Three-quarters of the 2,099 doctors responding to the nationwide survey conducted by the American College of Emergency Physicians indicate they have seen an increase in emergency room (ER) visits since Jan. 1, 2014.
That's when the Affordable Care Act (ACA), better known as Obamacare, went into effect.
In the same survey, 28 percent of the respondents say ER use has increased greatly.
What providers are witnessing daily in the ER is not what the Obama administration promised would happen, says Dr. Richard Armstrong, a surgeon who practices in Michigan and serves as a board member of the Docs4PatientCare Foundation.
Obamacare obviously did nothing to reduce the incentive for patients to use the ER as their primary care doctor, Armstrong said.
High ER Primary Care Costs
All people make their choices based on incentives, and yet Obamacare did nothing to require co-pays from Medicaid patients, Armstrong says.
Its not unusual to see a Medicaid patient who simply has a headache to come to the emergency room instead, because it wont cost them anything to get some Advil [there], which they could buy themselves at the drugstore across the street, Armstrong said.
This drives up the cost of care for hospitals that believe they are bound by law to treat these patients and dont want to turn patients away. A 2013 study by the Robert Wood Johnson Foundation reported a visit to the ER costs about $580 more on average than the same treatment administered in a primary care doctors office.
Government Picking Plans Does Not Work
One of the stated primary goals of Obamacare is to expand Medicaid, even though its long been known Medicaid patients use the ER more than patients with other means of paying, says Dr. John OShea, a Pennsylvania surgeon who also serves as senior fellow in The Heritage Foundations Center for Health Policy Studies.
The problems are worse in states with the greatest shortage of primary care physicians, which are the same states experiencing the largest expansion of Medicaid, OShea says. This situation will be exacerbated if government projections of primary care physician shortages come true. Some experts predict the United States could have a shortage of primary care physicians exceeding 20,000 doctors by 2020.
OShea says the cost of health care is also being driven up by government officials picking plans for low-income patients rather than allowing market forces to control the process, including allowing these patients to choose care that works best for them.
This is another serious reminder the government picking plans, even for Medicaid patients, just doesnt work, OShea said. It would be better for the government to heavily subsidize patients and let them choose the care that works best for them, rather than what is happening now.
But instead of doing the hard work of addressing specific problems within the health care system, such as the lack of access to primary care doctors by Medicaid patients, OShea says it was politically easier just to declare millions of previously uninsured people now covered.
It looks really good politically, and thats what they went for, OShea said.
Jim Waters, firstname.lastname@example.org, is president of the Bluegrass Institute, a free-market think tank in Kentucky.