Now that we have learned something, isn't it time to act?

Anyone who reads this blog, or the textbook, knows that we encourage companies--and governments--to test the effects of various programs.  The Oregon Medicaid expansion gave us a nice natural experiment, about which we have blogged before, to understand the effects of increasing health insurance coverage on costs.  In addition to encouraging hospital visits--with no discernible effect on health--now we learn that it encourages emergency room visits. 

Conventional wisdom holds that it should, by diverting them from expensive emergency room use to less-expensive visits to doctors and nurse practitioners. This argument was very popular with advocates for health reform in 2009, and it remains a sort of folk wisdom among educated people; I’ve heard some version of this argument in virtually every discussion I’ve had about health care in the last decade.

To health-care economists, though, the question is more complicated. Health insurance does theoretically let you go to a primary care physician rather than relying on ER docs who are legally required to treat you. On the other hand, it also reduces the cost of going to the ER. And as the basic laws of economics tell us, when you reduce the price of something, people usually want to consume more of it.

Just once, I would like one of these advocates to apologize and admit that they were wrong.   And now that we have learned something about how the act works, shouldn't we go back and change it so that it works better?