A new health care analysis out says that the U. S. emergency care system has serious problems, namely overcrowding, declining access, and "poor capacity to deal with public health or terrorist disasters." Nowhere does the article mention one major cause of at least the first two of those problems. That major cause would be massive numbers of people who go to the ER for non-emergencies. Some of these people have no insurance, and know that they won't be turned away, so the ER becomes their primary physician. But other people do have insurance, and don't care about paying the higher co-pay so they can receive instant care. All of these non-emergency visits strain the system, and raise insurance costs. It seems to me that I've heard of hospitals that wanted to turn away non-emergency patients, but in the end did not succeed. I will try to find some examples of this and post and update.