Increase in emergency department visits persists following Medicaid expansion

first_img Read Full Story Visits to hospital emergency departments (EDs) not only jumped by 40% in Oregon after Medicaid coverage was expanded there in 2008—but the increase persisted for at least two years, according to a new study led by health economists at Harvard T.H. Chan School of Public Health and the Massachusetts Institute of Technology.The study also found no evidence that the newly insured are more likely to substitute doctor’s office visits for trips to the ED; rather, it found that Medicaid makes it more likely that individuals will use both types of care.The study will appear in the Oct. 20, 2016 issue of the New England Journal of Medicine.“Our finding that Medicaid increased ED visits generated a lot of debate about whether this might just be a temporary spike; now we know that the increase in ED visits persisted for at least the first two years of Medicaid coverage,” said Amy Finkelstein, the John and Jennie S. MacDonald professor of economics and co-Scientific Director of J-PAL North America at MIT, who led the study with Katherine Baicker, C. Boyden Gray Professor of Health Economics at Harvard Chan School.The researchers examined new evidence from the Oregon Health Insurance Experiment, a unique, randomized controlled evaluation of the effects of Medicaid expansion. Oregon’s lottery provided an unprecedented opportunity to separate out the effects of Medicaid from confounding factors to assess the impact of coverage on a wide range of outcomes, from health care use to financial security to mental and physical health.last_img read more

Morrissey residents relocate to Pangborn Hall for renovations

first_imgThe men of Morrissey Manor have found a temporary home in Pangborn Hall while the Manor is being fully renovated for the first time in two decades. This overhaul of the South Quad dorm, constructed in 1925, follows renovations of Walsh Hall and Badin Hall in the previous two years. Residents of Walsh and Badin were also temporarily located to Pangborn during their renovations.Morrissey Manor’s Little Flower Chapel was renovated in 2015, but the building has not seen extensive improvements since 1998.“Morrissey will receive an elevator and fitness room for the first time in its history,” Morrissey Rector Zack Imfeld said in an email. “Every part of the building — except the Chapel — will be improved, balancing Morrissey’s classic 1925 feel with modern construction.”Residents of Morrissey, a hall long infamous for its small rooms, are looking forward to the new changes, Smith said.“Bigger rooms is the one thing that stands out, especially for a Morrissey guy,” sophomore Ryan Smith said. “It was pretty tight last year being in a double with such limited space. I’m looking forward to next year and having bigger rooms.”For the Manorites, the move across South Quad is a change of scenery but not of culture, as signified by their Little Flower Chapel, Smith said.“Seeing the chapel untouched while everything else is under construction was symbolic of how that culture and that vibe — no matter what you do to the physical appearance of Morrissey — you won’t touch that culture and that’s something that’s going to carry with us through Pangborn and to when we return to the Manor next year,” Smith said.Imfeld said the dorm has been preparing for the move since it was first announced during the 2015-16 academic year.“I don’t think the move will impact us drastically — we’ve been planning as a hall community for a few years, so all of our traditions and processes were created and enhanced to make our transition as smooth as possible,” Imfeld said. “The beauty of our move is that while the building may be different, the community is the same and that’s the beauty of the residential system here at Notre Dame.”Senior Brady McLaughlin, Morrissey’s hall president, said the Manor does not plan to commemorate their temporary relocation in any way.“Our plan this year is to keep on doing what we want to be known for, keep on doing what we have been known for,” McLaughlin said. “Honestly, as a senior, I would be kind of pissed off if we were trying to do something different this year. I stayed in Morrissey because I love Morrissey.”Smith said ensuring that first years who have only ever lived in Pangborn carry on the Morrissey legacy when they return to the Manor is a top priority for upperclassman.“We want [first years] to carry on the same traditions, and even though we’re being renovated that doesn’t mean that we’re wiping away the old Morrissey,” Smith said. “It still lives on pretty strong in our hearts and that’s something that we want to carry into the new building next year.”Smith said the changes may temporarily move Morrissey out of the home they love, but residents are optimistic about the new challenge and look forward to their return to the Manor next year.“It’s exciting because I think we do have a good community, and I don’t just say that as a Morrissey guy. I really do think it’s a great group of guys with great leadership at the top,” he said. “I think if we can carry that into a brand new building with brand new facilities, it’s going to be really great not just for us but for the rest of campus because we do some really cool stuff throughout the year.”Tags: Construction on Campus, Morrissey Manor, Pangborn Hall, renovationslast_img read more

Springtime Stoke at the New River Gorge

first_img– Jay Reese is a rock climber for the B.R.O. Athlete Team. Check out his bio here. Rock climber Jay Reese from the BRO Athlete Team fills up on sun and psyche as Spring wakes up in the New River Gorge of West Virginia. It’s 6am and bells are chiming. My eyes peel apart from 4 hours of unconsciousness, a few hours too early after a few beers too many. I slap around for my phone to turn my alarm clock off, cursing the late night game of high stakes trivia that got me into this predicament. But it’s not my phone making the noise. Maybe it’s the alarm clock? Nope. Sounds like a doorbell? What doorbell? My doorbell! Growing tired of waiting at our normal meeting place, my climbing partner David decided to trek down to the source. A common rule among the crew is that anyone that doesn’t make it to the meet-up is considered dead or immobile, but will be given the opportunity to correct their actions at the price of paying for breakfast. Since I was both of those things a few minutes earlier, ham biscuits would be on me. After a shotgun packing job I was in a car and bound for West Virginia.Cirque Wall New River GorgeThe New River Gorge in West Virginia was not our original destination, having just the night before made the call to scrub plans to go to the Red River Gorge in Kentucky due to a little snow. In this case “a little snow” was 20″ of a traffic jamming, ice forming, road ruining weather system known as Thor. Days of pouring over guidebooks, watching videos, and dreaming of rice bowls at Miguel’s fizzled before our eyes as news came in that Lexington, a town 45 minutes away from the Red, was reporting the most snow since 1943. Luckily for the trip, the New only got around 10”, so we closed one guidebook and opened another. After a cold winter of training in gyms, sneaking outside only to freeze stiff, and staring at pictures of Lynn Hill on Quinsana Plus, I was pretty excited to get back to the New and get on the Nuttal Sandstone cliffs that pepper the side of the valley.David and I rolled into the parking lot at the New to find we were alone save for some tire tracks in the deep snow. The tracks told a story of attempts at parking, spinning, pushing, and retreat. A bit of a concerning start to the day, hopefully the hike to the other side of the hill would be a bit better. We unpacked and repacked our climbing gear as the last member of our crew sauntered in. The sun was beaming and it was already in the high 40s. The temperatures would turn the friction up to 11, ideal conditions, so long as we could find some South facing, sunny rock that had already shivered off the thick layers of ice that could be seen from the bridge. Luckily we had just the place in mind.The Cirque, an amphitheater of brightly colored, bullet-hard sandstone, it is the crescendo of the 4.5 mile stretch of Endless Wall. Containing some of the hardest, most technical routes in the area, it’s not uncommon to pass a few broken dreams when walking the base of the cliff. Due to its concave shape, lack of tree shade, and South facing orientation, the Cirque is an ideal winter climbing location. Today it was host to a chaotic symphony of shattering glass. A hundred feet above us, giant icicles were warming up, losing their footing, and cascading to the floor below. The steep overhang of the wall kept us safe from the icefall, but every time a refrigerator size chunk of ice dislodged from the top and came roaring down I felt the need to duck and cover.Climbing at the Cirque is nothing less than perfect, albeit on the difficult side. We warmed up on a route aptly named “The Warmup”, where a less than easy start leads into a steep roof that burns the forearms and wakes up the brain cells. After a few laps on the climb we were ready to head to our respective projects for the day. Ricky (our tardy third member) was first on the rotation. A winter of living on homemade cheesecakes had apparently not hindered his superhuman pulling power as he danced up “Trebuchet Jr.”, a technical thinker of a route. Making it past the crux, a botched hand sequence sent Ricky down to the tight end of the rope. A quick rest and he was back on the wall and at the top. “One hanging” a project, where a climber only falls once during their attempt, is considered the last step before actually sending a route. It was Ricky’s first run of the day so he was off to a solid start.Cirque Wall New River GorgeNext up was David, my partner for the next 3 days of climbing and sleeping in the slushy mud. David is an odd cat, full of try-hard, physics equations, and grape nuts cereal. David and I had our sights set on a route called “Hasta La Vista” located at the end of the massive wall. Just to the right of the route was a beautiful waterfall, spraying bits of ice and water from the melt above. Chandeliers of ice bordered the spray, making for a beautiful setting for the climber but a nervous belay down near the drop zone. David styled his way through the route and after a few attempts he had the thing mostly dialed.It wasn’t until I was standing below the route tying in that I had the old familiar feeling of dread that comes from not climbing outside for a while. As a personal confession, heights terrify. that might seem weird in a sport where the very name of the game is heights, but in practice it rarely affects me. It’s only when I’ve been away for a while that the fear creeps in. Luckily I have learned to manage away this fear by assuring myself that nothing will break, my belayer is competent, and that as long as I take care to remember the fundamentals I shouldn’t end up like all that ice tumbling down around me.With fear pushed to the back of my mind I tied in and got ready to throw myself outside of the comfort zone once again. I had spent most of my winter training and I was excited to check and see where my fitness was after being away from real rock so long. On my first attempt I fell at the second hard throw, making it a bit further than I had expected for a first attempt. The fall had reassured my mind that falling is a normal part of climbing and my anxiety quieted down. After a few attempts I made it through the throw and up to the anchors. I managed to get on the route a few more times that day but was never able to put it all together. With the light fading, we all hopped on a few more routes, took some pictures of the ice, and discussed what to do next.The day ended like most of our trips to the New, at Secret Sandwich Society talking about how amazing the day was. The secret to climbing with a full tank of stoke is that every climbing day is the best climbing day you’ve ever had. This leads to a lot of enthusiasm and odd looks from non-climbers a table over as you pantomime your favorite moves of the day with a mouth full of french-fries and an IPA sloshing about the table. Ricky was heading back to Roanoke to do some sort of lumberjack woodworking project; as for David and I, we were about to drive into the dark of night, through the back roads West Virginia and into Kentucky. We had heard that temps were on the rise and most of the snow was gone at the Red. It was a bit of a foolish gamble for us to leave dry routes and cozy tents to head into questionable weather. But as soon as we pulled into Miguel’s campground at 1am and saw the fire blazing and tents strewn across the field I knew we made the right decision. That night we were so pooped that I slept in the passenger seat of my truck and kicked David to the bed of the truck with a sleeping pad and a guidebook. As the driver, I had first dibs on car sleeping spots. The next morning with a hunched back, soggy from sleeping in a steamy cab I asked David how he fared in the bed, he said had slept great with a perfect view of the Kentucky sky. Chalk that up to karma and all that gibberish.Cirque Wall New River GorgeWe rounded out our trip with a few more equally amazing days of climbing. Heading into Muir Valley the first day there and getting on some of the classic routes in the Solarium, “Air Ride Equipped” “Manifest Destiny” and my personal favorite “Super Best Friends”. The second day we finished off the trip by venturing into the Motherload. After spending a good bit of time staring in awe at the Madness Cave, we headed over to Buckeye Buttress to hop on a few more routes before packing it in. We finished off our trip with a few Ale 8’s and a 5-hour drive filled with conversations on climbing, the importance of pi, and how bad we smell.The beginning of spring is always a kick-start for the psych. With a crew of motivated friends, a rope, and a half a dozen routes bouncing around my head, I’m ready to soak in all the good things that spring has to offer. The ice is thawing, bluebird skies are becoming more and more common, and the stoke couldn’t be any higher.last_img read more