Good intentions run into cold logic and lose, again


Don't go there

Don’t go there

Expanding Medicaid expands use of emergency rooms as primary care centers.

Some supporters of President Barack Obama’s health-care overhaul say that putting uninsured Americans on Medicaid will reduce costly emergency-room visits by giving them more access to care in other settings.

But a new study found the reverse: A group of 10,000 low-income Oregon residents who recently obtained Medicaid coverage visited ERs 40% more often than those without insurance.

The new Medicaid recipients used ERs more often for all kinds of health issues, including problems that could have been treated in doctors’ offices during business hours, according to the study published Thursday in the journal Science. Earlier studies had found the same patients used more of other medical services as well.

In the latest study, which is based on records of 25,000 lottery participants, the authors said the increase in ER visits wasn’t surprising, because Medicaid made them effectively free. “As I tell my economics students, when something is free, people use more of it,” said Dr. Finkelstein.

By comparison, check out this story of patients declining treatment when they learn that they’ll have to pay for it. Chest X-ray for someone who’s got a cough, admission for someone who “felt chest pain” but wasn’t having a heart attack, these and more were deemed non-essential by the patients demanding them once they discovered that they wouldn’t be free.


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5 responses to “Good intentions run into cold logic and lose, again

  1. FenianForever


  2. hmmm

    Good, the insurance companies and the hospitals stayed quiet during the obamcare debates and deserve to get it good and hard as does the middle class and Balzac

  3. One reason they decline treatment is the knowledge that they’ll have to pay the sucker prices that are 5 to 10 times the prices the hospital negotiates with insurance companies.

    The draw for hospitals in all this is that they used to have to eat the cost of a lot of that care. Now millions more will be on Medicaid, which doesn’t pay much, but what it does pay is a lot better than nothing.

    • Indeed, the worst part of being uninsured some years ago was the inability to get the lower prices negotiated by the insurance companies. Today, I might pay a $45 co-pay and notice, when the bill arrives, that the doctor was only being paid $65 more. Not surprisingly, doctors try to make up the difference by charging uninsureds far more: $350-$450 more, in my case.
      Same with prescription drugs – uninsured but with assets? Boy will you pay.

      • This is what happens when prices get messed with by the government and the consumer gets everything “free”.

        A lot of insurance contracts are written to pay Medicaid plus X%, so the government essential starts the price setting process.