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

seattletimes.com

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

#71

Post by MarkSweep »

louison11 wrote: post #67
alexpotato wrote: post #43

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 without insurance and without social security help, the cost of medical care in most of the world for the same services is dramatically lower. To give you an idea, I got an ECG (heart test), X-Ray and complete blood panel done at a local clinic here in Europe for 29 euros. The key to addressing what you’re pointing at is mostly fixing the scam that US college education has become. It’s the crazy tuition that get…

It’s not just the cost of college that limits the supply of doctors. There is an explicit limit on how many people can become doctors each year in the US:

http://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-...

In addition, in many states in the US you have to get permission to open a new medical facility:

https://en.m.wikipedia.org/wiki/Certificate_of_need

Often the people on the board own existing medical facilities, so you literally have to get permission from your potential competition to compete with them.

https://www.justice.gov/archive/atr/public/press_releases/20...

For example from the above link:

“ In 2006, the Antitrust Division alleged that a hospital in Charleston, West Virginia used the threat of objection during the CON process, and the potential ensuing delay and cost, to induce another hospital seeking a CON for an open heart surgery program not to apply for it at a location that would have well served Charleston consumers.”

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

#72

Post by protastus »

louison11 wrote: post #67
alexpotato wrote: post #43

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 without insurance and without social security help, the cost of medical care in most of the world for the same services is dramatically lower. To give you an idea, I got an ECG (heart test), X-Ray and complete blood panel done at a local clinic here in Europe for 29 euros. The key to addressing what you’re pointing at is mostly fixing the scam that US college education has become. It’s the crazy tuition that get…

The problem in the US is far bigger than the cost of medical education.

The US doesn't have single payer healthcare. For every medical professional actually helping a patient, there's a legion of bureaucrats (administrators, insurers, accountants and lawyers, along with all their support staff) spread over a huge network of businesses adding their cut. Go to the ER and you'll be getting bills for it 2 years later. This massive overhead needs to go away to enable price transparency and reasonable costs.

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

#73

Post by klooney »

willcipriano wrote: post #57
davidw wrote: 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…

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...

We do have socialized medicine for more people than are in the British NHS, if you add up medicare, medicaid, and the VA.

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

#75

Post by harimau777 »

alexpotato wrote: post #43

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…

I wonder if there would be a role for someone specialized in diagnosis/triage?

I'm a martial artist, so it's not uncommon for me to go to the Dr. when all I really need to know is if an injury is a normal "take a break and let it heal" injury or one that needs actual treatment.

I imagine there's similar cases for questions like "is this the common cold or something else?" or "is this something babies just do or a sign of a problem?".

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

#76

Post by brewdad »

denimnerd42 wrote: post #46
Rebelgecko wrote: post #45

Earlier quoted context omitted.

Why not an urgent care?

Fine in theory, but the experiences I've had leave something to be desired. Ideally, I want to see doctors I have relationships with, aka my PCP, to facilitate and advise. But they are not interested in that.

Yes. The past three times I've gone to Urgent Care I have been punted to the ER for no good reason twice and received an incorrect diagnosis complete with a prescription that did nothing to alieviate my symptoms. If you get sick/injured in my area between 4pm Friday and 9am Monday...good luck.

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

#77

Post by kixiQu »

MR_Bulldops wrote: post #48
kixiQu wrote: post #10

> Increasingly, the staff of the ED who have always upheld the proud notion of being the one place where the doors are always open to anyone who needs care at any time, have felt besieged. Yeah, okay. At another nearby "nonprofit" local hospital, not atypically: ( https://www.nytimes.com/2023/01/25/podcasts/the-daily/nonpro... ) > The centerpiece of this program were a series of scripts, like theatrical scripts, that…

> Yeah, okay. What's with the attitude? Do you think it's ED staff that created those training documents? Do you think ER physicians who spent years jumping through hoops to get accepted into medical school, then spent 4 years in medical school followed by 4 years working 100 hour weeks for minimum wage as a resident do all of that so they can gouge patients for money? Do you think RNs who jump through years of hoops…

Why should it matter whether they feel bad about it, whether they "get off by" it? The reporting here is very clear: the possibly-illegal profit-seeking of purportedly nonprofit health care facilities isn't something "hospital admins" do on their own, it's something that those patient-facing staff are out there consciously enacting every single day. And anyone there could have decided they find that unacceptable and moved to work for other institutions. Definitionally, the ones still there did not. Everybody is complicit. And I say this as someone who is conflicted about my own job, who has all sympathy for individuals trying to figure out their own moral responsibility in shitty situations, so I'm not directing vitriol as those workers at all – that is, when they're not publishing op-eds framing their workplace as the last bulwark of social ethics where they help the helpless and do what others won't and people should be looking to them for guidance and don't ask about how many patients they send to collections please and thank you.

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

#78

Post by brewdad »

lm28469 wrote: post #40
giraffe_lady wrote: post #31

Earlier quoted context omitted.

The thing is the doctor you would get to look at it tomorrow can simply decline to, the ER can't.

Exactly, and that's why when you go there you have to wait 8 hours because you have 38 non emergency scenarios before it's your turn.

ERs do triage on incoming patients. If you arrive with non-life threatening issues, you will be pushed to the back of the line repeatedly. Occasionally, a patient or intake nurse will misjudge the problem and the patient dies in the waiting room.

Greatest health care system in the world.

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

#79

Post by kayodelycaon »

freedude wrote: post #62

For millennium churches did this for free. Many of the good ones still will give the person a meal and someone to listen to in addition to wise counsel. In a word people need Jesus.

Unfortunately, I've never seen a church do anything to help random people off the street. Finding a new church is difficult because everyone has their own cliches and you don't really get a chance to talk to people and know them on Sundays.

People are busy and don't have time for people who aren't their friends.

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