"Back in 2007, President George W. Bush was being challenged on his opposition to the Children's Health Insurance Program - which provides health coverage for children in families too poor to afford private insurance, yet too "wealthy" to qualify for Medicaid. His response was honest, if characteristically clumsy: "People have access to health care in America. After all, you just go to an emergency room.""
"By law, ERs must evaluate and stabilize every patient who walks through the door, regardless of complaint or ability to pay. But by saying the quiet part out loud, Bush laid bare an uncomfortable truth: Emergency departments are not just for emergencies, and never have been. I've been an ER doctor at an inner-city trauma center for 35 years. And while I've seen plenty of gunshot wounds, drug overdoses and heart attacks, true emergencies - the kind that animate medical dramas on television -"
Emergency departments are legally required to evaluate and stabilize every patient, regardless of complaint or ability to pay. Many patients use ERs as de facto primary care when no other options exist, including the uninsured, those whose clinicians are unavailable, and people worried about new symptoms. Inner-city ERs manage both severe trauma and a large volume of non-emergent complaints from the "worried well" and the "sick and stoic." Providing high-quality, around-the-clock care without appointments consumes substantial resources and increases costs. The ER functions as a stopgap for gaps in the health care system and strains capacity.
Read at The Mercury News
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