Universal Health Care Probably Won't Help Overloaded Emergency Rooms At All

Emergency rooms are notoriously overloaded. Many politicians and commentators had hoped that Obamacare might help the issue by influencing people to use preventative care instead of waiting to get problems checked at the emergency room. It appears those hopes are unfounded.

A study released last week suggests that the number of emergency room visits is likely to stay the same and clinic visits are likely to go up once Obamacare is fully in effect.

The study by the University of Michigan Medical School and the Robert Wood Johnson Foundation looked at the impact of the Children’s Health Insurance Program (or CHIP), a federal/state program instituted in 1997 that provides healthcare to poor and near-poor children. Currently, more than 7 million children have CHIP insurance.

The researchers, led by University of Michigan emergency physician Adrianne Haggins, M.D., M.S., examined trends and patterns of emergency room visits and non-emergency outpatient visits of Americans between ages 11 and 18 in the years before and after the implementation of the law.

Adolescents provide a good group to gauge the impact of Obamacare because CHIP was the last national program to expand insurance coverage broadly. To control for other factors besides the implementation of CHIP, the researchers also looked at trends for young adults aged 19-29 at the same time. As young adults usually require a similar amount of healthcare as adolescents, they make for a good control group.

Here’s what they found:

  • Outpatient visits rose significantly among adolescents after CHIP went into effect, while young adults’ outpatient visits were flat.
  • ER visits by adolescents stayed flat after CHIP went into effect, while ER visits by young adults actually rose slightly.

Expanded healthcare improves access to outpatient services but does little to help empty out crowded emergency rooms.

If reducing ER visits is a policy goal, universal health care doesn’t look like the answer. According to Haggins, it goes deeper than having insurance or not having insurance.

“Accessing the ER is a cultural learned behaviour partly because the public knows that the ER is always open if they have difficulty accessing care,” said Haggins.

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