NCPA - National Center for Policy Analysis


February 12, 2009

The past decade has seen more emergency room patients than ever before.  Americans are living longer, leading to more chronically ill elderly, but there are fewer primary care physicians available to serve them and other patients.  So patients turn to the emergency room when in the past they would have gone elsewhere, says Carla Keirns, a clinical instructor at the University of Michigan.

According to Devon Herrick, a senior fellow with the National Center for Policy Analysis:

  • It's not the uninsured who burden America's emergency rooms so much as it is people who are carrying government insurance policies.
  • The low reimbursement rates offered doctors by government programs means very few will accept taxpayer-funded insurance any more, leaving those on government plans to visit ERs for care instead of primary care physicians.

People carrying taxpayer-funded insurance are far more responsible for flagrant emergency room overuse than the uninsured, says Herrick.  Emergency rooms have replaced primary care physicians for many Americans, in part because programs like SCHIP and Medicaid pay doctors so little that few will accept patients carrying those insurance policies.  As a result, those patients have become accustomed to going to the ER.

Nick Jouriles, president of the American College of Emergency Physicians, said financial incentives, limited resources, and other factors mean emergency departments find themselves boarding patients for several hours who could be treated outside of the emergency department.

Jouriles warned the unnecessary boarding of patients could create a national safety problem if an emergency happened and a large number of people needed emergency treatment, as too few beds would be free for incoming patients.

What can be done?

  • Keirns suggests lawmakers should think more strategically about elder care and reimbursement.
  • Herrick suggests policymakers should encourage people to receive private care instead of taxpayer-funded care; reducing or eliminating mandates and other barriers to private insurance would allow patients to rely on primary physicians rather than emergency rooms for day-to-day medical care.

Source: Jillian Melchior, "RESEARCH: Uninsured Aren't Cause of Hospital Overcrowding,", February 11, 2009.

For study text: 


Browse more articles on Health Issues