Whoa! 9 patients made nearly 2,700 ER visits in Texas

[justmeagain]

I wonder if some of these people aren't "selling" or otherwise loaning their personal info to others. So, maybe Mary Jones was seen 15 times this month, but it was 9 different Mary's. If they're going to different hospitals it probably wouldn't show up.

Identity theft or misuse is becoming a huge issue in terms of medical insurance, not just credit cards and bank accounts.

Tess

Interesting.......

[Liz]

I honestly would not mind paying more taxes if it meant everyone-not just the ones the insurance companies deem "worthy" could go see a dr when they need to without fear of going into debt or not being able to afford other bills. My aunt worked her entire life, paid into the system, never used it. She has RA now, she got laid off from her job awhile back and her COBRA runs out this month. No private insurer will take her because of the RA. What is she supposed to do? I will happily pay more in taxes so she and others like her will not have to suffer. It's worrisome that the gov will be in charge of anything else, but the system we have now IS NOT WORKING! Maybe if people can afford to go to the dr for preventative care instead of having to wait until they need an ER, the charges wouldn't be so high. I can dream right? LOL!

Not to go too far off topic, but have your aunt check and see if her state has a high risk insurance pool she can purchase a policy from. I live in Maryland, and the program is called MHIP here. Its purpose is that if there is a huge difference in cost of coverage due to a condition, one cannot purchase a policy due to prior conditions, the policy one has will not cover said condition, or if there is an automatically qualifying condition, that one can purchase a plan. The MHIP plan is a run of the mill BCBS policy, and no provider is the wiser that it was purchased through the state pool instead of privately or through an employeer, its just a CareFirst policy. Hopefully there is something like that in her state!

And agreed. But then, we'd have to say that while yes, primary basic care is a right we'll afford to all citizens, those citizens better do something in return. i.e. follow doctors orders, properly care for and monitor their condition, not eat complete crap all the time, exercise, not smoke... One can dream! With rights come responsibilities.

[duetchan]

So really, they can't scrape up $75 (from family/friends/selling stuff etc) to pay up front and would rather be stuck with most likely thousands of dollars in bills later?

Working at the admitting/registration desk at an ER I can say that just about everyone who comes in to the ER in this situation would gladly gather up the money to be seen in the walk-in clinic, but they get turned away the moment they say they have no insurance and are told to go to the ER. At least that's the situation where I am.

As far as the gov't insured coming to the ER. There are some plans that will only cover ER visits in their plan terms and thus these people use the ER as a doctors clinic. Not fair. Not how the plan was intended for these people, but if you are a person in the situation where you can't afford care and you have this loophole most people will take it.

Yes, this is all imperfect and makes problems for all, but it is what it is right now and until someone comes up with the perfect solution it's what we are stuck with. This is the reason why some hospitals, like the one I work for, have started to ask for ER copay and or deductible payments at the time of service once they have been seen by the doctor because of more and more non payments by people. This payment is a request not a requirement, but when you ask people for that payment most are more than willing to pay what they can towards it at the time.

[tenisha]

Silly Beth.

We don't need universal healthcare. We are the richest country in the world and we can afford to spend millions and billions of dollars on the uninsured.


A great shirt I found online says: "America: Only the Insured survive"

Hate to burst your bubble, but the US is far, far, from the richest country in the world. Why then is there a national "debt"?

[tenisha]

Richest country in the world borrows money from 3-rd world country, China..

Yes- so called "3rd world'...

[Nutts4Coops]

Doesnt seem fair that these 9 people (and millions of others) can use medical services for free, while I have worked everyday of my life and still have to pay to re-take 2 medical tests because my insurance refuses to cover them, because they say the tests weren't "preventative". Why should I even have health insurance if it's not going to cover what could have been life-saving tests?

[beth119]

Doesnt seem fair that these 9 people (and millions of others) can use medical services for free, while I have worked everyday of my life and still have to pay to re-take 2 medical tests because my insurance refuses to cover them, because they say the tests weren't "preventative". Why should I even have health insurance if it's not going to cover what could have been life-saving tests?

Good question...

Short answer?

Insurance companies SUCK

[Mothernature]

Wow! The system itself has created most of the problem ....

Ok, Please don't hassle me about my opinion but I somewhat understand. No, I do not condone drug use or abusing the system. Read on...

Yesterday I was talking to a freind at work. Her 20yo son is having an issue that he really should seek medical attention for. She said she told him if it did not improve by Saturday that he sould go to the ER.

I said, why the ER? We have a brand new 24 hour walk in clinic. Her reply...

He does not have insurance. He cant pay the $75 fee. The collect payment BEFORE you can see a doctor. At the ER they will send me a bill.

Even though the ER vist will cost a fortune, it is the only alternative because of the required up-front payment. Like I said, I feel that the system has created it's own nightmare.
.

The co-pay for the ER with my husbands insurance is $250.00. It was a lot of fun back in May when I was told to go to the ER at 11pm.

One of my doctors works out of an office in the local hospital. DS and I waited for a bus after my appointment. There was a billing specialist who was quite open and frank about hospital billing.

She told me that many people come in with expired insurance. The ER does not verify so the doctors see the insurance and run tons of tests (many unnecessary-her words). The next day, she runs the insurance and finds out it is expired. All of a sudden the patient has a huge bill. Patients without insurance receive just the tests they need.

She said she's seen patients who came in too late or very sick because they were afraid to rack up bills they could not pay.

People need to understand hospitals are for emergencies. PCP's and specialists deal with the rest. Because hospitals can not turn any one away, it is abused. I think everyone should have access to care. The system has to be restructured to minimalize costs.

[ibnuts]

These costs are the problem with having three things:

1. No access to affordable (or free, if necessary) health care which is accepted by all providers.

2. A system which rewards doctors/providers based on the number of procedures they charge for instead of a set compensation per patient (doctors are paid more if they order more tests).

3. A corollary to 2: doctors feel forced to order more tests to seem more "thorough," since there are no limits placed on awards made in malpractice claims. Some doctors pay >$100k/yr in malpractice insurance.

4. There is no competition among providers of the "big ticket" procedures, such as MRIs, CAT scans, etc. After the initial capital investments for these machines, they cost extremely little to keep up. Charging $1,000-$5,000 for a single procedure is ludicrous, but they can do so because most patients are insulated from the cost by insurance companies/medicaid. If patients were able to "shop around" for better prices on procedures like they can on other products/services, then we'd see the prices of these procedures drop dramatically.

A public option (1) would decrease the number of ER visits. However, any public option needs to address the other points (especially 2 & 4). Balancing a free option with the need to motivate patients to shop around for cheaper service providers is difficult, and I'm not sure how it could be implemented. Perhaps by charging patients co-pays but then offering rebates of those co-pays based on their cost savings?

While it is my opinion that the insurance companies are vampires and care nothing about their "customers" (i.e. the patients), I'm not too optimistic about the government actually addressing all these things. Between all the special interest groups and lobbyists in Congress, I'll be quite surprised if whatever comes out isn't either fiscally disastrous or just something that pleases the insurance companies. That is, assuming something even does come out, as half the time they seem content to just argue aimlessly. That said, I'd rather see a fiscally disastrous universal health care policy (that helps those Americans that need it most) rather than the previously fiscally disastrous tax cuts (which only helped rich Americans) and the ridiculous expenditures on military campaigns in foreign countries.