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COST: Emergency Room Utilization on the Rise

Americans are still feeling the effects of the recent economic recession. Many who have lost their jobs have also lost their health care coverage, leaving hospital emergency rooms inundated with people seeking care, according to the Washington Post.

This year, DC's Providence Hospital reported emergency room visits increased by 13 percent. Larry Gage, president of the National Association of Public Hospitals and Health Systems, told the Post, "The absolute number of people using emergency rooms has gone up as much as 20 to 30 percent in the last six to eight months due to the recession and people losing their jobs. The only option in their minds is going to the hospital."

This trend is visible not just in DC and the surrounding area, as the Post reports, but across the nation. Back in April, the American Hospital Association reported that approximately 60 percent of hospitals were seeing more uninsured patients in their ERs, and 70 percent of hospitals were seeing higher rates of uncompensated care.

The problem with emergency room care, as we've discussed before, is that an ER is not a good substitute for primary care. The ER is just that -- a place for emergencies. And emergency treatment is far more costly than simple preventative measures. Additionally, hospitals have no way to provide emergency care for free -- it, like all other care, costs money. The cost of ER care for uninsured patients doesn't disappear. Uninsured patients often are billed directly for treatment but are unlikely to have the ability to pay. This cost strains hospital budgets and can be indirectly shifted onto families and individuals that do have insurance coverage in a "hidden tax" of higher premiums (Most estimates put the hidden tax somewhere between $1,000 and $1,300)

"I'm hearing a lot of people say: ‘Please help me. I lost my job,'" Raolat Abdulai, director of Howard's free clinic, told the Post. "It just shows how desperate things are right now. People really need health care."

An alternative to emergency room care, regardless of insurance status, is a community health clinic. The Post reports that community clinic utilization in Montgomery County has also increased recently, up by 43 percent in the past year. We've argued many times that wellness and preventive care saves money and improves patient health, something which is especially true for the uninsured who seek care in emergency rooms. Many community health centers have received federal stimulus funds, in hopes of expanding their outreach to more patients.

Albertha Boone, a DC resident, suffers from asthma, high blood pressure, and needs knee surgery, but she is unable to afford health insurance and relies on ER visits and over the counter medication to manage her conditions. Rather than seek emergency room care, Boone would probably benefit greatly from visits to a community health clinic. Instead of waiting for her hypertension to grow into something more serious (such as a stroke), she could receive check-ups from a primary care doctor and prescription medications that would allow her to manage her condition.

As we follow the health care debate, (and we know it's easy to get caught up in the drama of DC) it's important to remember why we're having this debate in the first place. Most Americans are not getting the care they need and deserve from our health care system. When we talk about fixing the health care system, we're talking about everything that goes into that conversation -- bringing down costs, improving quality, and making sure that everyone has sustainable, affordable coverage. It won't be easy, but it is necessary.

almost nine in 10 hospital

almost nine in 10 hospital execs believe the current economic downturn will impact them more heavily than the crash of 2001 to 2002.