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Obamacare may mean more ER crowding

cpwill

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Ah, I remember listening to weeks of prattling on about how the REAL problem with our healthcare system was the 'free riders' who used the emergency room; and that the solution, somehow, was for everyone to pay for them to get insurance instead.


so it's nice to know that even that fake argument is problematic.


Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law.

That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding. It would seem these patients would be able to get routine health care by visiting a doctor's office, as most of the insured do...

Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."

Kellermann and other experts point to Massachusetts, the model for federal health overhaul where a 2006 law requires insurance for almost everyone. Reports from the state find ER visits continuing to rise since the law passed — contrary to hopes of its backers who reasoned that expanding coverage would give many people access to doctors offices.

Massachusetts reported a 7 percent increase in ER visits between 2005 and 2007. A more recent estimate drawn from Boston area hospitals showed an ER visit increase of 4 percent from 2006 to 2008 — not dramatic, but still a bit ahead of national trends....

Crowding and long waits have plagued U.S. emergency departments for years. A 2009 report by the Government Accountability Office, Congress' investigative arm, found ER patients who should have been seen immediately waited nearly a half-hour.

"We're starting out with crowded conditions and anticipating things will only get worse," said American College of Emergency Physicians president Dr. Angela Gardner....
 

Deuce

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Oh no, more people will get treated for injuries and illnesses. THIS IS TERRIBLE!
 

LaMidRighter

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Oh no, more people will get treated for injuries and illnesses. THIS IS TERRIBLE!
At higher ER costs. Yeah, that's ****ing brilliant.:roll:
 

Deuce

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Dr. Arthur L. Kellermann predicts this from the new law: "More people will have coverage and will be less afraid to go to the emergency department if they're sick or hurt and have nowhere else to go.... We just don't have other places in the system for these folks to go."

At higher ER costs. Yeah, that's ****ing brilliant.:roll:

Yeah those hurt people with nowhere else to go should just stay home so that it doesn't cost us money!
More people are going to be accessing health care, so yes, there will be more people at ER's too. An increase in demand on such services. If only there was some other market force that could adapt to this change... some way to increase the number of available doctors and hospitals...

The solution to crowded ER's isn't fewer patients, for god's sake.
 
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LaMidRighter

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Yeah those hurt people with nowhere else to go should just stay home so that it doesn't cost us money!
I stopped reading here because you started from a position of ignorance of the subject, no reason to read further. This isn't about traumatic or life threatening situations, this about people with the ****ing sniffles abusing the more expensive ER and how it will INCREASE. You are either misrepresenting the situation deliberately or you don't get the point of the discussion, either way you are wrong.
 

Deuce

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I stopped reading here because you started from a position of ignorance of the subject, no reason to read further. This isn't about traumatic or life threatening situations, this about people with the ****ing sniffles abusing the more expensive ER and how it will INCREASE. You are either misrepresenting the situation deliberately or you don't get the point of the discussion, either way you are wrong.

Masterful debate, sir.

The article in the OP didn't mention "the sniffles." It wasn't even about "abusing" the ER.
 
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LaMidRighter

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Masterful debate, sir.

The article in the OP didn't mention "the sniffles." It wasn't even about "abusing" the ER.
I see you can't read between the lines very well, the article indeed mentioned it if you know the issues on healthcare and know what the words mean.
 

Deuce

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I see you can't read between the lines very well, the article indeed mentioned it if you know the issues on healthcare and know what the words mean.

More people will be accessing healthcare as a whole. (THIS IS A GOOD THING) Seeing as how more people will have insurance, more people will likely go see their GP. More people will also go to the ER, as they'll be less scared about the cost of doing so.

Do you have any evidence that the ratio will favor ER visits over GP visits? Because if the ratio favors the much-cheaper GP visit, average cost per-person would be going down, yes?
 
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cpwill

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Do you have any evidence that the ratio will favor ER visits over GP visits?

yup. see: OP, Romneycare, what we are learning from.
 

LaMidRighter

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More people will be accessing healthcare as a whole. (THIS IS A GOOD THING) Seeing as how more people will have insurance, more people will likely go see their GP. More people will also go to the ER, as they'll be less scared about the cost of doing so.
You really think that don't you?

Do you have any evidence that the ratio will favor ER visits over GP visits? Because if the ratio favors the much-cheaper GP visit, average cost per-person would be going down, yes?
For "emergency" stabalize and realease vs. physicians costs the ER visit usually equates to free for the abuser. What can beat free?
 

MaggieD

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Well, right now ERs are kept crowded by nonemergencies. So, I see the point that things will only get worse. HOWEVER, triage is an important part of ER services. If I have the sniffles, am I really going to wait five hours to see a doctor? This would seem to be a problem of effective triage/use of services.

Perhaps doctors are worried that Physician Assistants will have a share of their practices as outlets like Walgreen's and CVS continue to provide quick and affordable healthcare for people with sniffles. Right now, the AMA is fighting these outlets every step of the way.

Stands to reason, though, that if I have to wait 3 weeks to see a doctor (which happens right now, my friends), the ER is the place to go.
 

cpwill

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yeah, our decision to recreate a guild for doctors has done us much damage; it's past time to begin to widely expand the healthcare provision network.
 

Aunt Spiker

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Yeah those hurt people with nowhere else to go should just stay home so that it doesn't cost us money!
More people are going to be accessing health care, so yes, there will be more people at ER's too. An increase in demand on such services. If only there was some other market force that could adapt to this change... some way to increase the number of available doctors and hospitals...

The solution to crowded ER's isn't fewer patients, for god's sake.

And praytell - with Obama attacking physicians and Dr's on a personal level, supporting the lowering of their pay - and with changes in the healthcare bill actually chasing Dr's away from their areas of practices . . . pray tell how are you going to get *more* people to become Dr's?

There is already a shortage of Dr's, nurses, physicians - do you know how many hours Dr's work during a week?

If the ones we *do* have in practice aren't enough - then HOW are we going to get more?

On top of that - it's not just a "dr/nurse" increase that will be needed. It's a "secretary, receptionist, supply specialist" - really - EVERY position in the entire healthcare field will become more stressed and those people will be in more demand. . .how can we fill all those positions that will be opened?

They're already understaffed and overstretched - and that will only get worse.

When that gets worse the quality of care PLUMMETS.
 

Deuce

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And praytell - with Obama attacking physicians and Dr's on a personal level, supporting the lowering of their pay - and with changes in the healthcare bill actually chasing Dr's away from their areas of practices . . . pray tell how are you going to get *more* people to become Dr's?

There is already a shortage of Dr's, nurses, physicians - do you know how many hours Dr's work during a week?

If the ones we *do* have in practice aren't enough - then HOW are we going to get more?

On top of that - it's not just a "dr/nurse" increase that will be needed. It's a "secretary, receptionist, supply specialist" - really - EVERY position in the entire healthcare field will become more stressed and those people will be in more demand. . .how can we fill all those positions that will be opened?

Yeah because receptionists and supply chain guys are so hard to find right now ;) You mean that more patients with more demand might actually create more job openings? THE HORROR!

I actually read an interesting idea recently about an "assembly line" health care model. Right now, we have guys going to eight years of medical school, working through residency and all that, all to end up doing one specific task. Is it necessary to get all of that education just to read an x-ray? You could have one guy just learn all about x-ray machines and how to interpret the results. Learning about circulatory problems or communicable diseases isn't particularly important to X-Ray Man. Yes, you'd still need the full-blown M.D. guys to be GP's or surgeons or some of the more complicated specialists, but there's probably quite a few jobs that don't really need the highly-educated 200k/year doctor.

Seemed like a good idea... in theory. But I'm hardly an expert.
 

MaggieD

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I actually read an interesting idea recently about an "assembly line" health care model. Right now, we have guys going to eight years of medical school, working through residency and all that, all to end up doing one specific task. Is it necessary to get all of that education just to read an x-ray? You could have one guy just learn all about x-ray machines and how to interpret the results. Learning about circulatory problems or communicable diseases isn't particularly important to X-Ray Man. Yes, you'd still need the full-blown M.D. guys to be GP's or surgeons or some of the more complicated specialists, but there's probably quite a few jobs that don't really need the highly-educated 200k/year doctor. Seemed like a good idea... in theory. But I'm hardly an expert.
I think our specializations have led to more effective medicine. If I have a melanoma, as an example, who do I want to remove it? A general surgeon who sees one a week? Or a specialist that sees 40? Doctors have got to let go of some of their responsibiities and put them in the hands of Nurse Practitioners and just nurses in general. I was receiving ongoing treatment where I saw "the doctor" once a week. The nurse who talked to me B4 hand gave me all the information I needed. The doctor simply came in for three minutes and blessed me. Charge for that blessing? $140.

Major chains are trying to get into the healthcare delivery system with Nurse Practitioners in their stores -- Walgreen's and CVS being two. They're available to write antibiotic prescriptions for sore throats, to advise when to go to the hospital, etc., etc. Doctors are fighting that tooth-and-nail because it'll cut into their revenues. As usual, it's greed holding back reform.
 
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