Nothing could be further from the truth.
The fallacy of this tale was formally demonstrated in an article in the Journal of the American Medical Association, which showed that the overcrowding in American ERs is NOT due to the uninsured. Rather, it is due to insured Americans who cannot get in to see their primary care physicians.
But it really should not take a peer-reviewed study like this for us to understand the fallacy in the idea that ER overcrowding is caused by the uninsured. After all, a large proportion of the uninsured are people who have assets. (If they had no assets they likely would be eligible for Medicaid.) That is, they are people who may have jobs, homes, cars, bank accounts, etc., but their employers (who, in many cases, are themselves) cannot afford to provide them with health insurance. The chief point being, these individuals have something to lose.
These are not the people who will voluntarily enter an ER, at least, not readily. These are the people who will sit at home for hours or days, hoping against hope that some medical "issue" they're experiencing (such as, perhaps, crushing chest pain, or paralysis of the left side), will just go away. They do not behave like insured individuals who, when faced with similar medical issues, will just go ahead and dial 911, all willy-nilly. The uninsured realize that the moment they set foot into an emergency room it will cost them at least several thousand dollars, which they will either have to pay, or spend months or years fighting off the increasingly intimidating, commission-based bill collectors being dispatched these days by your friendly local hospitals. The uninsured are putting their assets and their futures at risk if they come to the ER.
ER overcrowding is really caused by people who have insurance - whether it’s Medicare, Medicaid or private insurance - and who are therefore entitled to their healthcare by whatever means they calculate is the most convenient. Increasingly, because primary care practices are hard to find, are booked for weeks in advance, and are less and less user-friendly by the day, the convenience calculation tends to default (incredibly) to the ER. (That insured people are choosing ERs - notoriously one of the most unpleasant experiences American citizens can encounter in peacetime - instead of primary care offices should itself set off major alarms about the state of American primary care.)
This should all be pretty obvious and intuitive, and the truth really should surprise only those credulous folks among us, who habitually believe the “official” truths being advanced today by politicians, media, and various authorities on healthcare.
Here's some useful advice for those without health insurance from About.com's Guide to Health Insurance.
More of the Top 10 Overblown Health Stories of the Decade.
Sources:
Newton MF, Keirns CC, Cunningham R, et al. Uninsured Adults Presenting to US Emergency Departments: Assumptions vs Data JAMA. 2008;300(16):1914-1924.
