The trou­ble with free-stand­ing ERs

The Washington Post Sunday - - SUNDAY OPINION -

Re­gard­ing the May 8 front-page ar­ti­cle “De­tach­ing the ER from the hos­pi­tal”:

Our health-care sys­tem is plagued by a cri­sis of high costs, un­equal ac­cess and poor (as com­pared with other coun­tries that spend far less per capita) out­comes. Richard Yount, who opened a free­stand­ing emer­gency room, sought to de­velop a ser­vice where “money just fell in your lap.” Mr. Yount and po­lit­i­cal and busi­ness lead­ers seem to be­lieve that health care is like any other con­sumer good and that it is okay to let com­pa­nies reap large prof­its from pa­tients with the per­sonal as­sets or in­surance cov­er­age to pay pre­mium rates for ser­vices they may not need. They also ac­cept that other providers, who have a moral com­mit­ment or reg­u­la­tory obli­ga­tion, will pro­vide care to the less for­tu­nate, of­ten at a fi­nan­cial loss.

Free-stand­ing ERs di­vert well-funded pa­tients from com­mu­nity and other hos­pi­tals that form the health-care safety net for the poor, the el­derly, the unin­sured and the med­i­cally com­plex. These free­stand­ing ERs also in­crease the cost of care by du­pli­cat­ing and of­ten un­der-uti­liz­ing high-cost equip­ment and by com­pet­ing for scarce per­son­nel in or­der to treat the priv­i­leged few.

The new ad­min­is­tra­tion as­serts that the “free mar­ket” and en­tre­pre­neur­ial in­no­va­tion can solve the prob­lems of our health-care sys­tem. If free­stand­ing ERs and for­tune seek­ers such as Mr. Yount rep­re­sent the best that the mar­ket can pro­vide, we are all in trou­ble. Roberta Shapiro, Wash­ing­ton

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