Medicaid patients should not be allowed to bypass their primary care physician’s office and utilize the Emergency Department for non-emergency services because it leads to decreased efficiency of Emergency rooms and increases health care costs which becomes a burden on the taxpayers. Also, this kind of abuse interrupts the continuity of care because Emergency rooms are not supposed to provide primary care in the long-term or at all. It also puts real emergency patients at risk due to unavailability of emergency rooms.Emergency departments are the only place in the healthcare system where patients have access to all kinds of medical services at any time of the day irrespective of their ability to pay or severity of their medical condition. Primary care providers are often closed on the weekends and the evening. Most of the time primary care providers are so booked-up, it is difficult to schedule an appointment. In an effort to save money, Medicaid constantly tries to keep the physician payments down, and obstructs care with all kinds of bureaucratic obstacles. As more and more physicians refuse to accept Medicaid patients for this reason, patients have learned that they will be seen if they report to the Emergency room and they won’t have to pay for it because of their Medicaid coverage. Under Medicaid, primary care and ED visit, both don’t have a copay. But if the primary care send the Medicaid covered patient to specialists, they might have to copay there whereas in an ED, all these services and speciality care are included in the ED visit. So, EDs are a much cheaper option for Medicaid patients. Another reason being convenience because they won’t have to take leave from work or deal with child-care to go to an ED. All these are some of the reasons that Medicaid patients are using the ER rather than seeing their primary care physician.If I have to make changes to the current system, I would suggest some kind of incentive to the providers who will accept Medicaid patients after hours or some kind of 24-hour community clinics should be established. I think that Medicaid beneficiaries should be charged a copay for non-emergency visits to the ER. And most importantly, primary care infrastructure needs a major expansion.