits of those accustomed to using the emergency room for care.
  2. There will be enough primary care physicians available to take on these new patients.
  3. The provision of insurance will reduce subsequent hospitalizations and emergency room visits by the previously uninsured.
  4. The cost for the care of these patients will decline and “the cost curve will be bent downward.”

All of these assumptions are wrong.  Yale University researchers studied emergency room use in New Haven, Conn. and found that there was no difference in subsequent visits to emergency departments nor in the number of inpatient admissions.  Primary care physicians are not available 24/7 and patients knew the emergency room would be open.  In Massachusetts, in spite of requiring insurance for everyone, emergency room use went up, not down.

It takes 17 years from the decision to increase the physician workforce to actually get more doctors in a community.  Thirty-two million newly insured will need a lot of doctors, and we don’t know how many will follow through in their plans to quit medicine.  New facilities must be built, students recruited, and physicians trained.  It all takes time.

Certainly all those folks with financial resources who are uninsured will be happy to pay for their health insurance rather than pay the much smaller financial penalty for not having insurance. Won’t they?

They wouldn’t try to sell us a bill of goods, would they?  Surely they are sincere.  They wouldn’t lie to the American people about something so important.  Would they?

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“approached uninsured patients using emergency rooms in New Haven, Conn.”

One city out of how many in America?

“Yale University researchers studied emergency room use in New Haven, Conn. and found that there was no difference in subsequent visits to emergency departments nor in the number of inpatient admissions”

I wonder if the problem is that their is no after hour care in this area of the nation.

“When asked why they used the emergency room in the first place, the subjects blamed it mostly on the fact that they knew the emergency room would be open when they wanted care (65%) and because they had nowhere else to go (76%), but 52% also said it was because they lacked health insurance.”

I go to the doctor when I am ill. I go to the mechanic when my car is broke. For a non-partisan discussion of health care I go to who…

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Comment by Mark Baird April 3, 2010 @ 6:57 pm
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The point, Mark, is that ObamaCare is based on many false assumptions that don’t hold up under investigation. An earlier piece (on which you commented) cited a study that showed that about 83% of those who use emergency rooms are insured, about the same percentage of insured and uninsured as in the general population. The assumption that vast amounts of money will be saved by insured people no longer going to emergency rooms is false.

The larger point is that, as Democrats have admitted now that ObamaCare has passed, it is not about improving health care, but about redistribution of income. That, in turn is based on the false assumption of a zero-sum game — that money in society is a finite pie and if the rich get more the poor get less. See here.
Income redistribution sounds like it will help the poor, but it just doesn’t work, and government interference interferes with the mobility of American society. Neither “the poor” nor “the rich” are the same people over time.

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Comment by The Elephant's Child April 3, 2010 @ 8:15 pm


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