The Limits of Policy Analysis – National – The Atlantic

Naturally, even-handedness demands that I here expose the wrong-headedness of some liberal scheme.  And as it happens, I have one all ready in the oven here:  the chimera of reducing emergency room use.  The argument that health care reform could somehow at least partially pay for itself by keeping people from using the emergency room was always dubious.  As I, and others argued, there’s not actually that much evidence that people use the emergency room because they are uninsured–rather than because they have to work during normal business hours, are poor planners, or are afraid that immigration may somehow find them at a free clinic.

Moreover, we argued, non-emergent visits to the emergency room mostly use the spare capacity of trauma doctors; the average cost may be hundreds of dollars, but the marginal cost of slotting ear infections in when you don’t happen to have a sucking chest wound, is probably pretty minimal.

But even I was not skeptical enough to predict what actually happened in Massachusetts, which is that emergency room usage went up after they implemented health care reform.

Bad news for keeping costs down.

check me out at posterous here.

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