Would expanding Medicaid reduce pressure on our ERs? Methinks not. Yesterday I saw a patient in my office for pneumonia and an ear infection. He had rales and wheezes, and was coughing up a storm. I provided the necessary treatment, and he should be fine. I charged him $66 including the meds. His girlfriend went to the emergency department for the same basic thing. She needed a nebulizer treatment also, which I or any other family practice doc could have provided. She¬†was on Medicaid. It probably cost somewhere around $800. Maybe a lot more. It didn’t matter to her. She won’t be paying for it. Even her boyfriend understood when I mentioned that it was a big waste of money. He understood that the money will be coming out of his paycheck, and mine. A lot of people, including some members of Idaho’s legislative committee on the “Medicaid gap,” are operating under the delusion that expanding Medicaid will ease pressures on emergency departments. That is opposite to what would actually happen. If Medicaid is expanded, ERs will be inundated with more non-emergency care than they are now. A study was done by Manya F. Newton, M.D., et. al., entitled “Uninsured Adults Presenting to U.S. Emergency Departments: Assumptions vs. Data,” published in the Journal of the American Medical Association, October 22/29, 2008. The study found that “publicly insured patients use the ED substantially more often than uninsured patients.” Those “publicly insured patients” are precisely the group that Medicaid expansion would increase, swamping our ERs and costing us a fortune.

Originally posted November 3, 2016 on Facebook.

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