Question

reasons why uninsured and underinsured Americans use the emergency room frequently

and which behavioral economics heuristics are relevant to this situation and why?

Answer 1

Ans) Insured and uninsured people masks important differences among the insured. In particular, while the uninsured appear to use the ED slightly more than the privately insured, they use it substantially less than the publicly insured, including the subset of the publicly insured on Medicaid.

- For example, the average number of ED visits for the uninsured (0.18) is only slightly higher than for the privately insured (0.15) but dramatically lower than for adults on Medicaid (0.52). It is Medicaid enrollees’ high ED use that stands out here.

- Second, in contrast to the similarity of ED use by the insured and uninsured, the use of outpatient care and inpatient hospital care is much lower for the uninsured than for the insured. Only about two-fifths of uninsured adults had an outpatient visit, compared to about three-quarters of adults with private or public insurance or on Medicaid.

- Uninsured adults averaged about two outpatient visits per person per year, compared to about six for the insured overall and almost nine for those on Medicaid.

- Similarly, uninsured adults were less than half as likely to have an inpatient hospital admission (3.0 percent) as the insured (7.6 percent) overall, and less than a fifth as likely as those on Medicaid (16.9 percent).

- Thus, while the uninsured are not overrepresented in the ED relative to the insured, they do use the ED for a much larger share of their medical care than the insured do.