A reportagem do The Wall Street Journal exagera a chamar de ricos aqueles com renda quatro vezes acima do nível de pobreza nos Estados Unidos. Mas, mostra o quão complicado é a situação da assistência médica naquele país. O acesso a consulta não é simples. A marcação de consulta em consultório é tão complicada quanto no nosso serviço público. A hora marcada não é bem na hora marcada e, por aí vai uma série de problemas no relacionamento médico-paciente que desemboca na procura do pronto-socorro para atendimentos de problemas sem risco de morte. April 8, 2008, 2:52 pmRich,
Not Poor, Are Crowding Emergency Rooms Posted by Jacob Goldstein
This is the conventional wisdom: Priced out of health insurance, ever more Americans are crowding into emergency rooms because they can’t afford a trip to the doctor.Yes, ERs are getting busier. But it’s not because of poor people or the uninsured, according to this analysis in the Annals of Emergency Medicine.The study is based on national surveys conducted between 1996 and 2004. During that time, overall visits to the ER increased by 26% — but a disproportionate share of the growth came from those whose incomes put them at more than four times the poverty level, and who typically get their care at a doctor’s office. The percentage of uninsured ER patients remained flat, at roughly 15%.The researchers did the study because the conventional wisdom didn’t seem to match the on-the-ground experience of ER docs. Instead, they saw a rise in ER traffic across the demographic spectrum, said Jonathan A. Showstack a study author based UCSF’s Institute for Health Policy Studies.“Focusing the political debate and the health-care debate about the overuse and sometimes the ‘abuse’ of emergency departments by the poor and the uninsured is really missing the point,” he told the Health Blog. “It’s based on the wrong assumptions and an incorrect interpretation of what’s really going on.”While expanding health insurance coverage may sound like a big enough issue to tackle, the findings of the study suggest that it wouldn’t do much to slow the influx of patients to emergency departments.Instead, the the authors conclude, “increase in ED use may be attributable to lack of ready access to primary care and other structural problems in the health care system.” Trying to fix those will make the insurance issue look easy.