Fewer cardiac arrests after Affordable Care Act expanded coverage

[Suppressed]

Expansion of health care insurance as a result of implementing the Affordable Care Act in Oregon significantly reduced the burden of sudden cardiac arrest (by 17 percent) among 45- to 64-year-old residents of Multnomah County. Such an effect was not observed in the over 65 age group, for whom coverage did not change.

Notice how we don't get haw many cardiac arrests happened in OR or over how many years this was compared? This omission is intentional.

Yes, they are clearly in there.  Not sure how you missed them.

[Suppressed]

The only ones who make out well on Obama care is those who are on expanded medicaid. And they call ambulances to go to the ER for a sore throat because it costs them nothing.

BINGO.

So the question is, is there a way to triage ER visitors so cases such as that get turned away and forced to go to a clinic?

[Restored]

BINGO.

So the question is, is there a way to triage ER visitors so cases such as that get turned away and forced to go to a clinic?

No. Because....lawyers.
When a person comes into the ER, you have to treat them.

[thackney]

BINGO.

So the question is, is there a way to triage ER visitors so cases such as that get turned away and forced to go to a clinic?

You know this is easily possible.  What is lacking is the will to stand up to the unreasonable demands, against social "just-us" warriors.

[driftdiver]

BINGO.

So the question is, is there a way to triage ER visitors so cases such as that get turned away and forced to go to a clinic?

Blue Cross actually tried to do this and got massive pushback from Hospitals and Lawyers.   Their approach was to tell the insured that if they went to the ER and it was determined to be a non-critical issue then coverage would be denied. 

[thackney]

No. Because....lawyers.
When a person comes into the ER, you have to treat them.

That should not be forced into the ER.  Judgement and referral to the appropriate clinic would eventual reduce this ER burden.  Always accommodating the people abusing the system has only lead to more abuse.

[thackney]

Blue Cross actually tried to do this and got massive pushback from Hospitals and Lawyers.   Their approach was to tell the insured that if they went to the ER and it was determined to be a non-critical issue then coverage would be denied.

As it should be.  I worked with a man who did this with his family.  He would not make doctor's appointments.  He only went to the ER, for anything including kids with sniffles.  He was making over $100,000/yr.  He was also an idiot.

[Frank Cannon]

Yes, they are clearly in there.  Not sure how you missed them.

Bullshit. There are no numbers other than the national numbers in the article. You have to go to the JAHA study to find out that they only did this study over 5 years. When you are dealing with such a small sample (under 900 people) 17% is not a lot. Why not show us the data over 20 years? Because they know it will not give them the results they want.

Beyond that, Obamacare costs are not free as the article claims. Preventative care costs 4X what it did without it.

[driftdiver]

As it should be.  I worked with a man who did this with his family.  He would not make doctor's appointments.  He only went to the ER, for anything including kids with sniffles.  He was making over $100,000/yr.  He was also an idiot.

My insurance plan has a $250 copay for ER visits.   It gets waived if you're admitted or in a couple other cases.   Like if you go in because of chest pain you don't pay the copay.    Personally I think this is a good approach.

[Restored]

That should not be forced into the ER.  Judgement and referral to the appropriate clinic would eventual reduce this ER burden.  Always accommodating the people abusing the system has only lead to more abuse.

You go to the ER and they turn you away. Then you have a heart attack. Then you sue the hospital for turning you away. Then a lawyer gets rich.
I worked in the ER. We had to treat everyone. However, it might take us a long time to get to you.

[thackney]

My insurance plan has a $250 copay for ER visits.   It gets waived if you're admitted or in a couple other cases.   Like if you go in because of chest pain you don't pay the copay.    Personally I think this is a good approach.

Story was from over 20 years ago, probably should have said that.

[andy58-in-nh]

You just made an apples-to-oranges comparison.  Comparing to the American population, you should be comparing to the county population included in the study.  It's given as 636,000 adults.  That's about 0.25% of the US.  The analysis showed a lot of statistical power.

Actually, no.  The population of that county suffered heart attacks at an extremely small rate both before and after the ACA.

There were 377 incidences in the year before - 0.0593% of the county population; vs. 354 incidences 3 years later - 0.0556% of the county population. Controlling for other potential factors, especially region-specific variables and changes in the population cohort over a three-year period, this is not particularly significant.

The greatest differential was among the younger age group (45 to 64) - 102 incidences before vs. 85 three years after - which is the "17%" they are crowing about - but those are vanishingly small numbers in a large population: 0.016% before, vs. 0.013% afterward.

And, even if increased access to Medicare caused this modest improvement, is it really worth bankrupting the country?     

[Bigun]

Take a look at the sample size: one county, about 350 people. Put another way, that's about 0.0001% of the American population.

B I N G O ! ! !

[Suppressed]

Blue Cross actually tried to do this and got massive pushback from Hospitals and Lawyers.   Their approach was to tell the insured that if they went to the ER and it was determined to be a non-critical issue then coverage would be denied.

Well, I do have to admit that one problem is if the person doesn't get the full care they might receive in an ER setting. 

The daughter of a friend of mine was recently diagnosed by the ER with cancer after being sent home by the urgent-care clinic, where the doctor made her feel like a hypochondriac because the strep and mono tests were negative.

[Weird Tolkienish Figure]

Statistical noise?

[Suppressed]

Statistical noise?

Look at the report.  Doesn't look like noise.

[Suppressed]

And, even if increased access to Medicare caused this modest improvement, is it really worth bankrupting the country?   

That's part of the question...how much are lives worth, and should people be forced to pay to prevent deaths of the poor.

[Restored]

And, even if increased access to Medicare caused this modest improvement, is it really worth bankrupting the country?   

Psst...Medicaid

[thackney]

That's part of the question...how much are lives worth, and should people be forced to pay to prevent postpone deaths of the poor anybody.

[Bigun]

That's part of the question...how much are lives worth, and should people be forced to pay to prevent postpone deaths of the poor anybody.

Amen!  We are all going to die!  It's a pre-existing condition we all have!

[driftdiver]

Well, I do have to admit that one problem is if the person doesn't get the full care they might receive in an ER setting. 

The daughter of a friend of mine was recently diagnosed by the ER with cancer after being sent home by the urgent-care clinic, where the doctor made her feel like a hypochondriac because the strep and mono tests were negative.

I don't trust urgent care clinics.   They are fine for cuts and bruises, maybe a sinus infection that flares up on a holiday weekend.

They've missed serious conditions in my kids.   They are a good tool to reduce some medical costs but they don't replace a good family doctor. 

[Smokin Joe]

The A.C.A. being signed into law alone has reduced heart attacks by 17%?

Right.  Whatever.

Bunch of quacks.

Yeah. People got the bill and had a heart attack and died. Then the numbers dropped off from the peak...

[Smokin Joe]

Psst...Medicaid

Yep! We have the 'best fed' poor people on the planet!

[Smokin Joe]

That's part of the question...how much are lives worth, and should people be forced to pay to prevent deaths of the poor.

Not just the ordinary poor! Add in heroin addicts, tweekers, people who catch incurable diseases because of how they behave, and so much more!

[Wingnut]

Not just the ordinary poor! Add in heroin addicts, tweekers, people who catch incurable diseases because of how they behave, and so much more!

Round them up!  We must reduce the surplus population.