Charles Kruathammer was paralyzed by an injury as a medical student but finished and became a psychiatrist then a political writer and essayst.
Valuable commentary from a fine writer and sage.
Here he comments on our favorite issue, medical myths and fallacies.
http://www.nationalreview.com/node/370537/print
One of several likelihoods: If you build a healthcare system with ER as the one exception fallback after trying to regulate/restrict/control/ treatment, why wouldn’t everybody be more likely to use the ER?
Mr Krauthammer hits the mark again. His purpose is to point out what others wish to ignore and that is human nature. No matter how much money you throw at someone they will never change unless they become willing.
The simple question I have is if you provide something for free will people use it less or use it more?
“Emergency room usage: It’s long been assumed that insuring the uninsured would save huge amounts of money because they wouldn’t have to keep using the emergency room, which is very expensive. Indeed, that was one of the prime financial rationales underlying both Romneycare and Obamacare.
Well, in a randomized study, Oregon recently found that when the uninsured were put on Medicaid, they increased their ER usage by 40 percent.
Perhaps they still preferred the immediacy of the ER to waiting for an office appointment with a physician. Whatever the reason, this finding contradicted a widely shared assumption about health-care behavior.”
Wrong conclusion, at least given the conditions it can’t be made like that.
If I have a choice of waiting 3 days to see a GP or waiting an hour to see an ER doc, and I’m in serious pain (for example), I know what I’ll do and I’m insured and have been all my life.
What changes the frequency of insured people seeking ER care is reduced availability of GP care. Doctors close shop because they retire faster than new ones graduate, for Medicaid at least many don’t accept Medicaid patients because Medicaid pays them peanuts, well below their regular rates, etc. etc.
So those uninsured that were put on Medicaid had a choice of seeking doctors far away who were already overworked, OR continue to use the ER, OR pay a doctor out of pocket like before on top of their Medicaid payments.
And that no doubt was in at least part responsible for the increased ER use. People who could not afford ER visits and were ashamed to ask for free care, and now can afford them as Medicaid pays for it no doubt also helped.