nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, July 2, 2010

Another Myth Exploded: Crowded ER's Not Due To Uninsured

The increase in ER visits, caused by uninsured that had no choice, was one of the factors driving health care reform.  Not true, apparently.

According to Assoc Press (July 2), the view that giving health coverage to 30 million would allow those patients to be seen in doctors' offices failed to consider
-There's already a shortage of front-line family physicians in some places and experts think that will get worse.

-People without insurance aren't the ones filling up the nation's emergency rooms. Far from it. The uninsured are no more likely to use ERs than people with private insurance, perhaps because they're wary of huge bills.
-The biggest users of emergency rooms by far are Medicaid recipients [emphasis mine]. And the new health insurance law will increase their ranks by about 16 million. Medicaid is the state and federal program for low-income families and the disabled. And many family doctors limit the number of Medicaid patients they take because of low government reimbursements.
As we seen dozens of times so far, the supporters of HCR had no idea what consequences would unfold from their efforts.

Duplicating the experience of ER's in Massachusetts--the prototype of universal health coverage--hospitals across the country are preparing for the surge, for which they have no resources (space or providers).
Rosy assumptions by reform supporters that we can incentivize doctors to go into primary care, and that increasing the output of physicians and other providers, will solve any problems with access to care, have yet to prove themselves--and those programs haven't even begun.  Further, it's not clear that just pushing more people into the pipeline will result in more coming out the other end, for 10 years at least, and maybe never, for these reasons:  (1) training to provide patient care, whether by physicians, physician assistants, or nurse practitioners takes time, a lot of time, and (2) the number of training institutions with training slots for interns residents and other providers is limited.
Focusing on getting everybody covered by HCR was short-sighted.  Being covered means nothing if there's nobody to see you.
Doc D

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