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Health Insurance Plan Crisis Hurts Emergency Room Patients

Millions of people in America go without a health insurance plan, yet they still come down with illnesses and injuries they are unsure of how to handle. Although they aren't suffering from a severe ailment that requires an ambulance, Tylenol and a Band-Aid don't help. Many of these uninsured individuals head to an emergency room instead of a primary doctor they may not have. Hospital emergency rooms are legally required to treat every patient that comes through, regardless of their insurance status. Indeed, people with public insurance or no insurance at all were found to have an average wait no longer than those with private plans. This has led to more people jamming the ER for minor problems, which isn't the intended purpose of said facilities.

Crowded ER rooms endanger those people suffering from true emergencies. Hospitals do their best to triage patients and treat them in order of need. A study found that over the past decade, wait times for emergency patients increased on average. In 2006, under half of patients in emergencies were seen within the time frame medically recommended for best outcomes (14 minutes); this figure dropped nearly ten points from 1997. The delay can result in a greater likelihood of complications. After they leave the ER, some of the about 50% of emergency patients not seen in time may be dealing with side effects that drive up their health insurance plans' premiums, or even give them pre-existing conditions that make finding any health insurance at all more difficult.

The flood of non-urgent patients has also negatively impacted the quality and speed of care provided to those with urgent conditions. The speed of their treatment has similarly declined. Unfortunately, such an influx--coinciding with the steadily increasing prices of health insurance rates--has proven to be a struggle for most American hospitals, even with the best triage policies. People with urgent, semi-urgent, and non-urgent conditions can wait hours in the same line. Waiting for such long periods doesn't simply cause annoyance; the results can be unhealthy or even deadly. Having people with a variety of conditions in the same room for an extended length of time can also result in certain diseases being communicated from the extremely sick to the relatively healthy. Since the majority of hospital ER facilities aren't meant to hold so many people, employees are often unable to quarantine those patients who are most ill.

How can emergency rooms be taken back for the people that most need them? The goal of Congress' healthcare reform proposals is to insure up to 96% of the U.S. population. Hopefully, these people will be able to use their newly affordable health insurance plans to see primary care physicians when they've come down with the seasonal flu or a sprained ankle and a pediatrician when their child has an ear infection instead of clogging up the ER. Those doctors would also provide them with preventative care, which is better and cheaper in the long run. Emergency room bills are expensive; while hospital ERs are required to treat a person even if they are unable to pay, the bills can run into the hundreds or thousands of dollars--and some hospitals may hire bill collectors in an attempt to seek payment. Urgent care clinics, such as the Minute Clinic and Take Care Clinic, will also alleviate the load on emergency rooms. They treat many minor medical problems for a flat fee regardless of insurance status, and are often open later than doctors' offices.

Emergency rooms were meant to be a safety net for those in dire straits. After all, it's common knowledge that they are unable to deny medical care, which is a glaring exception in the United States, where some pre-existing conditions can cause someone to be ineligible to buy a private health insurance plan. Instead of a last resort, they have been taken advantage of by the entire health insurance system, patients and plans alike. One of the touted benefits of healthcare reform is that of a almost fully-insured public, which would serve to reserve the ER for those who need it most. Whether that will come to pass is unknown.

(Image: Rosser321 under CC 2.0)

Yamileth Medina

Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can get a health insurance plan right now while waiting for a public option, if it ever gets passed. Yamileth lives in Miami, FL.

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