Study debunks emergency room myths

[snopes]

The uninsured are not responsible for overcrowding in the nation's hospital emergency departments, despite conventional wisdom to the contrary, a study says.

http://www.deseretnews.com/article/1...257138,00.html

Everyone knows that the real problem is all the illegal immigrants.

What's great is I can use this post in any topic.

[RivkahChaya]

My son has been to the ER for a few things that maybe weren't true emergencies, but for which it wasn't a good idea to wait, and if it popped up after hours on Friday, the ER was the only choice. His doctor's practice has a weekend clinic, and there is an afterhours clinic that is opened until about 10pm on weekdays. There's also a clinic called the "Acute Clinic" opened during the day run by our doctors practice that is designed for people who don't need ER care, but can't wait two weeks for a doctor's appointment-- things like infections that need antibiotics. The idea is that generally healthy people with transient problems needing treatment ASAP will not be squeezed into a doctor's schedule that is full of people receiving well-patient care, like yearly physicals, or regular appointments for things like diabetic monitoring, Rx renewals for high blood pressure medication, and such.

It's a pretty good system in that when I go in to have an appointment scheduled a week earlier to have stitches removed, or something, I don't end up getting bumped for all the people who need to get in right away for high fevers or something, and I don't pay ER costs for something that isn't really an emergency, but can't wait either, like when my husband needed a prescription for Compazine because he had food poisoning, and was getting dehydrated from the puking, and it was about seven pm.

The problem is that none of the clinics, not the acute, the afterhours, or the weekend clinic take patients under 24 months, so if a baby or toddler is sick, or gets a bad head bonk on Saturday afternoon, it's off to the ER, because there is no pediatric clinic. DS just turned two, so from now on he can be seen other places, but this city still really needs a pediatric acute/afterhours clinic.

[Arriah]

I would suggest that many of those people on 'public insurance' are underinsured and that leads them to the ER. I know ages ago when we looked at that, they would only cover preventive care for DD1 and DH and I would have only gotten catastrophic care. So if we'd gotten a cold, we'd have no choice but to wait till it was a horrible infection and then go to the ER if we wanted it covered. brilliant policy there.

[Sylvanz]

Originally Posted by Arriah

I would suggest that many of those people on 'public insurance' are underinsured and that leads them to the ER. I know ages ago when we looked at that, they would only cover preventive care for DD1 and DH and I would have only gotten catastrophic care. So if we'd gotten a cold, we'd have no choice but to wait till it was a horrible infection and then go to the ER if we wanted it covered. brilliant policy there.

My "Public Insurance," a county health care plan, does not allow trips to the ER for ANY reason. If I got hit by a bus it would not be covered. Stupid privately uninsured people should really not get unexpectedly sick or injured you know. The more I think about our insurance "system" the more it boggles my mind that we haven't done something better yet. It's scare tactics, ignorance, and people voting against their best interests that has prevented it so far. All of that and a foolish and much exaggerated knee jerk fear of teh ebil, "Socialism," *shudder.*

Edit to add: Oh yeah and I probably won't be eligible for this insurance for long, and I don't have the $ for private insurance, and my chances of going full time at my job are slim to none. Ain't the US "Health Care System" grand?

P&LL, Syl

[Ali Infree]

I am surprised that it takes a study to find these things out. The idea that people without insurance will go to the ER because they have a cold is moronic on the face of it. My experience with this was always that I would not go and get medical care unless I was very sick. Even with health insurance, I tend to wait till I feel rotten to go to the doctor.

I cannot believe the number of people who still spout out that the US has the best health care in the world. Around here, it is almost impossible to go to a convenience store that doesn't have flyers for progressive dinners, spaghetti dinners, benefit shows, or just collection cans for adults and children needing expensive care or operations. Does this happen anywhere else in the developed world?

BTW, the scenes in Sicko where the Michigan resident sneaks into Canada to get health care is terrific. So GenYus, you're right:

Everyone knows that the real problem is all the illegal immigrants.

Ali "just a sucking chest wound away from hospitalization" Infree

[lyra_silvertongue]

Originally Posted by Sylvanz

Edit to add: Oh yeah and I probably won't be eligible for this insurance for long, and I don't have the $ for private insurance, and my chances of going full time at my job are slim to none. Ain't the US "Health Care System" grand?

P&LL, Syl

But Sylvanz, with universal health care the government decides what kind of care you get. And if it's so great, why do "so many" Canadians come to America for care?

(This is how my mother argues against socialized medicine.)

[RivkahChaya]

Is that the same government that passed a law requiring insurance companies to allow women having mastectomies to stay overnight in the hospital?

FWIW, I sort of have government healthcare, in that I have US military insurance. It is excellent. They pay for anything the doctor recommends, and have paid 100% of all our emergency room visits. The single problem I have with them is that after paying 35,000 dollars for me to have a baby (that's prenatal care, and the long labor with the emergency c-section, plus my son's neonatal care), but then refused to pay 78 dollars for me to get a prescription for a new diaphragm, or for the diaphragm itself. However, having everything else paid for, I could afford the diaphragm.

We do pay a premium, because my husband is in the reserves-- if he were active, we wouldn't pay a premium-- but it covers all three of us, and is way less than what we'd pay for healthcare if we had to pay for everything ourselves, or had some kind of lousy "catastrophic only" coverage.

I think the government could probably do healthcare quite well.

I suspect the ER overcrowding lately is the result of multiple factors, and one of them is the nursing shortage.

But I think uninsured and underinsured people probably do disproportionately end up in emergency rooms (they can be disproportionate, and still be a minority), just because they are more likely to let something go until it becomes a crisis-- for example, not treating a wound when it first happens, then when it becomes infected, and developes into gangrene or septicemia, going to the ER. OK, maybe that's extreme, but I'm certain things like it happen.

I had health insurance before that made ER visits a LOT cheaper than doctors visits. My plan only paid 80% of the doctors bill, where as it only charged a $25 flat fee for an ER visit. That, added with a typical two week wait for a regular doctors appt. made me much more likely to use the ER and save weeks of waiting, and a significant amount of money.

[Arriah]

Originally Posted by Ali Infree

I cannot believe the number of people who still spout out that the US has the best health care in the world.

Because most expensive=best, duh!

We do have a good number of highly capable specialists, just that noone can afford to visit them.

[Eddylizard]

Originally Posted by RivkahChaya

The single problem I have with them is that after paying 35,000 dollars for me to have a baby (that's prenatal care, and the long labor with the emergency c-section, plus my son's neonatal care), but then refused to pay 78 dollars for me to get a prescription for a new diaphragm, or for the diaphragm itself.

Yeah kind of odd that. For some reason the NHS has a bug up its ass about paying for sterilizations.**

When I wanted a vasectomy, I was by all accounts lucky to have a doctor who would send me forward to have it done on the NHS. A lot of people get turned away, and have to get it done privately.

Now the vasectomy was £125*. I don't have figures but if I'd fathered another child, then what would that cost the state? After prenatal care, childbirth, vaccinations, and education (okay not a health thing, but the money comes out of the same pot) a lot more than £125 for sure. There are probably other state costs associated with a child that are too numerous to mention, and I'm just assuming a child that never gets sick with anything - ever. Like that happens.

Okay I'll concede that a healthy child grows up to be a taxpayer, but I still think on a cold cost benefit analysis that the government were better off shelling out for the vasectomy.

*£125 to me if I walked in off the street. NHS I'm guessing gets it a bit cheaper. Oh and before you ask, yes £125 is not a huge amount of money to most people, but DW and I barely had enough money at the time to feed the family and keep a roof over our heads. This financial situation was a large part in our decision to take steps not to have another baby.

**Although other forms of birth control (condoms, pill, diaphraghm, IUD, the Jag, implants and maybe others) are readily available free on the NHS. I wonder how the costs to the state compare to that of a vasectomy? How much does say 20 years of oral contraceptives cost?

Originally Posted by Ali Infree

I am surprised that it takes a study to find these things out. The idea that people without insurance will go to the ER because they have a cold is moronic on the face of it. My experience with this was always that I would not go and get medical care unless I was very sick. Even with health insurance, I tend to wait till I feel rotten to go to the doctor.

Wow. It's not. I work at the front desk of a pediatric ED. I would say 1/3 of the people we see come in for cold/flu/etc. I can't say how many of these people have insurance as we do not take care of that until you are in a room (that way, we are not being discriminatory based on ability to pay). I would guess that most have public insurance based on the number of "Do you take medicaid?" I get. I do not blame the parents for this - I only know of one doctor's office (the one ran by the hospital I work for) that takes medicaid. If my kid had an ear infection on a Friday evening and I had no other choice, the ED it is. I'm not going to wait three days with my kid in pain to get antibiotics.

We do see a lot of people who do not have insurance (again, only based on the "I don't have insurance - can my child still be seen?" questions I get). I would say they put a "kink" in the system, but this group of people is not the sole cause of ED overcrowding.

[FullMetal]

Originally Posted by lyra_silvertongue

But Sylvanz, with universal health care the government decides what kind of care you get. And if it's so great, why do "so many" Canadians come to America for care?

(This is how my mother argues against socialized medicine.)

Because they want to jump the queue. (or get an MRI for a slipped disk which an x-ray has already shown to be the cause) and it's not that the government decides what kind of care you get, the doctor still does that. the problem is actually with the management of the money given by the gov't. whats the point of having 2 MRI machines in a hospital if only one get's used 50% of the time and the other lies dormant, while there's a waiting list 10 miles long to get an MRI. (although if it's an emergencie you do get in... I've known many people who've had an MRI the same day, because it was an emergency, the people on waiting lists generally can wait, some can't, but that's a fault of the Doctor doing the diagnosis not the system.

[Magdalene]

Originally Posted by Ali Infree

I cannot believe the number of people who still spout out that the US has the best health care in the world.

I can. I just got into a debate with a guy from my high school class who spouted off, "Why are all the Canadians coming here for surgery then?" (I obviously missed the mass invasion from the North.) "Have you LIVED in Canada?" (Spoken as though Canada is a third-world country, and incidentally, this guy didn't either.) "We have the best health care in the world and everybody knows it, that's why they come to America!" I gave him a WHO list showing our ranking. Then his tune promptly became, "I don't care what the rest of the world thinks."

This guy has been in the military ever since high school, and yeah, medical treatment in the military's probably as close to socialized medicine as the U.S. comes currently, but the point is, he's always HAD health care for free. So he lacks complete and total compassion for those who haven't been so lucky, because it's all, "I don't want my tax dollars funding OTHER people's medical care, if they don't have it, they were slackers and jerkoffs."

I told him my story. Didn't make a damn bit of difference to him.

Magdalene

[Themis]

Originally Posted by Magdalene

I told him my story. Didn't make a damn bit of difference to him.

Are you new here?

[Nonny Mouse]

Originally Posted by Magdalene

I can. I just got into a debate with a guy from my high school class who spouted off, "Why are all the Canadians coming here for surgery then?" (I obviously missed the mass invasion from the North.) "Have you LIVED in Canada?" (Spoken as though Canada is a third-world country, and incidentally, this guy didn't either.) "We have the best health care in the world and everybody knows it, that's why they come to America!" I gave him a WHO list showing our ranking. Then his tune promptly became, "I don't care what the rest of the world thinks."

Just out of curiosity, do you have a link to that list?

Nonny

Originally Posted by Magdalene

This guy has been in the military ever since high school, and yeah, medical treatment in the military's probably as close to socialized medicine as the U.S. comes currently, but the point is, he's always HAD health care for free. So he lacks complete and total compassion for those who haven't been so lucky...

That guy sounds like a jerk and that might indeed be the reason he lacks compassion, but I doubt it.

I have always had free (or nearly so) health care, also through the military system, from birth through my father then my husbands and currently have Tircare (military) as a benefit of my husband's military retirement for which we pay a small premium (less than $40/month) but receive the best coverage of any insurance I have known (working on the other side in the medical field I have dealt with many).

Although I have never known first hand what it is like to be under insured or uninsured (although there was a short time between marriages that I was uninsured, I did not get sick or need medical care so it really did not affect or impact upon me at all) I have always had plenty of compassion and understanding for those who are or those who must pay high premiums for poor coverage. Simply being "lucky" in this aspect does not make one less understanding or less compassionate at all.

And having been a recipient of "government health care" my entire life (and having received some of the best medical care and treatments) at no or little cost to me, I will echo RivkahChaya in that I think the government could do health care well.

Originally Posted by FloridaGirl

Wow. It's not. I work at the front desk of a pediatric ED. I would say 1/3 of the people we see come in for cold/flu/etc. I can't say how many of these people have insurance as we do not take care of that until you are in a room (that way, we are not being discriminatory based on ability to pay). I would guess that most have public insurance based on the number of "Do you take medicaid?" I get. I do not blame the parents for this - I only know of one doctor's office (the one ran by the hospital I work for) that takes medicaid. If my kid had an ear infection on a Friday evening and I had no other choice, the ED it is. I'm not going to wait three days with my kid in pain to get antibiotics.

I can so relate to this. I've worked in several hospitals in different states and I still say the ER sees far more cases of non-insurance or Medicaid than real emergencies. I personally loved the ones that come in on a Fri night/Sat morning at 2 am with a discharge... or constipation... or any number of other things that make you say one, they have no insurance and two, why the hell did they come in the middle of the night for this?

[Mad Jay]

I think US has one of the best medical professionals in the world. THe problem is that they are so damned few of them and they are so damned costly, that many people cannot afford to get the healthcare

That is quite a shame if you think about it. In a sense, we do have one of the best healthcare in the world. We have one of the best medical professionals; US is where a lot of medical and pharmaceutical research is done; In most places, US has pretty good infrastructure to supply medical services to it's residents. People can't afford it. It's like a city that has a big water tank, an excellent filtration system and each house is fitted with the neccesary plumbing, but water flows only to some of the residents. How unfair is that?!

[Nick Theodorakis]

Originally Posted by medtchva

I can so relate to this. I've worked in several hospitals in different states and I still say the ER sees far more cases of non-insurance or Medicaid than real emergencies. I personally loved the ones that come in on a Fri night/Sat morning at 2 am with a discharge... or constipation... or any number of other things that make you say one, they have no insurance and two, why the hell did they come in the middle of the night for this?

Because it's less crowded, and/or they're working during the day?

Nick