American healthcare, 2016.

I live in a sparsely-populated rural state.  ER visits have increased in my state.
In the largest city in the state, the top four ER uses are for:

  1. Urinary tract infection.
  2. Strep throat.
  3. Earache.
  4. Non-strep throat.

The cost of healthcare this year, in this one city, for these conditions, generates approximately $200 worth of UNCOMPENSATED HEALTH CARE per year PER CITIZEN of the state.

The use of the ER’s has surged, as the newly insured do not incur the costs of providing the healthcare.  The provision of care FOR EACH VISIT for the above conditions averages $500 PER VISIT.

This one city contains perhaps 50% of the state’s population. I don’t know what the costs are in other cities, towns and rural communities.  If it’s comparable, perhaps it costs the unpaid providers about $400 per citizen per year.

I have not been to the emergency room in years.  Neither has my family.  Of the conditions above, none are life-threatening, and only a STREP THROAT and INFECTIOUS OTITIS MEDIA has any compelling reason to be seen whatsoever.

It sounds compassionate and decent to change amoxicillin to an over-the-counter medication.  Doing so is Third World medicine – it’s bad medicine, it is wrong, and not in the best interests of the community.

People speak of the cruelty and lack of access that the “old” healthcare system offered poor people.  I get it.  To speak in the brutal language of public health care, what damage would be done if ALL those cases were turned away at the door?  Some cases of deafness for OM and serious consequences of strep throat, no doubt.

What would happen if afebrile patients were turned away at the door if they complain of sore throat or earaches, and were just handed an antibiotic for afebrile UTI?

But it costs at least $200 PER CITIZEN PER YEAR for UNCOMPENSATED ER HEALTH CARE for nonemergent ailments.  Probably over $400 per citizen per year – just to run the ER’s!  How long can that go on for?

What else can we do?  I welcome your thoughts.