Straining Emergency Rooms by Expanding Health Insurance

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Science  17 Jan 2014:
Vol. 343, Issue 6168, pp. 252-253
DOI: 10.1126/science.1249341

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The crowded, chaotic emergency room (ER) is often invoked as a symbol of all that's wrong with the American health care system. The uninsured, the story goes, cram into ERs—legally prohibited from turning away patients—for routine medical attention that could be provided more cost-effectively through primary care providers (also known as general practitioners in many countries). It's an image of America's dysfunctional approach to providing “free” health care for those who cannot afford it. In policy circles, this take on ER medicine has been cited by, among others, Health and Human Services Secretary Kathleen Sebelius, as justification for universal health coverage, because the current system “has forced too many uninsured Americans to depend on the emergency room for the care they need.”