It wasn’t supposed to be this way. ObamaCare was supposed to reduce hospital emergency room visits by providing more Americans with health insurance so they could see primary care doctors instead.
Yet a new survey by the American College of Emergency Physicians (ACEP) reveals the opposite is happening. Stephanie Armour, writing in The Wall Street Journal, says the survey of 2,098 emergency-room doctors conducted in March, 2015 shows about three-quarters believe visits have risen since January, 2014. A year earlier, less than half of doctors surveyed reported an increase.
Dr. Howard Mell, a spokesperson for the ACEP, comments on the survey:
“There was a grand theory the law would reduce ER visits. Well, guess what, it hasn’t happened. Visits are going up despite the ACA, and in a lot of cases because of it.”
This survey result is no surprise to those who are familiar with the statistics on Medicaid. An Oregon study in 2008 revealed that Medicaid patients were 40% more likely to use emergency rooms than even the uninsured, and 50% more likely than those with private health insurance. Medicaid patients have poor access to primary care physicians and therefore use the emergency rooms more often.
ObamaCare has largely been an expansion of Medicaid. Recent analysis reveals that 89% of the net gain in the number of insured Americans under ObamaCare comes from new enrollments in Medicaid. With millions of more people on Medicaid, it was predictable that millions more would be going to emergency rooms.
Source: American College of Emergency Physicians
The Wall Street Journal
More than half of providers listed in Medicaid managed-care plans couldn’t schedule appointments for enrollees, according to a December report by the Health and Human Services Office of the Inspector General. Among those who did offer appointments, the median wait time was two weeks, but more than a quarter of doctors had wait times of more than a month for an appointment.
People who are sick will not wait a month to get an appointment. Therefore, they seek care where they cannot be refused – hospital emergency rooms.
Dr. Ryan Stanton, an emergency room physician at Baptist Health Lexington in Kentucky says ER volume rose about 10% in 2014 from 2013, and was up almost 20% in the first few months of 2015. “We’re seeing a huge backlog in the ER because the volume has increased. This year we already have had to board people in the ER because of the sheer volumes.” He is referring to the practice of keeping patients in the ER until a hospital room becomes available.
The ACEP report also speculated the increase in ER visits may reflect the closing of some hospitals and emergency rooms. Smaller hospitals are struggling under the weight of increased costs and many have closed. Others have been consolidated under larger hospital systems that may already have sufficient emergency rooms and have closed the one in the smaller hospital.
The use of hospital emergency rooms should be limited to urgent and emergent conditions. Routine use of ERs for non-emergency care not only increases waiting times but may also contribute to higher morbidity and mortality rates.
A 2013 study by Truven Health Analytics that examined insurance claims for more than 6.5 million ER visits by commercially insured people under age 65 found just 29% of patients required immediate attention. Twenty-four percent didn’t require immediate attention, 41% received care that could have been provided by a primary care physician and 6% received care that would have been preventable or avoidable with proper primary care.
These statistics clearly show that emergency rooms are being inappropriately used by many Americans. This will continue until we develop a healthcare system that makes it easier and affordable to see a primary care physician than to go to the emergency room. ObamaCare has not been the solution – it has only made the problem worse.