Busting The Myth of Emergency Rooms and Uninsured Care

November 28, 2011 § Leave a comment

There’s a myth that goes like this: uninsured people use ER’s like doctors offices, default on payments, and drive up premiums for everyone else. It’s a phenomenon called cost-shifting but its effect is really blame-shifting. It’s true that ER costs are exorbitant enough to cause payment defaults or financial crises for unisureds and poor people but, in fact, most stay as far away from ER’s and doctors offices as they possibly can. Studies show that they use the emergency room only when there’s a health emergency.

Overuse of ER services tends to happen when insured people are uncertain if their symptoms are urgent or else are incentivized to seek care in the one stop shopping environment of an emergency room. The copay is manageable and every conceivable test is available but the resulting cost to their insurer is huge and it boomerangs back in the form of increased premiums for everyone. The top trend in ’09 was to push rising health care costs back on employee healthcare plans. Since the opening of this century employee contributions to health plans have increased 131% making participation in health plans impossible for the working poor. 

Want more proof of this contention? To capitalize on the trend of insured people using emergency rooms instead of doctors offices, hospitals are building and marketing expensive new free standing ER’s in affluent neighborhoods. Private rooms, valet service, bring your insurance and come on in!  Why do they do that? Because Federal law allows ER’s to charge more for their services. Yes, alot more and ER’s also get higher remibursements from insurance companies because, as part of larger hospitals which are merging and becoming hospital monopolies,they can strong arm insurance companies under the rally cry of patient protections. They also strong arm their own doctors into meeting the monopoly’s bottom line. The “First do no harm” ethic mixes with the business mandate of “First make it profit” and we get higher premiums for all, questionable health benefits, and unreachable treatment costs for patients with poor and low incomes.

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