What a Trip to the ER Says about the American Healthcare System

Sunnie Yi Ning ’18
Contributing Writer 

Last Friday night, I had a severe and abnormal headache. After calling the nurse on call, I waited an hour before getting a response, only to be informed that I should go to the ER. There, after waiting an hour and a half, I was finally seen by the triage nurse, who told me that the average waiting time would be three hours and fifteen minutes that night. Frustrated, I gave up and left the ER.

Afterwards, I looked up the data for the ER waiting room. At Cooley Dickinson, the average waiting time before being seen by a doctor is 48 minutes, and the average time spent in the emergency room before being sent home is 2 hours and 32 minutes. Nationally, patients who need to be seen in one to fourteen minutes are being seen in over twice that timeframe (37 minutes). This means that their symptoms could get worse and even become life threatening – during that waiting time, people’s lives are at stake!

Why do we have to spend so long waiting in the ER before getting treated? The answer is simple:  supply has gone down while demand has risen. ER visits went up by 34 percent from 97 million in 1995, while the number of emergency departments has gone down down by 11 percent during the same period.

The reason for higher demand in the ER is because of its conveniences compared to the primary care system. Although the ER has a long wait time, primary care requires an appointment, meaning days off of work, which many cannot afford. Insurance-linked inconveniences are another cause: in-network health care clinics might be hard to find, and co-pays for referrals can be expensive for low-income families. ERs are closing their doors because nearly half of all emergency services go uncompensated, but the ER is still required to treat all people who come through the door.

The inaccessibility of healthcare shocked me. The basic right of access to health care is severely compromised by worries about cost, time off of work, endless diagnostic tests, unavailability of in-network clinics and expensive co-pay, among other things. Even worse is that the current healthcare structure promotes wealth disparity. Research shows that people with a lower income are more likely to go to the ER than see a primary healthcare provider. Many give up trying to get the treatment they need simply because they can’t afford the time, energy or money. In the end, when minor symptoms become severe ones, people will visit the ER. But even at the ER, many must suffer through a long waiting period before getting proper treatment, which could be life threatening. At the same time, the cost of healthcare continues to soar. In 2015, employer-provided health plans surged nearly 9 percent to more than $1,000, creating an additional burden for American workers. In the end, we have a system where healthcare resources are ultimately more available to the wealthy than for the poor.

It seems to me that the American healthcare system requires a fundamental change to orient itself toward the need of the patients, from decreasing the ER waiting time to giving a wider range of choices to suit individual needs. It requires a change in the mindset of the healthcare industry: to stop seeing patients as consumers and instead start seeing them as people who deserve treatment when they are ill.

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