I think a lack of education is a large cause of the frequent visits for minor, non-ER problems. When I recently had an Ortho situation on Saturday, I called my primary and he ordered an X ray. I went directly to Radiology, bypassing ER altogether. They sent the results to him and he told me I needed to see Ortho, which I then did - on Monday. Saved an ER run, an ER fee, which I'd have been charged for using ER but not being admitted, and saved an office visit co-pay to primary doc. Feel sort of guilty that primary didn't get paid for his role but not that guilty. Why should I clog up the system with my painful, urgent, but non life-threatening, fairly minor problem and why should I have to spend hours and bucks to sit in an ER and still get the same treatment I arranged for myself? Hmm, maybe they should pay me the copay!
Anyway, education on how to treat cuts, scrapes, minor trauma, and the like could de-clog the ER's a lot.
Another thought: bill charity recipients for ER usage for non-ER stuff. Make them pay a co-pay, just like we have to if we are insured. Enforce this, force payment by cutting out some of their benefits until the ER charges are paid. Must be careful, of course, to not cause death or disfigurement by this policy, or starvation. But I know lots of welfare recipients who somehow always have money for beer, cigarettes, hair extensions, cell phones, and acrylic nails. How do they do this yet not have money for ER????? I think they (at least, the people I personally know) buy stolen goods (DVD players, computers, etc.), they run up cell phone bills that they never pay. I say this because I see them with the phones this month but the phone is gone next month. Then in a few months, they have another one - different one, different company, then that one is gone shortly. I do understand their plight, I do believe there are plenty of white collar criminals that go unpunished, it all just makes you wonder.