Contrary to Obama's Claims, Insuring the Uninsured Via Medicaid Cause More to Go to the Emergency, Not Fewer

You've heard this claim sixty thousand times: The uninsured don't go to doctors before a condition worsens, so they show up at the emergency room with a condition that could have been treated much more cheaply earlier.

Or: The poor go to the emergency room because they know they can't be turned away. And thus the absolutely highest-dollar part of the hospital is overutilized, thus driving up health care costs. Which you pay for, because, in the end, the hospital isn't eating that loss.

So, Obamacare was supposed to reduce costs by weaning the uninsured off their habituation of using the emergency room as a local health clinic.

Nope. Medicaid patients use the emergency room forty percent more than the completely uninsured.

Is there a single claim about this program that wasn't a "wrong promise"?

A new study of Medicaid beneficiaries in Oregon makes a strong version of this case. The study, published today in the journal Science, finds that adult Medicaid beneficiaries rely on emergency rooms about 40 percent more than similar uninsured adults.

"When you cover the uninsured, emergency room use goes up by a large magnitude," said Amy Finkelstein, a health economist at the Massachusetts Institute of Technology who served as a lead investigator on the study, in an MIT press statement accompanying the study.

There were no exceptions to the trend. "In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use," said Finkelstein.

As Peter Suderman notes there, a previous Oregon Medicaid study also demonstrated that people on Medicaid experience no better health outcomes than those without any insurance at all.

posted by Ace at 07:42 PM

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