More people with health insurance was supposed to mean fewer people going to emergency rooms (E.R.). It has not worked that way. The number of people using E.R.s is rising.
Medicaid is covering many of those coming to E.R.s. Most are living in states that increased the number of people eligible for Medicaid. Many are having trouble finding doctors. When they do find a doctor who will take them, they often have to wait a long time for appointments. The testing that usually follows also can take a long time.
When problems that are serious, but not emergencies, occur they feel they have no choice but to go to the E.R.
The new health insurance program does not cover undocumented people and some legal immigrants. For them, sometimes the emergency room is the only choice.
Ways to end the flow of patients to the E.R. are costly. It would require a system that promptly saw patients during after-work hours and on nights and weekends. It would use telemedicine that put patients in touch with health professionals and specialists.
It would also help if doctors stopped sending end-of-the-day patients to emergency rooms. It would help if urgent care practices could provide more services to divert patients from emergency rooms.
Patients can be handled more efficiently in the E.R. if doctors know they are part of a good health care system.
The real problem is the lack of a primary care health system. More attention has been paid to having insurance than to making sure patients get timely care.
In the meantime emergency rooms will be busy.
Source: The Wall Street Journal September 25, 2015