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Thursday, October 23, 2008

One Less Excuse for Bad ER Service

Hospitals love to cite over-use by the uninsured to explain overcrowding in their emergency rooms. That excuse is now being questioned. It has had credibility because hospital emergency rooms have to treat everybody who shows up regardless of their ability to pay. The offices of private physicians do not have to do that.

Hospital people have also used this excuse to justify their failure to improve emergency services generally. They say that if they make the service better, it just attracts more of the uninsured.

A recent study out of the University of Michigan and published in the Journal of the American Medical Association found that the uninsured actually use emergency rooms at a lower rate than do the insured. Something over ten percent of emergency room visits are by uninsured patients, whereas something like seventeen percent of Americans are uninsured. (Uninsured not to blame for ER waits, The Boston Globe, October 22, 2008)

That comparison is probably not quite legitimate since seniors – the heaviest users of health care – are all insured by Medicare whereas the uninsured are disproportionately young and healthy.

The main point, however, is that nearly ninety percent of the people using emergency rooms do not come expecting free care. They come for other reasons which they consider to be legitimate. They deserve better service than they have been getting.

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