Despite the state’s move towards universal health insurance, visits to Massachusetts emergency rooms went up 7% between 2005 and 2007. This is consistent with a 2008 study in the Annals of Emergency Medicine showing that the primarily driver behind an increase in emergency room utilization from 1996 to 2004 was lack of access to convenient care, not lack of health insurance. In this study, uninsured individuals accounted for less than 16% of emergency room visits.
The moral of the story: health insurance coverage does not equal access to care, at least not as long as we have a shortage of primary care physicians. Ensuring access to care requires transforming our payment system, addressing the structural defects in healthcare delivery, and revitalizing primary care.
