Myth: Adding people to the insurance roles from Obama-Care will increase costs, and overburden an already stressed system leading to increased physician wait times.
The myth is false. In healthcare system after healthcare system, when you provide access to healthcare the costs decrease. The best example in the United States is the Malcolm Baldrige award winning SouthCentral Foundation. This is a primary care organization that takes care of Alaska Natives. Over ten years ago SouthCentral took over primary care from the Indian Health Service. They took a burdened system and made several fundamental changes:
(a) Promised same day access to primary care physicians.
(b) Patients are not charged a co-pay or a deductible.
(c) In addition to the primary care physician, they can see any member of the team which includes a behavior therapist, dietician, pharmacist, or midwife.
Despite this Southcentral Foundation did NOT see people lining up to ‘over-use’ – people in general do not wake up and say ‘hey I think I will go to the doctor for fun today’ – with a few exceptions and those very few exceptions need to be ‘managed’ appropriately. Their per capita use of specialists has dropped by over 50% and emergency department visits dropped by over 50%. But surprisingly primary care in person visits dropped by 20%.
When people do not have barriers to access they know they can get what they need when they need it – which hugely decreases their need to have an appointment ‘just in case’ or ‘because I could get one.’
When you open up access (insurance coverage) you WILL see an increase, but it will be limited to a number of months as backlogs of needs are worked down and then TOTAL visits should actually DROP because you have an intelligent system that gets you closer to what you need rather than multiple visits/hits just trying to get things taken care of.
The most intense, costly, and burdensome care for the system is care delivered late in an illness. It is easier taking care of pneumonia with a pill from your primary care physician’s office than going to an emergency room, getting admitted and having intravenous antibiotics. It costs less to manage a child’s asthma through primary care, than having them show up at the emergency room with an asthmatic attack.
The more people have insurance, the more access they can have to their physicians, costs decrease. The more barriers to care, the less people see physicians- but they get sick at the same rate.
The model for SouthCentral Foundation is being looked at from Scotland to Canada, to Oregon. It is a great model for healthcare, one that costs less that what you pay already. Imagine, healthcare that costs you less, but you get more access to physicians.