Who pays more of their ED bill: the uninsured, or Medicaid?

Here’s one study with an answer that’s surprising, and another finding that’s not:

Govt program a strain on U.S. emergency rooms: study

Thu Nov 8, 2007 3:15pm EST

By Lisa Baertlein

LOS ANGELES (Reuters) – The U.S. government’s Medicaid program for the poor may put more financial burden on overcrowded hospital emergency rooms than the nation’s 47 million uninsured, according to a study published on Thursday.

Researchers at the University of California San Francisco and Stanford University found that the uninsured patients paid 35 percent of their overall emergency room bills in 2004, versus 33 percent for Medicaid.

Wow.  Read the rest for the full story of declining reimbursement from all sources, then ask why ED’s are closing.

ED: Wrong Place for Mental Health Care

A terrific editorial right on point.  The author is Susan Stefan, who is director of the National Emergency Department Project at the Center for Public Representation.

Read it all, but here’s a good slice:

Wrong place for mental-health care

By Susan Stefan  |  November 7, 2007

Boston.comHOSPITAL emergency departments are among the least appropriate and most expensive places in Massachusetts for patients in psychiatric crisis. Yet these departments are where police, families, group homes, nursing homes, and others routinely take people who are agitated, panicked, or threatening to hurt themselves. Emergency departments are also where people go at the end of the month when their medications run out, when their primary physicians can’t see them for two weeks, when they are frightened or desperate and have nowhere to turn after 5 p.m. and their therapist’s answering machine tells them to go to the emergency room.

It’s very well written, and worth the time.

It also helps to explain why a lot of us in Emergency Medicine dislike the idea that we’re the “Safety Net” for all of societies’ problems.  We’re not trained and certainly not equipped to take care of every conceivable problem.