The uninsured, it’s said, use emergency rooms for primary care. That’s expensive and ineffective. Once they’re insured, they’ll have regular doctors. Care will improve; costs will decline. Everyone wins. Great argument. Unfortunately, it’s untrue.
A study by the Robert Wood Johnson Foundation found that the insured accounted for 83 percent of emergency-room visits, reflecting their share of the population. After Massachusetts adopted universal insurance, emergency-room use remained higher than the national average, an Urban Institute study found. More than two-fifths of visits represented non-emergencies. Of those, a majority of adult respondents to a survey said it was “more convenient” to go to the emergency room or they couldn’t “get [a doctor’s] appointment as soon as needed.” If universal coverage makes appointments harder to get, emergency-room use may increase.
Samuelson goes on to question whether extending health insurance to the uninsured would really do much to improve their health. I share his skepticism, but it’s worth pointing out that a desire to improve health outcomes isn’t the only reason to wish more people had insurance: Lack of health insurance creates a lot of financial anxiety for a lot of people. That’s a good reason for reforms that would make insurance more affordable even if those reforms would not do much to improve health.