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Despite Obamacare's Expanded Coverage, More Patients Going to the ER
CNS ^ | July 2, 2014 | Barbara Hollingsworth

Posted on 07/05/2014 9:04:24 AM PDT by xzins

(CNSNews.com) – Despite expanded health insurance coverage under the Affordable Care Act (ACA), more people are going to hospital emergency rooms (ER) for treatment because they can’t get an appointment with a primary care physician, according to the American College of Emergency Physicians (ACEP).

“Nearly half of emergency physicians responding to a poll are already seeing a rise in emergency visits since January 1 when expanded coverage under ACA began to take effect,” according to ACEP, which gives overall emergency care in the U.S. “a dismal D+ grade.”

In addition, 86 percent “expect emergency visits to increase over the next three years,” and 77 percent say their ERs “are not adequately prepared for significant increases” in patient volume, according to the online poll.

“Emergency visits will increase in large part because more people will have health insurance and therefore will be seeking medical care,” ACEP’s president, Dr. Alex Rosenau, explained. “But America has severe primary care physician shortages, and many physicians do not accept Medicaid patients, because Medicaid pays so low.”

“When people can’t get appointments with physicians, they will seek care in emergency departments. In addition, the population is aging, and older people are more likely to have chronic medical conditions that require emergency care,” Rosenau added.

In some areas, wait times for a doctor’s appointment are already quite long, says Dr. Michael Murphy, an ER physician from New Jersey.

“With the Medicaid expansion and the Affordable Care Act, people have insurance but they can’t get in to see their primary care physician. So they’re going to the emergency department” with minor conditions, even though “the whole intent [of the ACA] was to get the sore throats, coughs, congestion and whatnot” out of the ERs.

“One thing that the Affordable Care Act did, and I think, you know, it’s a great thing for everybody to have health insurance, but what we’ve seen just recently, and all the data from Q1 and Q2 right now, 2014, shows that volumes have increased dramatically. They’re predicting about a 15 to 20 percent rise in [patient] volumes across the country, people with insurance, and now they’re flooding to their physicians,” Murphy told CNSNews.com.

“Well, the physicians can’t [handle the increased volume]. It doesn’t make financial sense to hire another physician or another nurse practitioner with decreased reimbursements, so what they’re doing is, they’re trying to see the same 15 to 20 percent bump in volume with the same providers that they have."

“And what that does is, it just creates greater wait times. That access to care is not there. And the frustrating part is that for patients immediately with new insurance, is that you can’t even get in.”

“What if you have a horrible diagnosis from the emergency department of cancer and you need to go see a family practitioner to get a referral to go see an oncologist? Well, the first time you can get in to see a family practitioner might be three months.”

And with more patients and less revenue coming into already struggling hospitals, ER doctors are constantly being pressured to speed things up, Murphy said.

“We get daily pressure to do more with less, and to see your patient in seven minutes or less, get your patient out of the emergency department. They’re always telling you to move, move move and see more patients in the same amount of time,” he told CNSNews.com.

“You have to. It’s a simple financial game. If you’re getting paid less per patient, you have to see more patients to keep the lights on.” But “when you are pressured, and you have to see five, six, seven patients an hour, and you have to do all your own documentation, you’re going to miss stuff,” he said.

However, even going to the nearest ER will soon not be a viable option, Murphy warned.

“Hospitals are closing left and right, and all that volume has to go somewhere,” he said, predicting that health care in the U.S. will be “rationed” within the next decade.

“We fought a couple of wars and you had this massive increase of patients at the VA [Veterans Administration]. And I think that just as private practices are closing, you’re also seeing large hospital systems close down and merge with other large hospital systems. And when that happens on a larger scale, that’s when you get these massive influxes into other facilities and that’s when it can hit the fan. And I think we’re going to get to that point.”

“I think there’s going to be a point where there’s not enough to go around and care is going to be rationed unless you’re paying premium top dollar. And that’s just an unfortunate reality. It probably won’t happen for another five or ten years unless we have some dramatic thing that happens in the meantime,” he told CNSNews.com.

Murphy, who is also co-founder of ScribeAmerica LLC, a group that trains physician assistants to help doctors maintain their medical records, noted that there has been “a dramatic decrease” in the number of solo practitioners since the 1980s due to a “cumulative effect” of lower government reimbursements and the “ever surmounting pressures of more regulation.”

Currently, only 18 percent of physicians in the U.S. are Marcus Welby-style solo practitioners, and many of them are selling their practices, he said, adding that it won’t be long before they are replaced by giant health care groups employing hundreds of physicians.

“I can only imagine this trend will continue and soon there will only be a very few personalized, custom private practices. And the ones that will be there will be in very affluent areas, they’ll be kind of that concierge practice,” Murphy told CNSNews.com.

“And the rest will be large group centers,” he predicted. “And then even those will go to the next round of consolidation." But the consolidations will come at a cost to patients, he warned.

The result will be a kind of “factory medicine” where doctors work 9-to-5 and are less personally invested in their patients, he said.

“Once you lose that vested interest [as owner of a private practice], and adopt that employee mindset instead of an owner mindset, you stop caring and you lose that personal touch. At the end of the day, it’s not personal anymore."


TOPICS: Front Page News; News/Current Events
KEYWORDS: 0carenightmare; emergency; er; expense; obamacare; obamacarehospitals
“Hospitals are closing left and right, and all that volume has to go somewhere,” he said, predicting that health care in the U.S. will be “rationed” within the next decade.
1 posted on 07/05/2014 9:04:24 AM PDT by xzins
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To: All

“We get daily pressure to do more with less, and to see your patient in seven minutes or less, get your patient out of the emergency department. They’re always telling you to move, move move and see more patients in the same amount of time,” he told CNSNews.com.


2 posted on 07/05/2014 9:04:57 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: xzins

This country is pretty much over. We have been ruined. I can hardly stand to hear about this stuff anymore. We have waited too long. Six years is all it took. I really don’t believe anyone can stop this miserable dive.

Unreal


3 posted on 07/05/2014 9:07:41 AM PDT by dforest
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To: xzins

Less care, at a lower quality and a higher cost. Gotta hand it to Obama, he really fixed that Healthcare problem.


4 posted on 07/05/2014 9:07:58 AM PDT by fhayek
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To: dforest
This country is pretty much over. We have been ruined.

I cannot bring myself to disagree with you ... sadly.

5 posted on 07/05/2014 9:15:25 AM PDT by The Duke ("Forgiveness is between them and God, it's my job to arrange the meeting.")
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To: xzins

NOTHING_TO_SHOW_FOR_IT_PING!


6 posted on 07/05/2014 9:15:59 AM PDT by The Duke ("Forgiveness is between them and God, it's my job to arrange the meeting.")
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To: xzins

“Expanded coverage”? B.S. The only coverage that’s expanding under Obama is the NSA, IRS, & HHS violations of our Constitutional rights.


7 posted on 07/05/2014 9:17:39 AM PDT by PapaNew
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To: xzins

This is terrible. Where are the illegal aliens going to get primary care if everyone else starts mis-using the ER?


8 posted on 07/05/2014 9:19:48 AM PDT by skeeter
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To: xzins

Death panels as Sarah predicted. Maybe Krauthammer needs to leave the room.


9 posted on 07/05/2014 9:21:52 AM PDT by miss marmelstein (Richard Lives Yet!)
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To: miss marmelstein

Since Charles is a doc, he can treat himself. :>)

I’m thinking they’ll declare conservatism a mental defect and allow the death panels to be pro-active.


10 posted on 07/05/2014 9:31:33 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: PapaNew

You didn’t get the memo...NSA will do all prostate exams.


11 posted on 07/05/2014 9:32:56 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: xzins

Everybody overlooks the benefits of the Death Panels.

Every year sliced off the lifespan is HUGE for SocSec and Medicare financials.


12 posted on 07/05/2014 9:35:20 AM PDT by nascarnation (Toxic Baraq Syndrome: hopefully infecting a Dem candidate near you)
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To: xzins

This is EXACTLY what we conservatives predicted would happen four years ago.


13 posted on 07/05/2014 9:41:38 AM PDT by Hoodat (Proverbs 29:2)
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To: dforest

I agree, sadly. It had to happen sometime. I thank God that I won’t be here for the very worst of it.


14 posted on 07/05/2014 9:42:43 AM PDT by mrsmel (One Who Can See)
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To: xzins

Just because you sign up and pay for Obamacare doesn’t mean you actually have coverage.


15 posted on 07/05/2014 9:50:39 AM PDT by E. Pluribus Unum ("The more numerous the laws, the more corrupt the government." --Tacitus)
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To: xzins

Obamacare puts more people on Medicaid. 40% of doctors don’t accept Medicaid patients. As a result, it is far easier to go to the ER for routine needs rather than trying to find a doctor. Add to that the illegal aliens who use the ERs as free health clinics and you have a real problem.


16 posted on 07/05/2014 9:53:36 AM PDT by kabar
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To: miss marmelstein

I heard earlier today that most of the Alzheimer’s drugs aren’t working and there are no new ones in the pipeline.

Gotta fund cures for scabies, lice and the new strains of TB.


17 posted on 07/05/2014 9:54:50 AM PDT by Cowgirl of Justice
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To: xzins
NSA will do all prostate exams.

I thought it was going to be the IRS since they're so good at it.

18 posted on 07/05/2014 9:57:03 AM PDT by seowulf (Cogito cogito, ergo cogito sum. Cogito.---Ambrose Bierce)
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To: xzins

I got the memo, but I deleted it.


19 posted on 07/05/2014 10:02:58 AM PDT by PapaNew
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To: Hoodat

It’s rational behavior. If they can go in for a dollar down catch me for the rest, why would they sign up for something with a coupla hundred buck monthly premium, co-pays, and a 6000 a year deductible. The deductible alone should keep people from signing up. That’s like having no coverage at all. How many of tell our car insurance companies we want a 6000 deductible?


20 posted on 07/05/2014 10:10:32 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: xzins

Betsy McCaughey was on Fox & Friends this morning, talking about 1,200 new pages of regulations for health care. Huge new reporting requirements for doctors treating medicare payments, including requirements that they discuss issues like obesity, even if it isn’t the reason for the doctor visit. And if the doctor doesn’t fulfill the new requirements, he can be fined.

How many doctors are going to start dumping their medicare patients now?

Maybe that will finally start waking people up. Nothing else has worked.


21 posted on 07/05/2014 10:13:14 AM PDT by Twotone (Marte Et Clypeo)
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To: xzins

Well, he can examine his mental inability to apply common sense. But where’s the scrip for that?


22 posted on 07/05/2014 10:15:41 AM PDT by miss marmelstein (Richard Lives Yet!)
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To: Twotone

I don’t know how you can keep serving people you don’t make money on. There was something a few years ago my doc did (ekg or something) that he says he now sends to the hospital. The insurance companies won’t reimburse him now except a few bucks, but the hospitals they will, so he says, “Why do it?” It’s a rational decision on his part.


23 posted on 07/05/2014 10:17:25 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: xzins

ping


24 posted on 07/05/2014 10:35:19 AM PDT by gattaca (The heart of the wise inclines to the right, but the heart of the fool to the left. Ecclesiastes10:2)
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To: dforest

Nobody stopped this because our master’s masters wanted this. Your government never ever had our interest st heart, they have always worked for their contributors.


25 posted on 07/05/2014 10:51:51 AM PDT by WilliamRobert (We are doomed if good men stand by and do nothing.)
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To: xzins
Don't worry subjects. The overlords are exempt

26 posted on 07/05/2014 11:34:47 AM PDT by Organic Panic
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To: xzins

Tried going into the local “Walk -In” Clinic a few days ago to get a Tetanus shot. The 20 something behind the counter didn’t even know what a Tetanus shot was and said I had to make an appointment. In order to make an appointment she needed to know my “Soch”, for billing purposes, I had planned on paying cash but NO, they only bill. Got so mad I just left. The BS paperwork and attitude created by the Gov’s involvement is why our healthcare system is failing.


27 posted on 07/05/2014 11:57:56 AM PDT by PatrioticRose
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To: xzins

And if you can’t get an appointment to see a primary care physician, you can’t get a referral to a specialist.

If you go see a specialist w/o a referral from your PCP, your insurance doesn’t cover it.

So, it’s basically the same as before if you didn’t have insurance at all.


28 posted on 07/05/2014 12:29:17 PM PDT by Lorianne (fedgov, taxporkmoney)
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To: xzins

I believe that’s a a grossly inaccurate headline. It should be:

“Because of Obamacare’s Expanded Coverage, More Patients Going to the ER”


29 posted on 07/05/2014 12:29:50 PM PDT by catnipman (Cat Nipman: Vote Republican in 2012 and only be called racist one more time!)
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To: xzins
predicting that health care in the U.S. will be “rationed” within the next decade.

I predict by the next decade computers will diagnose more patients than real doctors and do a better job. If not, only the political class and elites will get any quality care.

30 posted on 07/05/2014 7:17:29 PM PDT by itsahoot (Voting for a Progressive RINO is the same as voting for any other Tyrant.)
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To: xzins

Wonder what the temper tantrum will be then.


31 posted on 07/05/2014 7:29:20 PM PDT by RWB Patriot ("My ability is a value that must be earned and I don't recognize anyone's need as a claim on me.")
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To: xzins

And on top of that rationing, how much you want to bet that a person’s politics will be a major deciding factor on whether they get the needed card or points or whatever they’ll have to show?


32 posted on 07/05/2014 7:32:21 PM PDT by RWB Patriot ("My ability is a value that must be earned and I don't recognize anyone's need as a claim on me.")
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To: RWB Patriot

Card, points, something will determine. If they go after people with the IRS, then they’ll go after people with HHS.


33 posted on 07/06/2014 2:20:43 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: dforest

“Six years is all it took.”

Obama and the Dems certainly accelerated the process, but this was happening before he ever showed up. The open border and H1-B fraud was going on for decades.


34 posted on 07/06/2014 3:16:06 AM PDT by kearnyirish2 (Affirmative action is economic warfare against white males (and therefore white families).)
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To: xzins

“I don’t know how you can keep serving people you don’t make money on.”

You don’t; the ERs close. Happened in southern CA, and is happening in my area (northeastern NJ); the illegals flood the emergency rooms, the state reimbursement doesn’t keep up, and the ER shuts down.

“There was something a few years ago my doc did (ekg or something) that he says he now sends to the hospital. The insurance companies won’t reimburse him now except a few bucks, but the hospitals they will, so he says, “Why do it?” It’s a rational decision on his part.”

My wife’s doctor sent her somewhere for a test that she’d had previously in his office; he said he could do it in his office if she was on welfare, but the insurance company wouldn’t pay for it otherwise.


35 posted on 07/06/2014 3:19:31 AM PDT by kearnyirish2 (Affirmative action is economic warfare against white males (and therefore white families).)
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To: PatrioticRose

We have started going to the Walgreens and CVS minute-clinics for things like Tetanus shots, flu shots, and other routine vaccinations instead of the doctor’s office or walk-in clinics. They can treat a lot of non-life threatening conditions now. Some keep a nurse practitioner and the pharmacists are trained to give shots. I got my flu shot at CVS year before last the he did a great job. The pharmacist gave a better shot than the nurse at my doctor’s office did this year.


36 posted on 07/06/2014 11:09:35 AM PDT by Tennessee Conservative
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To: dforest

our country and our culture....seriously wonder if I could live in Canada....could I get my 401k out?


37 posted on 07/06/2014 9:31:18 PM PDT by cherry
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To: itsahoot

I’m sure our hollywood stars will still get their breasts enlarged, their lips pumped, their hair restored, their noses done, and their eye lids lifted....we need to keep up the falsehoods as long as we can...


38 posted on 07/06/2014 9:56:46 PM PDT by cherry
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To: Cowgirl of Justice
I heard earlier today that most of the Alzheimer’s drugs aren’t working

That's news to me that they "aren't working". Working for this class of drugs means stabilizing, or delaying worsening for a while, and only occasionally means improvement in function (my mother seems to be one of the lucky ones).

There are basically two types of drugs in this category, the Acetylcholinesterase inhibitors and the NMDA blockers.

Gotta fund cures for scabies, lice and the new strains of TB.

The pharmaceutical companies invest money where they see profit potential (and technical promise), not where some politician thinks the money should go.

39 posted on 07/06/2014 10:08:34 PM PDT by steve86 ( Acerbic by nature, not nurture)
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To: steve86

http://www.reviewjournal.com/life/health/alzheimer-s-drugs-not-working-according-ruvo-center-study

This might be from the story I heard on the news.


40 posted on 07/07/2014 6:19:09 AM PDT by Cowgirl of Justice
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To: cherry

FoxConn says robots will build Apple’s new iPhone, so burger flippers can’t be far behind.

I think they use robotic surgery on prostate cancer already.


41 posted on 07/07/2014 8:24:32 AM PDT by itsahoot (Voting for a Progressive RINO is the same as voting for any other Tyrant.)
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To: Cowgirl of Justice

Thanks for the link. It is a poor (horrible) headline. The proper headline should be something like “New drugs being tested for dementia fail in early testing”. The old standbys still work the same as they ever did.


42 posted on 07/07/2014 8:41:07 AM PDT by steve86 ( Acerbic by nature, not nurture)
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To: xzins

We just found out that under Obamacare when you go to your Doctor for your annual check up and you’re on Medicare and discuss your prescriptions there will be a charge for that. My wife got a $22.00 tacked on to her bill for just that.


43 posted on 07/07/2014 9:36:37 AM PDT by Rappini (Veritas vos Liberabit)
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To: Rappini

It’s all about the power and control, and then comes the money. This is a dictator’s dream.


44 posted on 07/07/2014 9:42:30 AM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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To: xzins

I know a woman who was all in for obamacare because “Too many people are going to the emergency room.” I wonder what the beee-atch is saying now.


45 posted on 07/07/2014 1:00:13 PM PDT by VerySadAmerican (Liberals were raised by women or wimps.)
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To: VerySadAmerican

Wait til the deductibles kick in. I was reading an analysis of the premiums, deductibles, co-pays and they reported that the minimum out-of-pocket was something like 12,000 a year. The platinum has far lower deductibles (2000 range), but far higher monthly premiums. The bronze has much lower premiums but outrageous deductibles.


46 posted on 07/07/2014 3:18:26 PM PDT by xzins ( Retired Army Chaplain and Proud of It! Those who truly support our troops pray for victory!)
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