Friday, April 9, 2010

It's Not What You Think

A few weeks back, I took care of an older lady who was quite vocal about her displeasure with the care she received in the ED. Sent by her doctor for an evaluation by one of our neurologists, the patient was not happy to learn that the neuro resident was covering the entire hospital, and that she was nowhere near the top of his list. As her wait dragged over several hours, she was eventually moved into the hallway to make room for incoming patients.

Throughout her visit, as I checked on her several times, she became increasingly upset. She explained to me that she had chosen her career over having a family, had earned a great deal of money, and did not feel she deserved to be subjected to the realities of an over-crowded urban emergency room. "I know it's all those people without insurance," she told me, "that are causing me to wait. It just isn't right."

Despite my explanations that, as a major trauma center, we treat anyone who walks through the door, and that most of our patients are in fact insured, she continued to cast disparaging looks at her fellow patients, imply that her wealth entitled her to better care, and mutter about the uninsured.

Well, next time she comes back I'll have some numbers to back up my claims. According to a study published last month, 60% of frequent ER users (the 8% of ER patients who account for 28% of ER visits) are enrolled in Medicare or Medicaid. Only 2% of uninsured adults visit the ER four or more times per year, states the article.

So take that, Mrs. Howell. Turns out those dirty, sick, injured masses you wouldn't deign to share the hallway with are in fact just like you - insured, working individuals who simply can't get an appointment with their regular doctor or are told to get a work-up in the ER.

Insurance doesn't equal access.

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