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Health care reform and the ER

Many people expected ER visits to drop sharply after 2006 health reform in Massachusetts, once people had better access to primary care. But that hasn’t happened. Peter Smulowitz, M.D., of Beth Israel Deaconess Medical Center says his latest research shows ER visits actually increased in the years immediately following reform.



  • Anonymous

    This report fit perfectly with my own direct experience.  My girlfriend has worked in public education for the past several years, and her “benefits” package includes health coverage with Kaiser Permanente in Colorado.  A couple of years ago she started having occasional, severe breathing difficulties, with symptoms very similar to an asthma attack even though she’s never been asthmatic.  Kaiser assigned her to a pulmonologist, who prescribed monitoring equipment and a logging regimen to try and get a clearer handle on the cause – so far, so good.  But when her symptoms began to significantly worsen, Kaiser refused to either move up her next visit with the pulmonologist – which at the time was scheduled for more than a month later – or to assign her to a different doctor who could see her sooner.  And as a perfectly predictable result, a few days later she ended up in the Emergency Room.  The Insurance industry has always talked ad nauseam about keeping people out of the ER, but in this case the gatekeepers at Kaiser directly caused the exact opposite.  As it turned out, my girlfriend’s problem was finally diagnosed as an allergic reaction, and successfully treated.  The allergist was particularly critical of Kaiser’s standard practice of referring cases like my girlfriend’s to pulmonologists by default…

    The motivation for Kaiser’s lack of prompt action in my girlfriend’s case is beside the point.  The point is, the health care system in this country is clearly unable to handle, in timely fashion, the case load it already has.  What does everybody think is going to happen when there’s this huge influx of people suddenly trying to use their mandated coverage?  Massachusetts’ experience so far, as the doctor in this report said, has clearly not met expectations.  The question for the rest of the country is whether the health of its citizens, to say nothing of its entire economy, can afford to follow the same path.


    NRAExpertRifleman: Did you know that Kaiser’s Emergency Care Facility is a seperate company form Kaiser itself? If not check it out. It is a totally different Company that run’s the whole place. They make their own decisions on who can go in the E.R. and who stays out. And then when you do get a bed, they try to get you out as soon as possible. And you would naturally ask, why that is. Well they give Huge bonuses to the people who are in charge of the patients, to get them out as soon as possible. That’s how their employes make their bonuses. The problem is, they don’t tell you that. they make all those decisions in ADMINISTRATION, to the only people who make any real money there.It is one of the sickest system’s I have ever encountered. In any other civilized nation that is just unimaginable. Only in America can you get such a ridiculous way to run a hospital. I think Kaiser is a dangerous place for Health Care, if you can call it that?