15 December 2012
Phil Greenspun posted an article discussing a study of the efficiency of Medicaid in Oregon.
The conclusion was that Medicaid increased hospital use by about 30 percent, outpatient medical care by about 35 percent, and total spending by 25 percent. Finkelstein noted that advocates for expanding health insurance often predict that use of hospital emergency rooms will decrease when everyone is insured. That turned out not to be true in Oregon. The insured and uninsured used emergency departments at hospitals at roughly the same rate.
My observations here in Spain, a country with a state-subsidized medical system, has been that waits at emergency rooms are excessively long, due to large numbers of people visiting for common colds and other minor problems. It has gotten so bad that the government has begun to impose a minimum (nominal) payment to access the emergency room.
Update: A friend suggested that a desire to see a more efficient system implies less access. That’s untrue. Efficiency is about maximizing productivity, with minimum wasted effort or expense. Greenspun offered some interesting ideas for health care reform a while back.