Why is ER So Expensive, and What Happens If You don’t Pay The Bill

ER stands for the emergency room. If we rank the health care service providers, it comes after primary care and urgent care center. As its name suggests, the emergency room provides services to patients in extreme emergencies. There are different types of emergencies.

Non Fatal Medical Emergency

It is the type of situation in which a patient is suffering from a situation that is not serious enough to take its life but still, it is excruciating and sickening. For example, a person who slipped on the wet floor broke his leg. He would immediately be rushed towards the emergency room.  Analyzing his situation, he would be referred to a physician or an orthopedic specialist. The doctor would decide that either the patient should undergo surgery or not and then provide suitable treatment.

Fatal Medical Emergency

It is the type of situation in which the patient is suffering from a life-risking emergency. For instance, a patient with the case of severe food poisoning arrives. The doctor immediately arranges a bed for him. Several different liquids mixed with drugs would be given to him  through the drips. His BP would be continuously monitored. A nurse would be appointed to take special care of the patient so that his health condition can progress towards a stable state. If the same patient is not brought on time or not appropriately treated, he could also die.

We cannot assume that the cost of all this treatment would be $20. The cost would be high because of the services provided by the staff. Each service includes testing, treatment, doctors, and extra care.

Why Emergency Room Is Expensive?

There are some reasons given that thoroughly explain that why emergency rooms are expensive.


Physicians: If there is a minor emergency, like throat infection, flu or root canal, etc, the patient is referred to the physicians. They thoroughly examine the patient. They ask about his routine, his diet so that they could thoroughly examine his situation. If the patient is in extreme pain, they will give him the suitable medicine right away to relieve him.

Specialist: If the patient suffers from a chronic disease, he would be referred to the specialist. Specialist doctors are the people who have taken an additional five years course on a specific body part or organ after their graduation. For example, a cardiologist is a doctor who has specialized in the study of the heart. So if a patient is under cardiac arrest arrives, the specialist immediately starts treating him. He would arrange a special room for him. There would be a whole team, including nurses and practitioners, who would assist the doctor. First, they would try to stabilize his condition. Then they would continuously monitor his BP. If the patient s finding difficulty in breathing, they will apply an oxygen mask to him. All of this has to be done in minutes. It is a challenging and pressurizing task.

Surgeons:  A Surgeon is the doctor who performs the surgeries. A surgeon has specialized in surgery. If a patient arrives there for a regular checkup, but the report shows that the three valves of his heart are closed, the patient would be referred to a heart surgeon. That surgeon would perform a bypass surgery that averagely lasts for 8 hours. The surgeon would practically cut patient and work on his beating heart, making sure that he stays alive. He would insert a machine through his mouth that would act as a temporary heart during the surgery so the patient may not die. There would be a whole team with the doctors that would perform the surgery. The assistants, assisting surgeons, ward boys, OT staff, and technicians are all included in this team.

Lab Technicians: They are the people who are experienced in taking blood tests, X-rays making reports. They are the ones who know how to use a machine properly.

Nurses: They are the ones who assist a doctor or surgeon during the treatment, and afterwards, they take proper care of the patient. They continuously monitor their BP. They change their drips. They provide them with medicines.

So all of this staff is highly qualified and dedicated to their jobs. That is why being treated by them costs more.


If a patient arrives with back pain and he explains that he fell from stairs. The doctor would immediately ask him to do the x-ray. If the x-ray report shows that one of the spinal discs is dislocated, the doctor would immediately ask for the MRI report to examine if the slipped disc has not affected any organ nearby. That is how precise they are in their checkups. Regular checkups involve the usage of very advanced machines that leads to a huge bill.


The emergency rooms are heavily equipped. Several costly machines are present in there. These machines use much energy as well as proper demand maintenance. There are special people called lab technicians who handle these machines and are familiar with their use. Some patients require separate rooms that also adds to the billing. Some of the equipment is given below:

  • valve masks
  • Suction units
  • Trauma board
  • ECG Monitor
  • Incubators
  • Ventilators
  • The emergency rooms also provide ambulance service.


The emergency room is functional 24/7. The doctors work in shifts. It is a tough job for them to work in emergency rooms dealing with fatal situations 24/7.

These all are the reasons that result in high billing if one gets treated in the emergency room.

What Happens If You Do Not Pay The Bill

People are scared of emergency room billing because they know that it will be an enormous financial burden. Many health insurance plans help the people covering emergency room bills. However, what happens if a person does not pay the bill? Well, that bill would be added to his medical debt. The collection agent would call that person, again and again, asking him to pay his bill. If that person tries to ignore the debt, a lawsuit would be filed against that person by the collector. He would be called in for court trials, and if he did not have any proper justification, he could be arrested and punished. So there are many things by which a person can relieve himself from this burden.

  • Suppose the patient thinks that he is in a stable condition and the treatment provided to him in the emergency room can be provided in the urgent care center. So without having a second thought, he should shift himself to urgent care so that the rest of the treatment is not that costly.
  • He should show his bankruptcy to the court. That can also help him out.
  • He can negotiate with the emergency room’s staff in case of high billing.