Saturday, July 29, 2006

Don't blame immigrants for healthcare crisis

It's not immigrants who are straining the emergency healthcare system--it's folks on Medicare and Medicaid, who can't find doctors because the government reimbursement rates are so low that most doctors won't take these patients; and the increasing number of people who can no longer afford private health insurance.


High levels of ED [emergency department] use among Medicare beneficiaries and Medicaid enrollees are a potential source of increases in ED visit rates in the future. The aging of the population and retirement of the baby-boom generation will greatly increase Medicare enrollment and the proportion of the population who are elderly, who tend to have higher levels of ED use compared to other age groups.

Also, continued increases in private insurance costs could result in increases in both Medicaid and other public coverage of nonelderly people, as well as increases in the number of uninsured people. High use of EDs in Medicaid likely reflects in part little or no cost sharing for health services use, and perhaps lack of access to office-based physicians (because of low physician reimbursement rates under Medicaid)


This study also shows that longer waiting times for appointments with physicians and a higher number of physician office visits relative to the number of physicians in a community increased ED visit levels, and the effects were greatest for poor people (Exhibit 2). In part, this may reflect the fact that physicians with full practices and constrained reimbursement from Medicaid and other payers were less willing to see low-income patients in their offices and more likely to refer such patients to the ED.

Original story here.


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