More patients flocking to ERs under Obamacare
Meanwhile, Hagans campaign is finally going up on the air , so we may now see what will happen when the Dem campaign engages in earnest here. * OBAMA HAS ACCOMPLISHED DOMESTIC AGENDA: Jonathan Chait reviews the agenda Obama laid out in his first inaugural address in 2009 and compares it to what he has accomplished since : Those were the four major areas of domestic reform: economic recovery measures, health-care reform, a response to climate change, and education reformWith the announcement of the largest piece of his environmental program last Monday, Obama has now accomplished major policy responses on all these things. There is enormous room left to debate whether Obamas agenda in all these areas qualifies as good or bad, but ineffectual seems as though it should be ruled out at this point.All of Obamas domestic reforms involved compromises and imperfections, a quality they have in common with every major accomplishment in history. Also like the major accomplishments of the past, Obamas will undergo future revision.Whats no longer possible is to imagine that historians will look back at Obamas presidency and conclude not much got done. One wonders how the Green Lanternites , who prioritize process manipulation over all else, would respond to this. * WHATS DRIVING RESISTANCE TO CLIMATE ACTION: Paul Krugman asks why opponents of the EPA rules are so adamant, given that the costs arent all that great, and concludes : Think about global warming from the point of view of someone who grew up taking Ayn Rand seriously, believing that the untrammeled pursuit of self-interest is always good and that government is always the problem, never the solution. Along come some scientists declaring that unrestricted pursuit of self-interest will destroy the world, and that government intervention is the only answer. It doesnt matter how market-friendly you make the proposed intervention; this is a direct challenge to the libertarian worldview.
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A January study in the journal Science found that getting covered under Oregon's 2008 expansion of a Medicaid program for uninsured adults increased ER use by 0.41 visits per person, or 40 percent relative to visits among a control group. All sorts of visits went up those for serious problems, as well as "for conditions that may be most readily treatable in primary-care settings." Enter Obamacare, which in Kentucky added 330,615 people to the Medicaid rolls by expanding the program to cover residents earning up to 138 percent of the federal poverty level $15,856 for an individual in 2013. State officials said newly signed-up recipients are reflected in the number of overall Medicaid patients seen in ERs in March, which is up 9 percent compared with the same month last year. Claims data from Passport Health Plan, a Louisville-based Medicaid managed-care organization, separates out the newly insured, and suggests they are slightly more likely to use emergency rooms than traditional Medicaid patients. Too few doctors Bill Wagner, executive director of Family Health Centers, a Louisville-based network of clinics serving the poor, echoed many others about why people are flocking to ERs: "More than anything, this highlights the shortage of primary-care physicians." Overall, University of Kentucky figures show the state had 9,273 practicing physicians in 2012. The federal government categorizes 48 of Kentucky's 120 counties as areas with too few primary-care physicians. "We still turn some patients away," Wagner said. "Overall in the community, there's still a shortage.
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