Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

seattletimes.com

Post reply on HN
Print view View original

81–90 of 114 posts

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

#81

Post by kayodelycaon »

pcwalton wrote: post #33
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'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. In the US, this is what urgent care is for. If there's an urgent care clinic in the area, you should absolutely not go to the ER for that kind of stuff. The price of the ER reflects the fact that i…

Urgent care varies a lot. Going to one around here is not a good idea. I don't think any of them has more positive reviews than negative ones.

I decided to risk one of the better reviewed places. It was empty and I was completely ignored by the staff who were on their phones. My worst taxi experience was better. At least I left before they could rip me off.

Ended up going to the ER and the nurse told me the urgent care place would have just sent me to the ER anyway.

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

#82

Post by bell-cot »

My #1 beef with Urgent Care - short hours.

8 years ago, I managed to stab myself with a little shrubbery snipper, mid-day on a holiday-weekend Sunday. Wound was maybe 1/3" deep, with a trivial amount of blood. I just needed the wound cleaned out, a tetanus shot, and maybe 3 stitches.

I was in Ann Arbor, MI - home to 2 huge hospital complexes and a zillion MD's.

The front desk nurse at the ER really didn't want me treated there - because of the insane ER cost overhead - for something that she probably could have handled in 5 minutes at her kitchen sink. Eventually, she gave up on trying to find an Urgent Care clinic that was actually open at ~2pm on a sunny Sunday afternoon.

Before insurance, the ER bill was well over $1,000.

Checking Google Maps for "Urgent Care Ann Arbor" just now - most of 'em are open 7 days a week (some as few as 5 days). And at most, they're open for 12 hour/day. No quick way to tell if some of the "7 days" ones would close on a holiday weekend.

Vs. ER's are 24-hour, every day of the year.

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

#83

Post by [deleted] »

ejb999 wrote: post #65
willcipriano wrote: post #57

Earlier quoted context omitted.

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...

I don't think it's beyond the competency of our leaders - I think our leaders know that not enough people actually want it. If politicians thought it was a winning strategy (defined by getting re-elected), they would be all over it. People that already have subsidized insurance (i.e. thru employers), and are happy with it, see no reason for it to change. Especially people who have good health insurance and/or don't g…

[deleted]

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

#84

Post by dontlaugh »

ejb999 wrote: post #65
willcipriano wrote: post #57

Earlier quoted context omitted.

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...

I don't think it's beyond the competency of our leaders - I think our leaders know that not enough people actually want it. If politicians thought it was a winning strategy (defined by getting re-elected), they would be all over it. People that already have subsidized insurance (i.e. thru employers), and are happy with it, see no reason for it to change. Especially people who have good health insurance and/or don't g…

That’s if you assume election results are somehow correlated with citizen desires. With first past the post and gerrymandering, it’s not even close to that.

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

#85

Post by bell-cot »

giraffe_lady wrote: post #38
maxsilver wrote: post #22

Earlier quoted context omitted.

> 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…

That might be generally true, I don't have wide enough experience to say. But in the urban core of large cities, churches are frequently a resource for acute needs. When I was homeless I took refuge from bad weather in them, charged my phone, shaved in their bathrooms, etc. Shit one time I went in one to figure out the time and the priest walked me to CVS and replaced the battery in my watch. Some or most of them pro…

THIS.

There are plenty of churches where looking after the less-fortunate is still a serious priority. Unfortunately, there are no "Faux Xian" disclaimers posted on the doors of the other sort of church.

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

#86

Post by maybeinsured »

mrguyorama wrote: post #70
repiret wrote: post #41

Earlier quoted context omitted.

Others have pointed these things out individually, but I wanted to say them all in one place: An urgent care is well suited to needing a couple stitches or a cast. At the ER, you're also paying for: * A facility and staffing equipped to handle serious trauma and critical illness. * (In the US) A facility that legally cannot turn away people for inability to pay. Exacerbated by being in a national medical system where…

As an insured person, an urgent care costs the same as an ER visit and does less for me. My equally insured girlfriend had to pay several hundred dollars to an urgent care facility for a rapid strep and rapid covid tests, about $50 in a civilized country.

I pay $80 for Urgent Care services such as this in the US, a civilized country, the trick being I pay out of pocket then send in the receipt to my insurance for credit.

Sorry to hear your girlfriend found a crap business.

https://www.holycitymed.com/primary-care/?gclid=EAIaIQobChMI...

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

#87

Post by ejb999 »

brewdad wrote: post #76
denimnerd42 wrote: post #46

Earlier quoted context omitted.

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.

That has been my experience as well - best advice, don't get really sick or really hurt outside of regular business hours. Broke my foot a few months back and called all the urgent care outfits in my area for an appt - none of them were seeing patients due to lack of staffing.

Waited a few days to be seen at an ortho office once I had a referral from my primary care physician in place.

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

#88

Post by ejb999 »

brewdad wrote: post #78
lm28469 wrote: post #40

Earlier quoted context omitted.

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.

which health care system magically triages patients correctly 100% of the time and never makes mistakes?

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

#89

Post by pcthrowaway »

pcwalton wrote: post #33
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'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. In the US, this is what urgent care is for. If there's an urgent care clinic in the area, you should absolutely not go to the ER for that kind of stuff. The price of the ER reflects the fact that i…

> life-threatening emergencies

It's not really just for life-threatening emergencies. If you cut your toe off at 2 AM you probably want to go to an ER to see if there's a chance it can be reattached.

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

#90

Post by bell-cot »

kayodelycaon wrote: post #79
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.

> ...I've never seen a church do anything to help random people off the street...

The Salvation Army is a church, admittedly not a huge one: https://en.wikipedia.org/wiki/The_Salvation_Army

At least in cities I'm familiar with (mid-western US), things like charity for the homeless have become church specialties. Most churches in an area will not do it themselves - but instead provide volunteers/donations/etc. to support a few local churches which offer free meals to the needy, shelter for homeless families, etc. Consider the economies of scale if only St. Matthews's is serving free hot breakfasts 365 days a year. Vs. if the dozen or two individual churches which support the St. Matthews Breakfast Ministry each tried to serve up daily breakfast. Or the confusion and redundant facilities if they rotated, and everyone had to remember "Breakfast is at 1st Baptist this week, then Redeemer Lutheran next week, then St. Mary's Catholic, then...".

Post reply on HN