The Uninsured Are Not Causing the ER “Crisis”

When it comes to arguments for “universal” health care in America, the hardest myth to kill seems to be the one that goes like this: “Uninsured people do not have access to primary care physicians. Therefore, they wait until their symptoms are severe, then go to the ER, and don’t pay their bills. Hospitals suffer financial distress and health costs spiral up.”

I (and others more clever than me) have debunked this thoroughly, in my analysis of ABX1 1, the California Health Care Deforminator proposed by Governor Schwarzenegger and Assembly Speaker Nuñez last year. Nevertheless, the good folks at the New America Foundation (who fed Schwarzenegger this line) have never recanted their erroneous estimate of the so-called “hidden tax” that the uninsured impose on the insured through cost-shifting by hospitals (although they now seem to be trying to dodge responsibility for the idea by claiming that the governor thought it up).

Now comes along a new study published in the Annals of Emergency Medicine, the official journal of the American College of Emergency Physicians, which compares ER visits from 1996 to 2004. Guess what?

  • The proportion of ER visits by uninsured patients declined from 15.5% to 14.5% of all ER visits;
  • The proportion of ER visits by patients who had a relationship with a primary care physician increased from 52.4% to 59.0% of all ER visits; and
  • The proportion of ER visits by patients in households earning 400% or more of the Federal Poverty Level increased from 21.9% to 29.0% of all ER visits.

So, not only do we not have a crisis, the non-crisis itself is fading away, and, if anything, we are facing a developing potential crisis amongst higher income, insured patients!

The U.S does not need “universal” health insurance; it needs to fix the health insurance that already exists, through competition and individual choice.

Nothing contained in this blog is to be construed as necessarily reflecting the views of the Pacific Research Institute or as an attempt to thwart or aid the passage of any legislation.

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