Wednesday, May 6, 2015

Obamacare Architect Admits that Obamacare has Resulted in a Flood of Patients to Emergency Rooms

Former White House Obamcare adviser Ezekiel Emanuel writes at NYT:
BACK in 2009, a big selling point of health care reform was the idea that expanding insurance coverage would increase Americans’ access to preventive and primary care and decrease the unnecessary use of emergency rooms, saving billions. President Obama said it this way: “One of the areas where we can potentially see some saving is a lot of those patients are being seen in the emergency room anyway, and if we are increasing prevention, if we are increasing wellness programs, we’re reducing the amount of emergency room care.”

There is one big problem with this logic: data. A new survey by the American College of Emergency Physicians found that 75 percent of emergency room doctors reported increases in patient volume since the Affordable Care Act went into effect. There was a similar result when Oregon introduced a limited expansion of Medicaid in 2008. Researchers at Harvard and M.I.T. found that, 18 months after the expansion, per-person emergency room visits among the new Medicaid patients had increased by 40 percent. This was most likely because previously uninsured individuals could now go to emergency rooms without owing a co-pay.

Opponents of the Affordable Care Act point to these increases as confirmation that yet another promise of the law was false. But these failures do not mean that the emergency room problem is unsolvable, just that insurance coverage alone is insufficient.
Of course, characters like  Ezekiel never consider market solutions. They are always tinkering. So how does he plan to tinker out of this mess and into the next central planning disaster? He tells us in the NYT commentary that he likes a Seattle plan:
[A] $100 cash incentive if workers complete four steps. The steps evolve each year but have included signing up for MyGroupHealth, an online platform where workers can email doctors, order prescriptions, and access health information and self-help resources; completing a “health risk assessment,” a tool commonly used in corporate wellness programs; and completing preventive primary care and dental appointments..

A $100 incentive may not seem like much, but for low-income workers making an average of $12 an hour, it is the equivalent of a day’s earnings. By persistently educating patients, the program has helped them effectively navigate the health care system..

The good news is that this strategy is not neurosurgery. It is a relatively simple set of interventions that could easily spread to almost every other employer and insurer. This is how we’ll finally deliver on the president’s promise — and save all of us billions of dollars.
I think a better solution might be to pay Ezekiel $100.00 to just go away,


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