Obamacare

Emergency Room Visits Continue to Rise Under Obamacare

The health law was supposed to reduce pressure on emergency care facilities. It hasn't.

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Whitehouse.gov

In September, 2009, President Obama gave a prime time speech to the joint Congress making the case for the health care law that would come to be known as Obamacare. Much of the speech was devoted to explaining and justifying the law's major components. Subsidies, he argued, were necessary to ensure that health coverage would be affordable enough that people would actually buy it. The individual mandate requiring most people to maintain coverage was necessary to ensure that free-riders didn't take advantage of the law's regulations and subsidies to wait until sick before purchasing coverage.

"Such irresponsible behavior costs all the rest of us money," Obama said. "If there are affordable options and people still don't sign up for health insurance, it means we pay for these people's expensive emergency room visits."

Nearly six years later, the mandate is in force, and the subsidies are offsetting a hefty chunk of the premiums for most of the people who've gained private coverage through the law's exchanges. Millions of people have been covered by the law; last month, Gallup reported that the national uninsurance rate had dipped to its lowest point since 2008.

And yet in the time since Obamacare's major coverage expansion has kicked in, the number of emergency room visits has not gone down. Nor has it held flat. Instead, it appears to be growing, perhaps quite a bit, according to a survey of nearly 3,000 ER doctors noted in The Wall Street Journal. Granted, this is a survey, so it may not be the most precise way to guage what's happening to ER usage under Obamacare, but it certainly provides a sense of how those on the ground, working in ERs, view what's happening. 

The report suggests that the increase in utilization may be quite significant. The Journal quotes one ER doctor in Lexington, Kentucky as saying that emergency room visits rose 10 percent last year (the first year in which coverage was widely expanded under the law) and has gone up 20 percent during the first few months of this year. 

The idea that expanding coverage would reduce emergency room visits was always among the weakest arguments for the health care law. That certainly wasn't the experience in Massachusetts in the years following the implementation of its health care overhaul under Gov. Mitt Romney, which served as a model for the national plan. And it's been clear for years that Medicaid beneficiaries, who often have trouble finding doctors, end up in the emergency room more often than other types of patients. That seems to be a big part of the story here. Back to the Journal:

Many doctors don't accept Medicaid patients because the state-federal coverage provides lower reimbursement rates than many private health-insurance plans. The waits for primary and specialty care by participating doctors appear to be leaving some Medicaid patients with the ER as the only option, according to ACEP.

And it's not just that there are more patients—the patients are, it seems, somewhat sicker than before. As the Journal reports, "the ACEP survey also found that ERs are seeing sicker patients: About 90% of the doctors polled said the severity of illness has stayed the same or gotten worse." 

The U.S. health care system's overreliance on emergency room care, which is generally more expensive than other, more regular types of health care, is one of the problems that Obamacare was supposed to solve, or at least mitigate. Instead, it looks like the law has made the problem worse; it was a fix that, predictably, only made things even more broken. 

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  1. Because it was always a concern troll position to take.

    Liberals pearl-clutching about free riders is so hilarious disingenuous that the only response they ever should have gotten is mocking laughter.

    1. These people pearl-clutching about anything is so hilariously disingenuous that the only response they ever should have gotten is mocking laughter. They’re so self-involved that the idea that they give the tiniest shit about anything but themselves and their emotional “needs” is beyond parody.

      1. You just don’t want to pay your fair share.

        1. (calls 911 for a visit to the ER from outrage)

          1. I’m using my outrage to power a small town.

            1. “They aren’t hot flashes, they are POWER SURGES!”

              1. I’ve harnessed the power of towering indignation, as well.

            2. Are you sure that isn’t just gas?

              1. Nope, outrage. I bottle the gas.

            3. That’s my secret, Captain. I’m always outraged. /SJWHulk

          2. Just imagine when masses of poor emotionally unstable lefty youth start arriving at emergency rooms on a daily basis because something has triggered them.

            This is an imminent thing because academia are loosing an entire generation of emotional cripples on society.

    2. They should be mocked and laughed to scorn at every opportunity. What else can you do with someone who is so delusional?

    3. I make up to $90 an hour working from my home. My story is that I quit working at Walmart to work online and with a little effort I easily bring in around $40h to $86h? Someone was good to me by sharing this link with me, so now i am hoping i could help someone else out there by sharing this link… Try it, you won’t regret it!……
      http://www.work-cash.com

      1. Where can I get a job nostril raping spammers to death?

      2. http://www.plusaf.com/linkedin…..people.jpg

        drill down on the work-cash link for one of the best things since sliced bread and Nigerian “we’ve got money for you” schemes… Just send money and we’ll make [ourselves] rich…

    4. Indeed.

      The whole rationalization about cost shifting via people using the emergency room was a smokescreen to obscure the fact that Obamacare would (and has) resulted in a massive increase in cost shifting/free riding/wealth redistribution.

      In fact, that was the major point of Obamacare – to massively increase free riding. All those people who are getting taxpayer subsidized premiums are free riding. All the people with pre-existing conditions who are getting coverage that they could not get in the market on their own and the old folks who are getting coverage at rates that do not reflect their actuarial risk are free riding. Other people are being forced to pay higher rates for lower quality plans than they previously had in order to pay for that free riding.

      Creating MORE free riders was the entire purpose to begin with.

      1. This whole thing could be solved by giving everyone a 1-year grace period to get into the system. You can choose not to, but any attempt to enter at a later date and you’ll be subject to the market rate for someone your age and condition. This way, you cannot get coverage if you wait until you’re sick (or rather, you can, but at cost-prohibitive market rates).

  2. I think it won’t take long to change the talking point from “they shouldn’t be getting care in the ER” to “they are accessing needed care and that’s the important thing.”

    1. Much like adding more recipients to Medicaid is a win for the ACA, somehow. What the hell? Seriously?what in the actual hell? Reliance on Medicaid is a sign that “expanding access to affordable insurance” failed abysmally. It’s certainly a sign that cost controls were a myth.

    2. Already started.

      “We’re seeing a failure of access to care,” said Dr. Howard Mell, a practicing ER physician in northeast Ohio and spokesman for the American College of Emergency Physicians.

      Millions of Americans now have medical coverage, but because primary-care doctors are closing their offices and not accepting Medicare patients, even mild health crises are being pointed toward the ER, Mell said. “Obamacare isn’t failing, but we knew it wouldn’t handle ER visits,” he said.

      “More people have insurance, but the cultural norm has been to wait until they’re sick to seek care,” said Dr. Mitchell Morris, a provider consultant at Deloitte Consulting. “As they get educated, ER use will go down over a period of years.”

      http://www.modernhealthcare.co…../301169969

      1. “As they get educated, ER use will go down over a period of years.”

        You bet! He knows that, since that’s what the tea leaves looked this morning.

  3. “the patients are, it seems, somewhat sicker than before. As the Journal reports,”

    Wonder what would account for sicker patients turning up in ER. Can’t see ACA pushing that in any particular direction.

    1. I blame Bush. And rape culture.

      1. Also, climate change and GMOs.

        1. And the Koch brothers.

        2. Climax changes and G-Strings??!!!! What the hell!!!!!

    2. It’s possible that with the aca kicking in, people who wouldn’t even go to the ER are finally going, causing those numbers to swell.

    3. People who otherwise could have afforded a trip to the Minute Clinic once or twice a year now can’t becuase that money is tied up in health insurance they didn’t bother with. So rather than going to CVS when they got a sore throat they try to wait it out and by the time they give up and go to the ER they’ve been walking around with Strep for 2 weeks

    4. They won’t go to the doctor because their deductibles are sky high, so they put it off until it’s an emergency?

      1. Ding-ding-ding!!

    5. Higher deductibles and copays. I’ve found that I see the doctor less since the ACA came out (on my fucking birthday too.).

  4. Alt text: Don’t leave me hanging.

    Shit. Is that racist?

    1. “Learn to fist bump, you fucking crackers.”

      1. “Somebody teach me how to fist bump, yo”

      2. Elbow bump. Don’t want to spread germs in the new health care-aware regime.

    2. nice

  5. http://www.nationalreview.com/…..rine-timpf

    OT: Apparently, “yes” sometimes means “no” – the by-far stupidest thing you’ll read (as of today, anyway) about “rape culture”

    1. Reading minds is not just for married people anymore.

      1. Sounds like someone didn’t anticipate their spouses needs recently.

    2. having to endure relatives kissing her cheeks “even as I winced and turned away

      Do you understand? Familial affection is rape culture.

      1. the creepiest sort

    3. What about when “no” means “yes”?

      1. WOW! WOWOWOWOW!!!

        Sir Rapesalot, you want to just put a fucking BILLBOARD UP!! WOW!!!!

        1. I was raping people before you were even born son.

          1. Ah – in that case, STEVE SMITH INTEREST ANY NEWSLETTER. YOU SEND.

            1. You may be screaming “no, no, no,” but all STEVE SMITH hears is “Who wants RAPE?”

        1. I read that and I thought it was a parody until I got to the bottom.

    4. We need a term for people who are actually allergic to the concept of personal responsibility; people who will do anything, or take the most ridiculous positions, just to wash away that horrible, terrible personal responsibility. Any ideas?

      1. Pussies?

      2. Hitler?

        1. Bradley Hitler-Smith.

      3. “Self-infantilization” is a bit clunky.

        1. Yes it is. Just like your m…ass.

          1. “A bit clunky” is not enough….term for SF’s ass.

            Larded Monolith is more what I was thinking.

            1. Arthur C. Clarke has nothing on NutraSweet’s ass.

              1. “SugarFree’s Ass is a Harsh Mistress.”

                1. It fires barrels of wheat.

                  1. Related:

                    How This Beetle Shoots Jets of Superheated Liquid Out of Its Butt

                    http://gizmodo.com/how-this-be…..1701389198

        2. We’ll call them SID

          Self Infantilized Dumbass

          Because they are suffering from SIDS

          Self-infantilization Derangement Syndrome

          1. What are stiff and pink and make women squeal?

              1. “You’re so anti-racist, you’re like really racist sometimes.”

                1. “I feel like I just got hate-crimed.”

      4. Responsibiliphobic? Responsibilivoidant? Responsibilitarded?

      5. Women?

      6. autodoulons

        “Self-enslaving” in Greek

        1. Ok…that’s getting there. The only problem is it isn’t insulting or condescending enough.

          1. My French teacher was fond of “pauvre petit” – definitely condescending.

            Shorter = “ce pauvre”…..followed by a slowly shaken head and “tsk, tsk, tsk”….

            1. You know who else just wanted to pet it?

              1. Lennie Small?

      7. Trigger happy?

        Emotionally special?

        Snowflakes?

      8. Responsidisabilitiers?

      9. Erwachsenes?ugling.

      10. Tyrannical Tikes

    5. These nitwits will eventually put The Onion out of business. If I had written that screed as satire, I’d circular file it as too far fetched.

      1. In the future every serious publication will sound exactly like the onion and no one will think it’s funny.

    6. Her favorite position is the Admiral Ackbar.

    7. “Sometimes, for me, there was obligation from already having gone back to someone’s room, not wanting to ruin a good friendship, loneliness, worry that no one else would ever be interested, a fear that if I did say no, they might not stop, the influence of alcohol, and an understanding that hookups are ‘supposed’ to be fun,” she writes.

      In other words, she is oppressed by having to learn how to make the most basic adult decisions. I guess she’d better go to her safe room and eat some Play-Doh.

      And I suppose she expects me to have great respect for her.

      1. Maybe feminists believe that women are children and lack agency because they personally are children and lack agency. In other words, projection.

    8. “all rape is racist, classist, ableist, patriarchal, hetero and cissexist

      The lack of self-awareness is impressive.

    9. Apparently, she got “raped” by Auntie Mildred on her 5th birthday:

      Bosiljevac writes that she’s been dealing with the oppression of this culture her whole life ? beginning with having to endure relatives kissing her cheeks “even as I winced and turned away” ? and that it continues to influence her sexual decision-making abilities

  6. Another example of a progressive policy that produced the opposite result from what was claimed.

    1. Progressives have good intentions, and good intentions always produce good results. Obviously this was caused by people with bad intentions. Specifically evil capitalists in their quest for immoral profits. This market failure requires more well-intentioned government intervention. And if it goes wrong, well it wasn’t their fault. It was the fault of someone with bad intentions.

      This is how we pave the Road to Hell.

      1. Yes, and progressivism is a scientific ideology that measures and analyzes its results to adjust and improve outcomes. Because science and good intentions.

        1. By “science” you mean “consensus,” right?

          1. Scientific Consensus is so close to Intentions that I get them mixed up.

          2. By science, he means the math that determines if we sent a sufficient amount of unbelievers to the death camps in the event of failure. Then you use that data to make sure more deniers are sent next time around. Kulaks and wreckers you know, always ruining the utopia.

          3. 10 out of 9 ‘scientists’ agree.

          4. 10 out of 9 ‘scientists’ agree.

  7. This market failures will be fixed with single payer. Feeling their power after passing a $15 minimum wage, my state is trying to enact single payer.

    1. What will fix non-market failure?

      Silly me, everyone knows that there is no such thing.

      1. More regulation.

    2. This market failures will NOT be fixed with single payer

      The only way anything like a socialist version of medicine might be work is by providing an annual lump sum, per person, in a bankable / carry forwardable, individual health savings account and then sending the patient a bill for every bit of health care they consume. When people start seeing what things cost, they will be much more cautious about what they spend, with the hope of having something left for someday when they really are sick.

      Single payer, with the feds picking up the tab is a guaranteed entry to skyrocketing costs and illness, and spiraling timeliness and quality.

      1. When I was in cooking school (early 90s), one of our chefs was from Germany. I remember how he mocked Americans for going to the doctor for every little thing. He said that while medical care was “free” back home, there was a social stigma attached to using it. You had to be really fucking sick. For example he said that while he was training to be a chef back in Germany, a fellow student accidentally stabbed himself in the belly with a filet knife. He put a bandaid on it and went back to work. You know that would have resulted in a hospital visit here.

        1. When I was in cooking school (early 90s), one of our chefs was from Germany. I remember how he mocked Americans for going to the doctor for every little thing. He said that while medical care was “free” back home, there was a social stigma attached to using it.

          Medical care isn’t free in Germany. Germany requires everybody (even those on welfare) to buy insurance, and forces you to buy shitty low-end plans from regulated private insurance companies unless you’re in a high income bracket (in which case, you have to buy a costly luxury plan).

          And the reasons people don’t go to doctors in Germany is that the wait times are extremely long, the doctors will treat you badly if you’re in the low-end plans, and the doctors are generally miserable themselves because they don’t get paid a lot for the unpleasant work they do.

      2. Single payer, with the feds picking up the tab is a guaranteed entry to skyrocketing costs and illness, and spiraling timeliness and quality.

        Um, MARKET FAILURE.

        Duh.

      3. Mildly OT, but I would like to see (and have no idea where to find) the extent to which countries with socialized care free-ride on the innovations of healthcare markets. It’s all well and good that taxes are paying for care but you’d likely be less enthusiastic if the quality were stuck in the mid-twentieth century.

        1. That’s the reason prescription drugs are cheaper outside the US. And, of course, many Canadians come to the US for treatment to avoid waits.

      4. Look, you can’t be letting people do whatever they want. Smarter people (that would be progressive top men… I mean women … minority women … umm, gay transvestite wise latinas, of course) need to decide. We’ll need a strong ‘End of Life Management’ program for those who don’t agree.

        1. You know who else implemented a Strong End of Life Management Program for his opponents?

      5. Funny thing is you could do that for less that what we were spending for medicare/medicaid/government employee health care before Obamacare was passed

      6. “When people start seeing what things cost, they will be much more cautious about what they spend, with the hope of having something left for someday when they really are sick.”

        wow. you really believe that nonsense? No, they will spend it the second they get it and complain it was not enough.

      7. “When people start seeing what things cost, they will be much more cautious about what they spend, with the hope of having something left for someday when they really are sick.”

        wow. you really believe that nonsense? No, they will spend it the second they get it and complain it was not enough.

    3. my state is trying to enact single payer.

      What? I hadn’t heard about that. All the more reason I need to get the hell out of Washington as soon as I can…

      1. Yep, group soliciting donations came to my door, trying to enact single payer. Will it make into a bill or an initiative? I don’t know, but what I do know is that evil never sleeps.

        1. God dammit

        2. There’s a legislator in CA who introduces a single-payer bill on a regular basis, and it’s never gotten any further than that.
          CA gov’t is lefty and stupid, but not THAT lefty and stupid.

      2. I grew up in WA state on the Olympic Peninsula literally a minimum 30 minute drive from a “major town” (e.g. high school, movie theater, bowling alley, wal-mart). It was a beautiful place and I am glad I grew up there. But now it’s a cesspool of statist, progressive, authoritarian, nimbys and as soon as I lined up a job post-college I moved to bordering Idaho. Idaho also has its statist authoritarians, but more socon xenophobic drug warrior types. Both are awful but I think I just traded for the “lesser of two evils.” I still managed to relocate to a beautiful area.

        I feel your pain.

    4. Vermont looked at single payer; a small state with a small population and a relatively healthy dose of “community” – a place where SP could moat likely work (or fail the least hard). They eventually killed it after looking at 160% income tax increases.

  8. This is due to all the police violence on #BlackLivesMatter. DUH!

    Ferguson, Baltimore – BOOM – ER’s are overrun.

    You’re WELCOME, WHYTE MURCA!

  9. That’s because the beatings haven’t continued, *enough*.

  10. Unexpectedly!

  11. Imagine that.

  12. Hmm, lets mandate that poor people spend money that they don’t have to buy insurance that has a large deductible.

    Those people get sick, well they can even less afford to go see a doctor now, nor can they afford to miss any work so they try to just push through it and hope it goes away.

    For some of them however it is really a serious condition and doesn’t and they end up in the ER.

    Anyone with half a brain should have seen that this was going to result in more not less ER visits.

    The people who lacked insurance before and could afford an office visit just paid out of pocket, they didn’t go to the ER. The high cost and high deductible of the Obamacare plans however remove that option from them leading to more ER visits.

    1. All of that and don’t forget, lets mandate that poor people buy insurance and do nothing to increase the supply of doctors making it harder for everyone to get a doctor to accept them as a patient or get an appointment even if they do. And then wonder why more people are going to the emergency room.

  13. Tony’s head explodes.

    (goes to emergency room)

    1. No way.

      Tony will be along to say that this just shows we need more government

    2. The democrats wanted to do this right, but the Republicans wouldn’t let them. So to get all of those Republican votes needed to pass this, they had to amend it until it was bad, just to satisfy the Republicans.

      Leftist will accept that as gospel.

  14. We got stuck in the equivalent of an Obamacare Silver plan a few years ago. Then we had some issues, and got stuck with five thousand dollars worth of medical bills. Switched back to the POS, though the price has doubled since Obamacare kicked in. At least I’ve paid the medical bills down to under a grand.

    It’s no surprise that these people are going to the ER. It’s hard to find a medical provider that will take that high-deductible insurance, because they know that most people will simply not pay their portion, forcing the provider to write it off or go to collection.

    This forces many people into the ER to get basic care, since it’s the only place they can get it.

  15. If you think it’s bad here, how about what Obama’s done to the number of emergency room vists in Pakistan and Afghanistan.

    1. You don’t go to the emergency room after you’ve been blown apart by a Griffin missile.

      1. You so if your near enough to the target to get some shrapnel but not enough to get blown up.

        1. How are you going to get to the ER when anyone rushing to your aid is considered a combatant when the drone swings around for the double tap?

      2. Sure you do, you just arrive in separate vehicles.

      3. Obama is helping the Pakistani funeral industry.

  16. But, the real question is, are we having another libertarian moment?

    1. We better refer that question to the millenials.

      1. How about the Mexican millenials?

        1. Only if they’re into buttsex.

    2. Only for a moment and then the moment’s gone.

  17. Yeah, I read an article the other day about requiring genetic testing for insurance ala Gattica. My first thought was all the people who would just choose to pay the no insurace done and go to the ER instead. Let’s just take the costs in the opposite direction as intended.

  18. I have been on Medicaid (Medicaid through HIP/Emblem) for the past year and a half. I have NEVER had any trouble finding doctors who take my insurance, and I have received cancer treatment (including surgery and hospital time) at the best cancer-treatment network in the world (Sloan-Kettering). I have never had a problem getting my insurance to pay for medical equipment or visiting nurses. I have never had to wait more than a few days to see my primary-care doc and once I was able to see her the day after my problem (ear clogged with wax) presented itself WITHOUT making an appointment. I have never had to pay a co-pay, either.

    Medicaid is far and away the best health insurance I have ever had. I wish I could stay on it forever.

    1. Oregon would like to have a word.

    2. Medicaid is far and away the best health insurance I have ever had.

      My condolences.

    3. You refer to Medicaid as health insurance.

      It is not. It is welfare.

      Glad to hear your experience on it has been so good. I’m pretty sure that’s quite atypical.

    4. How much is your deductible and premiums on Medicaid?

      1. Florida Man, the answer to your questions are zero and zero.

        1. So you’re bragging that you got world class healthcare paid for by working Americans?

          1. Not bragging, just stating for the record. I have a friend who lives in Denmark. There, if you break your arm, you go to the hospital, get treated, and never receive a bill. That’s the way it should be everywhere.

            1. Why should you not have to pay for services rendered? Do you have a job? Don’t you expect compensation if you perform work? Why do hospitals not have a right to charge for care they provide?

              1. Florida Man, because having health-care providers charge patients for services rendered causes patients to put off getting treatment, during which time their illness or injury gets worse and costs more in the end. Government-subsidized health care saves money in the long run. Health care should be paid for by taxes on wealthy Americans (those who own more than 40 million dollars) who inherit their wealth rather than working for it.

                Before Obamacare, insurers were free to drop clients when they got sick and expensive. Libertarian ideology supports the insurers’ right to do this. It effectively mean no substantial health insurance for anyone, and any serious illness means bankruptcy.

                1. Health care should be paid for by taxes on wealthy Americans (those who own more than 40 million dollars) who inherit their wealth rather than working for it.

                  Why $40 million? Why inherited? No one needs more than about $30k/year to live on. Maybe more in big cities. Confiscate everything above that and we’ll all have free healthcare among other things. It’ll be paradise.

                  1. Holy crap. I need to read downthread first. Damn, they said almost the exact same thing too.

                2. Government-subsidized health care saves money in the long run.

                  Medicare and Medicaid have cost over $1 trillion a year total for about four-five years now. That is hardly “savings.”

            2. There, if you break your arm, you go to the hospital, get treated, and never receive a bill. That’s the way it should be everywhere.

              Why is it better to pay $10000 for a broken arm that should actually cost maybe $200 to treat? Because that’s effectively what the Danish system boils down to.

          2. I would prefer that my health insurance not be paid for by working Americans. I would prefer that it be paid by taking a 90% tax from people who own more than 40 million dollars. These people are not “working” Americans.

            We should nationalize the Koch brothers’ fortune TODAY!

            1. Why 40 million? Did they not work for it? Do Africans that are living on less than a dollar a day have a right to force their way into your home and steal the products of your labor?

              1. I choose 40 million because anyone with 40 million doesn’t need any more and can afford to pay big taxes without pain.

                No, the Koch brothers did not work for their money.

                No, Africans should not be allowed to take the products of my labor because I do not own more than $40 million.

                1. Why not more than say 30,000 a year? If you can’t live on 30,000 a year you should be sent to Africa until you can learn to live on 1500 a year. Anything over 30K is a luxury.

                  1. OK, you go first.

                    1. Intelligent Mr Toad|5.4.15 @ 4:49PM|#
                      “OK, you go first.”

                      Fine.
                      You’re handle is a lie; even toads aren’t that stupid.

                2. I want to play too.

                  So, after you’ve confiscated 90% of the rich’s wealth, what do you use to pay for everyone’s health care next year?

                  1. From anyone who has managed to hold onto more than 20 million of course – and onward.

                    What this means is that we actually need for there to be some people who are rich enough we can confiscate at least part of their wealth to pay for our wants/needs. Interesting take on socialism/democracy.

                    Back when I was a sort of “communitarian” (as a kid), I thought the idea was that people of average to above average productive ability just accepted that they needed to be sharing some of the wealth they were producing with those of lesser ability — being an average producer did not get you out of the expectation that you should be PRODUCING more than you consumed (only exception: temporary or permanent disability). What else does “from each according to ability, to each according to need” mean? (I like to bring this one up whenever somebody seems to think that any given government program is going to be “free” to them).

            2. Fuck off, thief.

              1. I guess some arbitrary limits are more meaningful than other arbitrary limits. Good thing we have bright lights like Toad to show us The Way.

                Assuming, of course, that the medical professional whom Toad would enslave haven’t screwed up his medications to give him delusions of grandeur.

                1. Good thing we have bright lights like Toad to show us The Way.

                  When’s Clint Eastwood gonna roll up in his Gran Torino when we need him?

                  1. Mr. Toad, in verse:

                    Don’t tax you,
                    don’t tax me,
                    tax that fellow behind that tree!

            3. I would prefer that it be paid by taking a 90% tax from people who own more than 40 million dollars.

              So basically, you’re a thief that needs the government to rob from people because you’re too lazy to do it yourself.

            4. Ok dumbass, do you know what it means to “own more than X”?

              It does not mean that you have more than $x in your bank account, it means the total value of all your assets is $x.

              When you apply a 90% tax on Americans who “own more than $40 million” what you are doing is nationalizing corporations. Nobody has $40 million in cash assets sitting around, a person worth $40 million might have $4 – 6 million in cash or cash equivalents, the other $34 – $36 million of their wealth will be in the form of real property or stocks/bonds. Confiscating that wealth will not in any meaningful way help the government pay for your medical expenses becuase they would first need to find someone to buy the stocks or property they seized through taxation.

              The problem is with the rich knowing that the government was just going to take 90% of whatever they owned they would never buy those assets back from the government, certainly not for anything near the price the government confiscated them at.

              So even ignoring the fact that a 90% tax on wealth would collapse the economy as investment and capital generation would evaporate instantly you still have the problem that it wouldn’t pay for free universal health care because the super rich simply lack the cash assets to meet the need.

            5. You know, I consider myself a mostly tolerant person. But then shameless parasites like you open your mouths and I suddenly see the value in maintaining Gitmo.

            6. I would prefer that it be paid by taking a 90% tax from people who own more than 40 million dollars. These people are not “working” Americans. We should nationalize the Koch brothers’ fortune TODAY!

              Ah, the political program of the NSDAP.

    5. Medicaid is far and away the best health insurance I have ever had. I wish I could stay on it forever.

      I’m glad you’ve had such a magical and wondrous experience, but you might want to double-check that you’re not a lying sack of shit. Medicaid eligibility isn’t time-limited.

      1. kbolino, you’re right that medicaid is not time-limited, but I expect that when I get done dealing with cancer I will be able to earn an income again, and then I will not be able to continue on Medicaid.

    6. :and once I was able to see her the day after my problem (ear clogged with wax) presented itself WITHOUT making an appointment. I have never had to pay a co-pay, either.”

      So you went to the doctor because your ears were dirty with wax ?

      Sir, you are part of the problem and in no way are you an intelligent anything.

      You can clean your ears without a fucking Doctor to do it for you.

      And you are bragging that others paid for a zDoctor to clean your ears and you are proud that you didn’t have a co pay.

      You should be ashamed to post such shit about yourself.

      Do you go to the Doctor to get her to cut your toe nails as well since you don’t have to pay for it ?

      1. OneOut, no I went to the doctor because my ear was CLOGGED with wax, wax was pressing against my eardrum, I was in pain and could not hear with that ear. I consider that I did medicaid a favor by waiting a day and going to my private doc rather than sticking them with the bill for a much more expensive emergency-room visit.

        You cannot clean your ear yourself in that circumstance. If you put a q-tip in your ear you just press the wax further in and pack it more firmly against your eardrum. You can also perforate your eardrum. Ask any doc and (s)he will tell you never to put anything smaller than your pinky finger into your ear. (That’s what they taught me when I was in med school.)

        1. What is necessary in that circumstance is to flush the wax out using a device which squirts a stream of water into your ear canal and simultaneously vacuums the water out. The cycle washes the wax out.

          Sometimes it is necessary to soften the wax with medical ear-drops first. This process can take several days. I was lucky the water treatment worked without drops!

          1. And I am not “bragging”. I read the comments here about how terrible government health care programs are, and I needed to point out that that runs contrary to my personal experience on Medicaid.

            1. Intelligent Mr Toad|5.5.15 @ 12:16AM|#
              “And I am not “bragging”. I read the comments here about how terrible government health care programs are, and I needed to point out that that runs contrary to my personal experience on Medicaid.”

              Well, you may not be “bragging” but you are seen here as a slimy piece of shit.
              You claim that others are required to pay for your medical care simply because they have been successful, and you, as a pathetic moral failure, should not pay for what you want.
              Well, most of us here have a suggestion for you: Get fucked with a rusty farm implement; you are the example of the worst sort of slime we rarely see.

              1. No, not because they have been “successful”. Because they inherited their wealth without being successful, or even lifting a finger, for it.

  19. Wait, you mean if people have subsidized emergency room care, they’ll use more of it than if they have to shoulder the entire liability themselves?

    That seems to break every rule of economics.

    /sarc

  20. The uninsured rate among U.S. adults declined to 11.9% for the first quarter of 2015 — down one percentage point from the previous quarter and 5.2 points since the end of 2013, just before the Affordable Care Act went into effect. The uninsured rate is the lowest since Gallup and Healthways began tracking it in 2008…

    1. Insurance is not the same as care.

    2. Only if you count Medicaid.

      1. Which, as I mentioned above, they do. Because it’s the only way the act looks remotely successful: they shunted more people onto welfare. Add to that the number of people who had plans canceled by the act and it’s beyond laughable that anyone in the pro-ACA camp still offers up enrollment numbers as a plausible metric.

    3. Obamacare has insured 25 percent of the original 44 million uninsured at a cost of $72k/per insured. And you call it a success. What would failure look like?

    4. Medical bills are astronomically high and rising faster than the general inflation rate. Why did the politicians concentrate on figuring out a way to force all Americans to pay these sky high bills? Why didn’t they focus on trying to lower these bills, by (oh I don’t know) increasing the supply of healthcare? You’d do that by lifting some of the numerous roadblocks in place that prevent more hospitals and emergency rooms and urgent care centers from opening. Right in my neighborhood there is a fight going on to try to keep an emergency center open. The county/state wants to close it because “there’s already another one in the area.” This is absurd.

      1. True.

  21. Here’s another perverse incentive: the people with very low or totally subsidized premiums are also eligible for off-sets to their deductible up to 95%.* It’s really no skin off their asses to go to the more expensive ER. They’re not paying for it.

    * Sorry I don’t have a link. I’ll try to find one. It caught my attention because I thought the high deductible plans were worthless to the poor. When I read about the deductible off-set, I threw up a little bit in my mouth and navigated away.

    1. They’re called ‘cost-sharing reductions’. Naturally…

  22. “Such irresponsible behavior costs all the rest of us money,” Obama said.

    That means a lot coming from him.

    1. Any politician would ever utter those words deserves a slap in the face from 1000 people lined up waiting, like that scene in Airplane.

  23. Could it be that the current spike in ER visits and worse health is from nausea created by D.C. and the MSM?

  24. And, of course, a great deal of emergency room visits are by illegal aliens, who end up not paying and thus get free care.

  25. it’s as if the easiest part of reforming health care -insuring more people- was done at the expense of everything else. and what’s so stupid about that, is the mistakes were all self-inflicted if they had not done something other than throw it together and then not read it. of course that’s different from saying it was a good idea at all, especially to libertarians of course.

  26. Obama claims to be pro-choice but forces his insurance on all citizens

    1. And the occasional drone-fired missile.

  27. “And yet in the time since Obamacare’s major coverage expansion has kicked in, the number of emergency room visits has not gone down. Nor has it held flat. Instead, it appears to be growing[…]”

    Probably due to all the people needing emergency care from overdosing on too much re-legalized cannabis!

  28. Perhaps, there is a large influx of people in the first years of a program, most of whom hardly even bothered with ERs prior to ACA?

  29. Oh brother

  30. An massively unpopular, unconstitutional law shoved down our throats by a Statist Regime…
    What could possibly go wrong?
    Remember “If you like your doctor, you can keep your doctor”?
    Built on a foundation of lies, this too will fail.

  31. Google pay 97$ per hour my last pay check was $8500 working 1o hours a week online. My younger brother friend has been averaging 12k for months now and he works about 22 hours a week. I cant believe how easy it was once I tried it out.
    This is wha- I do…… ?????? http://www.netjob80.com

  32. Google pay 97$ per hour my last pay check was $8500 working 1o hours a week online. My younger brother friend has been averaging 12k for months now and he works about 22 hours a week. I cant believe how easy it was once I tried it out.
    This is wha- I do…… ?????? http://www.netjob80.com

  33. Okay, this has probably already been covered in the previous comments, but there’s so much silliness between my late entry and the earlier ones, that I will just reiterate.

    Do a lot of insurance policies offer X number of free or discounted emergency room visits per year? If so, this might also be a contributor.

    But yes, free riders were in fact the whole point of the legislation.

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