Patterico's Pontifications

5/15/2010

ObamaCare Fallout: Crowded ERs

Filed under: Health Care — DRJ @ 10:45 am



[Guest post by DRJ]

The Hill reports health care reform will result in even more crowded emergency rooms because there aren’t enough doctors to treat so many new patients:

“A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people either have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency.

People who build hospitals, however, say newly insured people will still go to emergency rooms for primary care because they don’t have a doctor.

“Everybody expected that one of the initial impacts of reform would be less pressure on emergency departments; it’s going to be exactly the opposite over the next four to eight years,” said Rich Dallam, a healthcare partner at the architectural firm NBBJ, which designs healthcare facilities.

“We don’t have the primary care infrastructure in place in America to cover the need. Our clients are looking at and preparing for more emergency department volume, not less,” he said.”

That’s what happened in Massachusetts, too, and the waits are still long. The Democrats’ answer? Rep. Jim McDermott wants government to pay for more doctors. Others see a need for more hospitals. And everyone says the money must be spent now because of the long lag times in educating doctors and building medical facilities.

— DRJ

19 Responses to “ObamaCare Fallout: Crowded ERs”

  1. I’ll bet we could get the next crop of doctors trained lickety-split in Cuba. I understand they’ve discovered a fast way to train them. Sort of a Rosetta Stone for medicine.

    Just keep saying, “Tome dos aspirinas y llámeme por la mañana.”

    Gesundheit (6acc51)

  2. Rep. Jim McDermott wants government to pay for more doctors.

    As if government-backed guarantees of college tuition won’t raise the cost of a medical degree to even more stratospheric heights.

    Another Chris (35bdd0)

  3. These people have no clue what they are doing.

    SPQR (26be8b)

  4. Well, fortunately we have all kinds of money “now”. Otherwise this HC bill could have turned out to be a real disaster.

    Chris (6b0332)

  5. People who historically used emergency rooms as their primary care provider will be inclined to continue to use emergency rooms as their primary care provider. And, now they perceive it to be free, they should do it more often.

    Jim (582155)

  6. Interesting little study that further undercuts the arguments of Democrats in favor of their silly legislation.

    It turns out that making people healthier does not actually cut health care costs long term.

    SPQR (26be8b)

  7. Rep. Jim McDermott wants government to pay for more doctors.

    I am willing to bet that the reason there aren’t more doctors today are twofold:

    1. Students don’t have the desire to slog through the rigorous educational requirements to become doctors.

    2. Students don’t have the cognitive ability or self-discipline to complete a rigorous medicine curriculum.

    I know that the Jim McDermotts, Nancy Pelosis, and Barack Obamas of the world would have us believe that there are all sorts of qualified young people who want to be doctors yet can’t afford medical school, but I have never yet met anyone who was legitimately qualified for medical school and didn’t matriculate due to economic hardship. A few years ago, in response to the nursing shortage in California, it was suggested by the educational establishment that the AVN curriculum be watered down (less chemistry, less biology, less math) so that more students could get through. That should give us a pretty clear idea of where the Democrats are taking us with medical doctors. Soon we will start to see students who received a “B-” in introductory biology and a “C” in organic chemistry accepted into medical school. Lots of luck when one of them performs open-heart surgery on you.

    Then again, we could always import more doctors from the Third World. They have a huge surplus of them there, don’t they?

    JVW (08e86a)

  8. Wanna bet the standards for admission to med school will be PC’d to gin up a bunch of Obamadoctors? Can’t wait for that.

    BT (74cbec)

  9. Why don’t we just take some oppressed people and make them doctors instantly?

    After all, racism is the cause of…everything, isn’t it?

    Patricia (160852)

  10. Medical school is still popular but the realities of postgrad debt are seeping through the wall of BS. My niece in Chicago decided not to apply to medical school because she didn’t want the debt. She is very bright and has a BS in molecular biology from U of I and an MS from Loyola. Instead, she applied to nursing school, where she got a full scholarship and is now working in the OR at Rush. She is on the transplant team and is very happy with her decision.

    Plus, her rock band is doing very well. She is the red head in the photo on the right. The nursing job gives her plenty of flexibility when they tour which they do more and more.

    Even today, primary care is the choice of all of 5% of medical graduates. Want to know why ? The income is crappy and they are loaded with debt like every other medical graduate. Primary care will be filled by nurse practitioners (My niece’s plan until she decided she liked the OR better) and physician assistants. Workers comp in California, for example, is mostly done by PAs. I talk to them on the telephone every weekday. Most of them are sincere and some are excellent.

    That is the future. I told my medical students that, if they wanted to do primary care, to get an MBA. Two of them did it. They will be managing “practice extenders” who, if you are lucky, will be RNs or PAs.

    Mike K (82f374)

  11. I’ve noticed the same thing, Mike K. I know two engineers with post-graduate degrees who went back to school to pursue work in the medical field. One went back 20 years ago and is now a doctor. Another went back 2 years ago and is studying to be a nurse practitioner. For most people, there’s not enough extra benefits to justify a medical degree.

    DRJ (d43dcd)

  12. After all, racism is the cause of…everything, isn’t it?

    The meaning, brevity and very definition of racist seems to have become so overused that it’s been watered down that it’s essentially diminished in it’s original power.

    There was a long period of time when the term was reserved for the non-debatable acts of discrimination. It was used with deliberateness and used sparingly. And it seemed that the accusers knew the power of the accusation and the serious impact it would have on the accused offender.

    Now it’s an everyday word, a tool if you will, thrown out to immediately claim the higher moral ground and to reframe the argument of those we disagree with. It could be on it’s way to becoming benign because of it’s indiscriminate overuse.

    Dana (1e5ad4)

  13. When things are done for the wrong reasons in the wrong way, one should expect wrong results.

    But we all know that, this is not a surprise.

    MD in Philly (ea3785)

  14. DRJ, a guy I know was an IT guy for medical applications. He was kind of itinerate and worked for various companies but found that his lack of a degree was really starting to hurt his business. He was almost 50 and didn’t want to go back for a computer science degree. I told him to look into an RN program. They are all junior college programs now and he could probably wind up as an IT chief at a medium sized hospital with an RN and his background. I haven’t heard from him recently so don’t know how it worked out. A few years ago, the IT chief at Cedars in LA was an RN who went to Stanford and did their medical informatics course.

    With electronic medical records, there is a big opportunity.

    Mike K (82f374)

  15. Note how no one suggests improving retention of primary care docs. Massachusetts has had a PCP flight which continues and worsens the shortage, others leave generalist practice for subspecialties or administrative positions. Docs over 50 like me are looking for the exits, the more so as Obamacare details are revealed. I’ll likely make more money initially at the price of dhimmitude to the medicrats. The Obamites would rather have compliant PAs than less controllable experienced docs.

    Teflon Dad (adcb71)

  16. Just wondering where all these newly minted doctors are going to get their residency training. Academic MDs typically make about 80% of MDs in private practice, and we already have trouble retaining the academic MDs we have. Throw a new batch of residents into the mix, add the work hour restrictions,increase the paperwork, and you may well get what you deserve: a bunch of expensively educated junior doctors who have nowhere to go.

    Orthodoc (a3d089)

  17. This legislation will continue to have these types of consequences for hospital and ER staff. Hopefully, the level of care remains strong.

    Nurse Practitioner Salary (f1c8c8)

  18. #3 and #6.

    Ben saying it for some time here.

    Fact is the Health Care Legislation wants to spend massive resources on the healthy while eliminating care for the sick.

    Problem is that being sick while certainly correlated to lifes style choices is also a function of DNA and sheer dumb (bad) luck.

    And either way, this legislation does much to promote bad lifestyle choices by making it “free.”

    Torquemada (2a42d3)

  19. Don’t cry for the ER or the Hospital….. ER’s are what keeps a hospital busy and very profitable.

    “Overnight observation” means $$$$$$$$$$$$$$$$.

    Torquemada (2a42d3)


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