Is there a humane and compassionate way to renovate medicaid and serve us all?

I work for a charity hospital. I’m grateful for being a part of our mission statement: “To treat every person with premium care, regardless of ability to pay.”

Here’s the rub. Medicaid pays fully for any ER visit. This means our ER is full 24/7 with people who use the ER as their family doctor.

I don’t blame them. You get seen immediately, get your script and get out. It’s much faster than going to a community clinic.

Second part of the rub: At least here, community clinics take no longer than private practice to see patients. It costs us all a hell of a lot to go to the ER, even with insurance (because it costs a hell of a lot to staff an ER)

How can we give good care to the poor and maintain a prime ER for everybody? I think it has to be a penalty/copay for using the ER as a regular doctor. Thoughts?