Will fewer people rely on emergency rooms for health care?
General Reference (not clearly pro or con)
Ken Terry, MA, former Senior Editor at Medical Economics Magazine, stated the following in his Aug. 23, 2010 article "Health Care Reform: Overcrowded ERs Are Bad and Getting Worse," available at www.bnet.com:
"From 1997 to 2007, according to a government survey, the number of ER visits in the U.S. climbed 23 percent to 117 million — an all-time high. In the U.S. population as a whole, there were 39 ER visits per 100 people in 2007 — a significant number given that most people are healthy and have insurance. Contrary to popular belief, only one-fifth of ER visitors are uninsured. The rest go to the ER because they don’t have a regular doctor, because their doctor is unavailable, or because they have a type of insurance, such as Medicaid, that’s unwelcome in many medical practices."
Michael Murphy, CEO of Sharp Healthcare, stated the following during a Mar. 23, 2010 interview on KPBS radio "How Will Health Reforms Affect Community Clinics, Hospitals?," available at www.kpbs.org:
"I think clearly one of the goals of healthcare reform is to get people covered and, clearly, this bill anticipates we’ll have 32 million people covered. 16 million of them will be covered by MediCal, 16 million more through the insurance exchange. And the total desire and appropriate thing to happen in this healthcare reform is for those people to get attached to medical home models so that their issues do not become emergency room issues and are treated in the most appropriate and cost effective setting in either community clinics or physicians’ offices or ambulatory sites long before they need an emergency room. And, clearly, that should have a positive impact on the emergency room."
Barack H. Obama, JD, 44th President of the United States, stated the following during a June 11, 2009 town hall speech at Southwest High School in Green Bay, Wisconsin, available at www.whitehouse.gov:
"[W]hen somebody doesn't have health insurance, they're forced to get treatment at the ER, and all of us end up paying for it. The average family pays a thousand dollars in extra premiums to pay for people going to the emergency room who don't have health insurance. So you're already subsidizing other folks; it's just you're subsidizing the most expensive care. You'd be better off subsidizing to make sure they were getting regular checkups. We're already paying for it. It's just it's hidden in your premiums…
Now, covering more Americans is obviously going to require some money up front. We'll save money when they stop going to the emergency room and [start] getting regular checkups, but it's going to cost some money up front."
[Editors Note:In March 2010, President Obama signed the Patient Protection and Affordable Care Act (HR 3590), the Health Care and Education Reconciliation Act of 2010 (HR 4872), and Executive Order 13535 which restricted federal funds from being used for abortion services. Pro, Con, or Not Clearly Pro or Con positions made prior to the final wording of these three elements of the health care reform legislation may have changed since March 2010.]
Marc Siegel, MD, general internist and Clinical Associate Professor of Medicine at New York University's Langone Medical Center, stated the following in his July 28, 2010 USA Today article "The ER Myth: No, Health Care Law Won't Cure This Ailment":
"Let's face it: The ER won't turn you away, but individual and overburdened doctors can and will...
Already, we don't have enough doctors. Indeed, the Association of American Medical Colleges estimates that the U.S. will be 160,000 short by 2025. ERs, too, have downsized over time. A yearly survey by the American Hospital Association has shown a 10% decline in emergency departments from 1991 to 2008, despite an increasing demand for such care. So if we have depleted ERs, not enough doctors and millions of more patients, the math doesn't work.
To make matters worse, 16 million more patients will be eligible for Medicaid by 2014, but doctors are limiting the number of such patients they see. Where will these patients go? You got it. The ER. Medicare will soon have the same problem, as more than 70 million Baby Boomers begin to flood the system...
Yet instead of simply complaining about our impending doom as we add 30 million more people to the health insurance coffers, I suggest that the folks in Washington transitioning the health care reform from law into reality must deal with the world as it exists, not as it was sold to the American people...
Consider the ER challenge just one of many we're likely to see as the health care law reveals itself, bit by bit, to the American people."
Angela Gardner, MD, President of the American College of Emergency Physicians, stated the following in a July 19, 2010 letter to Donald M. Berwick, Administrator of the US Centers for Medicare & Medicaid Services, available at www.gardnersgate.blogspot.com:
"Emergency departments in this country handle more than 120 million patient visits per year and utilization of our services continues to steadily increase. As we have learned from observing the evolution of the Massachusetts medical care system, and its near universal coverage, emergency department utilization has actually increased in that state, rather than decreased, as many projected. We believe this is the result of a number of factors, including the federal mandate applied by the Emergency Medical Treatment and Labor Act (EMTALA), the lack of internal medicine physicians and general practitioners in the state, injuries and illnesses that occur after normal physician office business hours, and the fact that emergency departments continue to be the sole source of access to the health care system for many in that state, despite their insurance status. The one true lesson from Massachusetts is that coverage does not equal access.
Frankly, we are concerned that the combination of health care law reforms and the general delay in producing more primary care physicians could potentially overwhelm America's emergency departments, many of which currently operate at or above capacity on a regular basis...
As you know, enactment of health care reform was only the first step. We look forward to working with you to ensure the implementation of these laws help our patients receive the best medical care possible, including maintaining access to lifesaving emergency medical services that are so vital to our communities."