• The ER still isn’t the same as health care

    Steve Benen notes that evidently, some politicians are still trying to make the argument that the emergency room means that everyone gets health care:

    I’d hoped we hear the argument much less after the Affordable Care Act became law, but the notion that the uninsured can just rely on emergency rooms hasn’t gone away quite yet.

    Here, for example, was Virginia Gov. Bob McDonnell (R) on Fox News the other day:

    “The fact is a lot of people that don’t have insurance are getting [care] right now. They’re not denied in the emergency rooms. They’re generally not denied by doctors. It’s not a pretty system, but the idea that people are not getting health care particularly for critical needs is just — is just not the case.”

    This is silly, but just won’t go away.  Yes, you are guaranteed care for emergencies in the emergency room.  There are so many reasons why this is not the same as “health care”, but I’m going to list just a few:

    1. The ER is still not free.  You still get billed.  It can still bankrupt you.  And it’s expensive.
    2. Even if it’s free, someone (taxpayers) have to pay.  Why is Gov. McDonnell OK with that?
    3. You cannot get primary care in the ED.  No screening tests.  No vaccinations.  All the stuff we want people to do, you can’t get done in the ED.
    4. You cannot get chronic disease management in the ED.  No diabetes care.  No asthma care.  No ongoing care.
    5. If you wait until you get sick enough to go to the ED, you’re going to be less healthy than if you had received care earlier.

    Is that enough?

    This is like arguing that since you can take your car to the shop when the engine dies you never should get the oil changed or the gas tank filled.  You need both.

    • Add to #4: No chemotherapy. No organ transplants.

      And it’s like arguing that (emergency) engine repairs are enough, when in fact you need not only the oil changed routinely but also the (threadbare) tires replaced.

    • Don’t you mean “ER” and not “ED”??

    • “ED”=Emergency Department. what we call them now

    • The group that should also be mentioned are those that need fairly aggressive treatment to stave off kidney failure. Sure, they can just wait until it is an emergency, ie their kidneys have failed. Cheaper in the long run if avoid it.

      I anesthetize a lot of kids (I like most kids more than most adults). I am seeing more kids come in with what should have been minor problems, but due to lack of ability to pay, are showing up in the ED as real emergencies. Breaks my heart to see these kids so sick.