I've said little about this subject, but a problem I keep hearing about is the cost of emergency room visits by people who treat the ER as a walk-in clinic for minor health issues. I don't know how big this problem actually is, but a friend who works in an ER has been complaining about it a lot lately. She insists that it is enormous costly for the hospital where she is employed. She tells me that they have many patients who have visited the ER for routine treatment dozens of times--for minor earaches, colds, the kinds of things many of us don't even phone a doctor about because we know they will resolve on their own in a few days.
Explanations floating around: uninsured patients who can't pay know that they will be seen by a doctor if they go to the ER; some public aid patients can't find a private-practice physician; some public aid patients would rather not wait for an appointment at a clinic or doctor's office and don't give a rat's ass about the costs they impose upon others. What I hear consistently is that uninsured patients and public aid patients use the ER for very minor problems far more often than insured patients.
I have no way to evaluate these explanations, but it is interesting to me because most insured people I know are extremely reluctant to use an emergency room. Most won't go unless they really think they are in serious trouble.
I suffered a minor ankle fracture two years ago (photo, not for the sensitive viewer). I bought some crutches at Walgreens' and waited overnight to go to a hospital-affiliated walk-in clinic. The cost of my X-Rays and treatment was probably about 1/4-1/5th what it would have cost in an ER.
I'm not advocating an approach as extreme as mine. If you think you've fractured a bone and a decent clinic isn't opened, get to an ER. And enough men and women have died of heart attacks and strokes because they were reluctant to go to an ER. I'm just saying that most people I know don't want any part of an emergency room if it can be avoided.
So in all the talk about health care cost containment, has anyone offered any reasonable solutions to dealing with the problem of patients who chronically abuse the E.R?