Who woulda thunk it?
(Courier Journal) It wasn’t supposed to work this way, but since the Affordable Care Act took effect in January, Norton Hospital has seen its packed emergency room become even more crowded, with about 100 more patients a month.
That 12 percent spike in the number of patients — many of whom aren’t actually facing true emergencies — is spurring the hospital to convert a waiting room into more exam rooms.
That’s just the opposite of what many people expected under Obamacare, particularly because one of the goals of health reform was to reduce pressure on emergency rooms by expanding Medicaid and giving poor people better access to primary care.
Instead, many hospitals in Kentucky and across the nation are seeing a surge of those newly insured Medicaid patients walking into emergency rooms.
As Ed Morrissey points out, this isn’t the first report like this, but it does “show that the increase in emergency-room usage is not just a one-time spike.” He highlights a video report from Bloomberg from a few weeks ago. He also notes
The issue isn’t merely a burst of enthusiasm from newly-covered users, although that’s part of the problem. New coverage has created more demand, as was easily predicted, but did nothing to address supply.
And a doctor hits the nail on the head with the perfect description
“It’s a perfect storm here,” said Dr. Ryan Stanton of Lexington, president of the Kentucky chapter of the ER physician group.”We’ve given people an ATM card in a town with no ATMs.”
It may or may not be true that Ocare incentivizes users to head to the ER for every issue, but it surely provides no means to brake the issue. A little story: back when I was with AT&T, they switched all management in the wireless division (I’m not sure if this happened in the wired department at the time) to a Health Savings Account. One of things HSAs do is make people think about the cost of their own care. Per the Carolina’s top HR rep, those thoughts of personal cost causes an immediate decrease in the use of ERs for minor issues, which was a big driver in reducing overall costs. The regular plans saw the company paying $8-12K per year per employee. HSAs dropped that to $6-8k per year. Certainly, employees would pay more out of pocket yearly if they hit their deductibles. I would have spent about $450 more per year if I made it to my $1,100 deductible. Yet, I never did hit that level, and saved money every year but one (I came very close to breaking my elbow. Long and stupid story that did not include the words “hey, y’all, watch this). Users no longer immediately jumped to the ER, and instead went to the doctor, an emergency clinic, or simply the drug store.
If Ocare users think it’s all “free”, they will use it willy nilly without thought of cost. If only people had warned against this before Ocare was passed.