Insured people use emergency rooms more

People covered under health care plan use emergency rooms 40 percent more than those who do not have health insurance, claimed a study.

"When you cover the uninsured, emergency room use goes up by a large magnitude," said Amy Finkelstein, Ford Professor of Economics at the Massachusetts Institute of Technology (MIT).

Finkelstein, along with Katherine Baicker, professor at the Harvard School of Public Health, examined emergency room records for roughly 25,000 people over 18 months.

They found that access to Medicaid - the government-backed health-care plan for low-income Americans - consistently increases visits to the emergency room across a range of demographic groups, types of visits and medical conditions, including types of conditions that may be most readily treatable in primary-care situations.

In no case the researchers were able to find type of conditions for which Medicaid caused a significant decrease in emergency department use. "These results suggest that other Medicaid expansions are unlikely to decrease emergency room use," said the study published in the journal Science.

"If we've lowered the price of the emergency department, we would expect people to use it more," said Finkelstein.

However, Medicaid also lowers the out-of-pocket costs of other types of health care, such as primary-care doctors. Some policy analysts in the US have suggested that expanding Medicaid could reduce emergency department visits by the formerly uninsured by bringing them into more regular contact with primary-care doctors and clinics for preventive care. In theory, that could also reduce overall system costs, since urgent care is expensive.

Prior work by the researchers showed that people who obtain Medicaid increase their use of primary and preventive care. But the net effect of Medicaid in the study was to also increase use of emergency services, the study concluded.