Emergency departments (ED) are frequently utilized by patients with minor complaints. It has been a long-standing assumption in the medical community that this use was based on the inability of certain subgroups of the population to access primary care providers secondary to inability to pay. This study examines the use of the ED for minor complaints and the distribution of patients according to mode of payment. Our findings suggest that ED utilization for minor complaints is not, as previously believed, higher in patients with the inability to pay primary care providers. Rather, subsidized patients (Medicare/Medicaid) appear to use the ED equally for major and minor complaints, while there is an increased utilization by commercially insured patients for minor illnesses and injuries, and a lower rate in patients who are self-pay.