One of the problems is poor primary care and a gap in urgent care. In many cases, patients have no way of getting triage advice over an issue that occurs at 3 A

One of the problems is poor primary care and a gap in urgent care. In many cases, patients have no way of getting triage advice over an issue that occurs at 3 AM, leaving with a choice of waiting till morning then going to a doctor (after waiting or scheduling), or going to the ED. This article is the perfect storm of all these dysfunctions combined: - no triage available, so went to ED (a sane choice in the absence of medical advice). - the ED is required to make sure the Patient doesn't have some critical condition, so they will be zealous with tests. It's usually not a motivation for profit, it's a desire to make sure they don't miss some condition that may be less common but could cost the life of the patient. That risk assessment is usually different from what many patients are willing to accept. - the insurer is trying to curb on unnecessary ED visits which, unfortunately is a problem many EDs face. Having a team of critical care workers tend to benign issues is terribly inefficient for both the patient and the hospital. The hospital passes the bill to the insurer who is then scratching their heads when they see so many resources used to treat something so benign. Now of course there's the issue of very critical issues that present with very generic symptoms: your head ache could be a simple dehydration or some busted blood vessel in the brain; the ED will have to rule out the latter before declaring it to be a non-consequential headache. This is why traditionally insurers have paid up without much of a fuss. But we need to fix all these problems. If 24h urgent care were more readily available (via tele-health AND in-person), a lot of this could be avoided.