Adele Ferguson - Why people wind up in emergency rooms

A BELIEF I HAVE held for years as to a prime reason for the high cost of health care got knocked for a loop the other day by a news story in USA Today.

It is not vast numbers of people without health insurance who take their health problems to emergency rooms because they know the law mandates treatment whether they can pay for it or not. This way, I reasoned, they avoided doctor bills and the taxpayers got stuck for the much, much higher cost of the ER.

But it has nothing to do with insurance.

“People come to the ER when they need to come to the ER,” says Angela Gardner. president of the American College of Emergency Physicians.

One of the factors that drives people to the ER, according to a new report by the Centers for Disease Control and Prevention, that has nothing to do with insurance is the impatience to have a non-severe problem evaluated in same day service.

Further, many such patients have consulted their personal physician who sent them to the ER, if the emergency occurred during the days and hours medical offices are open. But if you hurt yourself or get sick during the evening hours or overnight, there is no place to go for immediate treatment than the emergency room. If you call 911, the nearest ER is where you’ll be taken, unless your injury requires a wider range of specialists or equipment in which case they will take you to the nearest ER providing that.

The report in USA Today made its investigation into who used the ER in 2007. Total number evaluated was 116,802,000. It divided ER users that year into age groups and their types of insurance. In the under 18 group, 27 percent used Medicaid, 17 percent had private insurance and 18 percent were uninsured. The rest? Doesn’t say. Those categories for ages 18 to 44 were 38 percent, 17 percent and 21 percent. Those aged 45 to 64 came out 39 percent, 16 percent and 19 percent. Those over 65 were not tracked other than 27 percent used Medicare, or Medicaid, 32 percent used both.

HIGH MEDICAID use of ER was no surprise, according to the study, because many patients can’t find primary care physicians who will take Medicaid patients.

I decided to ask was this trip necessary of people I knew had used the ER, starting with myself. I have been twice in my lifetime, both times for labyrinthitis, where your inner ear gets cockeyed and you suffer extreme vertigo and upchucking. The first time I called my doctor at her office and she sent me to the ER. My husband took me. The second time it was night, I was alone at home and called 911 for transport.

My husband made two ER visits, once when he fell on a slippery deck at home and suffered a head injury. The second turned out to be pneumonia. I called 911.

I asked my hairdresser if she had ever gone to the ER and she said yes, sent there by her doctor for abdominal pain. Her husband fell and broke his hip and once cut some finger tips off at home. Another hairdresser at her shop had been an ER patient for a hiatal hernia attack.

MY BROTHER was sent to ER by his doctor for a severe gall bladder attack. His wife took a visitor to ER when he spilled hot grease on his hand while cooking blackened salmon and her mother and aunt when they suffered heart attacks.

Now, it’s obvious that all these people genuinely required emergency care and all had insurance of some kind. I can only presume that the people using the ER who don’t have insurance had just as genuine a health problem as we all did.

But I no longer believe they are just ducking the doctor. The fact they can’t afford insurance or a doctor visit doesn’t keep them from seeking help. People come to the ER when they need to come to the ER.

(Adele Ferguson can be reached at P.O. Box 69, Hansville, Wa., 98340.)