ER Overload

My husband is active duty military, we live in San Diego, and for the last six months EVERY time I call for an appointment for my child or myself, we are told that there are none available and to go to the Emergency Room. So, I need a follow up on some medication, sorry none available go to the ER. My son needed immunizations, and there were no appointments available, so I had to take him to Public Health! My neighbor had to take her children for basic services such as a rash that needed medication and a sore back. Why do we even have insurance, if we can NEVER get an appointment??

The reason the ED is packed is multifactorial:
#1 The uninsured/illegal immigrants DO fill the ED. Anyone who does not believe this to be true PLEASE call me and we will visit the local ED.
#2 The insured who come to the ED, come because there are FEW primary care Docs that will see same day patients with minor illnesses. Why won't they see the same day minor illness patients you ask? Reimbursement is negligible-not worth the time to file the claim ($37-40)!!!!!! The Docs will see the Annual exam and get re-imbursed at a higher rate.....Let us be honest.
#3 The other reason patients visit / frequent the ED is for work up of problems that PREVIOUSLY were worked up in the hospitalized patient. Insuranc will no longer allow patients to be hospitalized for work up of less acute/chronic problems so the patient is referred to the ED to undergo a quick workup (one stop shopping).
Unfortunately IT IS ALL ABOUT FUNDING......If Pres Obama cuts the funding guess what???? Your local hospital will be as efficient as the local post office.
edwdwells

have to sit and wait for the doc to take care of the *** and their bullet wounds first!!

While I see that Dr Newton is correct in much of her analisys of the problems, I disagree with her statement about the Emergency Medical Treatment and Active Labor Act .

I lived in Dallas and Fort Worth, Texas for 9 years prior to my wife???s death. She was chronically ill with Rheumatoid Arthritis. We both had good insurance but only once or twice went to the ER because it was always full and the wait was measured in multiple hours. We went to Urgent Care Facilities if it was after the normal Dr. Office Hours. The problem we had in Texas was Illegal (undocumented) Aliens. The ER was always packed and no one spoke English. Don???t even try to get into an ER on Friday or Saturday night at John Peter Smith Hospital, Harris Methodist, or Parkland???.the line is out of the door.

While, as Dr. Newton says, there may be a bill sent to people that used the ER, they would never be paid. The people would give fake addresses and the bill would just be returned. Without valid identity devices, they could use any address. There was a group that had fake IDs generated using an abandoned lot as the address for the bill. Every year, our property taxes to support the hospitals went up, ER Facilities closed down, and the remaining county / city supported ER became more packed and on the edge of bankruptcy.

Many of the "insured" patients have Medicaid or a Medicaid HMO plan. This insurance costs the patient nothing as does their ER visit. I see, on a daily basis, the abuse of this system by patients who simply refuse to make or keep an appointment at their local community health center or other provider. ER care is extremely expensive and is not designed to provide primary care service including colds,sore throats or vaginal infections

Included in the "insured" group would be Medicaid and Medicaid HMO patients. This population makes up a significant number of ER users. I experience this daily as a pharmacist that serves the Medicaid population. Many of these visits could be handled at the patients primary care office or Community Health Center. A sore throat,cold or vaginal infection is not an emergency .