Three stories about the uninsured and emergency rooms came across the transom today. As I've written about in my analysis of the Schwarzenegger-Nuñez California Health Care Deforminator ABX1 1, the notion that the legions of uninsured crowding America's ERs is the cause of the health care "crisis" is myth. Nevertheless, today's stories remind us that this situation demands serious reform. First, a study estimating that illegal immigrants account for one quarter of uninsured residents. Obviously, in a country where we (bizarrely) insist on our employers as health insurers of first resort, people who are not legally employed are more likely to be uninsured - but health reform cannot change that.
Second, a report from the Centers for Disease Control (CDC) concluding that the average ER wait has increased from 38 minutes to an hour over the past decade. Although 17% of the cases were for uninsured patients, 83% had private insurance or were dependent on a government plan. Guess what? The researchers determined that there was no increase in the number of cases that were "true emergencies."
The "solution", according to a doctor who appears to speak for the American College of Emergency Physicians, is more taxpayer dollars to fund ERs. That's the wrong answer: As I and others have written before (search "EMTALA" in this blog), the government caused this problem through a law called EMTALA, which requires hospitals that accept Medicare patients to take care of anyone who walks in the ER door.
More government money will only perpetuate this dysfunction. Instead, Congress needs to repeal EMTALA, or at least tighten it up so it only applies to true emergencies. (See this post about ER patients who get tired of waiting and leave!)
The real solution is at hand: urgent clinics (similar to retail clinics, but staffed by doctors instead of nurse practitioners) where people unwilling to wait in a crowded ER can get treated for $60 to $200, according to today's Wall Street Journal. Convenient health care - no government needed!
