Remember how Obamacare was going to save big bucks and reduce wait time in emergency rooms? The idea was that millions of previously uninsured Americans accustomed to using ERs for basic medical treatment would snatch up Obamacare coverage and start getting primary care from regular (and cheaper) medical practices.
Nice thought. But it doesn’t look like it’ll pan out.
Indeed, notes Rick Dallam, it looks like “it’s going to be exactly the opposite over the next four to eight years.” In an article in The Hill, Dallam, a health care partner at a firm that designs health care facilities, notes: “We don’t have the primary care infrastructure in place in America to cover the need. Our clients are looking at and preparing for more emergency department volume, not less.”
A big part of the problem: a growing shortage of primary care physicians. The American Academy of Family Physicians recently predicted that by 2020, the United States would have 40,000 fewer family physicians than needed. As the doc supply diminishes, it will be become increasingly more difficult to get a timely appointment. Inevitably, more and more folks will resort to emergency rooms to get the medical attention they want.
But there is another, even bigger problem, rooted in the new law itself: Roughly half of the 34 million newly insured under Obamacare will get their coverage via Medicaid, a poorly performing welfare program. Medicaid reimbursement rates for physicians are so low that many doctors simply refuse to accept Medicaid patients. Based on previous experience, Medicaid expansion will not only “crowd out” private insurance, but will also swell the ranks of those getting routine, non-urgent care through hospital emergency rooms. The result: an even higher reliance on emergency room care among Medicaid beneficiaries than among the uninsured. What a mess.
To expand coverage to more Americans without hindering access, Congress would have done better to change the current tax preference given to employer-sponsored insurance and to transform Medicaid into a premium support program, so low income persons could be mainstreamed into the private health insurance system that serves their fellow citizens.