Actually, a lot of over-utilization of the ER comes from people with employer-paid health insurance. If benefit levels are lowered for ER claims, patients go to the ER less and yet still go when they should (they just don't go when they shouldn't). People with health savings accounts utilize the health system at a lower rate than people with employer-paid benefits (though they still have health as good as those in employer-paid plans).
The last time I was in the ER there were a lot of morons there with ailments that should have been treated in a doctor’s office. My rule of thumb is very simple: If it ain’t bleeding, broke, or on the outside when it should be on the inside, then don’t go to the ER.
I don't believe that. When I've had to go to the ER, the place is full of hispanic faces. Few are speaking English. Few of them appear to have a real emergency problem. The ER staff grabs the real bleeding/broken bone emergencies ahead of the rest who are using the ER for "free" healthcare. This abuse is the reason many ERs are closing. If everyone coming to the ER had employer-paid health insurance, they wouldn't be drowning in red ink. They would be flush with cash from exorbitantly priced ER services. It is those with insurance that keep the ERs from completely shutting down.