Too broke for the ER, patients flee

[Warpy]

In hindsight, maybe Jesse Ashlock shouldn’t have walked out of the New York emergency room last summer, only a couple hours after being knocked unconscious in a Brooklyn bicycle crash.

Medical crews told him he needed a blood test, chest X-rays and probably a CT scan to check for head injuries. And he certainly should have had treatment for major road rash, including raw scrapes on his face, neck and hands.

But the 31-year-old editor for a design magazine was between jobs, briefly without health insurance and afraid of being stuck with a sky-high hospital bill. The doctor on duty dismissed Ashlock’s questions about cost, telling him she was “a physician, not an accountant,” he said.
---------
About 119.2 million visits were logged in U.S. emergency departments in 2006, according to a report last year by the federal Centers for Disease Control and Prevention. Of those, about 1.5 million, or 1.3 percent, ended with discharges against medical advice, or AMA. Doctors believe those numbers are both underreported and growing.

MUCH more at http://www.msnbc.msn.com/id/30628634/

Single payer, universal coverage NOW. Our system is killing us.

[Rabrrrrrr]

1. Absolutely. I think the biggest reason that Repukes don't want univesal health care

is that it would take too much leverage they have over their employees (those that actually give their employees health care, anyway).

If people had health care whether they worked or not, they would also feel free to leave the shitty jobs and seek something else.

It would also mean that people would be much free-er to seek a career in the arts - music, painting, writing, and so forth. And artists tend to be liberal, so that scares Republicans as well. They hate artists. They only like propagandaists, like Kinkade or some of the country western folk.

They speak about socialist fears, because that's the only way to get the ignorant working lower-classes to hate the idea; but I don't think the higher-ups care about possible socialism at all.

They fear losing some of their control over the people.

How many people work at jobs just because of the benefits? I know a hell of a lot. Most of whom would flee their work if they didn't have to fear possible medical bills.

And what do people who lose their jobs fear most? I find that for most who have lost their jobs, what they fear is - ta da - possible medical bills. They don't fear the loss of income as much as their fear of getting injured or having other medical problems.

[Xipe Totec]

2. Bingo!

:thumbsup:

[shireen]

4. very good analysis.

i've felt the same for a long time! You articulated it very well!
:thumbsup:
:fistbump:

[Robb]

5. Nailed it

:hi:

[trotsky]

11. Yup.

:thumbsup:

[SkyIsGrey]

22. This is what I am......

going through right now. I have a autoimmune disorder which has kept myself out of work for the past two weeks and has been a constant bane for me for quite some time. I have been having dizzy spells for the past three months that have been on a more and more consistent basis. Episodes of abnormal fatigue which has become worse lately with strenuous physical activity, I do not feel tired but completely shut down. I tried to go back to work yesterday and became fatigued within a couple of hours; had a few instances where I blacked out for about half a second; "toughed it out" for the day and wound up going to the ER from it.

It is a catch 22. Go to work, at a well paying stressful job, so I have the insurance and money for the resulting expenses (e.g. being off of work for two weeks, and now, counting). But it is that job that is "killing" me.

Like Sarah Palin eluded to. It would just suck to wind up like a socialist country like Sweden, that country is the armpit of humanity. :sarcasm:

[Festivito]

3. Maybe this is why Canada's emergency rooms are full -- NOT.

We get ten year old stories of Canada's system being full during their changeover and during their flu epidemic.

Here we are with people who don't bother to stay in the ER making room for others, so we don't have long lines.

Well, we do have lines, it takes weeks and months for us to get some operations -- same as in Canada -- and we pay nearly three times as much as Canadians pay nationwide.

WE ARE DISGUSTING, and I'm tired of it.

[YewNork]

24. People who don't go to the ER, but should.

Exactly. Emergency Rooms in the U.S. would have more people except for the fact that there are people who should go there
but who don't because they can't afford it.

And for people who give the standard response that hospitals are not allowed to deny treatment on the basis that the patient can't pay,
they don't seem to remember that patients are not allowed to ignore the bill the WILL be sent to them on the basis that they can't pay, either.

In Canada, if a person has an emergency, he doesn't even think "Can we afford it?" It's a non-issue.

[lib2DaBone]

6. Control and Punishment...that is what Republicans stand for..

How ya gonna keep 'um down on the farm..? Since the late 70's the American workplace has become increasingly like a prison labor system.

Mandatory drug tests, snooping and spying on employees to include even key-stoke monitors and reading all e-mail. Open employee mail. Timed bathroom breaks. Working lunches. Nit-picky chicken shit punitive control freaks.. that about sums up working today.

If you want to read some good articles, check out Barbara Ehrenreich. She writes about life in the workplace and how American workers are treated worse than cattle.

http://barbaraehrenreich.com/workersrights.htm

[AnneD]

7. Happy to K&R

Health care folks have been dealing with this screwed up reality for far too long. Patients go with out care until their life is in danger then go to the ER,take half the prescribed amount to make it go further, we send them out too early give then a few fast lessons and expect them to be their own Nurse and care giver, etc, etc.

[nykym]

8. Interesting

AMA Against Medical Advice or American Medical Association Hmmmmmmmmmmmmm!

[subterranean]

9. I don't blame that guy for walking out.

He's right, those three tests would have cost him thousands of dollars. I probably would do the same thing in that situation.

[Warpy]

10. He toook a huge chance with his life

Natasha Richardson had a similar injury and was dead in hours.

It's just a dirty shame they didn't offer him the cheaper alternative of waiting in "chairs" for a few hours followed by a cheaper skull series, something that would have cost a few hundred rather than a few thousand.

That would have made sure that he'd be checked in a few hours and a gross examination of his head made to see if there was any blood pooling. No, it's nowhere near as good a picture as a head CT. Yes, they used to diagnose bleeds like that all the time.

Until and unless this country gets serious about cleaning up the catastrophe in health care, doctors are going to have to start thinking like this: diagnosing with outmoded but cheaper technology, treating things empirically instead of ordering a battery of expensive tests, and doing palliative treatment for people who don't have the means to get their problem fixed but whose lives are severely limited trying to live with it.

No, it's not good medicine and it's not defensive medicine, but a waiver can shield them from legal consequences of the latter.

It's certainly better than having someone with a documented knock on the head with loss of consciousness die in his sleep because he couldn't afford the state of the art diagnostic tests.

[Quantess]

12. One thing physicians aren't trained to do

is to consider the staggering financial cost of treatment to the uninsured.

[Warpy]

13. I know I've had to be proactive

and suggest older and cheaper drugs and treatments. They hate it when I do that to them, but it does get them thinking.

I'm an RN, though, and I know what the limits of older diagnostic tests and drugs are.

In any case, docs have been the best, working with me and undercoding their fees.

[Donnachaidh]

14. Those same ER doctors claiming to be *physicians* hire the meanest

collections agencies available. So much for their *caring* about their patients. It's something they play at work. :puke:

[Fire_Medic_Dave]

26. After all it's the physicians and not the hospitals right.

[Senator]

15. Re-Proving That Healthcare Is Simply NOT A Commodity

It is not something that can be bought and sold subject to normal "market forces."

Exactly like national defense, we all need health care in precisely the same amount and quality -- which is to say we need as much as necessary at the time necessary.

Consequently, ALL profit from health care is blood money. Time is not on the side of the profiteers, as the system is inevitably collapsing on itself. But neither is it on the side of our fellow Americans being victimized by them.

--

[jody]

16. Ashlock refused medical procedures because they were too expensive but what if a govt. sponsored

health program refused to authorize those same treatments because they were too expensive?

Would DUers who said Ashlock made the correct decision agree that govt also made the correct decision?

[Warpy]

17. What the hell makes you ASSume that is going to be the case?

That paranoid scenario hasn't been borne out in any emergency care in any single payer system around the globe.

People who are so terrified of the mean old government rationing their own care haven't checked what insurance companies are doing to us all in that department by denying coverage, delaying care until it is often futile, and denying care completely.

[jody]

18. So your position is that the medical procedures were justified and Ashlock was wrong in refusing? nt

[Warpy]

19. My position was clearly stated in great detail

[jody]

20. No, my hypothetial question was precisely like your OP with the sole exception that the procedure

was refused by a government sponsored program rather than the patient.

Of course you've read a few of the numerous papers in medical journals showing whether procedure X is or is not cost-effective in emergency rooms.

When the U.S. finally has some version of universal health care, government will approve directly or indirectly cost effective models to determine whether a patient is eligible for medical procedures.

Obama recognizes that and said "I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now."

[Lydia Leftcoast]

23. I have never heard of real emergency cases being turned away in a single-payer system

This includes the time that one of my former teaching colleagues took students to London. One of the students broke her leg, and the NHS patched her up--a tourist, not a resident--at no charge.

(The British policy is that foreigners get emergency care only.)

[Wednesdays]

21. K&R

:kick:

[area51]

25. Kick on this life and death issue.

Find out more on single-payer healthcare.

Why stand idly by while 100,000 people die in the U.S. each year due to lack of healthcare.