President Obama and his liberal enablers repeatedly told us that when the uninsured need health care, they go to the emergency room—the most expensive source for health care. Once government required everyone to be insured, millions of Americans would find a primary care physician instead, improving their health and lowering medical costs.
It sounded reasonable, even many Republicans (e.g., Mitt Romney and Tommy Thompson) echoed that message. It just happened to be wrong—dead wrong.
A new study from the health policy journal Health Affairs explains, yet again, that for lower-income people the hospital emergency room is their default health care provider. It’s something most of the health policy community knew, but no one could convince the ObamaCare supporters of that fact. They didn’t want to let the facts get in the way of a huge new government program.
The Health Affairs study has an imposing title: “Understanding Why Patients of Low Socioeconomic Status Prefer Hospitals Over Ambulatory Care.” While the study concedes that being uninsured and underinsured plays a role, it points out, “But even in countries with near-universal health insurance coverage, low-value use persists among low-SES (socioeconomic status) patients. This suggests that factors beyond insurance shape preferences for inpatient versus ambulatory care.”
What might some of those factors be?
- Doctors’ offices tend to be open during normal business hours and low-income workers often have jobs that don’t give them the flexibility to leave during the day.
- Low-income workers tend to be paid by the hour, so taking time off to go to the doctor may reduce their income, which they don’t feel they can afford.
- Low-income workers tend to be younger, and on average healthier, than the population. People who rarely need to see a doctor may feel little impetus to find a regular care provider.
- And many doctors won’t take new Medicaid patients, whereas the hospital will.
ObamaCare will not reduce emergency room care use; it may even increase. Low income is a big determiner of who will use the emergency room, and that problem has been rising under the president’s economic policies.
Because Obama was more concerned about passing a health care bill than fixing the health care system, ObamaCare defenders used arguments they thought would make the sale—even if they were wrong.