Free Markets, Free People


More “good news” about the health care bill’s impact

Remember the mantra that said, “once everyone has insurance, emergency rooms won’t be jammed as they are today”.

Says those who actually know about such things – “Wrong”.  In fact, they’re likely to be even more jammed than they have been in the past.   The reason?  The number of primary care doctors won’t change just because the number of insured have.

“Everybody expected that one of the initial impacts of reform would be less pressure on emergency departments; it’s going to be exactly the opposite over the next four to eight years,” said Rich Dallam, a healthcare partner at the architectural firm NBBJ, which designs healthcare facilities.  

“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,” he said.

But don’t take Dallam’s word for it – we’ve actually had experience that was apparently ignored:Massachusetts in 2006 created near-universal coverage for residents, which was supposed to ease the traffic in hospital emergency rooms.

But a recent poll by the American College of Emergency Physicians found that nearly two-thirds of the state’s residents say emergency department wait times have either increased or remained the same.

A February 2010 report by The Council of State Governments found that wait times had not abated since the law took effect.

Yes, it appears the public was sold yet another bill of goods.

Even the Chief Actuary at the Centers for Medicare and Medicaid Services is forced to grudgingly admit it:

Richard Foster, Chief Actuary at the Centers for Medicare and Medicaid Services, told The Hill that the current dearth of primary care physicians could lead to greater stress on hospital emergency rooms.

“The supply of doctors can’t be increased very quickly – there’s a time lag,” he said, adding, “Is the last resort to newly covered people the emergency room? I would say that is a possibility, but I wouldn’t say anybody has a very good handle on exactly how much of an infrastructure problem there will be or exactly how it might work out.”

Really?  Not enough doctors, everyone insured, Massachusetts example?  Of course they have a pretty good handle.

In fact, the American Institute of Architects predicts that the cost for hospitals could be in the $2 trillion dollar range over the next 20 years to meet coming demand.  Such building, at the moment, is pretty much on hold due to the economy.

The point, of course, is that access to insurance doesn’t mean access to a doctor.  And thus one sure way to see a doctor is via the emergency room.  Lack of insurance may have kept some away from seeking services there.  That won’t be the case anymore.  And, given the Massachusetts example, that’s proven to be true there.

So once again, reality meets a political promise and the promise is found wanting.

The cost of the bill, according to the latest CBO numbers, has now risen to over a trillion dollars in the first 10 years (bending the cost curve in which direction?  Up.), despite claims that it was under 800 billion, so the fact that this particular promise is wrong as well shouldn’t surprise anyone. 

~McQ

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9 Responses to More “good news” about the health care bill’s impact

  • “we’ve actually had experience”

    Pish and tush. A beautiful, pragmatic theory is much more important than sordid, ideological reality. You are so  biased.

  • “Such building, at the moment, is pretty much on hold due to the economy.”

    Of course. There are much more important things to do with that stimulus money than healthcare. Bicycle paths, for instance.

  • {chuckle} You grunt engineer types talk a good game about responsibility, but when it really comes time to hold up your responsibilities to society, we see you don’t really mean it. You’re all, like, “oh, that’s too expensive and we don’t see how to make it work and the laws of economics blah blah” as if you dense righties without advanced social science degrees knew anything about economics.

    Look, we already decided. Healthcare is a moral right, and our savior leader has produced legislation that guarantees it. So we wise leftists with advanced degrees have done the hard part and committed society to that principle. Now you grunt engineer types need get to work and take care of the details. That includes those selfish doctors with their whining about too much work and how they might just retire. We certainly can’t have that, and I’m sure Obama with his Christlike visage is figuring out a way to coerce get them on board right now.

    Doing the details that make our grand designs work is your job. You’ll figure it out. You always have before. So stop whining about it and get to work. You don’t hear me whining about all the work I have to do indoctrinating teaching bored undergraduates who sit in my class thinking about sex all the time bright young minds and grading papers and doing paperwork for low pay.

    Plus I’m so dedicated that I’ve written a book on the side, which was a lot of work, and it seems totally unappreciated since only about three dozen copies of it sold. Yet I don’t get discouraged. In fact, I’m writing another one: “Dense Righties – A Comparison to Aboriginal Tribes From Around the World.” That’s why I come here – research for my book. And certainly not to bolster my self-respect by lecturing down to you grunt engineer types about quantum mechanics. Which I totally understand by the way. I read an article in Newsweek about it.

    • Is your next book going to be titled, “The Sun and Other Low Probability Quantum Events”?  I must have an autographed copy!

      • Sort of. My next book does involve quantum statistics. It’s about how there are not nearly as many tea partiers as you sterile, inbred, dense righties claim. My working title is “Post-modern Academics vs. Your Lying Eyes: Why there are only a few thousand tea partiers no matter what the photographs show.”

  •  Such building, at the moment, is pretty much on hold due to the economy.

    Oh, it’s worse than that.  The Certificate of Need (CON) provisions in Obamacare have made it more difficult to build new hospitals.  In fact, the CON provisions have stopped some hospital construction projects, even some where millions of dollars had already been raised and invested, dead in their tracks.

    Add that to the fact that quite a few older primary care physicians are expected to just retire after this bill takes effect, and you get the impression that this bill would worsen emergency room access even if it didn’t insure a single new patient.

    The more I read about this bill, the easier I find itto  accept the idea that it is designed to fail, crash the health care market, and create the “need” for single-payer government run health care.  How else can you possibly explain effing it up this badly?

  • The whole national health insurance mantra has been exceptionally strange.  Those in favor, or at least attempting to justify it, have been caught in a multitude of “mischaracterizations” or outright lies: hiding costs (such as the “doc fix” and now the ER’s). miscounting the number of uninsured, telling us “no rationing” and then coming back an telling us about a “duty to die”, no funding of abortion, etc, etc, etc.  Whatever it took to meet an objection, some lie or mischaracterization was trotted out.
    Given what we know about this whole idea, few people in their right mind would have voted for this bill.  But, somehow, Democrats almost unanimously in the House, and unanimously in the Senate, voted in favor.  Since the bill will do virtually nothing it was claimed it will do, what was the motivation to destroy political careers?  Most, who were not in safe districts like Waxman and Pelosi,  will be in battles for their political life.  I have to believe most of those people knew the bill was essentially a lie.   What kind of pressure and inducements were offered?   It will be instructive to see where people like Stupak end up.  Were there promises made that we will only see later?

    As an aside, I believe this Senate bill to “reform” the financial system is a Chris Dodd retirement and post Senate career bill.   I fully expect him to get some high dollar job related to finance that he will “unexpectedly” discover in 2011.

     

    • “Since the bill will do virtually nothing it was claimed it will do, what was the motivation to destroy political careers?  Most, who were not in safe districts like Waxman and Pelosi,  will be in battles for their political life.  I have to believe most of those people knew the bill was essentially a lie.   What kind of pressure and inducements were offered?   It will be instructive to see where people like Stupak end up.  Were there promises made that we will only see later?”

      Ya know, reading the comment, a weird thought just hit me, it’s almost like they’re playing a simulation where the end game clock is nearly up and knowing the end is coming up they just have to keep the morale or attitude of the game population confused or satisfied long enough for the ‘win’ and after that it won’t matter.  Which is a rather disturbing thought.

  • This is another of those costs that have not been taken into consideration when this bill was being sold to the public.  Another cost that is being ignored is based on a logical assumption– that if you force everyone to purchase health insurance, a lot of people who would otherwise not have availed themselves of doctors and hospitals will be sure to do so for even the mildest of health concerns.  Hey, they’re paying for it, so they’re going to use it.  The problem with this is that the system depends on healthy Americans to pay for those who are not healthy, which means that if they seek out medical treatment the cost curve bends upwards even more sharply.

    Expect to see more “surprises” as time goes on and people “discover” issues that were already obvious before this bill was passed.  I’m sure that the press will continue to be shocked… SHOCKED… at the problems that this bill will create.