A weekly visit to the E.R.
In Austin, Texas 9 people racked up 2,678 visits to the E.R. in just 6 years. It averages out to about once a week for each of them. The cost was over $3 million to the local taxpayers as each visit had an average cost of $1120.
I have yet to see or hear ANYTHING from Obama and the Dems that will begin to control stuff like this. Well, for one thing, the "visitors" didn't pay a dime. The taxpayers picked up the tab.
I'd like to know how they plan to repeal natural laws of aging that concentrate 90 % and more of ALL medical care received in a lifetime into the final year of life. I saw it myself with my own grandparents and own mother. The last year of their lives was spent going in and out of the hospital.
Obama talks about "controlling costs" without a peep about reforming and revising Medical Malpractice; Malpractice Insurance ( the carriers are taking a beating on their investments); Resident training and working conditions; the nursing shortage etc.etc.
Re: A weekly visit to the E.R.
Should be provisions in Medicare and Medicaid that would place a significant copay for non life-threatening ER visits. Just like there are in most commercial insurance plans. There are also urgent care centers for when your own physician is on the golf course etc.
Re: A weekly visit to the E.R.
I think people are more educated about buying TVs than knowing what to do in a medical situation myself. I mean, there are no price lists.
There is no education about what to do when one needs care but it is not an emergency. If you are sick or wounded, you go to the hospital. That is what everyone learns in grade school.
Re: A weekly visit to the E.R.
Education would help even those on welfare. Often they just don't understand. Hurting itself isn't life-threatening; even a painful broken arm or something in your eye isn't life threatening or permanently disabling most times. Seems they would want quicker relief from pain. But if you are wounded in a bar knife fight or are removed by "the jaws of life", maybe you should go to an emergency room where you'll get pretty fast help.
Many urgent care centers are available. If you aren't an emergency, you may wait hours in a hospital, but maybe at most a half hour in a ungent care center. And it costs less.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
threlayer
Education would help even those on welfare. Often they just don't understand. Hurting itself isn't life-threatening; even a painful broken arm or something in your eye isn't life threatening or permanently disabling most times. Seems they would want quicker relief from pain. But if you are wounded in a bar knife fight or are removed by "the jaws of life", maybe you should go to an emergency room where you'll get pretty fast help.
Many urgent care centers are available. If you aren't an emergency, you may wait hours in a hospital, but maybe at most a half hour in a ungent care center. And it costs less.
Leaving aside arguable "emergencies" ( with a broken arm, the E.R. is a pretty good place to go imho ), a big part of the problem is use of the E.R. as the source of primary care. Every time I've gone to the E.R., the waiting room is packed with illegals and Medicaid recipients.
Re: A weekly visit to the E.R.
As I said, they don't know who else to go to.
Re: A weekly visit to the E.R.
Quote:
Education would help even those on welfare. Often they just don't understand
There isn't any education problem. Welfare recipients understand that Medicaid will pay 100% of the cost of an E.R. visit, including an ambulance ride ! This results in situations where Medicaid recipients will choose to go to the E.R. for something as basic as a pregnancy test ( which may cost the state's taxpayers hundreds of dollars ) in order to avoid having to spend $10 out of their own pocket at WalMart for a pee-stick !
Re: A weekly visit to the E.R.
This may be true in many cases for folks who like spending many hours of boring time on their hands. Some plans are HMO oriented and those may be different.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
threlayer
Should be provisions in Medicare and Medicaid that would place a significant copay for non life-threatening ER visits.
Do not equate Medicare with Medicaid; the former is a bought and paid for insurance policy the latter is welfare. With each though one can go to a private doctor and not rely on the ER.
The US of A spends a bigger % of GDP on health care then countries like Canada.
Re: A weekly visit to the E.R.
I have often wondered why hospitals don't run their emergency departments like a fee clinic. If you walk in on your own, you go into the waiting room for triage. Once the triage nurse decides how sick you are, then you get sent wherever to see whomever for further evaluation and or treatment. The Emergency Department should be reserved for people who have been evaluated as requiring the highest level of care immediately. But, it seems to me that not just welfare recipients but also the hospitals are shunting as many people as possible through the highly profitable Emergency Department knowing that Uncle Sugar will pay generously.
Z
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
Zofia
I have often wondered why hospitals don't run their emergency departments like a fee clinic. If you walk in on your own, you go into the waiting room for triage. Once the triage nurse decides how sick you are, then you get sent wherever to see whomever for further evaluation and or treatment. The Emergency Department should be reserved for people who have been evaluated as requiring the highest level of care immediately. But, it seems to me that not just welfare recipients but also the hospitals are shunting as many people as possible through the highly profitable Emergency Department knowing that Uncle Sugar will pay generously.
Z
This is the US of A's national health care system. The triage is who has insurance goes first as long as no critical patients are there. Not all hospitals have to take charity cases if the patient is stable public hospitals do. The only choice is to let people with no insurance die in the streets.
Re: A weekly visit to the E.R.
The ERs could do triage first and separate out those who need ER treatments from those who just need urgent care center (UCC) treatments. Maybe they'd have to have a contract with a few UCCs and some low cost transport service (not a Medicaid 'cab') for those to don't have transport to those facilities (though this could be an issue in the cases of mis-categorization). The problem is that the easy cases are cash cows for those hospitals.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
threlayer
The problem is that the easy cases are cash cows for those hospitals.
The thing is these people have no money or insurance. The hospitals don't make money on them as they are charity. That is why private hospitals do not treat them.
Only public hospitals have to take charity cases; doctors in private practice do not and that is what urgent care facilities are.
Hospitals do not make money on charity cases and often dump them in the street.
http://media.npr.org/programs/atc/fe...homeless/2.jpg
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
Earl_the_Pearl
The only choice is to let people with no insurance die in the streets.
No, that is not the only choice. First off, many people without insurance are not without means to pay. They voluntarily self-insure. For those, they should get treatment and be charged appropriately. For the others who fall through the cracks, that's what charity care is for. Hospitals that are not-for-profits get a substantial tax benefit, so they have an obligation to render charity care. For profits are not under such a benefit, so I can see their reluctance to render charity care. Public hospitals have a tax allocation in part to render charity care. Again, they have a duty.
However, I think you miss my larger point which was about work flow. It still seems to me that hospitals operating Emergency Departments should co-locate a walk in clinic. The initial triage should determine if a patient needs emergency care and route them to that department and all the rest should be routed to the clinic and given an appointment if they don't need urgent service, or seen if they do.
The problem with my solution is the ED would then be deprived of many well paying Medicare, Medicaid and private insurance cases. However, that change alone would reduce our (insureds and taxpayers) cost for the Medicare, Medicaid and private insurance patients who are making weekly and expensive visits to the ED. We (insureds and taxpayers) would still have to pay for the clinic treatment, but we would pay at lower rates because we would not have to pay for the premium charged by the ED.
Will this solve the healthcare problems in this country? Of course not, but it will reduce the cost of healthcare and reallocate resources more efficiently.
Z
Re: A weekly visit to the E.R.
I'd like to chime in that EMT workers don't always take no for an answer. I was in a car accident a few years ago, and actually broke several bones, but when the ambulance came I didn't want the ride. I kept telling the cops and paramedics NOT to take me, but they wouldn't listen and I wasn't in any condition to bat them off. Not being able to afford the trip was the exact reason I didn't want to be taken, even though I did need emergency care.
Re: A weekly visit to the E.R.
Zofia, thank you for expanding on my explanation.
In NYS all clinic and hospital bills are padded with a mandatory 8.85% surcharge (tax) which is handled by the state to reimburse those facilities for those not paying, bad debts, etc. This is charged to insurers and the self-insured as well as those poor trying to pay their bills alike.
So not only to the those poor who are trying to pay their own hospital/clinic bills, but those same poor have to pay for those poor who will not pay at all. So those people just trying to save their lives are paying taxes on that right. And that is just NOT RIGHT.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
threlayer
As I said, they don't know who else to go to.
That's NOT always true. They go to the E.R. bacause they KNOW they will be seen for "free".
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
Zofia
The problem with my solution is the ED would then be deprived of many well paying Medicare, Medicaid and private insurance cases.
I say again if one has insurance one does not use the emergency department of a hospital as their primary care doctor. I have two plans and if I go to the ER with a broken arm and am not admitted I still have to pay more if my primary care doctor did not send me.
The use of the ER is by people who do not have insurance.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
threlayer
In NYS all clinic and hospital bills are padded
All doctors and pharmacies pad their bills but insurance companies negotiate fees that are about 1/3 to 1/2 of the bill.
Re: A weekly visit to the E.R.
Quote:
Originally Posted by
Eric Stoner
That's NOT always true. They go to the E.R. bacause they KNOW they will be seen for "free".
Not everyone who needlessly uses ERs is welfare-level poor. It is true that welfare people do that. But it is also prevalent for people who are 'used' to going to ERs, those who don't have a personal physician or clinic nearby, and those ignorant of alternatives, even though they may have an insurance plan. Many plans charge a high copay (like $75-100) unless the ER visit is life-threatening.
I'm not sure but I'd guess that most UCCs are privately owned (PCs, LLPs etc). Those in particular will ceaselessly hound someone to get paid.
To an extent those who used ERs needlessly can crowd the more pressing cases out, particularly when an ambulance is bringing in a real emergency(ies) . That's why I like the triage diversion technique Zofia and I posted.