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 cant 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, ACEPs 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 cant 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 doctors 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 cant get in to see their primary care physician. So theyre 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, its a great thing for everybody to have health insurance, but what weve seen just recently, and all the data from Q1 and Q2 right now, 2014, shows that volumes have increased dramatically. Theyre predicting about a 15 to 20 percent rise in [patient] volumes across the country, people with insurance, and now theyre flooding to their physicians, Murphy told CNSNews.com.
Well, the physicians cant [handle the increased volume]. It doesnt make financial sense to hire another physician or another nurse practitioner with decreased reimbursements, so what theyre doing is, theyre 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 cant 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. Theyre always telling you to move, move move and see more patients in the same amount of time, he told CNSNews.com.
You have to. Its a simple financial game. If youre 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, youre 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, youre also seeing large hospital systems close down and merge with other large hospital systems. And when that happens on a larger scale, thats when you get these massive influxes into other facilities and thats when it can hit the fan. And I think were going to get to that point.
I think theres going to be a point where theres not enough to go around and care is going to be rationed unless youre paying premium top dollar. And thats just an unfortunate reality. It probably wont 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 wont 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, theyll 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, its not personal anymore."
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.
Well, he can examine his mental inability to apply common sense. But where’s the scrip for that?
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.
ping
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.
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.
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.
I believe that’s a a grossly inaccurate headline. It should be:
“Because of Obamacare’s Expanded Coverage, More Patients Going to the ER”
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.
Wonder what the temper tantrum will be then.
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?
Card, points, something will determine. If they go after people with the IRS, then they’ll go after people with HHS.
“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.
“I dont know how you can keep serving people you dont 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 wont reimburse him now except a few bucks, but the hospitals they will, so he says, Why do it? Its 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.
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.
our country and our culture....seriously wonder if I could live in Canada....could I get my 401k out?
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...
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.
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.
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