NCPA - National Center for Policy Analysis


July 7, 2010

A new report from the National Center for Health Statistics (NCHS), the nation's chief health statistics agency, suggests the longstanding perception uninsured patients are clogging the nation's emergency rooms (ERs) is a myth.  There is a widespread perception uninsured patients are a leading source of unnecessary ER visits because they lack a primary care provider, a perception echoed by President Obama and other political leaders as a rationale for their recently passed health care legislation, says Devon M. Herrick, a health economist and senior fellow at the National Center for Policy Analysis. 

The report finds ER use is more closely associated with Medicaid enrolled patients.  They seek care in the ER more frequently than both the uninsured and those covered by private insurance. 

Other findings: 

  • Nearly one-third (32 percent) of Medicaid enrollees used the ER at least once during a 12-month period in 2007.
  • Individuals with private health coverage were only about half as likely (17 percent) to visit an ER, and a similar proportion -- one in five -- of individuals without health coverage did so.
  • Medicaid enrollees were three times as likely (15 percent vs. 5 percent) as the privately insured, and twice as likely as the uninsured (15 percent vs. 7 percent), to have visited an ER twice in the previous year. 

Nearly 120 million ER visits are made in the United States each year -- approximately 11 percent of all U.S. ambulatory care visits.  Some of that care could be done elsewhere, says Dr. Stephen Nichols, a regional medical officer for Schumacher Group, which contracts for emergency department services at community hospitals. 

"In general, 5 percent to 25 percent of patients who visit an emergency department in a community hospital have non-urgent complaints that could easily have been addressed in an outpatient setting," he says. 

Dr. John Dunn, a specialist in emergency medicine in Brownwood, Texas, agrees and thinks the number of non-emergencies is even higher.  "Thirty percent to forty percent are emergencies or urgent care and deserve treatment within a reasonable time," says Dunn.  "But it is care that could be seen to in an urgent care clinic or a well-equipped office, though the patients probably are better off in the emergency department." 

Source: Devon Herrick, "Report: Uninsured Emergency Room Use Greatly Exaggerated," Heartland Institute, July 7, 2010.

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