The study seemed to push back on other commonly held beliefs about emergency rooms, too—ideas that have shaped policies in questionable ways. For years, for example, insurance companies have penalized policyholders for using emergency rooms by making them pay higher copayments and coinsurance for ER service in an effort to keep people from seeking the most expensive care. The RAND study seems to raise the question of whether such a financially punitive approach is a good thing. “The ER is the only place where Americans have a legal right to care, but we don’t make a commitment to pay for it,” Kellermann said in a phone interview. In other words: If emergency departments are to play a key role in patient care in the new medical order, why should patients be penalized for seeking care in them?

Warren Robak, deputy director of RAND’s office of media relations, says that some studies they release get a lot of press and then fade away. Others get very little but end up having long legs. This is one that should.


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Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.