By John R. Graham • Wednesday September 24, 2014 1:30 PM PDT •
Hospitals, inveterate lobbyists for Obamacare, have responded rationally to its incentives: They have increased use of their emergency departments, and cut charity care.
On Tuesday, NPR had a feature on hospitals’ using online services to allow frequent flyers to book appointments with emergency departments:
Three times in one week, 34-year-old Michael Granillo returned to the emergency room of the Northridge Hospital Medical Center in Southern California, seeking relief from intense back pain. Each time, Granillo waited a little while and then left the ER without ever being seen by a doctor.
“I was in so much pain, I wanted to be taken care of ‘now,’ ” says Granillo. “I didn’t want to sit and wait.”
But on a recent Wednesday morning, he woke up feeling even worse. This time, Granillo’s wife, Sonya, tried something different. Using a new service offered by the hospital, she was able to make an ER appointment online, using her mobile phone.
Isn’t that exactly the sort of thing that Obamacare was supposed to stop? All those newly insured patients are supposed to get timely primary care, nipping their health problems in the bud at low-cost points of care. Back in July, I wrote about this worrying development, and concluded that we might all end up getting our health care in the ED. Well, it looks like that is the hospitals’ goal:
Recently, Dignity stepped up its marketing—with billboards, print advertisements and online and radio spots. One online ad features a woman sitting in a hospital waiting room, and then cuts to her on a living room couch with a dog, as the words on the screen read, “Wait for the ER from home.”
Who is not welcome? The uninsured, that’s who:
Stephen Maxwell had struggled for years with a bad back, but what he felt in December was something new.
In January, Truman Medical Center, the hospital he has relied on for care, rolled back its financial assistance program. Truman used to provide free or discounted care for uninsured people making up to 400 percent of the federal poverty level—$46,680 for an individual. Now, only those making less than 200 percent qualify for the help. The change was intended to motivate people to sign up for health insurance plans through the Affordable Care Act. (Kansas City Star)
Another Obamacare success story! Hospitals are where we spend most of our health dollars. And their incentives under Obamacare are worse than they ever were. The next health reform must ensure that hospitals are freed from the spell of perverse incentives.
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For the pivotal alternative to Obamacare, please see the Independent Institute’s widely acclaimed book: Priceless: Curing the Healthcare Crisis, by John C. Goodman.