Monday, July 12, 2010

More on reform and ER usage

I've written on this theme before, but here's some new information from health reform guru, economist and author, John Goodman.  In a nutshell, Dr. Goodman argues that the newly enacted reform law will not cut down on ER overcrowding and overutilization... much as I've stated here. 

According to the author:
In general, people with insurance consume twice as much health care as the uninsured, all other things equal. The trouble is that the new health insurance law has no provision for increasing the number of health care providers. As a result, when people try to increase their use of physician services, many will be disappointed and a large number are likely to turn to the emergency room when they cannot get their needs met at doctors’ offices:
  • Whereas the uninsured make almost two physician visits per year, the number is more than 3.5 for the privately insured and almost 7.5 for Medicaid patients.
  • On the average, we estimate the typical newly insured patient will attempt 3.6 additional physician visits.
  • If, say, only one-third of these turn to the emergency room because of inadequate primary care supply, that would equal between 39 million and 41 million additional emergency room visits every year.
That's the bad news.  The good news?
Apparently, HHS Secretary Kathleen Sebelius plans to use $250 million targeted for “prevention and public health” in the Patient Protection and Affordable Care Act for physician training instead. The funds would train 500 physicians, 600 physician assistants and 600 nurse practitioners. Also, she plans to raid pots of “stimulus” money created under the American Recovery and Investment Act.
So, relief may be in sight in the form of a narrowing of the gap between supply and demand for health care personnel. 

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