It seems that the rise in ER use comes not from the poor uninsured but from a much more affluent income sector.
From the Wall St. Journal Health Blog:
Rich, Not Poor, Are Crowding Emergency Rooms:
This is the conventional wisdom: Priced out of health insurance, ever more Americans are crowding into emergency rooms because they can’t afford a trip to the doctor.
Yes, ERs are getting busier. But it’s not because of poor people or the uninsured, according to this analysis in the Annals of Emergency Medicine.
The study is based on national surveys conducted between 1996 and 2004. During that time, overall visits to the ER increased by 26% — but a disproportionate share of the growth came from those whose incomes put them at more than four times the poverty level, and who typically get their care at a doctor’s office. The percentage of uninsured ER patients remained flat, at roughly 15%.
The researchers did the study because the conventional wisdom didn’t seem to match the on-the-ground experience of ER docs. Instead, they saw a rise in ER traffic across the demographic spectrum, said Jonathan A. Showstack a study author based UCSF’s Institute for Health Policy Studies.