ER visits and health care costs rise in Massachusetts due to lack of primary care access

Color me unsurprised.

A Boston Globe article today confirmed what has been discussed on this blog during the past year. Universal care without primary care access is a recipe to increase both emergency department crowding and health care spending.

We now have more data to back up this expected conclusion.

Despite an individual mandate covering almost everyone in Massachusetts, the cost of emergency care has risen 17 percent over the past two years, while ER visits rose 7 percent.

Stating the obvious, officials have concluded that, “emergency room crowding and rising costs will not be solved by providing people with health insurance alone,” and, what is needed “are more primary care doctors and nurses.”

It is very likely that whatever plan President Obama and Congress hammer out will look very similar to the Massachusetts approach, and I fully expect that the federal plan also will include an individual mandate, forcing everyone to purchase insurance.

And again, the results are going to be predictable. Without adequate primary care access, these newly insured patients will flood already crowded emergency rooms for care, further driving up spending and costs.

If you think what’s happening in Massachusetts, which by the way, has the highest density of physicians per capita in the country, is scary, replicating this scenario nationwide will be truly frightening.

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  • Anonymous

    I’m not sure that I would call it a disaster, it’s a few halting steps in the right direction.

    After all, a spike in ER visits and increasing ER costs don’t cripple our health-care system in the short term, but correctly focuses the attention of policymakers onto primary care, which is the solution to our long term problems.

  • Anonymous

    The only point of focus for the “policymakers” is their own wallet. Sad but true. Did you see any real, honest debate among politicians regarding healthcare ? Even the healthcare reform bill will be passed under the radar, like the stimulus bill.

  • Carla Kakutani MD

    So we have a chicken and egg problem: do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee for service, procedure happy payment system that is killing off primary care?
    If the administration is smart (and I think it is) they will build in a solution to this conundrum in their proposal.

  • Mike

    Carla, I think trying to have a workable solution in place BEFORE experimenting with the overburdened ER system would have been more prudent. Especially if Kevin and anyone else with any sense could have told you this would happen.

    Gee, what if physicians who had “been there” were spearheading this, instead of a bunch of politicians and administrators with little experience and obvious self-interests. Just a dream, I guess.

  • Anonymous

    It’s alright if politicians are focused on their wallets as long as their jobs depend on making their constituencies happy.

    Caring about their wallets is only problematic when campaigns are financed by entrenched interests… Fix campaign finance and health care will come next.

  • Anonymous

    I own a small Business and I can’t wait for this to happen…bring it on…the government has taken over banks, auto companies and now lets move on to health care the faster we do this the sooner people will realize socialism is a disaster and we can return to sanity…if you think the auto industry is temporary I will remind you of Amtrack that was suppose to turn around in three years. Lets destroy this economy quickly the faster the better then we can repeal all of these ridiculous government programs…I am so sick and tired of this yea soak the rich attitude…you want my money come and get it…you don’t care that I employ people and the people I employ think they are getting the short end and I should pay more…well if you don’t care about me, don’t care about the company that employs you and puts food on your table then I don’t care about you…can’t wait to hand out those pink slips and pay cuts…I will call it the socialist reform act for my business and laugh at you for getting what you asked for…or maybe I will just retire, shutdown sell all of my assets and kick back on one of the islands laughing at the mess you have created.

    Thanks HadEnough

  • K

    “…I am so sick and tired of this yea soak the rich attitude…you want my money come and get it…”

    I am so sick and tired of this hyper-individualist materialistic attitude…

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