l****z
发帖数: 29846 | 1 这个,左逼们来解释一下?
Health Reform Will Not Cut Emergency Room Visits, President Obama Hardest
Hit
One of President Obama's constant refrains during the battle over health
reform has been that expanding coverage would reduce inefficiency in the
system. In particular, he often cited expensive expensive emergency room
visits as something that reform could help reduce. But it turns out,
Obamacare, like Romneycare before it, is likely to increase emergency visits
, maybe substantially.
MIT News reports on a newly published Harvard study of Medicaid users in
Oregon:
Adults who are covered by Medicaid use emergency rooms 40 percent more
than those in similar circumstances who do not have health insurance,
according to a unique new study, co-authored by an MIT economist, that sheds
empirical light on the inner workings of health care in the U.S.
Emergency room visits are many times more expensive than primary care visits
for similar treatment. This is why, both before and after health reform was
passed, politicians cited reducing emergency room visits as a reason the
law was a good idea.
Wonkblog cites two examples today, Republican Gov. Rick Snyder and HHS
Secretary Sebelius who said back in 2009 "Our health care system has forced
too many uninsured Americans to depend on the emergency room for the care
they need."
But perhaps the person who has made this case more than anyone else is
President Obama. He has repeatedly said over the past six years that reform
would reduce ER visits thereby creating greater efficiency in the system (i.
e. saving us money). Below are 17 examples:
Nov 8, 2013 - "You know, one of the reasons to do it is -- I have said
this before. Sometimes people don't fully appreciate it. We already pay for
the health care of people who don't have health insurance. We just pay for
the most expensive version, which is when they go to the emergency room."
Oct. 30, 2013 - "we pay more in premiums and taxes when Americans
without good insurance visit the emergency room. (Applause.) We get taxed."
Oct 1, 2013 - "we should not have a system in which people are regularly
going to the emergency room, driving up costs for everybody else, because
they haven't acted responsibly."
April 30, 2013 - "we would rather have people getting regular checkups
than going to the emergency room because they don't have health care -- if -
- if we keep that in mind, then we're going to be able to drive down costs,
we're going to be able to improve efficiencies in the system"
July 17, 2012 - "If you don't have health care, then we're going to help
you get it. And the only people who may have a problem with this law are
folks who can afford health care but aren't buying it, wait until they get
sick and then going to the emergency room and expecting everybody else to
pick up the tab. That's not responsibility."
June 28, 1012 - "when uninsured people who can afford coverage get sick,
and show up at the emergency room for care, the rest of us end up paying
for their care in the form of higher premiums."
April 3, 2012 - "we shouldn’t have a system in which millions of people
are at risk of bankruptcy because they get sick, or end up waiting until
they do get sick, and then go to the emergency room, which involves all of
us paying for it."
Mar 15, 2010 - "she didn't want to be in a position where, if she did
get sick, somebody else would have to pick up the tab; that she'd have to go
to the emergency room; that the cost would be shifted onto folks through
their higher insurance premiums or hospitals charging higher rates."
March 3, 2010 - "taxpayers currently end up subsidizing the uninsured
when they're forced to go to the emergency room for care, to the tune of
about a thousand bucks per family. You can't get those savings if those
people are still going to the emergency room."
Feb 2, 2010 - "we want to make sure that everybody has health insurance,
which in turn allows us to cut back on some wasteful spending and help
upgrade hospitals and doctors and how they perform medicine because now they
're not dealing with as many emergency room patients."
Dec 9, 2009 - "Today, millions of Americans still have difficulty
accessing primary health care, and many of them are uninsured...So they don'
t get regular checkups, they don't get routine screenings. When they get
sick or hurt, they tough it out and hope for the best, and when things get
bad enough they head to the emergency room. So we end up treating
complications, crises and chronic conditions that could have been prevented
in the first place."
Sep 17, 2009 - "if there are affordable options and people don’t sign
up, then the rest of us pay for somebody else's expensive emergency room
care. And that’s not fair."
Sep 9, 2009 - "those of us with health insurance are also paying a
hidden and growing tax for those without it -- about $1,000 per year that
pays for somebody else's emergency room and charitable care."
Aug 14, 2009 - "if we can help provide coverage to people so that they'
re getting regular primary care and they're not going to the emergency room,
we will obtain some savings and that's partly...that's partly how we'll end
up paying for giving people health insurance -- because we're already
paying for it right now, we just don't notice it."
July 22, 2009 - "the average American family is paying thousands of
dollars in hidden costs in their insurance premiums to pay for what's called
uncompensated care, people who show up at the emergency room because they
don't have a primary-care physician."
Jun 5, 2008 - Sleep deprived Obama on the campaign trail:
Jan 25, 2007 - "They tell us it's too expensive to cover the uninsured,
but they don't mention that every time an American without health insurance
walks into an emergency room, we pay even more."
Obviously if Obamacare raises the number of emergency room visits by 40
percent, that isn't saving us money. Even if insured visits cost less on
average than uninsured visits, it wouldn't still not be a move in the right
direction (according to the President).
There were a few people pointing out back in 2010 that this method of cost
control was probably illusory. Massachusetts, which served as a model for
Obamacare, also saw increased emergency room visits after reform. | a**e
发帖数: 5094 | 2 还用搞研究？看病不花钱，当然跑医院跑的勤了。普通门诊看不上，就去急诊啊。
我曾经面了一个工作，让我管病房和急诊。我问干活干得多给奖金嘛。医院说没有。我
心想，医疗改革后，急诊室还不把我叫疯了。多干活还不给多钱，那就没什么好再谈的
了。
visits
【在 l****z 的大作中提到】
: 这个,左逼们来解释一下?
: Health Reform Will Not Cut Emergency Room Visits, President Obama Hardest
: Hit
: One of President Obama's constant refrains during the battle over health
: reform has been that expanding coverage would reduce inefficiency in the
: system. In particular, he often cited expensive expensive emergency room
: visits as something that reform could help reduce. But it turns out,
: Obamacare, like Romneycare before it, is likely to increase emergency visits
: , maybe substantially.
: MIT News reports on a newly published Harvard study of Medicaid users in
| T*********I
发帖数: 10729 | 3 “普通门诊看不上，就去急诊啊。”
精辟
【在 a**e 的大作中提到】
: 还用搞研究？看病不花钱，当然跑医院跑的勤了。普通门诊看不上，就去急诊啊。
: 我曾经面了一个工作，让我管病房和急诊。我问干活干得多给奖金嘛。医院说没有。我
: 心想，医疗改革后，急诊室还不把我叫疯了。多干活还不给多钱，那就没什么好再谈的
: 了。
:
: visits
| a**e
发帖数: 5094 | 4 http://www.hsph.harvard.edu/news/press-releases/having-medicaid
没想到，OR的这次抽奖活动意义这么重大。是social policy的random control trial.
结论无可非议，medicaid 曾加去急诊的次数，曾加医疗消耗。因为这些人看病基本不
用付钱。我们也发现，如果是medicaid的病人，有些指明要用brand name的药物，因为
反正也不用自己掏钱。反而是商业保险的病人，主动选便宜的generic药物。
有的洲过几年要涨州税，涨地产税了
visits
【在 l****z 的大作中提到】
: 这个,左逼们来解释一下?
: Health Reform Will Not Cut Emergency Room Visits, President Obama Hardest
: Hit
: One of President Obama's constant refrains during the battle over health
: reform has been that expanding coverage would reduce inefficiency in the
: system. In particular, he often cited expensive expensive emergency room
: visits as something that reform could help reduce. But it turns out,
: Obamacare, like Romneycare before it, is likely to increase emergency visits
: , maybe substantially.
: MIT News reports on a newly published Harvard study of Medicaid users in
| j*****7
发帖数: 4348 | 5 地产税是municipality来决定的吧，和州政府无关。
【在 a**e 的大作中提到】
: http://www.hsph.harvard.edu/news/press-releases/having-medicaid
: 没想到，OR的这次抽奖活动意义这么重大。是social policy的random control trial.
: 结论无可非议，medicaid 曾加去急诊的次数，曾加医疗消耗。因为这些人看病基本不
: 用付钱。我们也发现，如果是medicaid的病人，有些指明要用brand name的药物，因为
: 反正也不用自己掏钱。反而是商业保险的病人，主动选便宜的generic药物。
: 有的洲过几年要涨州税，涨地产税了
:
: visits
| a**e
发帖数: 8800 | 6 各个区都有州税的返还/资助，当州税不得不填别的窟窿而没有钱返还给local的时候，
地税就只好涨。
【在 j*****7 的大作中提到】
: 地产税是municipality来决定的吧，和州政府无关。
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