>if someone needs to treat cancer, it doesn't make any good to go to an emergency unit
That's because the ER is meant to stabilize a patient, not cure chronic disease. Which is to my point: people will forgo preventative medicine until their condition deteriorates and they need to be stabilized in an ER. People get their non-emergent conditions treated all the time in American emergency rooms.
E.g., if I have diabetes, an ER will not put me on a long-term treatment plan. But if I ignore my disease until I start having hypoglycemic symptoms an ER will treat me until I am stabilized enough to be released. Is this the best system? Absolutely not, but it's much different than saying "only the rich have access to healthcare".
FWIW, I used to work in healthcare, including redesigning ER processes
And how would anyone know if he has diabetes (for example) if the person doesn't have regular visits to medical facilities? In such a case they will go to emergency only when an emergency happens, probably when it is already too late. By saying that such a person has access to health care, you're just redefining health care to "emergency health care".
If this was not enough, hospitals are catching up to the "loopholes" in the law and abandoning poor neighborhoods, to make it even harder for people to use emergency rooms.
In the example of diabetes, many people are diagnosed when they show later term symptoms that require an ER visit. Since it's chronic, they won't be "cured" of the disease, meaning an ER can be their main mode of healthcare and the main mode of being diagnosed.
You may not understand the nuances of the article you referenced. Take Detroit, one of the cities used to support the claim in the article. The baseline decade used is the 1960s. Detroit has only about a third of the population it had in the 1960s so it's not rational to think they would maintain their previous healthcare infrastructure. Further, much of that population left for the suburbs of metro Detroit, meaning the healthcare facilities being built are just following the population demographics. Add onto that the point that healthcare has changed dramatically over the last 60 years with much more emphasis on outpatient care, and there are rational, non malevolent reasons to decrease the number of urban hospitals
Curious, in your healthcare experience, what would you estimate is the percentage of people who do have good insurance, but don't get preventative care by choice?
E.g. for myself, I have good insurance, but I don't have a "primary care doctor." I don't go to the doctor unless I'm injured or sick. And I don't mean a sniffle or cough, I mean sick as in I have felt awful for several days.
I don't think I have a good representative sample because facilities I worked for were a specific sub-population that would probably have a very high percentage that fall into the category of "no need for healthcare until something is broken or bleeding profusely"
With that said, it seems to be quite a bit and skewing higher for males than females.
If you have insurance and are not going for a routine exam once a year, you're doing a disservice to yourself because you miss the opportunity to catch issues that can be easily fixed when caught early but catastrophic if not. In fact many corporate policies require people to have regular exams exactly for this reason.
A lot of countries do not do “yearly physicals” like the American healthcare system recommends. This is because in countries with universal healthcare, patients within the country go to their GP/Primary Care Doctor far many more times on average than the typical American. So, in many countries, this practice is non-existent, basically because people just go to the doctor whenever they feel it is necessary—and far more often than the typical American does.
The average American sees a doctor 3 times per year. In France it is 6-7 times per year. In Japan, it’s 13 times per year. This statistic is directly linked to the cost of care.
That's because the ER is meant to stabilize a patient, not cure chronic disease. Which is to my point: people will forgo preventative medicine until their condition deteriorates and they need to be stabilized in an ER. People get their non-emergent conditions treated all the time in American emergency rooms.
E.g., if I have diabetes, an ER will not put me on a long-term treatment plan. But if I ignore my disease until I start having hypoglycemic symptoms an ER will treat me until I am stabilized enough to be released. Is this the best system? Absolutely not, but it's much different than saying "only the rich have access to healthcare".
FWIW, I used to work in healthcare, including redesigning ER processes