One of the most pernicious dysfunctions of the current health care system is that it often puts uninsured people, particularly workers with low and mid-level incomes, in the position of going to emergency rooms for treatment for non-emergency medical problems. This not only puts additional stress on emergency services, it is the least effective way to deliver non-emergency treatment, since ER doctors don’t know patients’ medical histories and rarely have access to their records.
As the debate over health care reform plays out in Washington, we’re hearing a lot from opponents of reform about the cost of government insurance but little in the way of countervailing arguments from proponents about savings.
The proper setting for non-emergency care is in the offices of doctors who provide primary care. Formerly known as “family doctors,” these physicians generally see patients on an ongoing basis and are best at diagnosing and prescribing the right treatments. However, doctors almost always require that their patients have some sort of insurance before they’ll take them on.
Emergency rooms are not only least effective and efficient treatment settings for primary care, they are the most expensive. The average ER visit costs $359 — more than double the $129 average cost of a primary care visit. But because hospitals, unlike primary care clinics, are legally bound to treat everyone who shows up, thousands of uninsured people seek primary care treatment in ERs every day, a phenomenon that needlessly adds billions to the overall cost of health care every year.
With a public option — a government insurance plan similar to Medicare, Medicaid and the coverage provided to the military, veterans, members of Congress and federal employees — people who can’t afford insurance now would be covered, and so would have access to primary care. This would not only improve the overall quality of health care and reduce stress on overburdened emergency rooms nationwide, it would eliminate billions in emergency services fees charged to those who can least afford them.
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