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The ER has become a sanctuary for society’s unmet needs

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Re: The ER has become a sanctuary for society’s unmet needs

#21

Post by notch656c »

genderwhy wrote: post #4

When you don't spend the time and money on preventative care as a society, you end up spending much, much more on emergency care. I feel like this has been quantitatively demonstrated again and again, but it's somehow still a political football.

Having worked in an ED I can tell you it's much more like "when you make ED the only place that can't turn away patients, patient goes there for everything including the common cold."

It's not so much a minor thing turned into an emergency (that is a problem of course) but rather the patient has no other venue for minor needs without money or insurance.

Re: The ER has become a sanctuary for society’s unmet needs

#22

Post by maxsilver »

at_a_remove wrote: post #8
derbOac wrote: post #2

Libraries also function in this role, but for different types of problems.

I was just about to mention that. The vulnerability to this kind of exploitation takes a different from than the emergency room. The Internet, search engines, Google, and so on created a kind of identity crisis in the library world, partially stemming from the people who think that they're going to learn with any depth from a quick search, but also self-inflicted, "Who are we in a 'digital age'?" sort of wailing. And…

> Interesting, too, that one of the other big societal institutions open to all comers, the churches, have largely dwindled.

Churches (at least in the US) haven't been open to all for many decades now, they're highly exclusive places. Yes, technically anyone can usually walk through the door on a Sunday morning for free, but other than that literal hour, Churches usually have a lot of restrictions before a person is allowed to meaningfully participate in any way (restrictions on income, location, wealth, lifestyle, etc)

US Christian Churches are basically political country clubs pretending to be non-profits by way of their religious veneer. I would argue they're almost the complete opposite of a Public Library or Emergency Room.

Re: The ER has become a sanctuary for society’s unmet needs

#23

Post by vkou »

User23 wrote: post #12
cjbgkagh wrote: post #7

Earlier quoted context omitted.

It is robber baron type stuff. It is absolutely nuts. I completely understand people escaping ambulances to avoid a $10K Aspirin. I avoid going to the US on the off chance that I might need medical care.

Somebody has to pay for all the "free" care.

And also for the profit margins of the owners of the hospital, and for the doctors' dachas, and for the administrative bloat in medical schools that leads to a medical education costing a million bucks, and, and...

Re: The ER has become a sanctuary for society’s unmet needs

#24

Post by [deleted] »

User23 wrote: post #12
cjbgkagh wrote: post #7

Earlier quoted context omitted.

It is robber baron type stuff. It is absolutely nuts. I completely understand people escaping ambulances to avoid a $10K Aspirin. I avoid going to the US on the off chance that I might need medical care.

Somebody has to pay for all the "free" care.

[deleted]

Re: The ER has become a sanctuary for society’s unmet needs

#25

Post by davidw »

denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

When we lived in Italy, my then toddler had one of these: https://en.wikipedia.org/wiki/Breath-holding_spell and as the article says "a breath-holding spell is a frightening experience for observers", which is actually a monumental understatement.

We called the equivalent of 911 with no thoughts whatsoever about money because it's simply not a factor there. He was fine before the ambulance pulled up (very quickly) but they took him and my wife to the hospital to check him up.

Didn't pay a dime for any of it, although of course you do pay higher taxes there. But the peace of mind is worth it and overall, Italy spends less of its GDP on health care than the US.

Re: The ER has become a sanctuary for society’s unmet needs

#26

Post by yamtaddle »

denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

After recently paying a fuck-ton for some stitches at an ER for a case that was a little hairier than urgent cares were willing to take on, but not at all life threatening, but also not something that could wait for a regular doctor... yeah, I'm seriously considering learning to apply sutures and buying a kit or something. I hate having to do "go, or don't and just hope it's OK?" when the best choice is clearly to go, and not having good options for taking care of it those kind of middle-grade problems myself.

(I did try superglue—growing up rural didn't teach me nothing about avoiding paying doctors—but one of the cuts was too big and too bleed-y for that to take :-( )

Re: The ER has become a sanctuary for society’s unmet needs

#27

Post by thatfrenchguy »

User23 wrote: post #12
cjbgkagh wrote: post #7

Earlier quoted context omitted.

It is robber baron type stuff. It is absolutely nuts. I completely understand people escaping ambulances to avoid a $10K Aspirin. I avoid going to the US on the off chance that I might need medical care.

Somebody has to pay for all the "free" care.

Hospitals in the US (just like a lot of other market participants) have no incentive to save money. This is what universal healthcare would give you: more money spent on care, less on bullshit. Obama famously said you couldn't do universal / single payer healthcare in the late 2000s because it would destroy too many jobs in billing.

Re: The ER has become a sanctuary for society’s unmet needs

#28

Post by lm28469 »

denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

I've always been told ER is for _emergencies_, I'd never go there for a 2nd degree burn or a small cut.

Emergencies as in "if I don't go there _now_ I might suffer _grave_ long term consequences" not as in "ouchie it'll be painful until I get it looked at tomorrow"

Re: The ER has become a sanctuary for society’s unmet needs

#29

Post by noorkersz »

davidw wrote: post #25
denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

When we lived in Italy, my then toddler had one of these: https://en.wikipedia.org/wiki/Breath-holding_spell and as the article says "a breath-holding spell is a frightening experience for observers", which is actually a monumental understatement. We called the equivalent of 911 with no thoughts whatsoever about money because it's simply not a factor there. He was fine before the ambulance pulled up (very quickly) bu…

but the USA has more millionaires

Re: The ER has become a sanctuary for society’s unmet needs

#30

Post by annoyingnoob »

denimnerd42 wrote: post #3

On the flip side.. as someone who pays their bills, the ER has become the #1 priority to avoid. I'd prefer not to pay 5000 or 6000 total - $3000 to a hospital and $3000 to an ER doctor agency for a small 2nd degree burn or small cut requiring stitches, or any other issue I may have been taken there in the past for. I'll sew my child up before I take them to a pediatric ER and I'll order the antibiotics from India or…

My daughter has needed to go to the ER several times, after 3 crap experiences with the ER nearby we now drive 40 miles to have a better experience. It is not only the billing issues, especially with the wave of 'Revenue Management' services providers are using, it is the patients in the ER. Dealing with the crazies, the people acting up to try to get attention, waiting for hours in this fun with a child, no thanks.
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