Tuesday, March 9, 2010

Don't blame the ER

At the center of this discussion [of wasteful health care spending] are "unnecessary" ER visits for minor conditions—colds, headaches, and feverish babies—that could be handled more cheaply in doctors' offices. If we could only convince patients to take their stubbed toes to urgent-care clinics or primary-care offices instead of ERs, the thinking goes, we could save a load and help fix this whole health care fiasco.

But there are a few problems with this logic. While the past decade has seen dramatic increases in the use of emergency care and ER crowding, ER care is but a tiny portion of the U.S. health care pie: less than 3 percent. The claim that unnecessary visits are clogging the emergency care system is also untrue: Just 12 percent of ER visits are not urgent. People also tend to think ER visits cost far more than primary care, but even this is disputable. In fact, the marginal cost of treating less acute patients in the ER is lower than paying off-hours primary care doctors, as ERs are already open 24/7 to handle life-threatening emergencies. And while we're at it, let's dispel one other myth: Despite the belief that the uninsured and undocumented flood ERs, most emergency room patients are insured U.S. citizens.
--Zachary Meisel and Jesse Pines, Slate, on where the big health care savings ain't

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