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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

#51
post #25

Earlier quoted context omitted.

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

[dead]

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

#52

Earlier quoted context omitted.

Well we're not only talking about adults but also talking about children here. At 9pm you get a small AND deep cut requiring stitches. It won't stop bleeding if you take pressure off. what do you do? At 9pm your family member accidentally drops a kettle of of hot but not life threatening water on your child and they get a large blister on their chest, what do you do? These are probably not serious situations but the…

Why not an urgent care?

Urgent Care has an annoying habit of charging a bunch of money to punt to the ER for liability reasons. Stitches and X-rays to see if you broke a bone are about the only thing they're good for.

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

#53
Bless them for caring. At the same time this really shouldn't be happening.

ER docs that can deal with incoming gun shot victims etc are a scarce resource and ER beds are expensive. There really should be a secondary channel people like this can flow into & the lack of this is a societal failure.

Leaning on the good heart & caring of ER gang is the wrong answer.

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

#54

This bugs me every time I read about free clinics and/or ER costs. It seems most Americans with limited or no healthcare is: 1. Go to the ER and pay $X000 2. Wait in line at a free clinic for 9+ hours and maybe/maybe not see a doctor This seems like a gigantic need for a middle ground to be filled. I know that CVS and WalMart have done things like the $60 Physician's Assistant visit at retail locations but that alway…

It's probably only available in some locations because every state has rapidly different scope of practice and prescribing rights for PAs / NPs.

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

#55

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…

Half of children are covered by Medicaid and there would be zero copay. It is a great program that has saved and improved many lives.

The ER might bill $6k for a cut requiring stitches, but most people have insurance, they will have a lower negotiated rate. A typical copay with insurance is more like $250, plus another $10-$20 copay to pickup medication.

Something not immediately life threatening like a cut requiring stitches could go to urgent care, they might bill $400, and your copay is under $100.

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

#56

This bugs me every time I read about free clinics and/or ER costs. It seems most Americans with limited or no healthcare is: 1. Go to the ER and pay $X000 2. Wait in line at a free clinic for 9+ hours and maybe/maybe not see a doctor This seems like a gigantic need for a middle ground to be filled. I know that CVS and WalMart have done things like the $60 Physician's Assistant visit at retail locations but that alway…

Even an online $60 "ask a doctor" service should be able to help a lot of people.

My guess is that, despite in some sense being a "free market" system, US health care is hyper regulated, and almost everything is either mandatory or forbidden, sometimes both.

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

#57
post #25

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…

US taxpayers already pay, per capita, the most on earth for socialized medicine in terms of government spending[0], we just don't get universal coverage beacuse it is beyond the competency of our leadership.

[0]https://www.oecd-ilibrary.org/sites/154e8143-en/index.html?i...

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

#58

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…

Half of children are covered by Medicaid and there would be zero copay. It is a great program that has saved and improved many lives. The ER might bill $6k for a cut requiring stitches, but most people have insurance, they will have a lower negotiated rate. A typical copay with insurance is more like $250, plus another $10-$20 copay to pickup medication. Something not immediately life threatening like a cut requiring…

Well. We have insurance. The insurance is also for emergency situations. It's high-ded at 3000 and the out of pocket max is something like 12,000. So yeah one ER trip a year is going to cost me 3000-12,000+. Urgent care is great in theory but I've not had great experiences. I'll also be paying the complete bill there too so 400+ which is fine. The problem is if they are too scared then it will be the $200 plus an ER bill and I'm back to where I started.

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

#59

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…

Half of children are covered by Medicaid and there would be zero copay. It is a great program that has saved and improved many lives. The ER might bill $6k for a cut requiring stitches, but most people have insurance, they will have a lower negotiated rate. A typical copay with insurance is more like $250, plus another $10-$20 copay to pickup medication. Something not immediately life threatening like a cut requiring…

It bothers me to no end that the cash price I pay is drastically higher than the cost the insurance company pays. especially since insurance is a royal pain to deal with, and requires specialists for billing, etc.

But then again, I can't believe hospitals don't have to have a 'menu' on their web site that shows their cash and average insurance cost of their 20 most common procedures.

I know almost nobody pays cash price, but I don't want my medical care to be treated like Kohls or JC Pennys where they show me a $7 t-shirt is "regularly $27" so I feel like i'm saving, even though we both know they never, EVER charged $27 for that t-shirt..

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

#60
post #28

Earlier quoted context omitted.

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"

Except if you try to get medical treatment for a minor injury the response is often 'no go to the ER' because people want to avoid liability.

I mean if you simply call up a doctor's office to check on an appointment, one of the prerecorded announcements they waste your time with is generally a suggestion to call 911 or go to the ER. The entire medical system is "not my job" turtles all the way down.
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