Aaron Carroll and Austin Frakt separate emergency care from necessary care:
Emergency care is important, but it’s not the same thing as health care. We know that people with depression require treatment, but in an emergency room we can’t do anything about it until they are ready to commit suicide. We may know that you would benefit from a hip replacement, but until it fractures, there’s not much that will be done in an emergency department. We may know you have arthritis, or ulcerative colitis, or migraines, or lupus, or hypothyroidism, or any of a host of other disorders, but until they are life threatening – there’s not much we can do for you.
The consequences of this attitude are real and significant. First, the emergency room is still not free; the hospital will likely bill even those will few resources, potentially bankrupting them. The costs to the system are prohibitive, since often the end-stage emergencies of chronic disease are significantly more costly than proper management. But most importantly, the suffering this “system” adds to those who are ill is inhumane, unnecessary, and hard to accept in the richest country in the world.
The Dish 