If you’ve encountered one or two of my rants about the “health insurance crisis”, you’re probably aware that I’m rather frustrated over conventional wisdom’s assessment of “insure everybody, and everything will be hunky-dory.” Such a position fails, after all, to consider that there’s a problem with inflationary pressures on the costs of delivering care.
Some of those pressures arise from structural issues within our health care system. For example, consider this post at Harvard Pilgrim Health Care’s blog:
First of all, inappropriate — or non-urgent — use of the Emergency Room was not limited to uninsured populations. It showed up across the board. People covered by private insurance, Medicaid and Medicare were just as likely to use the ER for non-urgent care as people without health insurance. About 20% of all ER visits by privately insured and Medicare patients were for non-urgent purposes. About 24% of all ER visits by Medicaid beneficiaries and people without any insurance were for non-urgent purposes.
Second, another 25% of all ER visits for each group were for primary care treatable/preventable maladies. In other words, almost half of all ER visits were either for conditions that could have waited at least 24 hours to be addressed, or could have been solved in a doctor’s office.[…]
[T]hese data also illustrate the limits of a care delivery system that’s built increasingly on a specialty care model. If 70% of all physicians are specialists and only 30% are in primary care — and some 40% of what goes on in an ER belongs in the office a primary care provider, something’s wrong.
It’s not mentioned in the post, but presumably the stats mentioned above predate Massachusetts’ experiment with universal health care, the goals of which are commendable and praiseworthy…but which have had the side-effect of significantly increasing the wait-time to get appointments with primary care physicians.
