A Little Obamacare Schadenfreude

One of the major goals of  Obamacare was to decrease the reliance of the huddled masses on emergency rooms. There were warning all along that it might not, for example the Oregon study, which showed that an increase in Medicaid spending increased ER visits without improving overall health care outcomes (although, people felt better about it).  Now, how is it working in real life?

Obamacare Increases ER Crowding

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 Louisville hospital to convert a waiting room into more exam rooms.

"We're seeing patients who probably should be seen at our (immediate-care centers)," said Lewis Perkins, the hospital's vice president of patient care and chief nursing officer. "And we're seeing this across the system."

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.

Nationally, nearly half of ER doctors responding to a recent poll by the American College of Emergency Physicians said they've seen more visits since Jan. 1, and nearly nine in 10 expect those visits to rise in the next three years. Mike Rust, president of the Kentucky Hospital Association, said members statewide describe the same trend.

Experts cite many reasons: A long-standing shortage of primary-care doctors leaves too few to handle all the newly insured patients. Some doctors won't accept Medicaid. And poor people often can't take time from work when most primary care offices are open, while ERs operate round-the-clock and by law must at least stabilize patients.Plus, some patients who have been uninsured for years don't have regular doctors and are accustomed to using ERs, even though it is much more expensive.

"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." . . .

Yep, it's actually making the problem worse.  It's almost like that was the point, breaking the system so that they could remake the way they really wanted it, single-payer socialized medicine.