NCPA - National Center for Policy Analysis


March 10, 2009

Hospital emergency rooms are overcrowded because uninsured patients have nowhere else to turn.  Right?  Wrong, says a study published in the Journal of the American Medical Association.  Hospital emergency rooms are, indeed, jammed.  But it's not for the reason proponents of nationalized health care suggest.

Researchers found most ERs are packed because more patients of all kinds -- insured and uninsured -- are choosing to visit them.  Further, ER patients are being kept there longer than necessary when they should often be checked in or treated in a doctor's office.

Moreover, in conducting the first study of its kind, researchers discovered that other scholarly papers on the uninsured simply assumed that they are the principal cause of emergency department (ED) overcrowding:

  • Among the 127 identified articles, 53 had at least 1 assumption about uninsured ED patients, with a mean of 3 assumptions per article.
  • Common assumptions include hypotheses that increasing numbers of uninsured patients present to the ED and that uninsured patients lack access to primary care.
  • Available data support statements that ED care is more expensive than office-based care, and this is true for all users, insured and uninsured.
  • It doesn't support assumptions that uninsured patients are a primary cause of ED overcrowding, present with less acute conditions than insured patients or seek ED care primarily for convenience.

In fact, Devon Herrick, a senior fellow with the National Center for Policy Analysis, blamed those carrying government insurance for much of the overcrowding of emergency rooms.

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

Source: Editorial, "Shocker! Uninsured not jamming emergency rooms," World Net Daily, March 9, 2009; based upon: Manya F. Newton, et al., "Uninsured Adults Presenting to U.S. Emergency Departments," Journal of the American Medical Association, Vol. 300, No. 16, October 22-29, 2008.

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