E.R. crowding: are the uninsured to blame?

• Author: Bailey, Ronald
• Position: Citings

ACCORDING TO the conventional wisdom, as enunciated by an editorial in the October 31 Raleigh News & Observer, "We all pay for the uninsured already: those patients without access to a 'medical home' simply clog our emergency rooms with non-urgent matters." As is often the case, the conventional wisdom turns out to be wrong.

For a study reported in the October 22, 2008 Journal of the American Medical Association (JAMA), researchers at the University of Michigan evaluated 127 peer-reviewed articles that made claims about the impact of uninsured patients on emergency room crowding. They concluded that "available data do not support assumptions that uninsured patients are a primary cause of overcrowding, present with less acute conditions than insured patients, or seek [emergency room] care primarily for convenience."

The JAMA study also found that patients with public insurance, such as Medicaid and Medicare, are more likely to crowd into emergency rooms for minor complaints than are the uninsured. Only about 17 percent of E.R. visits in the United States in the last year studied were by uninsured patients, about the same as their...