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Military.com Forums Hot Topics & Current Events Point-Counterpoint Medical Emergency Room|
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New Member |
Currently, anyone without insurance or the ability to pay can go to a hospital emergency room and by law they must be treated (that would also include illigal immigrants).
Because of this the emergency room is being inundated with non-emergency patients. If the Government wants to solve some of the medical problems then establish Free Health Clinics. All those without insurance or the ability to pay would use these free clinics. This would free up the excess load on hospital emergency rooms by non-emergency patients. This past April I was in severe pain and my wife drove me to the hospital emergency room. There were 40 to 50 people in the waiting room and it was standing room only. I had my wife take me back home and called an ambulance (cost me $395.00). I had an infection and blood clot in my leg and was admitted into the hospital for nine days. Government intervention created this emergency room mess and this needs to be corrected right now. |
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Member |
It's this kind of problem that something such as a single-payer health system would address.
What happens is this: In the worse case scenario, patients who can't afford the copay to see their doctor wait until their minor condition (a stubbed toe by someone who doesn't know they're diabetic bc they haven't been to see their doctor in 10 yrs) develops into a really serious condition (gangrene sets in requiring amputation). The result is more people in the ER. I happen to think universal healthcare and the single payer system is the only way to solve this dilemna. Democrats are trying to fix it. Unfortunately, the health insurance industry is afraid of losing money and the Republicans are more interested in bloodying the President's nose by scoring cheap political points. |
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Highly Experienced Member |
The problem with emerg rms. are the hospital policies. They should be screened and turned away if it is not a true emergency. Ive seen to many cuts scrapes and sprains classified as emergencies, even fractures are not an emergency
The only screening Ive seen is to prioritise. But all are seen causing the backlog and none turned away to see private doctors. |
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Member |
hmm.
I disagree. I happen to think that the problem is the insurance companies. If they weren't more interested in lining their pockets than in treating you then they'd be able to say. Hmm. Maybe a $5000 deductible is too high. No one's going to want to pay it if they have tummy ache. If policies weren't so expensive then people could afford to go see their doctors for the little things (when they're still little). |
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Are you suggesting that people who turn up to casualty with a fracture should be sent home? That seems a somewhat Dickensian solution (I wonder whether the stupid censorbot will censor the name of the author of A Christmas Carol?) Having poor people wandering (or rather hobbling) around with untreated fractures would make parts of America look a bit Third World don't you think? |
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Highly Experienced Member |
To many hypocondriacs. Hypocondria is worse than an actual disease that can be cured. High co-pays could be the real answer all around. My union used to cover Emer Rm visits in full. People were using it for common colds and as a dr visit. Soon after they placed a fifty dollar co-pay on it, it stopped. |
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Member |
hmm. That's interesting. I hadn't thought of that.
I do believe hypochondria is another reason for spiraling medical costs. But then again I know if I paid $200 a month in medical insurance then I'd feel cheated if I didn't at least use it for something once in a while. I mean, hell. You paid for it, you might as well use it, no? |
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Highly Experienced Member |
So there you said it. Poor people, Its all about Poor people and nothing more. Ive had fractures that waited till the next day to see my doctor, simple fractures are not emergencies or are sprains. There should be free charitable clinics for the truly poor, like it was years ago for most, that went for dental care also. It was an incentive to make something of yourself and be able to afford private dentists and doctors and most did. Entitlements are draging us all down instead of the other way around. |
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----------------  Proud Member ----------------  |
Noon to nine here in this little town, there's an urgent care clinic across the hall from ER. Everyone through the door is screened (vitals, history, and presenting complaint) at ER--prudent way to do business. The UCC doesn't treat head or spinal injuries, chest or belly pain, shortness of breath; they don't stitch wounds or deliver babies. If it's non-emergent, then you go to UCC (and your charges drop considerably). They x-ray, differentiate, and splint or brace fractures and sprains. They treat rashes, earaches, sore throats, flu symptoms...and they write and fill prescriptions for cheap generics like ibuprofen, children's tylenol, a few broad-spectrum antibiotics, and a few of the milder pain killers.
It's staffed primarily with RNs and Nurse Practitioners/Physician's Assistants. They share the radiology dept. and lab with the ER--located on the same floor in the same wing of the same hospital. The rates they charge start around 20 bucks, and many prescriptions are less than 5. How do they make any money, you ask? They don't...but you wanna guess how much the ER doesn't lose treating sore throats and earaches? Wake up with Strep Throat on Saturday of a three-day weekend, or listen to the grandbaby you're watching for the weekend scream and pull his ears during that same holiday...you'll see that we need some options. If insurers and hospitals wanted to eliminate some of the losing deals they're forced into, it really wouldn't take much thought to find solutions. We put men on the moon, ferchrissake. I can sit in my recliner typing this nonsense on a wireless laptop, watch a ballgame on a High Def TV, and chat on a cell phone with my brother on vacation in Cancun. For twenty bucks you can buy a **** test at the drug store to verify whether your kid's smoking weed. Why does this **** have to be so difficult? You want the government to quit intervening? Get off your conservative ass and get your local hospital to start treating non-emergent cases outside the ER in a healthy way that makes financial sense. Now go a-way or I shall taunt you a second time! |
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Experienced Member |
Once again, the liberal provides a mature, well thought out post that fires on all cylinders. I'm not gay or anything, but I really enjoy reading and learning from your posts. Keep up the good work Yoop. Bravo Zulu!! Without question, the majority of the Liberals posting on this forum seem better educated, more articulate and capable laying an azz whooping to the majority of the current crop of wingnuts that post with nothing but emotion instead of facts. I raise my glass to the libs on this board.  I like that Bleah fellow though. I think he leans right for whatever reason (I would think the last 8 years would cure most people of that ailment) but he's a pragmatist and reasonable. Must be that submarine mentallity!!!! Here's to you Bleah and that other submariner Lewis (dead wrong on the school hour deal), but clearly articulate. |
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Experienced Member |
so you are saying that our taxes should pay for illegal immigrants to go to the ER? Forget the dog, Beware of Owner |
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Highly Experienced Member |
Gotta agree, since I see the financial back story every day. I get Medicaid applications from the hospitals in Philadelphia for uninsured patients treated in emergency rooms--and some of the bills are pretty outlandish. Joe Schmoe gets a cut that could easily be treated by a field medic with a few stitches, some antibiotics and a couple of Tylenol--he gets a $2,000.00+ bill from some MD at a hospital ER. Suzy Creamcheese (yes, I'm a Zappa fan) has a sore throat--the ER charges her $1,000.00 for having an MD tell her that the symptoms of a mild infection can easily be managed by over-the-counter remedies. Those bills get handed to us, since the patients are uninsured. The hospital either diffidently documents their claims or the people simply don't qualify under Medicaid standards--the hospital's charity fund ends up eating the bill. End of story? Nope. Costs are like energy--they are never completely destroyed but are instead dissipated. Bob the Builder, who has insurance, falls off of a scaffold and seriously injures himself. The insurance company picks up his tab, to include $3.00 rubber gloves and $1.00 cotton balls, but then his premium goes up. And so do his taxes as he pays for the costs incurred by Joe and Suzy. The hospital recoups most of its losses and so does the insurance company, but the rest gets picked up by you, me and Bob as honest taxpayers. Me, I'd rather pay extra out of pocket to fund a private low-cost clinic associated with a local hospital than pour money into that endless pit of a boondoggle. Hell, I'd even volunteer to work there on weekends--I already do that with cats.... |
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Experienced Member |
You're (maybe not you personally) paying for them now with higher insurance premiums with the added benefit that you can be dropped at any time and get to have a for profit institution determine if you get a procedure or not. What a bonus. |
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---------------- Proud Member ---------------- |
I'm not seeing him saying that at all... Maybe you could clear that up for me? Now go a-way or I shall taunt you a second time! |
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---------------- Proud Member ---------------- |
I'm not gay, and you don't have to be either, but it's okay to enjoy the writing whether you're born that way or made a choice--either way, far as I'm concerned. Mine's a Root Beer, thanks. That ipw fella will give you some readable viewpoint from the other side...some others as well. Maybe our potential congressional candidates should serenade us with their espousing abilities here on Mil.com---no ghostwriters. Let the Vets of this country vet the candidates in a forum where their words remain unedited for a very long time... Now go a-way or I shall taunt you a second time! |
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Experienced Member |
Anyone have a credible estimate of how many undocumented people use the emergency room? I bet it's much lower than many people assume.
Didn't Reagan pass the law that requires hospitals to treat all people in need regardless of their immigration status? |
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Member |
From the NYT op-ed page the next day:
Illegal immigration is an all-purpose policy explosive. Toss it into any debate and, boom, discussion stops because you’ve got people afraid that benefits or services might be going to those who don’t deserve them. The bomb went off again on Wednesday night when President Obama told Congress that his reforms would not apply to illegal immigrants. Representative Joe Wilson of South Carolina then blurted his way into talk-radio immortality with two words: “You lie!” Mr. Obama didn’t lie. The bills before Congress declare illegal immigrants to be ineligible for subsidized benefits. It is impossible to imagine any final bill doing otherwise. Mr. Wilson was a boor, but some Republicans still insist that he was right because the bill doesn’t ensure that the undocumented have no insurance. Time for a reality check. Illegal immigrants are here. They are not eligible for Medicaid, but many still get sick and many get care, often in emergency rooms. The current proposals would likely not stop them from using their money to buy coverage through an insurance exchange, without subsidies. Just as they can do now. Should we take a harder line? Force people to prove citizenship in emergency rooms? That’s illegal, for good reason. Make verification requirements so onerous that not a single illegal immigrant slips through? Very expensive, and not smart. It would be highly likely to snag deserving citizens — like old people who don’t have their original birth certificates. And besides, we’ve tried that: A House oversight committee reviewed six state Medicaid programs in 2007 and found that verification rules had cost the federal government an additional $8.3 million. They caught exactly eight illegal immigrants. In the case of an epidemic, like swine flu, should illegal immigrants go untreated so they can infect legal residents and American citizens? Hard-line Republicans insist that they will fight for citizenship verification. They could, in theory, get the country to spend whatever it takes to do that and proudly report back to their voters. But there is a line beyond which antipathy to the undocumented can be damaging to those voters’ health, not to mention the federal budget. Mr. Wilson and his admirers seem to have crossed it. Sigh. Seems like Repubs just want to keep playing politics. Real people are suffering out there everyday while they want to grandstand and wail and mock outrage, etc. |
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Highly Experienced Member |
No "credible estimate" on a macro level but a pretty good local series of snapshots. Philadelphia has a number of hospitals associated with either universities or health care providers--HUP (Hospital of the University of Pennsylvania), is just that, but sometimes (inadvisably) uses outside contactors. Hahneman Hospital belongs to the Tenet network and is very reliable and pleasant to work with. Other hospitals, such as Pennsylvania, Thomas Jefferson, Presbyterian and Methodist Hospitals all work largely through PATHS, a billing services provider in New Jersey. I get quite a few applications from these hospitals and their providers for illegal aliens, and there's a discernable breakdown for them. ER treatments and admissions come largely from Hahneman, HUP and Presbyterian--we require an emergency medical statement with very finite dates and treat only those costs. No statement, no treatment--the hospitals and providers know this. Pennsylvania Hospital and to a growing degree HUP and Hahneman give us a considerable number of labor and delivery applications. In those cases the mother is an undocumented alien who can only be funded for her hospital stay but the child gets full ongoing Medicaid coverage from the date of birth. I'm in one of a number of district offices in Philadelphia, and I average about 25-30 such applications a month--we authorize most of them. Over time that adds up, and again I only serve a fraction of a single city in a pretty large state. Take that where you will.... |
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Member |
So, I'm curious. That's 25-30 births out of a pool of how many overall births?
You can beef about the mother's healthcare costs if you want (personally, I'm not sure it's such a great idea to have women giving birth in department store bathrooms, if you look at it from a public safety standpoint). But the healthcare costs for the child is a different story. That kid's an American citizen the minute he or she is born. If you want to change that rule, then that's an entirely different discussion. (rhetorically: if it was good enough for you to be born here, why isn't it good enough for that little brown baby?) |
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---------------- Proud Member ---------------- |
Don't go down the little brown baby road, Frank. Anyone born in the US is born a citizen. That's a Constitutional definition not subject to skin color evaluation---you stepped across the line to suggest that anyone was going there. Now go a-way or I shall taunt you a second time! |
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Highly Experienced Member |
Well, let's take this point by point, shall we? And let's proceed from the fact that, figuratively speaking, I'm a small fish in a little pond. In case you missed that point, I work in one of about 16 district offices in Philadelphia County. Philadelphia is a big city, but it's only a small part of a large state--the other end has Pittsburgh, and I know nothing about their stats. The rest of the state is relatively rural, but that's changing--at least in the east. What's the overall pool of births in the state? In the city? In my district? Damned if I know. We have a large number of American citizens who receive TANF, and births to those families don't even hit my desk--they're handled by ongoing caseworkers, and my plate's too full to even bother asking. Not that they'd be able to cough up numbers on demand. I've done their job, and it wasn't easy. What I get is overflow--people who don't fit into the normal (and in Philadelphia swollen) welfare system but get treated on an emergency basis--and only within my district's geographical boundaries. I could perhaps try to get a city-wide statistical snapshot, but that would take some serious time and effort--are you willing to negotiate a price for that? No personal checks, of course. The mother's healthcare costs are limited but generally covered; no beef there, unless you somehow managed to create one out of a half-eaten cheesesteak. As for your dramatic "bathroom birth", I ate the baby and drowned the mother in the toilet--no cost to Medicaid, and I'm sure to get off next week by pleading insanity and threatening public safety by drinking a case of beer and eating a boatload of enchilladas--how sarcastic do you want to get, amigo?
That was the "money shot", buddy. If you want to accuse me of insensitivity or stinginess, then have at it. If you even think of playing some weak, watered down pathetic version of the hopefully by now discredited "race card", then do not be surprised if I club you over the head with it. Your questions were ideologically tortured but ultimately reasonable until you pulled that turd out of the bowl, and I treated them as such. That last question I won't even dignify--if you want to call me a racist, have the stones to do so openly.... |
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Highly Experienced Member |
Yooper, thanks for having my back on that--I owe you one....
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Experienced Member |
yes but universal healthcare is not the answer. I do agree that there needs to be some reform, but not what is being pushed Forget the dog, Beware of Owner |
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Experienced Member |
right now it is our insurance that covers them by deferring the costs to the paying customers, he seems to want to transfer that cost in taxes. I say we deal with the actual problem Forget the dog, Beware of Owner |
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Member |
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---------------- Proud Member ---------------- |
I'm hearing what you're saying, but I see the providers shifting the costs to paying consumers--insurance companies are just standing in the middle, marking that up for profit. In that many of those providers are subsidized in a number of ways (including directly for treating illegal aliens based on the number of aliens in that state), your tax dollars are already footing that bill--federal mandate and all that. Do you really think you save money treating illegal aliens as things are now? I actually hear people pizzed off here because illegals will be eligible to buy health insurance without subsidy under a proposed public option. Buy health insurance. How does that ring with you? Now go a-way or I shall taunt you a second time! |
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---------------- Proud Member ---------------- |
Por Nada. No debt incurred. You gave a reasoned statistical response based on your personal experience on the job, didn't extrapolate, speculate, or hyperventilate, and got a turd-bomb in return. I grow weary of insinuations about 'code words' and generalizations about what the people around here really mean. Now go a-way or I shall taunt you a second time! |
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Ah, the "I'm alright Jack" theory of healthcare. The point I was making is that for a considerable number of people it would seem that casualty is their only realistic chance of getting treated, even if an injury will keep for a day it still doesn't mean that it will get treated and will therefore probably heal badly. Still you're alright, aren't you Jack? One thing that has struck me about this "debate" is that while most Americans appear to object to paying for the treatment of people poorer than themselves they seem to be equally hostile to the idea of euthanasia. It seems to me though that the natural follow on from the belief that there is not a right to affordable healthcare is that there should be a right to autoeuthanise, provided that one pays for it oneself of course. |
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Experienced Member |
Thanks for the info IPW. |
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Experienced Member |
An American mate of mine once remarked - "if you're poor, don't go sick here" - now I see where he was coming from.
The 'Good Ol'Days' eh ? This is the 21st century, nobody in a modern affluent society should have to go cap in hand begging for medical treatment on charity.  |
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Military.com Forums Hot Topics & Current Events Point-Counterpoint Medical Emergency Room
