24 January 2008

Uninsurance Hurts the Insured Too

When I saw this editorial in the New York Times, I had mixed feelings. It's on the Harvard study on emergency room delays. (The article in the Boston Globe on that is here.)Their lede:
The nation’s failure to provide health insurance for all Americans seems to be harming even many of those who do have good health coverage. That is one very plausible interpretation of a disturbing increase in waiting times at emergency rooms that are often clogged with uninsured patients seeking routine charity care.
gives me the sense that one plausible solution is to bar giving medical care to the uninsured via emergency rooms. Although, according to Bush and libertarians, care in emergency rooms is why we already do have "universal health care" in America. The libertarians don't think it's right. It would be a shame if more people came to fear for their own care and instead of doing the right thing, chose to punish instead.

The NYT edit reads, "Uninsured patients — and those who have no primary care doctor — flock to emergency rooms for routine coverage, clogging the system."

It's important to note that it's not just routine coverage that the uninsured seek care for. It's also life-threatening conditions -- which might have been "routine coverage" had it been treated months earlier, in a physician's office.

What's more, part of the problem is that hospitals, needing to compete in a brutal for-profit environment, are closing emergency rooms, and physicians are declining to be part of care for emergency room patients. From the edit: "The Institute of Medicine, a unit of the National Academy of Sciences, warned two years ago that the nation’s emergency rooms were at a breaking point."

In response -- emergency room closures or near misses:That's just a round-up of today's closure news.

Here in Denver, they're closing city hospitals and relocating to the suburbs. Not a problem, say the PR people -- but if you talk with docs and nurses at Denver Health downtown, they're deeply concerned about what the urban healthcare future holds.

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