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 Why emergency rooms don't close the health care gap 
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Modmin Dude
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Post Re: Why emergency rooms don't close the health care gap
Most assuredly you're not going to like my responses, but here you go:
Quote:
*I think everyone should have access to basic preventative medicine (annual physicals, immunizations, testing, etc) - More cost effective and better chances of survival / recovery the earlier a disease / condition / etc is discovered - preventative medicine is something that is consistently brought up, but what do you do when you find that someone has early cancer? Do you cover that too? Where does it stop? There are early treatments (even dietary adjustments) that can be made, but no one wants to take them, everyone wants the quick, medical, EXPENSIVE fix. I guaranty you that if we did the "preventative" part and found the disease early, everyone will still complain if the disease itself isn't treated. So, you're back to covering everything, for everyone, which is utterly impossible without a massive waiting list and literally "death lines."
There are lots of things I currently pay for via taxes that I don't like and I'd be willing to bet that some of those are things you like or in favor for. In a civilized society we sometimes have to do things we don't like, sorry but that's just life.
We are all brothers and sisters and should take care of our families.

Quote:
*I don't think people should have to file bankruptcy in order to pay for their medical bills - me neither, and the problem is the "medical bills" aren't paid when someone files bankruptcy, which is why costs have to get passed down. However, IMO one of the BIGGEST problems with our HC industry is that they OVER CHARGE and OVER SERVE people to the point where they HAVE to file bankruptcy to cover their bills. A hospital charges about 400%-1200% more for an MRI/CAT Scan, X-Ray, EKG etc. than a "boutique clinic" that specializes in the service. 1) that's ridiculous, but 2) they often do UNNECESSARY PROCEDURES. I went to the hospital for a mild concussion that I KNEW was a mild concussion but I HAD to get written proof. I knew I wasn't in any danger, and I knew that I was fine. Not only did I have to get a cat scan, I also had to have 6 X-rays of my spine, and an entire jaw scan from this weird thing that went around your head in a circle. After everything was said and done what my family doctor could have done for $60-90 ended up costing over $2k, and ALL THEY WANTED TO DO WAS USE THEIR TOYS AND DRIVE UP THE COST. If I refused ANYTHING they said that they wouldn't even diagnose me, and they said that I would get billed for everything they did and not get any paperwork stating what they treated. And on top of that I got not one but TWO $25 tylenol, when a bottle costs $5, and I HAD to take them right there in front of the doc. Now what did I do about it... I phucked 'em, and I don't feel bad about it one bit. I disputed the charge with the collection company, threatened to take them to court, and paid $200 total, so the hospital received about $100 after I was there for almost 12 hours, unnecessarily so. And this is COMMON PLACE, and it happens EVERY DAY!
I apologize, I know you were almost a double-major or something, but was the other thing medicine?
Regardless, IMO your anecdotal story of your concussion isn't really helping, especially considering as this is a NFL football forum where we have been discussing concussions and they're impact on people rather frequently as of late. Do you have any actual proof of the doctors driving up the price? If so, considering your background in law one would think you might want to take them to court. C'mon man, step up! Start the process of fixing this problem. Fight the fight! If you choose not to, then IMO you prolly either don't have any actual evidence, have a defeatist attitude or are looking for a quick fix.

Quote:
*We are already paying for the so-called "free healthcare" provided at hospitals via higher taxes (I think) and higher health insurance premiums (fact). One way to look at it could be should be pay before or after the services are performed? Personally I would say before; as mentioned above, it is usually more cost effective than after. - But again, what do you do after the preventative part is done?
See above

Quote:
*Most everyone, at some point in their lives, will need some sort of health care - true, but our current system can't accommodate everyone, it is impossible, and it is likely impossible to build a system that can cover everyone, for everything, 100% of the time.
First off, nothing is impossible (defeatist attitude). Secondly, do you believe in American Exceptionalism? If so, then shouldn't America be able to come up with a workable solution? Isn't it even worth a try? Or should we just give up and accept the status quo?

Quote:
*I think our health insurance should be portable, not tied to job benefits. If I choose to work for another company and I have diabetes chances are I will have a difficult time getting "new" insurance at my new job. Sorry, but something about that just doesn't seem right (perhaps the lack of freedom that we Americans believe we are entitled to). - This I agree with fully, but contracts expire, and is an insurance company supposed to insure someone that they KNOW will cost them $10,000-$100,000 per year to cover for $1,200? I understand the difficulty in this, and I know its frustrating, but how is an insurance company supposed to keep the same rates for someone with a million dollar disease? It's just plain not do-able. Maybe if we had some sort of life-long policy with higher startup costs where they can offset the costs with healthy individuals, but you know as well as I do that people are too short-sighted for that, and they'll pass on the high cost health care for the cheap alternative, until they actually get sick, then its someone else's fault.
Hey, we can agree on something :cheers:
Did you see what Pablo suggested? Health insurance akin to auto, life, or homeowner's insurance. If you have a lot of claims, your premiums go up, if you're good / healthy, then lower rates. Though I would say that there should be no pre-exisiting conditions clause and no lifetime cap.
BTW - Nothing is "just plain not do-able" IMO - more defeatist attitude.

Quote:
*I do not trust the Govt as far as I could throw it - me neither
Agreeing again? Wow! :lol: j/k
Quote:
*I don't like the idea of paying higher taxes - me neither, and what people don't realize is that if we shift the burden of "health care" into a "burden of paying taxes" we've saved nothing, we've just created a mechanism to give something to people that aren't paying for it, and the system needs more than that.
Pardon me, but did you mean "and the system doesn't need more than that" or was that sarcasm? That said, could you further explain? Thanks,

Quote:
*If, as I believe, we are all brothers and sisters then shouldn't we do what we can to ensure our 'family' is healthy and cared for? - Sorry, this is just plain BS, and the majority of the World doesn't operate this way.
So what if "the majority of the World doesn't operate this way"? Does that make it right? Hell, there's still slavery in the World, is that ok? There is still rampant hunger across the Globe, does it make that ok? While you may call is "BS", in mine and several others opinions it is the right thing and the right way...and as I'm sure most of us will agree, the right thing is not always the easy or accepted thing. Change has to start somewhere.
"Can't we all just get along?" - R King
Quote:
*If we're only as strong as our weakest link (as was drilled into me via team sports & military) then wouldn't it make sense to have strong, healthy fellow Americans? - not really, it would be more beneficial to kill them off and get rid of them. Heartless, sure, but you asked whether or not we would be better off with them healthy, we wouldn't be.
Sounds more like taking the easy way to me, but to each his own.
Quote:
My response is in red.

Honestly, I like the Republican ideals best (I know, surprise, surprise, but sorry, they make the most sense). They say that we should eliminate corruption first, fix the system that we have 2nd (medicade/medicare), and allow for health insurance to be sold across State lines. All three of these things would IMMEDIATELY reduce health care costs and start us down the right path. What the Democrats tried to do was build a mansion on top of a crumbling foundation from a 600 sq. ft. shack. That's why I like Trump's comments, he correctly points that out.
How long have the Reps been talking about 'eliminating corruption'? I know at least since Reagan, prolly long before that. Have they done it yet? Nope. Hell, they've had 3 out of the last 5 Presidents and still haven't accomplished it. To be fair, the Dems are no better. (Is there really a difference anymore? Other than social policies that is) In all honestly, there will be corruption as long as there is money in politics. The entire system is broken and needs to be fixed. Neither Romney nor Obama will change a damn thing.

Quote:
Quote:
So, wjb, is that what you're looking for? Is that the type of response you're wanting? If so, you've got it now what will you do with it?
That's exactly what I was looking for, but I don't see why the disrespect had to be thrown in there left and right... :roll:
I apologize for coming across disrespectful, not my intention. This is one of the many things I have been trying to work on, obviously I have a ways to go.

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May 9th, 2012, 4:59 pm
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
TheRealWags wrote:
wjb21ndtown wrote:
A single-payer HC system IS left-leaning, and you know it, which is what this article is advocating for by discounting arguments against it.
I'm sure you'll dismiss them as "Rino" or some other creative label, but there are Republicans in favor of single-payer. Not too mention isn't Medicade or Medicare (get them mixed up) actually a single-payer system? Aren't most of those on said program satisfied with it?
That said, see below

Most people on Medicare or Medicade HATE the system, but no, it's NOT a single-payer system. There are other alternatives available for purchase, and that's the whole point. Obama Care creates a single payer system where everyone will more or less be on govt. health care. I have a problem with that, and so do most. There isn't ONE nation that has a single-payer health care system that likes it. The Canadians were telling us that we were crazy for pursuing Obama Care, as well as the Britts. I hear Cuba has a pretty good single-payer system... [-X
Wait a minute...you think the PPACA / ObamaCare is a Single-Payer system? No, it is not. I know some have purported that it is a 'step towards wingle-payer', but it definitely is NOT single-payer. If it were, there would be no United Health Care, Blue Cross Blue Shield, Kaiser, etc If it were single-payer, then there would be only Govt doctors, hospitals, and insurance.

wjb21ndtown wrote:
TheRealWags wrote:
wjb21ndtown wrote:
TheRealWags wrote:
The author of the article posted, Dr. Aaron Carroll is considered to be a Health Policy expert. You can read a short bio on his if you're so inclined. Please feel free to share an opposing viewpoint.

I read his bio, he's a college professor, you really think he's not a Democrat?
He very well might be, but what does that have to do with solving the health care issue? Personally I don't care if someone is Dem, Rep, Ind, Lib, Green Party or whatever if someone that is credible has an opinion on Health Care, then shouldn't we listen to what they have to say?

You can listen to what he has to say, but realize that it comes with an agenda. He provides Liberal solutions of bigger government when there are other alternatives. Most Liberals want to GROW a BROKEN SYSTEM. Most Republicans say "fix the system, THEN grow it, incrementally." The latter makes more sense to me. Does it make more sense to you?
Can you name one source that isn't going to provide their opinion without they're agenda / bias coming across? Yeah, me neither. You don't just dismiss someone's work just because they may not agree with your viewpoint, at least I don't think you should. He is one person, I'd like to find more from all ends of the spectrum.


wjb21ndtown wrote:
TheRealWags wrote:
Sorry, I do not follow any partisan rhetoric or tow any company line; I choose to think for myself. If you're the type of person that will automatically dismiss a credible source just because they're Dem or Rep or whatever, then IMO I don't think there is any hope for a rational, decent discussion. If that is indeed the case, then peace out sir, my conversation with you on this and any other topic is over.


No, I don't dismiss a credible source because of their ideology. If they're on point or make a good point then I'll agree with them. I saw the Liberal leanings in his post before I looked him up or knew who he was. I could see his agenda and I could see where he was going with his piece. Dont' get me wrong, I don't mind Liberal solutions that actually work. I'm a Libertarian at heart, I just don't like this big government, we're too stupid to think for ourselves, we're too weak to make our own decisions, lets bail everyone out all the time, philosophy - which is what they advocate...

You claim that you don't lean any certain way, yet time after time you tend to think govt. is the answer to our problems, yet you say that you don't like big government. You say that you "think for yourself" yet you let Liberal leaning articles and the Liberal leaning media weigh heavily on your mind-set. You say you're not a Liberal, but on most social issues you are.
I think that might be your sticking point. I sure I've mentioned several times before, I am fiscally conservative and socially moderate. I don't think the govt has ANY business being in my home or telling me what to do.
Back on page 1 I stated:
Quote:
Truth be told I am conflicted when it comes to HC.
Perhaps now you can see what I mean. I do not think Govt is the solution. Look back in history and its obvious to see where they usually screw things up.

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May 9th, 2012, 5:17 pm
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Post Re: Why emergency rooms don't close the health care gap
Clarification on Medicare:
wiki wrote:
Medicare is a national social insurance program, administered by the U.S. federal government, that guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease. As a social insurance program, Medicare spreads the financial risk associated with illness across society to protect everyone, and thus has a somewhat different social role from private insurers, which must manage their risk portfolio to guarantee their own solvency.[1]

Medicare offers all enrollees a defined benefit. Hospital care is covered under Part A and outpatient medical services are covered under Part B. To cover the Part A and Part B benefit Medicare offers a choice between an open-network single-payer plan (traditional Medicare) and a network plan (Medicare Advantage, or Medicare Part C), where the federal government pays for private health coverage. A majority of Medicare enrollees have traditional Medicare (76 percent) over a Medicare Advantage plan (24 percent). Medicare Part D covers outpatient prescription drugs exclusively through private plans, either standalone prescription drug plans or through Medicare Advantage plans that offer prescription drugs

In 2010, Medicare provided health insurance to 48 million Americans—40 million people age 65 and older and eight million younger people with disabilities. Medicare serves a large population of old, sick, and low-income people, many of whom would be unable to afford health care otherwise. On average, Medicare covers about half (48 percent) of health care costs for enrollees. Medicare enrollees must cover the rest of the cost. These out-of-pocket costs vary depending on the amount of health care a Medicare enrollee needs. They might include uncovered services—such as long-term, dental, hearing, and vision care—and supplemental insurance.[2]

http://en.wikipedia.org/wiki/Medicare_% ... _States%29

Medicare is essentially single-payer, or it is for 3/4 of patients.

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May 9th, 2012, 5:19 pm
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Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
There are lots of things I currently pay for via taxes that I don't like and I'd be willing to bet that some of those are things you like or in favor for. In a civilized society we sometimes have to do things we don't like, sorry but that's just life.
We are all brothers and sisters and should take care of our families.


Wags, I agree with you. There are tons of things that I don't like paying for that I do pay for, but I think they should at least fall within the realm of what the general public wants. The general public currently doesn't want a single-payer system, and that's my primary problem with the Bill. It back-doors itself into being a single-payer system, and literally takes advantage of people's stupidity and false media reports stating otherwise. Most educated adults can see through what this Bill does, and most hate it. I've advocated in the past for 1) catestrophic care only, and 2) for a bare minimal care, two separate insurance coverages that I feel should be available to everyone for a minimal cost. The bare minimum care would cover physicals, doctor visits for typical coughs and pains and whatnot, and the catestrophic care would cover severe illnesses. This could be done, as I see it, through a government subsidized system (big difference than govt. provided system), and I really do think it would cut down on costs.

That said, in order for the plan to work, you literally have to be willing to let people die that do not carry the catestrophic care coverage, and most Liberals can't stomach that. Like I said, under the current system you literally can't cover everyone for everything. IMO my proposed plan does better, but you're still going to have gaps. You just have to figure out where the gaps MUST exist, at least for now.

TheRealWags wrote:
I apologize, I know you were almost a double-major or something, but was the other thing medicine?
Regardless, IMO your anecdotal story of your concussion isn't really helping, especially considering as this is a NFL football forum where we have been discussing concussions and they're impact on people rather frequently as of late. Do you have any actual proof of the doctors driving up the price? If so, considering your background in law one would think you might want to take them to court. C'mon man, step up! Start the process of fixing this problem. Fight the fight! If you choose not to, then IMO you prolly either don't have any actual evidence, have a defeatist attitude or are looking for a quick fix.


Wags, the concussion story should help, because it shows 1) how hospitals over charge, 2) how hospitals over-serve, 3) why emergency roooms cost so much, 4) an extreme problem with medical billing, and I can tell you from experience that the problem that I outlined is rampant. Ask anyone that has been in an emergency room or taken a ride in an ambulance and they'll likely tell you the same exact story.

TheRealWags wrote:
Quote:
*We are already paying for the so-called "free healthcare" provided at hospitals via higher taxes (I think) and higher health insurance premiums (fact). One way to look at it could be should be pay before or after the services are performed? Personally I would say before; as mentioned above, it is usually more cost effective than after. - But again, what do you do after the preventative part is done?
See above


Actually, you never really answered what you would do after the preventative part was done. You just said "we need to do better," and "in a civilized society..."... If by that you mean that we will heal everyone, always, you're all wet. It simply won't work, not right now. If you want to get idealistic and say "never say never," realize I'm not. I'm saying that right now it won't work, period. The infrastructer simply isn't there. It would be akin to violating a law of physics, quite literally, by definition it is impossible.

TheRealWags wrote:
]First off, nothing is impossible (defeatist attitude). Secondly, do you believe in American Exceptionalism? If so, then shouldn't America be able to come up with a workable solution? Isn't it even worth a try? Or should we just give up and accept the status quo?


I'm not saying don't try to come up with a solution, I'm saying fix what we have now, and improve it down the road. The government isn't good at much, but what they're worse at than anything is sweeping, wholesale change. Big movements are something that they're always notoriously horrible at, and we always uncover loads of corruption and "externalities" (or horrific unintended consequences) later.

TheRealWags wrote:
Quote:
*I think our health insurance should be portable, not tied to job benefits. If I choose to work for another company and I have diabetes chances are I will have a difficult time getting "new" insurance at my new job. Sorry, but something about that just doesn't seem right (perhaps the lack of freedom that we Americans believe we are entitled to). - This I agree with fully, but contracts expire, and is an insurance company supposed to insure someone that they KNOW will cost them $10,000-$100,000 per year to cover for $1,200? I understand the difficulty in this, and I know its frustrating, but how is an insurance company supposed to keep the same rates for someone with a million dollar disease? It's just plain not do-able. Maybe if we had some sort of life-long policy with higher startup costs where they can offset the costs with healthy individuals, but you know as well as I do that people are too short-sighted for that, and they'll pass on the high cost health care for the cheap alternative, until they actually get sick, then its someone else's fault.
Hey, we can agree on something :cheers:
Did you see what Pablo suggested? Health insurance akin to auto, life, or homeowner's insurance. If you have a lot of claims, your premiums go up, if you're good / healthy, then lower rates. Though I would say that there should be no pre-exisiting conditions clause and no lifetime cap.
BTW - Nothing is "just plain not do-able" IMO - more defeatist attitude.


Sorry, but some things are flat out impossible. Insuring someone for $1,200 a month and covering a million dollar disease is impossible. The company would flat out go out of business. What Pablo suggested is more or less what they do... The "claim" is the disease, and it goes up per the cost of treating the disease. The problem is that the disease costs literally hundreds of thousands of dollars, over multiple years to treat.

TheRealWags wrote:
Quote:
*I do not trust the Govt as far as I could throw it - me neither
Agreeing again? Wow! :lol: j/k
Quote:
*I don't like the idea of paying higher taxes - me neither, and what people don't realize is that if we shift the burden of "health care" into a "burden of paying taxes" we've saved nothing, we've just created a mechanism to give something to people that aren't paying for it, and the system needs more than that.
Pardon me, but did you mean "and the system doesn't need more than that" or was that sarcasm? That said, could you further explain? Thanks,


What I meant, more specifically, was that the system needs a greater over-haul than simply shifting a health care burden to a tax burden on the people. That alone doesn't generate a "savings" there's no "extra money" in implimenting a system that does just that, but some are happy to jump on that bandwagon. The "change" that needs to happen MUST invoke some cost savings or its utterly useless.

TheRealWags wrote:
So what if "the majority of the World doesn't operate this way"? Does that make it right? Hell, there's still slavery in the World, is that ok? There is still rampant hunger across the Globe, does it make that ok? While you may call is "BS", in mine and several others opinions it is the right thing and the right way...and as I'm sure most of us will agree, the right thing is not always the easy or accepted thing. Change has to start somewhere.
"Can't we all just get along?" - R King


Stepping in for humanitarian reasons is valid and noble, but IMO, not where it just creates a greater burden or need. The fact of the matter is that our system currently covers more people than it should, and insuring literally millions more is only going to cause lines, not "more" care. We need to revamp the way things are done, not simply add people to the current system, and adding people to our current system isn't being more noble than promising something to someone and not giving it to them.


TheRealWags wrote:
Sounds more like taking the easy way to me, but to each his own.
It is, quite simply, a necessary evil under the current system that we operate under. It can be fixed and more people can be treated and more people can be covered, but the road we're currently going down does not help anything.



TheRealWags wrote:
How long have the Reps been talking about 'eliminating corruption'? I know at least since Reagan, prolly long before that. Have they done it yet? Nope. Hell, they've had 3 out of the last 5 Presidents and still haven't accomplished it. To be fair, the Dems are no better. (Is there really a difference anymore? Other than social policies that is) In all honestly, there will be corruption as long as there is money in politics. The entire system is broken and needs to be fixed. Neither Romney nor Obama will change a damn thing.


Health care wasn't really a big issue in my lifetime until Hilary championed it in the early 90s. The Clintons made it an issue (and it should have been long before that, no doubt), but GHB had the gulf war, GWB had the war on terror and health care took a back seat during those time periods. Like it or not, manufactured or not, we simply had more pressing needs that needed to be addressed at the time. Did much get done, nope, but there wasn't much of a push from anyone else either.

Now, back on topic, if we're only concerned with good ideas and implementing them (which is what you say you are), who cares who has talked about eliminating corruption for decades, and who cares whom hasn't done anything about it? Everyone agrees that it is a good idea, so why don't Dems and Liberals get it done? Why don't they let Reps be the party of talking, and the Dems be the party of action, and get this deal taken care of? I agree that the whole system needs fixing, but there are ways to tackle that in small chunks, without uprooting the entire deal. There are ways of unequivocally making HC more affordable (offering plans across state lines), that should be attempted first, before extending bad care and promoting systems with inflated costs and corruption. You do realize that when you amplify our current system (which is what Obama Care does) you're also amplifying all of the corruption in it, right?


TheRealWags wrote:
I apologize for coming across disrespectful, not my intention. This is one of the many things I have been trying to work on, obviously I have a ways to go.


No problem, you were just snippy and I didn't really know why. People on here seem quick to jump the gun lately, or add words to people's mouths, or add points their arguments and then attack something that isn't there. I really don't know why.


May 9th, 2012, 5:57 pm
Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
Clarification on Medicare:
wiki wrote:
Medicare is a national social insurance program, administered by the U.S. federal government, that guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease. As a social insurance program, Medicare spreads the financial risk associated with illness across society to protect everyone, and thus has a somewhat different social role from private insurers, which must manage their risk portfolio to guarantee their own solvency.[1]

Medicare offers all enrollees a defined benefit. Hospital care is covered under Part A and outpatient medical services are covered under Part B. To cover the Part A and Part B benefit Medicare offers a choice between an open-network single-payer plan (traditional Medicare) and a network plan (Medicare Advantage, or Medicare Part C), where the federal government pays for private health coverage. A majority of Medicare enrollees have traditional Medicare (76 percent) over a Medicare Advantage plan (24 percent). Medicare Part D covers outpatient prescription drugs exclusively through private plans, either standalone prescription drug plans or through Medicare Advantage plans that offer prescription drugs

In 2010, Medicare provided health insurance to 48 million Americans—40 million people age 65 and older and eight million younger people with disabilities. Medicare serves a large population of old, sick, and low-income people, many of whom would be unable to afford health care otherwise. On average, Medicare covers about half (48 percent) of health care costs for enrollees. Medicare enrollees must cover the rest of the cost. These out-of-pocket costs vary depending on the amount of health care a Medicare enrollee needs. They might include uncovered services—such as long-term, dental, hearing, and vision care—and supplemental insurance.[2]

http://en.wikipedia.org/wiki/Medicare_% ... _States%29

Medicare is essentially single-payer, or it is for 3/4 of patients.


Yea, but I don't think you understand, these people can still opt out of it, or they can CHOOSE to pay BCBS or HAP, or someone else. It's only "single payer" for them because they can't afford anything else.

It's like saying "fiat" is a single payer car company (the only company that these people can buy cars from), because that's all that they can afford... That also isn't true. Just because you and I can't afford a Ferrari, that doesn't mean that they don't exist.


May 9th, 2012, 6:00 pm
Modmin Dude
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Post Re: Why emergency rooms don't close the health care gap
Pablo wrote:
TheRealWags wrote:
Pablo wrote:
I see the fix to the problems fairly simple - indidual insurance and accountability along with a free market cost system, but we want to be so coddled as a country very few are willing to put some effort into their own HC needs.

My 2 cents anyways....
If it were really that simple, then why don't we already have that system in place?
Why don't we have a playoff system is college football? Why don't "fill in the blank"? Easy - money and laziness. HC is a huge % of our GNP and they like their power and profits, there is the money part. Second, guess how many folks know nothing about HSAs - the vast majority. It takes effort to keep yourself healthy and learn about all the HC options out there. Most people are drones and simply select one of the two options made available at work and don't give it a second thought.
Touche. Very valid points.

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May 10th, 2012, 10:08 am
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Post Re: Why emergency rooms don't close the health care gap
wjb21ndtown wrote:
TheRealWags wrote:
There are lots of things I currently pay for via taxes that I don't like and I'd be willing to bet that some of those are things you like or in favor for. In a civilized society we sometimes have to do things we don't like, sorry but that's just life.
We are all brothers and sisters and should take care of our families.

Wags, I agree with you. There are tons of things that I don't like paying for that I do pay for, but I think they should at least fall within the realm of what the general public wants. The general public currently doesn't want a single-payer system, and that's my primary problem with the Bill. It back-doors itself into being a single-payer system, and literally takes advantage of people's stupidity and false media reports stating otherwise. Most educated adults can see through what this Bill does, and most hate it.
Again it sounds as though you believe that PPACA is single-payer or perhaps a conspiracy towards creating a single-payer system, would you be able to provide some info pertaining to that line of thinking? I'd be interested in reading up on it.
wjb21ndtown wrote:
I've advocated in the past for 1) catestrophic care only, and 2) for a bare minimal care, two separate insurance coverages that I feel should be available to everyone for a minimal cost. The bare minimum care would cover physicals, doctor visits for typical coughs and pains and whatnot, and the catestrophic care would cover severe illnesses. This could be done, as I see it, through a government subsidized system (big difference than govt. provided system), and I really do think it would cut down on costs.
This sounds very interesting. In your earlier example of "what do you do when you find that someone has early cancer?" How would that be handled under your proposal? The 'bare minimal care' aspect covers the tests that discovered the cancer, and the 'catastrophic care' covers the needed treatment? What limits, if any, are there for the catastrophic care? What would the expected out-of-pocket costs be in this scenario?

This created the following scenario in my wacky brain: Remembering that we're for 'personal responsibility' and that some cancers can be caused by environmental factors and that some Govt policies (or lack thereof) could be responsible for those environmental factors, who should be responsible for the needed care? Should it be the affected person, that did nothing more than 'be' in said environment? Should it be the Govt, that is responsible for the policies (or lack thereof)?

wjb21ndtown wrote:
That said, in order for the plan to work, you literally have to be willing to let people die that do not carry the catestrophic care coverage, and most Liberals can't stomach that. Like I said, under the current system you literally can't cover everyone for everything. IMO my proposed plan does better, but you're still going to have gaps. You just have to figure out where the gaps MUST exist, at least for now.
We, as a society, are already 'letting' people die as they do not currently have access to health care, which IMO has little to do with someone being 'conservative' or 'liberal'; its a 'side-effect' of our current system. That said, I do understand there will be some gaps initially, but that doesn't mean the gaps have to be wide / large or exist for very long.

wjb21ndtown wrote:
TheRealWags wrote:
Regardless, IMO your anecdotal story of your concussion isn't really helping, especially considering as this is a NFL football forum where we have been discussing concussions and they're impact on people rather frequently as of late. Do you have any actual proof of the doctors driving up the price? If so, considering your background in law one would think you might want to take them to court. C'mon man, step up! Start the process of fixing this problem. Fight the fight! If you choose not to, then IMO you prolly either don't have any actual evidence, have a defeatist attitude or are looking for a quick fix.
Wags, the concussion story should help, because it shows 1) how hospitals over charge, 2) how hospitals over-serve, 3) why emergency roooms cost so much, 4) an extreme problem with medical billing, and I can tell you from experience that the problem that I outlined is rampant. Ask anyone that has been in an emergency room or taken a ride in an ambulance and they'll likely tell you the same exact story.
I've been in emergency rooms before a few times and didn't notice anything that would resemble 'over-serving', in fact I rarely saw anyone the entire time I was there sitting on a gurney. In my anecdotal story, I sat on said gurney for over 90 mins before seeing a Dr; the triage took approx 30 mins to be seen. That said, anecdotal stories are rarely a good source for creating policy on any level IMO.

wjb21ndtown wrote:
TheRealWags wrote:
Quote:
*We are already paying for the so-called "free healthcare" provided at hospitals via higher taxes (I think) and higher health insurance premiums (fact). One way to look at it could be should be pay before or after the services are performed? Personally I would say before; as mentioned above, it is usually more cost effective than after. - But again, what do you do after the preventative part is done?
See above

Actually, you never really answered what you would do after the preventative part was done. You just said "we need to do better," and "in a civilized society..."... If by that you mean that we will heal everyone, always, you're all wet. It simply won't work, not right now. If you want to get idealistic and say "never say never," realize I'm not. I'm saying that right now it won't work, period. The infrastructer simply isn't there. It would be akin to violating a law of physics, quite literally, by definition it is impossible.
Understand what you're saying here, but let me ask you, how would this scenario be different from your proposed plan? Wouldn't we still need more / better infrastructure to support it as well? We already understand / accept there will be gaps, however, if I'm understanding your proposal correctly there will still be more insured / have HC access than we have today, correct? Are you thinking that because these gaps might be greater under your plan, then there wouldn't be as big of a demand for the infrastructure?

wjb21ndtown wrote:
TheRealWags wrote:
]First off, nothing is impossible (defeatist attitude). Secondly, do you believe in American Exceptionalism? If so, then shouldn't America be able to come up with a workable solution? Isn't it even worth a try? Or should we just give up and accept the status quo?

I'm not saying don't try to come up with a solution, I'm saying fix what we have now, and improve it down the road. The government isn't good at much, but what they're worse at than anything is sweeping, wholesale change. Big movements are something that they're always notoriously horrible at, and we always uncover loads of corruption and "externalities" (or horrific unintended consequences) later.
I agree that a 'phased in' approach would prolly be better, not too mention less stressful on the current system. How would you suggest the phases to go? What comes first? second? etc?

wjb21ndtown wrote:
TheRealWags wrote:
Quote:
*I think our health insurance should be portable, not tied to job benefits. If I choose to work for another company and I have diabetes chances are I will have a difficult time getting "new" insurance at my new job. Sorry, but something about that just doesn't seem right (perhaps the lack of freedom that we Americans believe we are entitled to). - This I agree with fully, but contracts expire, and is an insurance company supposed to insure someone that they KNOW will cost them $10,000-$100,000 per year to cover for $1,200? I understand the difficulty in this, and I know its frustrating, but how is an insurance company supposed to keep the same rates for someone with a million dollar disease? It's just plain not do-able. Maybe if we had some sort of life-long policy with higher startup costs where they can offset the costs with healthy individuals, but you know as well as I do that people are too short-sighted for that, and they'll pass on the high cost health care for the cheap alternative, until they actually get sick, then its someone else's fault.
Hey, we can agree on something :cheers:
Did you see what Pablo suggested? Health insurance akin to auto, life, or homeowner's insurance. If you have a lot of claims, your premiums go up, if you're good / healthy, then lower rates. Though I would say that there should be no pre-exisiting conditions clause and no lifetime cap.
BTW - Nothing is "just plain not do-able" IMO - more defeatist attitude.

Sorry, but some things are flat out impossible. Insuring someone for $1,200 a month and covering a million dollar disease is impossible.
Sorry, I still don't believe anything is impossible; improbable? perhaps, but that doesn't mean we don't try.
Perhaps we should be asking why is it 'a million dollar' disease to begin with? Why does it cost so much? Why not work on bringing said cost down? Make it more affordable for both the insurer and the insured
wjb21ndtown wrote:
The company would flat out go out of business.
Isn't this part of capitalism? Companies that cannot adjust to the current climate go out of business and new ones that can handle it replace them? One would think this is a good thing, no? While I'm not one to support policies / efforts that are distinctly anti-business, I'm also not one to coddle them either. These insurance companies have been screwing the insured for decades, perhaps its time for them to 'pay the piper', so to speak. (Karma)

wjb21ndtown wrote:
TheRealWags wrote:
Quote:
*I don't like the idea of paying higher taxes - me neither, and what people don't realize is that if we shift the burden of "health care" into a "burden of paying taxes" we've saved nothing, we've just created a mechanism to give something to people that aren't paying for it, and the system needs more than that.
Pardon me, but did you mean "and the system doesn't need more than that" or was that sarcasm? That said, could you further explain? Thanks,

What I meant, more specifically, was that the system needs a greater over-haul than simply shifting a health care burden to a tax burden on the people. That alone doesn't generate a "savings" there's no "extra money" in implimenting a system that does just that, but some are happy to jump on that bandwagon. The "change" that needs to happen MUST invoke some cost savings or its utterly useless.
Certainly agree the entire system needs an overhaul (it has for quite some time), however couldn't the current system already be considered a 'tax burden on the people'? After all our taxes go to pay the un/under-insured now. Wouldn't it be more cost effective to shifts the costs to the 'start / beginning / preventive' part of the care rather than the 'end / emergency' part?

wjb21ndtown wrote:
Now, back on topic, if we're only concerned with good ideas and implementing them (which is what you say you are), who cares who has talked about eliminating corruption for decades, and who cares whom hasn't done anything about it? Everyone agrees that it is a good idea, so why don't Dems and Liberals get it done? Why don't they let Reps be the party of talking, and the Dems be the party of action, and get this deal taken care of? I agree that the whole system needs fixing, but there are ways to tackle that in small chunks, without uprooting the entire deal. There are ways of unequivocally making HC more affordable (offering plans across state lines), that should be attempted first, before extending bad care and promoting systems with inflated costs and corruption. You do realize that when you amplify our current system (which is what Obama Care does) you're also amplifying all of the corruption in it, right?
Did you listen to yourself writing this? Seriously? The bolded part is screaming to me that the 'Repubs are right! Dems must submit to our ways' Do you realize how silly that sounds? Imagine it in reverse 'Everyone agrees that it is a good idea, so why don't Repubs and Conservatives get it done?' As someone that aligns with conservatives, how would hearing that make you feel? I'm guessing you'd feel a bit like you're being attacked and blamed for something is the fault and responsibility of BOTH parties. IMO it is thinking like this that has brought us to our current state of hyper-partisanship. Each side blaming the other for the wrongs and claiming they have the correct solutions. That said, don't get me wrong the way the PPACA was pushed through is disgusting. There should've been televised bipartisan discussions on how to solve this issue, not the backdoor deals.

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May 10th, 2012, 11:11 am
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Post Re: Why emergency rooms don't close the health care gap
TheRealWags wrote:
This sounds very interesting. In your earlier example of "what do you do when you find that someone has early cancer?" How would that be handled under your proposal? The 'bare minimal care' aspect covers the tests that discovered the cancer, and the 'catastrophic care' covers the needed treatment? What limits, if any, are there for the catastrophic care? What would the expected out-of-pocket costs be in this scenario?

This created the following scenario in my wacky brain: Remembering that we're for 'personal responsibility' and that some cancers can be caused by environmental factors and that some Govt policies (or lack thereof) could be responsible for those environmental factors, who should be responsible for the needed care? Should it be the affected person, that did nothing more than 'be' in said environment? Should it be the Govt, that is responsible for the policies (or lack thereof)?


At least how I envision it, the catastrophic care insurance would be sort of al la cart. There are relatively cheap methods of "curing" or "treating" cancer, and there are uber, uber expensive methods. Bare minimum insurance would give the cheaper forms of care, more expensive programs would give higher levels of care, but again, you would have to have this insurance before you contract the disease, other wise you literally get no care for your ailment. For any "real" insurance program to work you have to have the insurance before the disease is contracted. That's what insurance is for, you pay now in order to not potentially get stuck with a bill later. In this country people want health insurance to act as a discount for medical care, meaning, they want to buy the insurance when they're sick, get 80% off of their medical bills, and cancel their insurance after they're cured.

TheRealWags wrote:
wjb21ndtown wrote:
That said, in order for the plan to work, you literally have to be willing to let people die that do not carry the catestrophic care coverage, and most Liberals can't stomach that. Like I said, under the current system you literally can't cover everyone for everything. IMO my proposed plan does better, but you're still going to have gaps. You just have to figure out where the gaps MUST exist, at least for now.


We, as a society, are already 'letting' people die as they do not currently have access to health care, which IMO has little to do with someone being 'conservative' or 'liberal'; its a 'side-effect' of our current system. That said, I do understand there will be some gaps initially, but that doesn't mean the gaps have to be wide / large or exist for very long.


I don't think you understand where I'm coming from. What I'm saying is, even after we've reduced health insurance costs, we have to let people that don't carry catastrophic care insurance die if they contract a catastrophic disease. The "gap" would come into play for infinity, where ever people refuse to be accountable for themselves and choose to not be covered.

TheRealWags wrote:
I've been in emergency rooms before a few times and didn't notice anything that would resemble 'over-serving', in fact I rarely saw anyone the entire time I was there sitting on a gurney. In my anecdotal story, I sat on said gurney for over 90 mins before seeing a Dr; the triage took approx 30 mins to be seen. That said, anecdotal stories are rarely a good source for creating policy on any level IMO.


How about surveys where 70-80% of the people state that they've been "over-cared for" after an emergency room visit? Or:

Quote:
Elliott S. Fisher of Dartmouth College details analyses demonstrating that decreased use of discretionary services in the Medicare program could save approximately $50 billion a year, or approximately 20 percent of current spending.


It isn't my anecdotal story Wags, it's how hospitals perform health care. I had to undergo the jaw scan, quite literally because they just got a "new machine" and they wanted to "try it out." That was blatantly discussed in front of me while I was at the hospital. Discussion of these sorts are like seeing rats, mice, and cockroaches... if you can see one or two, there's thousands more behind the walls... this isn't something that "happened to me" this is something that happens every day at hospitals across the nation... And, btw, I was billed $1,200 for them "wanting to try out their new piece of equipment." And still, NONE of this accounts for the fact that if I had gone to a family doctor, NONE of these tests would have been performed nor suggested. That's a $3140 swing in cost right here, with this one case, and it happens all of the time. Hospitals literally force people to take $25 tylenol, because they can. That's just disgusting.

TheRealWags wrote:
Understand what you're saying here, but let me ask you, how would this scenario be different from your proposed plan? Wouldn't we still need more / better infrastructure to support it as well? We already understand / accept there will be gaps, however, if I'm understanding your proposal correctly there will still be more insured / have HC access than we have today, correct? Are you thinking that because these gaps might be greater under your plan, then there wouldn't be as big of a demand for the infrastructure?


It's about cost, who's paying the tab, and who's getting the care, and what level of care that is being received. Liberals pound their fist and cry that poor people can't get physicals, go to the doctor for ordinary ailments, and those ailments regularly turn into much bigger problems that cost tons more, but they NEVER want to talk about what to do with people that take precaution and STILL get sick. They don't come out and say that they want to cover "everyone all the time, for every disease," but that is exactly what they want. My plan does more to cover the preventative stuff, and ordinary ailments, but doesn't cripple the system with forcing them to care for people with no insurance and million dollar diseases. that's why it doesn't put the stress on the infrastructure or the health care system.

It does "bridge a gap," and it does "close a gap" (that gap being providing AT LEAST the ordinary care, and preventative care that they should have), but it doesn't pretend to cover everyone, always for everything. It intentionally leaves people out to dry (just as the current system does), but curbs costs and lends a hand to people by way of preventative care and typical maintenance. I don't disagree that we should strive for something more, but again, this is something that we could do RIGHT NOW, that WOULDN'T turn the HC industry on its head, and it would provide EVERYONE with a modicum of health care coverage.

TheRealWags wrote:
I agree that a 'phased in' approach would prolly be better, not too mention less stressful on the current system. How would you suggest the phases to go? What comes first? second? etc?


I would suggest first getting everyone on some plan. That's step one, insuring everyone with some sort of health care that provides them real access to the HC system, gets their medical charts started and gets their preventative care rolling, and reducing waste/corrpution and implementing cost savings mechanisms into our system. Step two would be increasing that coverage to perhaps broken bones and larger ailments (normal surgeries like tonsils, removing an appendix, gallbladder, pancreas, kidney stones, etc.). And step three would be adding to our HC system (adding doctors, nurses, hospitals) along the way, to reduce costs, stream line waits, and hopefully increase universal coverages, ALL while multiple HC companies are competing for our business AND health insurance IS being sold across State lines (again reducing costs).

TheRealWags wrote:
BTW - Nothing is "just plain not do-able" IMO - more defeatist attitude.... Isn't this part of capitalism? Companies that cannot adjust to the current climate go out of business and new ones that can handle it replace them? One would think this is a good thing, no? While I'm not one to support policies / efforts that are distinctly anti-business, I'm also not one to coddle them either. These insurance companies have been screwing the insured for decades, perhaps its time for them to 'pay the piper', so to speak. (Karma)


You must be off here somewhere... In Capitalism companies go out of business all the time, but they at least have a business model to succeed. Forcing an insurance company to cover someone for a reasonable cost ($1,200 - $3k a month) to treat a million dollar disease is forcing them to have a business model that causes them to fail. NO COMPANY could succeed under that system. Success, for a company in that environment, would be impossible, BY DEFINITION. There is no company that could "handle" that handicap, none.

How have these insurance companies been screwing the insured for decades? BCBS is a NON PROFIT COMPANY! How does it screw the people it insures? The only people "screwing the insured" are the free riders that don't have insurance. They drive up the costs of HC and force the insurance companies and the Federal Govt. to bridge the gap, driving up health insurance costs. It's not the "bad companies" (again a Liberal mantra) screwing "the people."

TheRealWags wrote:
Certainly agree the entire system needs an overhaul (it has for quite some time), however couldn't the current system already be considered a 'tax burden on the people'? After all our taxes go to pay the un/under-insured now. Wouldn't it be more cost effective to shifts the costs to the 'start / beginning / preventive' part of the care rather than the 'end / emergency' part?


I don't disagree with any of this, and I think we need to start with preventative care. My only point was the "the people" seem to think that's its "ok" to implement a system that generates no savings (or no cost benefit), and they think it's a "win" if HC costs are supplemented with taxes. That's just plain not true, and it's only a mechanism to get the wealthy to pay for a bigger portion of the tab.


TheRealWags wrote:
Did you listen to yourself writing this? Seriously? The bolded part is screaming to me that the 'Repubs are right! Dems must submit to our ways' Do you realize how silly that sounds? Imagine it in reverse 'Everyone agrees that it is a good idea, so why don't Repubs and Conservatives get it done?' As someone that aligns with conservatives, how would hearing that make you feel? I'm guessing you'd feel a bit like you're being attacked and blamed for something is the fault and responsibility of BOTH parties. IMO it is thinking like this that has brought us to our current state of hyper-partisanship. Each side blaming the other for the wrongs and claiming they have the correct solutions. That said, don't get me wrong the way the PPACA was pushed through is disgusting. There should've been televised bipartisan discussions on how to solve this issue, not the backdoor deals.


Not at all Wags, you're taking the position of a jaded Liberal "why me" "why am I always wrong" "why do you think you're always right"... IMO the Reps approach to HC IS right, but it's only because the Dem approach is so radical and improbable and its rife with holes and issues. Reps want to fix the system incrementally. The Dems want to pass a bill that no one knows whats in it, stress the system to the point of failure, and try to run around like a chicken with our heads cut off and patch the holes in the process. You really think that's the way to go?

I'm not saying that the Dems should "submit" to the Reps "ways," and I'm not saying that anyone is "right" or "wrong." If they have another plan, THAT'S FINE WITH ME. What YOU said was "the Reps have talked about fixing corruption for decades and have done nothing..." and you said it as if it was the right thing to do, and as if THEY and THEY ALONE were the ONLY ones that could stick with their own idea. That somehow the Dems were free of guilt for NOT fixing corruption, and that somehow corruption couldn't be fixed because it was a Rep thing and they're not going to finish the project that they started.

This isn't a car in the garage. It's not an "item" that one side possess that they and they alone need to fix. This is a community project that anyone can pick up and run with. The Dems are just as guilty for not fixing the corruption in the system, and ANYONE can step up and fix corruption, and ANYONE can do the right thing.


May 10th, 2012, 2:33 pm
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Post Re: Why emergency rooms don't close the health care gap
Quote:
me neither, and the problem is the "medical bills" aren't paid when someone files bankruptcy, which is why costs have to get passed down. However, IMO one of the BIGGEST problems with our HC industry is that they OVER CHARGE and OVER SERVE people to the point where they HAVE to file bankruptcy to cover their bills. A hospital charges about 400%-1200% more for an MRI/CAT Scan, X-Ray, EKG etc. than a "boutique clinic" that specializes in the service. 1) that's ridiculous, but 2) they often do UNNECESSARY PROCEDURES. I went to the hospital for a mild concussion that I KNEW was a mild concussion but I HAD to get written proof. I knew I wasn't in any danger, and I knew that I was fine. Not only did I have to get a cat scan, I also had to have 6 X-rays of my spine, and an entire jaw scan from this weird thing that went around your head in a circle. After everything was said and done what my family doctor could have done for $60-90 ended up costing over $2k, and ALL THEY WANTED TO DO WAS USE THEIR TOYS AND DRIVE UP THE COST. If I refused ANYTHING they said that they wouldn't even diagnose me, and they said that I would get billed for everything they did and not get any paperwork stating what they treated. And on top of that I got not one but TWO $25 tylenol, when a bottle costs $5, and I HAD to take them right there in front of the doc. Now what did I do about it... I phucked 'em, and I don't feel bad about it one bit. I disputed the charge with the collection company, threatened to take them to court, and paid $200 total, so the hospital received about $100 after I was there for almost 12 hours, unnecessarily so. And this is COMMON PLACE, and it happens EVERY DAY!


Im not sure what the specifics of your case were wjb so I wont fault you for going to the ER but I just want to point out that the ER is a place that gets badly abused by many but especially by the uninsured who feel they have no access to health care. Going to the ED for a concussion is one thing but going there for carpal tunnel or a hernia or a lump thats been on your back for 5 years is another. People go to the ER for these things all the time when they know damn well it is not an emergency and could be better taken care of in an outpatient setting but they know they if they call to set up an appointment they will have to prepay if they dont have insurace so instead they go to the ED where the care is more expensive bc the resources are more limited (not bc of intent to overcharge) and subsequently stiff them on the bill. Costs are generally going to be higher in the ED because they do not have the advantage of continuity of care and because they have limited resources. They essentially have one shot to figure out first of all what your problem is but more importantly that it is not what the worst case scenario of a patient with your symptoms are. This is called defensive medicine and almost everyone in medicine practices like that for fear of lawsuits. Your emergency room doctor's intentions were not to overcharge you when he/she ordered the imaging studies you mentioned but rather to make sure that whatever head trauma you had that caused your concussion did not also cause a fracture in your cervical spine or in your jaw. His goal was not to drive up costs but to make sure you did not have any of the worst case scenarios especially because you were asking for some sort of paperwork presumably to allow you to return to work or some sort of physical participation and did not want that liability without doing a full workup on you. I do not see where you point out an unnecessary procedure was done on you but that is very rare unless you are saying imaging = procedure. Anyway the point is that you are demonstrating an example of something that drives up health care costs. I disagree with your opinion that the HC industry is the root cause of this problem - IMO its more a result of lawsuits and people taking the path of least resistance to access health care. Universal health care or not its going to be an expensive problem for this country if physicians have to practice while worried about lawsuits and if patients continue to use the wrong avenues to seek care.


May 10th, 2012, 4:21 pm
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Post Re: Why emergency rooms don't close the health care gap
wjb - I'll respond later when I have more time....

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May 10th, 2012, 4:26 pm
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Post Re: Why emergency rooms don't close the health care gap
The Legend wrote:
Im not sure what the specifics of your case were wjb so I wont fault you for going to the ER but I just want to point out that the ER is a place that gets badly abused by many but especially by the uninsured who feel they have no access to health care. Going to the ED for a concussion is one thing but going there for carpal tunnel or a hernia or a lump thats been on your back for 5 years is another. People go to the ER for these things all the time when they know damn well it is not an emergency and could be better taken care of in an outpatient setting but they know they if they call to set up an appointment they will have to prepay if they dont have insurace so instead they go to the ED where the care is more expensive bc the resources are more limited (not bc of intent to overcharge) and subsequently stiff them on the bill. Costs are generally going to be higher in the ED because they do not have the advantage of continuity of care and because they have limited resources. They essentially have one shot to figure out first of all what your problem is but more importantly that it is not what the worst case scenario of a patient with your symptoms are. This is called defensive medicine and almost everyone in medicine practices like that for fear of lawsuits. Your emergency room doctor's intentions were not to overcharge you when he/she ordered the imaging studies you mentioned but rather to make sure that whatever head trauma you had that caused your concussion did not also cause a fracture in your cervical spine or in your jaw. His goal was not to drive up costs but to make sure you did not have any of the worst case scenarios especially because you were asking for some sort of paperwork presumably to allow you to return to work or some sort of physical participation and did not want that liability without doing a full workup on you. I do not see where you point out an unnecessary procedure was done on you but that is very rare unless you are saying imaging = procedure. Anyway the point is that you are demonstrating an example of something that drives up health care costs. I disagree with your opinion that the HC industry is the root cause of this problem - IMO its more a result of lawsuits and people taking the path of least resistance to access health care.


1) Some drunk POS attacked me from behind and punched me in the back of the head repeatedly. I was fine, but I needed a medical report for my "injuries" to press charges because they weren't visible (lumps covered by hair).

2) Legend, I respect your affiliation with the medical profession, but in no way was my spine, jaw or anything else was danger of damage. The CAT scan and discussion with the neurologist were warranted, but everything else was way, WAY over-board, and completely unnecessary.

I didn't even go to the hospital until the following day, and told the doc that I was fine and I only needed a medical description of my injuries. I was forced to go to the emergency room because I had "University Health Insurance," which required me going to the school clinic first before getting a recommendation to go to my family doctor, but the school physician wasn't in so they recommended that I go straight to the hospital.

The SIX X-rays I received and the jaw scan were totally unnecessary (if they really wanted to investigate something an MRI would have been more appropriate), and they simply would NOT have been done had I gone to a normal doctor, period. Further, as I mentioned, the ONLY reason I got the "jaw scan," was because they just got the damn thing earlier that week. I had absolutely no jaw problems whatsoever, and it cost me an additional $1,200. That's completely ridiculous.


May 10th, 2012, 4:39 pm
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Post Re: Why emergency rooms don't close the health care gap
well there is a major problem with insurance plans like that which wont let you be seen in an outpatient setting in a timely manner. i cant speak to why the ER phsyician ordered the jaw scan - normally there would have to be some tenderness in the area on a physical exam, obvious trauma/bruising to the area or at least a complaint of pain in the area. I agree it sounds unnecessary but I have seen very few physicians that order tests for the purpose of driving up costs. that is not what is taught in medical school and generally there is no financial benefit to the physician himself of ordering such a test in an ER setting (in some outpatient settings the doc might be invested in a radiology suite or something similar but not an ER doc in a hospital)


May 10th, 2012, 4:55 pm
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Post Re: Why emergency rooms don't close the health care gap
Some of the little things bother me too. I was told that if I don't take $50 worth of Tylenol (I was experiencing a moderate amount of pain, but it's nothing that I would have medicated myself for), that I would have been "refusing treatment," and I would have been removed from the hospital without any paperwork or diagnosis (which is what I was there to receive). Again, ridiculous.

My Mother went to St. Johns for a heart issue and they removed her appendix just for the hell of it. They couldn't find anything wrong with her heart, so they took out her appendix so they would have something to bill, and they said "it will save you potential problems with your appendix later down the road" with no prior history of problems, or family problems. That bill was something like $20k and two nights in the hospital. I don't see how they justify that crap, and again, it happens all the time.


May 10th, 2012, 5:02 pm
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Post Re: Why emergency rooms don't close the health care gap
i dont understand how they could go from a heart issue to removing an appendix but if she was having an exploratory laparotomy (essentially surgically exploring the abdomen) most general surgeons would remove the appendix even if nothing was wrong with it. the only thing i can come up with if she was having a heart issue would be that they feared she had ischemic bowl which can be life threatening and would indicate the need for an ex-lap. if that was the case however she would have had abdominal pain among other problems. was her surgery a laparoscopic appendectomy (several small incisions < 1 inch each) or an open appendectomy as part of an exploratory laparotomy?

regardless it sounds as if you have some bad experiences which i would consider outside of what standard practice. its also possible that some of the details are forgotten or lost in translation somewhere. it is risky to operate on someone with heart problems especially if you are doing an unnecessary procedure and most surgeons tend to avoid risks unless absolutely necessary - not for the heck of it or for theoretical prophylaxis


May 10th, 2012, 5:17 pm
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Post Re: Why emergency rooms don't close the health care gap
The Legend wrote:
i dont understand how they could go from a heart issue to removing an appendix but if she was having an exploratory laparotomy (essentially surgically exploring the abdomen) most general surgeons would remove the appendix even if nothing was wrong with it. the only thing i can come up with if she was having a heart issue would be that they feared she had ischemic bowl which can be life threatening and would indicate the need for an ex-lap. if that was the case however she would have had abdominal pain among other problems. was her surgery a laparoscopic appendectomy (several small incisions < 1 inch each) or an open appendectomy as part of an exploratory laparotomy?

regardless it sounds as if you have some bad experiences which i would consider outside of what standard practice. its also possible that some of the details are forgotten or lost in translation somewhere. it is risky to operate on someone with heart problems especially if you are doing an unnecessary procedure and most surgeons tend to avoid risks unless absolutely necessary - not for the heck of it or for theoretical prophylaxis


Honestly, I don't remember. She has had a pace-maker for years, and she was having problems with it. I think it was exploratory, but she literally had no other health problems, ever. They were investigating her heart and took out her appendix, and literally said that they just did it for precautionary reasons, because it doesn't do anything and it can only cause problems later. It was more or less "we did it because we were in there, looking around, and didn't see anything else."

She has "total heart block" (her heart is healthy, but the nerve that tells her heart to beat doesn't operate, at all), and totally relies on her pacer. What's really effed up is she died three times the next day or the day after she got out of the hospital, and the last time she was dead for 12-20 minutes and has long-term memory problems, and emotional problems now. I'm sure she could have sued for a TON of money, but she refused.


May 10th, 2012, 5:25 pm
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