By Moe Lane | Watchdog Arena
So. Medicaid expansion has led to overburdened emergency rooms.
The primary thing that must be understood about the current situation – which is to say, that Medicaid expansion is causing a disproportionate strain on emergency rooms across the country – is that it is very much an “I told you so”kind of situation. Nothing that is happening right now was unexpected. Warnings were made. The warnings were ignored, but they were definitely made.
The Wall Street Journal sums up today’s state of affairs reasonably well: “Emergency-room visits continued to climb in the second year of the Affordable Care Act, contradicting the law’s supporters who had predicted a decline in traffic as more people gained access to doctors and other health-care providers.”
Essentially, most (the WSJ quoted a survey that said three in four) emergency room doctors have reported seeing more patients in the last year. That this is in direct contradiction to one of the original selling points for Obamacare is, again, not surprising – or at least should not be surprising. It is nonetheless surprising some people, judging from the number of news organizations that are treating this as shocking news.
It’s not. The mechanism for this was established years ago. Basically, the problem is this: Medicaid expansion has been used as a synonym for ‘getting people to doctors’ since Obamacare was first prepared for shoving down America’s throat. But it’s not a synonym.
Medicaid expansion may have technically put more people under insurance, but it’s done horribly at getting more people under care. Doctors don’t want to take Medicaid patients because government compensation rates aren’t very good and the bureaucracy is worse. So Medicaid recipients – including all of them now thrown onto Medicaid because they lost their original coverage – don’t have proper coverage. But they can go to an emergency room. Medicaid will at least cover that.
And thus the explosion in ER visits. The WSJ, again: “Nicholas Vasquez, a medical director for an emergency department in Mesa, Ariz., said volume rose 5% in a year, representing about 10 more patients a day. The stress from bigger caseloads prompted some nurses to resign, he said. ‘Physicians are working more shifts—that pushes them a lot,’ Dr. Vasquez said. ‘If they work too much, they get burnt out. For patients, it means longer waits.’”
That’s an important thing to remember, there: having more doctors and nurses costs money, just like everything else. Push them too hard, they quit; when they quit, they make conditions just a little bit worse. Vicious cycle, anyone?
Again, this was a known problem. But the problem is that Obamacare’s most fervent apologists have been groups and people who think that blatant appeals to emotion can take the place of sober analysis. So they assumed that getting more of The People on Medicaid solved the problem …and they never thought about what that means. Or even looked into just how good or bad Medicaid actually is. But of course Medicaid was good! It was a government program, right? Were The People complaining about it?
Well, yes, they were. Quite often. But the complainers pretty much got ignored. Which is why thinking of American voters in terms of The People can have such negative consequences. When all you see are The People, you forget that there are actual people – patients, doctors, and nurses – who might end up being specifically hurt by your generic good intentions.
This article was written by a contributor of Watchdog Arena, Franklin Center’s network of writers, bloggers, and citizen journalists.