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Z_CNHI News Service

January 10, 2014

Obamacare surprise: More Medicaid means more trips to the ER

(Continued)

“A lot of them don’t have a steady job, they don’t have a steady place to live, they may have drug or alcohol problems, and about all they can think about is getting through the day. They don’t make appointments. Thinking about next week or next month might as well be 10 years from now,” one hospital executive told me. That was about 30 years ago.

Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology and one of the architects of Obamacare, has apparently been aware of this all along. He told the Washington Post recently that promises of savings made by people like Sebelius were, “sometimes a misleading motivator for the Affordable Care Act. The law isn't designed to save money. It's designed to improve health, and that's going to cost money."

Gee, nice of him to acknowledge that now. I don’t recall him disputing either Sebelius or the president during the intense debate over whether Obamacare was going to save money.

Oregon officials contend that since 2008, when the patient sample was studied, they have cut the use of ERs with better patient management. But that has required putting “community health workers” – in essence, health-care babysitters – in hospitals to divert patients with non-emergency problems to a less costly setting than the ER. This, they say, will “train” them to do it on their own. Good luck with that.

Meanwhile, there isn’t much discussion about what happens if they get diverted to a doctor who doesn’t take Medicaid.

Everybody should be provided with health care. But in some cases – millions of them nationwide – handing them an insurance plan is not the best way to do that. It certainly is not the way to save any money.

That is something people like Gruber knew – and should have acknowledged – up front.

Taylor Armerding is an independent columnist. Contact him at t.armerding@verizon.net

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