In an attempt to reduce costs associated with unnecessary visits to the emergency room Washington State enacted a new policy limiting non-emergency visits to the emergency room for low-income patients who receive Medicaid benefits to only three per year.
In response to this new policy the American College of Emergency Physicians has decided to sue the state of Washington, saying that this policy could actually lead to increased costs in the long-term, and could even lead to an increase in mortality.
The main problem with the policy is the list of symptoms that the state considers “non-emergencies,” including difficulty breathing, dizziness, early-pregnancy hemorrhage, gall stones, abdominal pains and chest pains not related to a heart attack, all of which, the state contends, could easily and more economically be dealt with in the context of a regular doctor’s visit.
The president of the Washington chapter of the ACEP Steve Anderson refutes this contention:
“The ACEP is opposing the limit primarily because of the list of diagnoses that the state is proposing to be non-emergencies, like chest pains and heart arrhythmias and dysrhythmias, which can result in sudden death, sudden blindness, and hemorrhages during miscarriage.”
Government officials assert that the new policy, which went into effect on October 1, 2011, will reduce the cost of emergency room overuse by about 35 million dollars of taxpayers’ money per year.
Seattle doctor Nathan Schlicher explained that the three visit limit could actually end up costing Washington State more money in the long-run. Some people might get more ill, and a large number of the conditions on the state’s non-emergency list are actually clarion calls that more serious health problems are brewing.
“There’s chest pain on this list, there’s issues of kidney stones, there’s hemorrhage and pregnancy, a threatened miscarriage,” Schlicher said.
Josyann Abisaab, MD, is an emergency room physician at Presbyterian Hospital in New York City.
Josyann Abisaab MD 