ERs more crowded since Obamacare; tele-docs step up to help

Reducing emergency room visits can be now be added to the list of Obamacare’s broken promises. A survey released Monday by the American College of Emergency Physicians shows that three out four of its members report emergency room visits have increased since the law’s passage.

One of the key selling points for the Affordable Care Act (ACA) in 2010 was the promise it would lower healthcare costs by reducing emergency room visits. Millions of Americans without insurance were turning to emergency rooms, which, by law, cannot turn away patients for their inability to pay.

Before the passage of the ACA, President Barack Obama addressed a joint session of Congress, saying, “Those of us with health insurance are also paying a hidden and growing tax for those without it—about $1,000 per year that pays for somebody else’s emergency room and charitable care.”

One reason ER visits are on the rise seems to be Medicaid expansion. Millions of new Medicaid enrollees are using emergency rooms more often because the program now picks up some of the cost. What’s more, there simply aren’t enough family practice doctors to go around.

Some people who’ve found it difficult to get appointments with primary care physicians and specialists are turning to a new form of treatment delivery called telemedicine. It offers patients real-time interactions with a doctor through phone conversations and online communication. Doctors can diagnose minor and medium maladies; give counseling, psychiatric evaluations, and medical advice; and even prescribe some medications over the phone.

Telemedicine is not a substitute for primary or emergency care, but it can fill the gaps for patients who can’t get to a doctor, said Marousa Placiotis of the telemedicine company MD Plus. “They’re the ones pinch-hitting when you can’t get hold of the primary care,” Placiotis said. “There’s a doctor shortage right now, so the primary care may not be able to fit you in.”

Placiotis compared a telemedicine plan to AAA membership for car owners. It doesn’t replace insurance, but it can help you out in a time of need.

There are limitations to telemedicine: Doctors cannot prescribe narcotics, and they have to be in the same state as the patients to whom they talk. And they’re trained to know their limits, Placiotis said: “Our doctors have saved lives by telling [people] that they need to call 911.”

Listen to Jim Henry talk about telemedicine with Marousa Placiotis on The World and Everything in It.