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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

#61

Post by schemescape »

gnopgnip wrote: post #55
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…

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…

Plus deductible and coinsurance, which which are often much more…

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

#63

Post by rediguanayum »

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…

> 1. Go to the ER and pay $X000

Agreed most people think that the ER is $X000. What people don't realize is that the hospital then attempts to recoup the cost by charging paying patients and their insurance companies more. This is where those $20,000 ER visits comes from. While insurance companies push back, the other folks paying out of pocket lose. Some of them go bankrupt. Hospitals lose too and ultimately the community. Because emergency services almost always lose money for the hospital, many rural hospitals also go bankrupt or get bought out by private equity groups (https://www.nbcnews.com/health/health-care/private-equity-fi...).

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

#64

Post by floxy »

dividefuel wrote: post #42
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"

I agree that the ER should just be for emergencies. The problem is that there isn't anywhere else where you can get same-day care for many types of needs. My spouse has some minor heart issues. She wasn't feeling well one day and went to urgent care, but urgent care didn't have the equipment to assess her and rule out any major concerns. Urgent care suggested seeing a cardiologist, but they also said she should go to…

>but urgent care didn't have the equipment to assess her and rule out any major concerns.

Just curious what kind of equipment the Urgent Care didn't have (if you know). I went to the doctor last year, mentioned that I thought some heart palpitations. The doctor said, we'll lets do an EKG. I was thinking this would be something I schedule for later, but to my surprise, the nurse rolls in a machine, and the hooked me up to some electrodes and the whole thing was done in like 5 minutes.

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

#65

Post by ejb999 »

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...

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 get sick very often.

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

#66

Post by frumper »

dividefuel wrote: post #42
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"

I agree that the ER should just be for emergencies. The problem is that there isn't anywhere else where you can get same-day care for many types of needs. My spouse has some minor heart issues. She wasn't feeling well one day and went to urgent care, but urgent care didn't have the equipment to assess her and rule out any major concerns. Urgent care suggested seeing a cardiologist, but they also said she should go to…

They are wrong to treat her like that. If she stayed after the test results then sure, but until those tests are done they don't know any more than your wife does.

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

#67

Post by louison11 »

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 gets trickled down in the bill, and acts as a bottleneck guaranteeing scarcity of doctors and thus super high wages. A doctor in the US makes BANK, like lawyer money, not so much the case in Europe, where they’re upper class but not crazy rich.

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

#68

Post by mindslight »

yamtaddle wrote: post #34
thatfrenchguy wrote: post #27

Earlier quoted context omitted.

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.

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.

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

#69

Post by LarryMullins »

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 least.

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

#70

Post by mrguyorama »

repiret wrote: post #41
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…

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.

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