Obamacare Promises Broken, Emergency Room Visits Up

by Howard Danzig

We at ECCHIC have consistently pointed out that insurance does not equate to health care. Cash availability however does. Here is an article from one of the news services we subscribe to providing yet another example that giving control of your health care resources to insurance companies and government programs does not translate in to access to doctors. Insurance company and government controlled programs are narrowing networks, and becoming more restrictive in policy covered doctors, hospitals and related services.

This article (in full below) is about the recent visit on CNN by former Hewlett Packard executive Carly Fiorina who pointed out that Obamacare (the ACA) has not worked. “Demonstrably, if you look at the results of Obamacare, what you see is emergency room visits are up over 50 percent.”

The article by Christy Paavola about this goes on to say:

“One of the reasons for the increase is the expansion of Medicaid under ObamaCare.  Medicaid’s low reimbursement rates often times discourage physicians from accepting Medicaid patients, leaving the patients no choice but to go to the ER.  Another reason is the shortage of primary care physicians and restrictive networks found in some ObamaCare exchange-plans.  As Michael Tanner of the Cato Institute has said, “health insurance and access to health care are not the same thing.”

There are several reasons for this, including basic math: With so many people previously without insurance suddenly having it, there aren’t enough primary care physicians.

Here’s the article in its entirety – I hope you get a chance to read it as it’s very informative.

August 10 by Christy Paavola – Research

Yesterday, on CNN Carly Fiorina discussed the effects of ObamaCare saying:

  • Carly: “But guess what none of that has worked.  Demonstrably, if you look at the results of Obamacare, what you see is emergency room visits are up over 50 percent.”

Carly is right.  President Obama and supporters of ObamaCare have claimed the law would reduce Emergency Room visits but the opposite has occurred. The number of ER patients has increased by 75 percent according to the American College of Emergency Physicians.  In California, the number of Medicaid recipients visiting the ER increased by 50 Percent From 2013 To 2014.

  • President Obama In 2009:“I think that it’s very important that we provide coverage for all people because if everybody’s got coverage, then they’re not going to the emergency room for treatment.” (Sabrina Tavernise, “Emergency Visits Seen Increasing With Health Law,” The New York Times, 1/2/14)

One of the reasons for the increase is the expansion of Medicaid under ObamaCare.  Medicaid’s low reimbursement ratesoften times discourage physicians from accepting Medicaid patients, leaving the patients no choice but to go to the ER.  Another reason is the shortage of primary care physicians and restrictive networks found in some ObamaCare exchange-plans.  As Michael Tanner of the Cato Institute has said, “health insurance and access to health care are not the same thing.”

Research On Emergency Room Visits

Since January 1, 2014, when the requirement to have health coverage took effect in the Affordable Care Act, the volume of emergency patients in my emergency department has:

(Marketing General Incorporated, “2015 ACEP Poll Affordable Care Act Research Results,”Prepared For The American College Of Emergency Physicians, March 2015)

The Number Of California Medicaid Beneficiaries Who Visited The Emergency Room Increased By 50 Percent From 2013 To 2014. “The number of Medi-Cal beneficiaries who visited the emergency department increased by about 50% from 2013 to 2014, according to data from the Office of Statewide Health Planning and Development, Payers & Providers reports. Medi-Cal is California’s Medicaid program. According to the OSHPD data, nearly 800,000 Medi-Cal beneficiaries visited the ED in the first quarter of 2013. By the fourth quarter of 2014, that number increased to about 1.16 million. Observers say the increase correlates with the expansion of the state’s Medicaid program under the Affordable Care Act. Under the expansion, Med-Cal enrollment increased from 8.6 million in fall 2013 to about 11.3 million in late 2014.” (“Medi-Cal Expansion Correlates With Spike In ED Visits, Data Show,” California Healthline, 4/30/15)

  • “Anthony Wright, Executive Director Of Health Access, Said, ‘There Is A Direct Correlation With The Expansion Of Medi-Cal In 2013 And Early 2014’ And Increase In ED Visits, Adding, ‘[T]his Is What You Would Expect.’”(“Medi-Cal Expansion Correlates With Spike In ED Visits, Data Show,” California Healthline, 4/30/15)

“Contrary To Goals, ER Visits Rise Under Obamacare.”  “Contrary to Goals, ER Visits Rise Under Obamacare. 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.” (Laura Ungar and Jayne O’Donnell, “Contrary to Goals, ER Visits Rise under Obamacare,” USA Today, 5/4/15)

“A Major Reason” For ER Visit Increase “Is There Simply Aren’t Enough Primary Care Physicians To Handle All The Newly Insured Patients.” “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.’” (Laura Ungar and Jayne O’Donnell, “Contrary to Goals, ER Visits Rise under Obamacare,”USA Today, 5/4/15)

  • “Experts Cite Many Root Causes. In Addition To The Nation’s Long-Standing Shortage Of Primary Care Doctors — Projected By The Federal Government To Exceed 20,000 Doctors By 2020 ….”(Laura Ungar and Jayne O’Donnell, “Contrary to Goals, ER Visits Rise under Obamacare,”USA Today, 5/4/15)
  • “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, [American College Of Emergency Physicians] Said.”(Stephanie Armour, “US Emergency Room visits Keep Climbing,” The Wall Street Journal, 5/4/15)

“More Than A Quarter Of Doctors Had Wait Times Of More Than A Month” For Medicaid Patients.” “More than half of providers listed in Medicaid managed-care plans couldn’t schedule appointments for enrollees, according to a December report by the Health and Human Services Office of the Inspector General. Among providers who could offer appointments, the median wait time was two weeks, but more than a quarter of doctors had wait times of more than a month for an appointment…The waits for primary and specialty care by participating doctors appear to be leaving some Medicaid patients with the ER as the only option, according to ACEP.” (Stephanie Armour, “US Emergency Room visits Keep Climbing,” The Wall Street Journal, 5/4/15)

Primary Care Physicians Prefer To Take Patients That Have Insurance From Their Employers Instead Of People With “Government Plans.” “While the millions more who have health insurance certainly play a part in the doctor shortage, Alan Miller told CNBC’s ‘Squawk Box’ that poor reimbursement rates for primary-care physicians is also a major factor. ‘They get a better reimbursement when they take care of people that have insurance from their employer,’ the Universal Health chairman and CEO said. ‘The doctors are reluctant to schedule appointments’ with patients who have government plans.” (Matthew J. Belvedere, “Doctors ‘Reluctant’ To Take Obamacare Patients: Hospital CEO,” CNBC.com, 3/15/15)

**“Low-Cost Bronze And Silver [ObamaCare] Plans … Have Restricted Networks,” Leaving Patients With Limited Access To Care. “However, health insurance and access to health care are not the same thing. And evidence is growing that Obamacare is likely to make it harder for us to see a doctor or otherwise obtain care. Of course, we already know that the limited network of physicians available through most Obamacare exchange-based insurance plans is making it more difficult to see the doctor of your choice. Despite efforts by state regulators to mandate that insurers include more doctors and hospitals in their networks, most Obamacare plans, especially the comparatively low-cost bronze and silver plans, continue to have restricted networks. Nationwide, roughly 70 percent of Obamacare plans offer fewer doctors and hospitals than typical pre-Obamacare plans.” (Michael Tanner, “ObamaCare: Few Doctors, More Demand,” National Review, 9/10/14)

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