Wednesday, May 6, 2015

E/R Visits Were Supposed To Fall Under Obamacare

John Lott points me to this May 4, 2015 USA Today story:
Three-quarters of emergency physicians say they've seen ER patient visits surge since Obamacare took effect — just the opposite of what many Americans expected would happen.

A poll released today by the American College of Emergency Physicians shows that 28% of 2,099 doctors surveyed nationally saw large increases in volume, while 47% saw slight increases. By contrast, fewer than half of doctors reported any increases last year in the early days of the Affordable Care Act.

Such hikes run counter to one of the goals of the health care overhaul, which is to reduce pressure on emergency rooms by getting more people insured through Medicaid or subsidized private coverage and providing better access to primary care.

A major reason that hasn't happened is there simply aren't enough primary care physicians to handle all the newly insured patients, says ACEP President Mike Gerardi, an emergency physician in New Jersey.

"They don't have anywhere to go but the emergency room," he says. "This is what we predicted. We know people come because they have to."
 No surprise.  Obamacare increased aggregate demand for medical care without increasing the number of doctors.  This is quite similar to when Bill Clinton decided we needed 100,000 more cops on the beat, but the bottleneck in our criminal justice system was never enough arrests, but enough prosecutors and prison cells.  Unfgortunately, Democrats are big on these symbolic measures because Democratic voters are weak on process and math.  That's why they are Democrats.  What amazes me is how many become billionaires.


  1. I call BS on Mike Gerardi.

    There *hasn't* been a particularly large increase in middle class and upper middle class insurance rates. Most (if any really) increase has been on the bottom end of the economic spectrum.

    At that end people *primarily* use the ER or Urgent Care rather than a regular doctor. Always have, always will.

  2. I don't know what the avergae increase has been. I know my son, who works full-time fora TV station, has insurance with a $5000 deductible, and for many jobs, this is now the norm. A high deductible is not really an increase in annual insurance costs, but it is definitely a dramatic increase in out of pocket expenses.

  3. I don't have a doctor and good luck finding one. If I need to go to the doc I guess I'll go to the "Doc in the Box" corner clinic. FYI, I have been lucky in that I have never had hospital stays since a kid almost 50 years ago and have never had to use the ER.

    My insurance was canceled and I had to buy a new policy at double the premium. So much for the lie that you could keep your insurance.

    Now I did have a policy that was minimal and was mainly for big ticket like CT tests, hospital stay, etc. I could have paid for basic visits, blood tests, etc out of pocket. I don't need contraception.

    I went to a bronze plan which isn't all that great. I couldn't afford a better plan and being far from a high earner I still make too much for the subsidy so all out of my pocket.

    I didn't go to the doctor last year and haven't been to a doctor since 2008 when I went for a checkup. The only reason I buy it, besides it being the Messiah's law, is that I'm middle age so have the risk I could have an expensive bill I couldn't pay. But I do feel like a fool since I could have just bought a plan like I had before and paid the fine instead and no doubt saved at least a $1K I could have used to pay down debt including health insurance premiums on my credit card. I took money out of my IRA to cover the premiums.

    Fortunately my aches and pains haven't been severe enough to make me go to a doctor thus far. With the premiums I can't afford I can't afford the deductibles as well... At least I don't smoke (never have and glad since I couldn't afford $8 a pack), rarely drink (never more than a beer or small glass once a week) and don't do drugs of any kind. I could stand to lose maybe 5 to 10 pounds ( think I would be underweight if I lost more than that) so far from obese or a massive junk food eater. My soda pop drinking is like my beer drinking...maybe one a week.

    But in the end we all know the real goal was single payer, NHS style health care. OC (I refuse to call it ACA since it sure as hell isn't that) was just a side road to destroy the system so they could get there while paying off their insurance buddies and promising them a future administrative share of the take like is being offered for medicare plans these days.

  4. B. Oblivion:

    You should change your handle to oblivious, as anyone with even a tenuous grip on financial matters could have seen this trainwreck coming down the tracks at us.

    You cannot add more people and expect costs to drop, or expect doctors to be available when the patient load increases. BTW, lots of doctors are retiring, or eliminating public access, rather than deal with this mess. Not many new doctors are in the medical school pipeline now, at least not US students. You are going to see lots of immigrant doctors here in the future. Their quality won't be what you are used to expecting, but it is no longer a good looking future to be a doctor here, so those who would have are planning on doing something else. Why rack up huge schooling bills just to spend the rest of your working life paying it back, because the .gov will regulate how much you can make?

    EVERYONE I have heard from on their medical plan expenses says their costs went to 2x-3x higher, while the benefits covered dropped dramatically. THIS situation is EXACTLY what the real experts said would happen if OC was passed.

    So, you bought into the BS that the Dems produced? And you STILL believe it? What about the Easter Bunny? Santa Claus? Tooth Fairy? The Great Pumpkin?

  5. Let's be careful to avoid insulting people. I allowed this one because the rest of the content was very high quality.

  6. Sorry about that. His name/handle just got me going, and it went downhill from there. Well, that and the fact that so many people STILL think the OC "author" walks on water.

    What scares me is that I suspect that future historians will categorize the end result of our loss of culture as worse than the Nazi's regime. We now have the potential to go that way very quickly, and the ability to wreck the world as a result. Progressives, and their "useful idiots", have a lot to answer for. History will not look kindly on them, or the USA. Being in my 60's, I don't expect to see that day personally.

    Being that the Progressives have been found to have trained the originators of the Soviets, and in the person of FDR to have engineered the start of both the European and Japanese actions that began WW2, they have demonstrated that nothing is so bad that they can't deliberately make it worse, all in the pursuit of "improving mankind". The death toll they have racked up in the past 100 years is stunning, but I'm sure that with the muscle of the USA, they could easily blow past that low 9 digit figure and move it into 10 digits. Yay for technology!

    Oh, for a time machine...

  7. We can't end the racist enforcement of Prohibition because we lack enough Prosecutors. And it was racist by design. From Harry J. Anslinger and the effects of marijuana on the "inferior races" to Nixon:

    "Look, we understood we couldn't make it illegal to be young or poor or black in the United States, but we could criminalize their common pleasure. We understood that drugs were not the health problem we were making them out to be, but it was such a perfect issue...that we couldn't resist it." - John Ehrlichman, White House counsel to President Nixon on the rationale of the War on Drugs.

    "[Nixon] emphasized that you have to face the fact that the whole problem is really the blacks" Haldeman, his Chief of Staff wrote, "The key is to devise a system that recognizes this while not appearing to."

    And continuing in that vein today.

    I see another 1932 election in our future. Pity.

  8. But Prohibition is socialism for criminals.

    And you were fine with that in 2007.

    Milton Friedman however was not fine with it.

    The Drug War as a Socialist Enterprise by Milton Friedman

    I look forward to the day when Republicans give up socialism. Especially socialism for criminals.

    Then maybe they can criticize the left from a firmer footing.

  9. Will,

    How do you explain the Right championing a program invented by Progressives? Prohibition.

    The Right is just as much interested in a powerful State as the Left. They compliment each other.

    If you look at what happened in Germany in the 30s it was the same. The Right wanted Law and Order and the Left wanted Power and Control. The Right did get the more powerful State it wanted. And the Left used it against them.

    We are following the same trajectory.

    Who do you think those police forces and police powers will be used against once Prohibition is off the table?

    Once we got a Big Government Right the game was over. And the Right's favorite Big Government Program these days is Prohibition.

    Rand Paul is sending a warning. And most of the Right is not listening. And that is exemplified by the Clayton Cramer comment I linked to above.

    Any power you give the State no matter how good the intention WILL be used against you. It is why our Founders liked very limited government. They had first hand experience of the depredations of the State. We have lost that thread.

    We forget so easily:

    "First they came for..."

    Obama Care is just the latest in a long line of usurpations by the Left AND the Right.

    And the bad thinking behind all of it? "Men with guns (government) can solve ANY problem."

  10. What is ironic is that we have a great example of our Government not being able to solve a problem from our history. Alcohol Prohibition.

    I understand the Left thinking in terms of Government solutions. But the Right? We have a one Party State with two factions vying for control.

    Opposition to State Power from the Right ended with Nixon. We are just reaping the rewards. What is left is pockets of resistance and testilying cops.

  11. Pretty much all Americans support governmental solutions. Libertarians, at least Moon Is a Harsh Mistress libertarians are a tiny fraction of the population, maybe 5%.

    Big Government was not contrary to the Founder's vision. A big federal government was. But Revolutionary Connecticut required a Bible in every house. Some states required every house to have abucket and shovel. Extraordinary business regulation was common at the state level. Often bad ideas but showing that they weren't libertarians.