No Surprise: Romneycare Increased ER Visits And Costs

Mitt Romney has argued that he will repeal and replace Obamacare, even though many parts of the government health care initiative, are copied from Romney's own plan, Romneycare. Will voters be convinced Romney is the man with the plan, when they find out how useless Romneycare was in fundamentally changing the experience and lowering the costs of providing health care to poorer citizens?
Sometimes, it almost seems like there is a conspiracy of political and media dunces to play the dumbest cards in the dumbest way—for and at the American people.

In part, this is a result of having a professional and well-off class communicate the meaning of a professional and well-off class of political perpetrators.

For example, let's look at the Politico story explaining why Mitt Romney's signature health care law—Romneycare—is a big failure in Massachusetts.

The chief problem, the Politico writers, Jennifer Haberkorn and Kyle Cheney, tell us, is the failure of Romneycare to help control costs and reduce ER visits:
"The law’s failure to rein in health care costs is widely acknowledged by nonpartisan analysts, as well as conservative critics. But there’s more material for critics to work with if either party wanted to use it. For example, emergency room use has gone up, not down—undermining the law’s effort to get that problem under control by expanding coverage."
These are related ideas of course. One way you control costs in the system is to route people away from more costly ER visits and towards primary and preventative care providers. So, if ER visits are instead going up, not down, a basic means for lowering costs is thwarted.

But why have ER visits gone up, not down, in Massachusetts? Answering that question goes to addressing the whole problem with having well-off professional pols make policy that is interpreted by well-off professional journalists, but which policy actually does a poor job of addressing the needs of poor and working-class citizens. There is a basic class prejudice at work in the process which blinds policy makers and pundits from the reality of the lives of people impacted by policy changes.

Buried way down in the Politico article, as if it isn't the main point, is the following revelation:
"It’s getting harder for Massachusetts residents to see a doctor, too. A report released last month by the Massachusetts Medical Society found that only half of the state’s primary-care providers are accepting new patients, down from 70 percent in 2007. And the average wait time to see a doctor in family medicine is 45 days—up from 34 days in 2007."
Now, just think for a moment. Romney's argument was that forcing everybody to have health insurance, and indeed punishing them with a penalty (which the Supreme Court admitted was a tax) if they don't do it, creates a situation where many more people can now afford to seek out primary care. However, that's just the problem. All of sudden, the market is flooded with new customers, yet adding more qualified health care providers isn't a sudden or simple proposition. It can take years to create or attract more doctors. And you won't likely do that by promising to pay them even less money than before.

And not only are these new customers now ready to consume primary health care, but they can do it more often too. So, demands on existing health care providers, especially primary health care doctors, ought to greatly increase. What did the doctors in Massachusetts do in that case? As you can see in the quotation above, they decreased service to new patients, and increased the waiting time to see any doctor by 11 days to a six-week wait! What responsible parent is going to tell his kid—just wait six weeks until we can take you to the doctor? And what good is an insurance policy that produces such a stupid outcome for the people that matter—the people seeking help?

In the face of a rather obviously silly and predictable economic impact, people started going, more regularly too, to ERs, to get looked at faster than a month and half. And wouldn't anybody make that choice?

Of course, the professional classes, politicians and media pundits, who make and interpret the benefits of policy, never have to make that choice, and don't have any idea of what it must mean to be looking at waiting six weeks to see a doctor. Their comfy medical reality is simply different than that of the Americans impacted by health-care reform.

As the Politico article rightly points out, nobody on the Republican or Democratic side of the campaign wants to discuss the negative aspects of Romneycare or also potentially Obamacare. It does not help either candidate to do so. But it also does not help the American people to constantly be told such misleading drivel about the policy-making assumptions of their elected leaders. While no doubt the politicians assumed certain things correctly in crafting Romneycare—getting people out of ERs and into primary care is a less costly proposition—they didn't think about how to supply the increased demand for primary care services their government program would create.

Mitt Romney is the poster boy for class-oriented cluelessness that defines him now as the crass, heartless, rich guy who doesn't care anything about the 47%. But even when he tries something, like a health care plan, that looks on the surface like it might be offering some kind of caring solution to uninsured citizens, it ends up being ineffective at substantively changing the experience of the very people who need the help the most. When Romney says he doesn't care about the 47% and the very poor, he cannot help himself but mean it in deadly earnest.

A perfectly fair question and critique for Barack Obama, of course, is why he would have ever wanted to follow such a dumb plan. To say it was the only one he could get passed is just one more point on the side of arguing Obama was way too stupidly conservative in his first term.

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