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Should Insurance Cover Alcohol-Induced ER Visits?

Source: redwolfoz via flickr

Just as the Supreme Court is deliberating over the Obama administration’s mandatory health care coverage, another medical insurance debate is starting to simmer:   Should Emergency Room visits that are instigated by alcohol or drug abuse be covered by the patients health insurance – or – should those costs be borne by the patient themselves?

Recent statistics show that a good majority 0f ER visits involve alcohol or drugs.  In other words someone drinks to much, injures themselves, and needs emergency care.  Think it doesn’t happen often?  Think again;  A recent paper published in the Annals of Surgery show that over half of all Emergency Room or Urgent Care visits are the result of injuries that were caused when the patient had an increased amount of alcohol or recreational drugs in their system.  In other words better than 50-percent of these visits happened after someone drank too much or used illegal drugs.

This study goes on to suggest that medical professionals counsel their ER patients at the time of their care to help them curtail the alcohol or drug abuse.  They hypothesize  that there would be a decrease in the substance abuse, which would in turn help decrease the overall ER patient count.  To extrapolate this further, there would also be less strain on insurance companies bottom lines, which could translate to savings on premiums for average customers.

Meanwhile, at least 25 states in America allow health insurance policy writers to deny payments for ER and Urgent Care treatment of problems that are related to the patients “misuse” of alcohol.  Considering the current overhaul of the health insurance system, many experts predict that some doctors and nurses will forgo substance testing in their patients to dodge the chances of the claim being denied.

What do you think?  Should medical insurance cover the care of patients who bring on claims through their use of alcohol and recreational drugs – or – should these patients be made to pay their own way in these circumstances?

Vitals – ER visits after drinking may not be covered.

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