Emergency Room for Medicaid

According to a study by the University of California-San Francisco, from 1997-2007 emergency room visits have skyrocketed by 23% nationwide. The study cites the rise in Medicaid patients for the increase, as more and more doctors turn away state-funded cases because of lower reimbursements. Fox News Contributor Dr. Marc Siegel visited Varney & Company to discuss the growing problem in America’s hospitals.

“The Medicaid patients that are going there [to the hospital] are waiting longer,” said Dr. Siegel. “The entire statistic of [the] 23% increase is due to adults with Medicaid, not the uninsured, not private insurance but adult patients with Medicaid.”

Medicaid is the program that provides health care to low income citizens. The program is funded by both the states and the federal government but managed independently by the states. When doctors treat a Medicaid patent they are dependent on the government for reimbursement. These reimbursements have been dropping so doctors are now turning Medicaid patients away.

When this happens, Medicaid patients’ only option is to turn to the emergency room where the hospital is required to treat them by law.

“With the health-insurance reform coming in, the hospitals are worried that they are going to get more and more Medicaid patients, they’re going to get less and less from the federal government,” explained Dr. Siegel.

By the end of 2010 it is estimated that 16 million more Americans will join the Medicaid program as the new health-care law goes into effect. Along with the current strain on emergency rooms, this new wave of patients will further clog hospitals as people struggle to get treatment.

“This 16 million Medicaid patients are going to go to the ER for their cares,” said Dr. Siegel. “They are going to wait in line, they are going to clog the ERs, people that are the sickest are not going to be able to be taken care of right away.”

Experts worry that while more people will get access to government-run health care, more doctors will turn away those with Medicare and Medicaid.

“Physicians are balking from Medicaid. By some estimates, up to 50% of physicians are not taking new Medicaid patients,” said Dr. Siegel. “The bigger reason is that we [doctors] don’t have anywhere to send our patients when they are sick. We don’t have our networks, only the hospitals have the networks and they are totally overwhelmed.”