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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

#101

Post by dredmorbius »

LarryMullins wrote: post #69
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 For what it's worth, about 5 years ago I was without insurance and went to the ER to get 5 stitches in my finger. The total bill came out to $150. This was in America. I think if I had insurance then, they would have billed the insurance company 10x that at leas…

Insurance has negotiated rates with providers. These typically start with the facility's chargemaster billing and are negotiated off of it.

Depending on the relative negotiating strength of the carrier or caregiver network, that might be higher or lower.

It's the uninsured who are far more likely to be billed the maximum amount, in the US, as they have no negotiating power, most especially in the moment urgent care is required.

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

#102

Post by gumby »

__derek__ wrote: post #99
gumby wrote: post #18

The second arm of this system is using the police on the front line of psychiatric cases.

That actually plays into TFA: the police don't have anywhere to take kids in crisis, so they drop them at the Seattle Childrens Hospital ER.

...and when they are adults, the cops often just shoot them.

The cops should not be placed in this position in the first place. They train for a different job.

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

#103

Post by dsfyu404ed »

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 just don't get universal coverage beacuse it is beyond the competency of our leadership.

A large fraction of people are predisposed to attempt to solve the problem by incrementally throwing more money and more power at those leaders and then checking if the problem is solved.

Follow the incentives...

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

#104

Post by dsfyu404ed »

denimnerd42 wrote: post #36
lm28469 wrote: 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"

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…

Pretty much anything up to and including a non-life threatening bullet wound can be solved with readily available drugs, a good back country/extreme sports first aid kit and the internet.

Expensive machines and complex diagnostics are really the only big things an ER can do that you can't.

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

#105

Post by dsfyu404ed »

landemva wrote: post #96
MarkSweep wrote: post #71

Earlier quoted context omitted.

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 f…

To summarize, much of the price problem could be solved within each State.

So why hasn't it been solved in the states in which this kind of stuff is a priority?

Some states have really good healthcare for the poor but even they have exorbitant costs for everyone who's too well off to quality. You'd think at least one of them would tackle this.

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

#106

Post by patientplatypus »

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…

[dead]

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

#107

Post by softjobs »

dredmorbius wrote: post #100
mindslight wrote: post #68

Earlier quoted context omitted.

Don't forget Wall Street! I guess that's the jobs program for the upper class. Honestly after many decades of technological growth, extreme offshoring, and the workforce nearly doubling due to women entering it, I'd estimate that 80% of positions are bullshit jobs.

Adtech?

And its cousin, Fintech.

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

#108

Post by yumraj »

Few months ago I had to take my kid to Stanford Pediatric emergency. It was interesting to note that 80% of people required an interpreter to be called to speak with the medical staff. From what I could tell, many of them had avoided going to a doctor till the last minute.

And then I got the bill few weeks later of a couple of grands, for hand X-ray and a small splint and speaking for 5 mins with a doctor.

I’ll leave it at that.

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

#109

Post by User23 »

mindslight wrote: post #68
yamtaddle wrote: post #34

Earlier quoted context omitted.

The military is our blue-collar/lower-class jobs program. Our healthcare system is our white-collar/middle-class jobs program.

Don't forget Wall Street! I guess that's the jobs program for the upper class. Honestly after many decades of technological growth, extreme offshoring, and the workforce nearly doubling due to women entering it, I'd estimate that 80% of positions are bullshit jobs.

Have you noticed how your light switches still work and your toilet still flushes? Yeah? Turns out there are real jobs. Being a doctor is a real job too. It's a huge commitment and they deserve to be well compensated. But of course they're not, it's the administrators capturing all the economic rents.

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

#110

Post by rightbyte »

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.

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

The Salvation Army? They have both shelter and soup kitchens.

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