Obamacare Upheld, Conservative Heads Explode

[DigitalChaos]

I'd say the ACA bashers need to brush up on math skills.

According to a 2012 report by the AAMC, there were 34,000 active emergency medicine practitioners in 2010.



So, 6.17% of all the practicing ER docs were surveyed. And only 1.72% of those saw a large increase. If that number alarms you... wow.

The methodolgy used by Marketing General Incorporated (the company who conducted the survey) is also questionable. From their own press release: "This survey was conducted online in the United States by Marketing General Incorporated on behalf of the American College of Emergency Physicians between March 16-23, 2015, among 2,099 emergency physicians age 18 or older, providing a response rate of 9 percent and a margin of error of 2.1 percent."

That means 92% of the doctors polled did not respond.

A misleading headline claims another victim. I'm surprised you fell for it, @DigitalChaos.

That's a nice mix of cherry picking and pure denial you have there.

Of the 2100 doctors surveyed, 75% say that ER volume has risen. It's not hard to understand why that would happen. There is more to healthcare than just insurance. There aren't enough people to fulfill the need of primary care. ACA didn't help this. In fact, it is exacerbating it. It's pretty obvious that the people who need healthcare and have insurance, but no primary care service, will end up in the ER.


We are talking very basic supply and demand here. ACA drove up demand for healthcare service. The supply for primary care physicians/nurses did not go up.

[Baphomette]

That's a nice mix of cherry picking and pure denial you have there.

Cherry picking? I'm taking the exact figures given in the poll cited by the article you posted.

28% (or 1.72% of the 6.17% practicing ER docs surveyed) saw a large increase.
47% (or 2.9%) saw a SLIGHT increase.

Factor in methodology and percentage of error and you get a VERY unreliable survey. (Not to mention that the answers given were subjective - they weren't backed by official admission numbers.) That's just fucking math. But hey, call it denial if you want; it's pretty obvious you're the one engaging in that.

The supply for primary care physicians/nurses did not go up.

From the Bureau of Labor Statistics: "Job Outlook Employment of physicians and surgeons is projected to grow 18 percent from 2012 to 2022, faster than the average for all occupations. Job growth will occur because of the continued expansion of healthcare-related industries."

Do your fucking research. It's not that hard.

[allegro]

A big part of the problem is that many urban and rural areas do not have walk-in clinics or urgent care facilities or offices with primary care physicians. The system is currently TRYING TO FIX THAT, but it doesn't happen overnight. Here in the Chicago area, NorthShore University Healthsystem one of many huge systems that have hospitals, walk-in facilities, primary care facilities and physicians, etc., and all accept Medicare. But there aren't many of these types of systems in urban areas of Chicago, especially heavily populated with low-income minorities. If you don't have a FACILITY in your area except for a hospital, you're gonna go to a hospital. Period. The ACA didn't include suddenly building primary care facilities or walk-in clinics, or getting med students to change their focus.

Here is an interesting article.

Here's Bernie Sanders' report.

[DigitalChaos]

Of course it takes time to grow out the primary care. You must be forgetting all the rhetoric from the last few years about this. Even directly from Obama. It was all "when people don't have insurance and they need healthcare, they go to the ER!" It was a completely myopic focus and only for the purpose of propping up ACA.

And, honestly, the supply of primary care providers is only a piece of the puzzle. A lot of the ACA expanded coverage comes through Medicaid. People on Medicaid go to the ER *more* than uninsured people. Here is a flashback to 5 years ago: http://www.ncpa.org/pub/ba709 and a slightly wider look at that topic: http://reason.com/blog/2014/01/02/no...emergency-room

[DigitalChaos]

From the Bureau of Labor Statistics: "Job Outlook Employment of physicians and surgeons is projected to grow 18 percent from 2012 to 2022, faster than the average for all occupations. Job growth will occur because of the continued expansion of healthcare-related industries."

Do your fucking research. It's not that hard.

projections! I wonder how those projections match against the growth of healthcare demand... you know.. research!

oh shit, look at this:

Here is an interesting article.

"population growth and aging are estimated to increase the workload of adult primary care practitioners by 29 percent from 2005 to 2025, and the number of adult primary care practitioners is estimated to grow by only 2–7 percent. These projections are expected to lead to estimated shortages of 35,000–44,000 adult primary care practitioners."

[allegro]

"population growth and aging are estimated to increase the workload of adult primary care practitioners by 29 percent from 2005 to 2025, and the number of adult primary care practitioners is estimated to grow by only 2–7 percent. These projections are expected to lead to estimated shortages of 35,000–44,000 adult primary care practitioners."

More importantly, read Bernie Sanders' report, linked above:

Where Have All the Providers Gone?

Today, nearly 57 million people in the U.S. – one in five Americans – live in areas where they do not have adequate access to primary health care due to a shortage of providers in their communities. According to the Health Resources and Services Administration (HRSA), we need 16,000 primary care practitioners to meet the need that exists today.

This shortage is felt most acutely in rural and low-income urban areas. Although more providers of all types are needed, the shortage is overwhelmingly a primary care provider shortage, and it is expected to get worse. 52,000 primary care physicians will be needed by 2025.

Consider these sobering figures:

• Fifty years ago, half of the doctors in America practiced primary care, but today fewer than one in three of them do.

• As many as 45,000 people die each year because they do not have health insurance and do not get to a doctor on time.

• The average primary care physician in the U.S. is 47 years old, and one-quarter are nearing retirement.

• In 2011, about 17,000 doctors graduated from American medical schools. Despite the fact that over half of patient visits are for primary care, only 7 percent of the nation’s medical school graduates now choose a primary care career.

• Nearly all of the growth in the number of doctors per capita over the last several decades has been due to a rise in the number of specialists. Between 1965 and 1992, the primary care physician-to-population ratio grew by only 14 percent, while the specialist-to-population ratio exploded by 120 percent.8

This dramatic trend must be reversed.

See "SOLUTIONS" on Page 6.

[elevenism]

A big part of the problem is that many urban and rural areas do not have walk-in clinics or urgent care facilities or offices with primary care physicians. The system is currently TRYING TO FIX THAT, but it doesn't happen overnight. Here in the Chicago area, NorthShore University Healthsystem one of many huge systems that have hospitals, walk-in facilities, primary care facilities and physicians, etc., and all accept Medicare. But there aren't many of these types of systems in urban areas of Chicago, especially heavily populated with low-income minorities. If you don't have a FACILITY in your area except for a hospital, you're gonna go to a hospital. Period. The ACA didn't include suddenly building primary care facilities or walk-in clinics, or getting med students to change their focus.

Here is an interesting article.

Here's Bernie Sanders' report.

we don't have a doctor in Stratford, Tx AT ALL.
There's a NP...ONE NP...and it takes about 3-5 days to see him. On top of that, he's not the sharpest tack in the box.

So yeah, if you get sick here, you COULD drive 34 miles south to dumas, but they kinda tend to let people die there, and they lack modern medical equipment.

So insurance or not, if one of us is really sick, one of the other two drives her (or me) 1.5 hours to the hospital in amarillo.

[allegro]

we don't have a doctor in Stratford, Tx AT ALL.
There's a NP...ONE NP...and it takes about 3-5 days to see him. On top of that, he's not the sharpest tack in the box.

So yeah, if you get sick here, you COULD drive 34 miles south to dumas, but they kinda tend to let people die there, and they lack modern medical equipment.

So insurance or not, if one of us is really sick, one of the other two drives her (or me) 1.5 hours to the hospital in amarillo.

That's the biggest thing that the medical community and the ACA is trying to teach people; AVOIDING getting sick is the main goal, which is why we need primary and family care facilities, and urgent care vs. emergency care facilities.

People need a family care facility where they can go for an annual or six-month physical checkup, with the idea being to AVOID getting sick so they'll hopefully never need the hospital. If you fall down or get into a car wreck, there's not much you can do about that. But, lots of other illnesses can be prevented or avoided with regular checkups, blood tests, etc. Waiting until we're "sick" is often too late or a LOT more hassle; the idea is to prevent illness and hospitalization in the first place, if at all possible. But, that's hard to do when there aren't doctors available or people aren't knowledgable about prevention and their own roles in it. Really, even driving an hour-and-a-half once per year for a full-physical and a fasting blood test isn't too bad. It's worth it. I just had a preventative colonoscopy and they found and removed a polyp; I found out it's the type that most often becomes colon cancer. Waiting until it was full-blown colon cancer vs. removing it while it was benign worked out much better, obviously. Ditto for breast cancer screening, prostate cancer screening, diabetes screening, heart health screening, etc.

G works with a guy who was working on his lawn, felt nauseated, and went over like a tree on his front lawn. Ends up he had a fully-blocked artery and had a massive heart attack. He's 32. He's not obese, but he smokes like a chimney. Had he had regular checkups, maybe docs could have detected something and he could have prevented this?

But, yes, we still need a LOT more primary care in rural and low-income urban areas, as soon as possible. For sure.

[Dra508]

G works with a guy who was working on his lawn, felt nauseated, and went over like a tree on his front lawn. Ends up he had a fully-blocked artery and had a massive heart attack. He's 32. He's not obese, but he smokes like a chimney. Had he had regular checkups, maybe docs could have detected something and he could have prevented this?

But, yes, we still need a LOT more primary care in rural and low-income urban areas, as soon as possible. For sure.

Did he live?

Big problem we have is there are more specialists then GPs then ever. Seems to me, there needs to be more incentive to practice primary car medicine out where @elevenism lives. I'm sure there are a few programs to pay for your medical school and then be obligated to work somewhere for a bit, but doesn't seem like enough to actual have prevention work.

[allegro]

Did he live?

Big problem we have is there are more specialists then GPs then ever. Seems to me, there needs to be more incentive to practice primary car medicine out where @elevenism lives. I'm sure there are a few programs to pay for your medical school and then be obligated to work somewhere for a bit, but doesn't seem like enough to actual have prevention work.

I believe that Bernie Sanders' "Solutions" (page 6) in his above-linked report suggests many incentives.

Yes, that guy lived.

[elevenism]

thanks for turning me on to Sanders, @allegro , btw.

he is our ron paul.

[GulDukat]

ACA (Obamacare) upheld!

[GulDukat]

[Dra508]

^^^Lulz

SCOTUS Chief John Roberts working on his legacy foh sure.

[Deepvoid]

Can you hear that?? It's the sound of Republican heads exploding.

[DigitalChaos]

http://www.usnews.com/news/politics/...ealth-care-law

I had no idea this was happening until i saw the headline. Apparently they are using money to subsidize healthcare costs that was approved by Congress for other purposes. That sounds like a pretty basic Constitutional violation if so.