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Thread: Who's packing ERs? Not the uninsured

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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by RightinNYC View Post
    Who's packing ERs? Not the uninsured | Reuters



    This is very surprising. How is it that nobody knew this until now?
    This has been shown before with very little fan fair.
    Medicaid and Medicare patients are the most likely to use the ER instead of a primary care doctor.
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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by Deuce View Post
    A small demographic only represents a small portion of ER visits? I AM SHOCKED I TELL YOU!
    You must have missed this:

    "Among the under-65 population, the uninsured were no more likely than the insured to have had at least one emergency department visit in a 12-month period."
    If you thought that was the case before today, then you're far more clairvoyant than I.
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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by Deuce View Post
    A small demographic only represents a small portion of ER visits? I AM SHOCKED I TELL YOU!
    One study and you're all over that aren't you?

    Forget all the past stuff, the Gov't says that's all hog wash!

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    Re: Who's packing ERs? Not the uninsured

    From the economics literature, one would probably expect such an outcome. To put it in very simple terms, there is a desire for instant self-gratification. Hence, if that principle applies, the desire of people to receive instant care (even as in reality there is a wait, sometimes several hours in the ER) rather than seeking to schedule an appointment with their physician may be driving the phenomenon. It would be interesting to conduct exit surveys to find out why people who could readily have seen their physician (among the true non-emergency cases based on treatments that were administered in the ER) chose the emergency room.

    Perhaps a significant copayment for non-emergency cases (based again on the medical codes utilized in the ER concerning treatments) might be needed to deter those with non-emergency conditions from going to the ER? Under such a framework, those meeting the definition of needing emergency care would be treated as usual. Those who who did not meet the criteria and who likely had no reason to believe that they were suffering from one of the conditions that would qualify would be assessed a surcharge by their insurer.

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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by donsutherland1 View Post
    From the economics literature, one would probably expect such an outcome. To put it in very simple terms, there is a desire for instant self-gratification. Hence, if that principle applies, the desire of people to receive instant care (even as in reality there is a wait, sometimes several hours in the ER) rather than seeking to schedule an appointment with their physician may be driving the phenomenon. It would be interesting to conduct exit surveys to find out why people who could readily have seen their physician (among the true non-emergency cases based on treatments that were administered in the ER) chose the emergency room.

    Perhaps a significant copayment for non-emergency cases (based again on the medical codes utilized in the ER concerning treatments) might be needed to deter those with non-emergency conditions from going to the ER? Under such a framework, those meeting the definition of needing emergency care would be treated as usual. Those who who did not meet the criteria and who likely had no reason to believe that they were suffering from one of the conditions that would qualify would be assessed a surcharge by their insurer.

    Yikes! I don't think that's a good idea at all. Too many people wouldn't heed the warning signs that often appear before a heart attack, stroke, etc.

    I think the hospitals have found a better answer for now and that is as I said in my first post.

    If people think they're emergent, it's better to come to the ED and be assessed by medical personnel. If it turns out it's not emergent, move them over to the "other" ED. The urgent care. People are still cared for and the ED functions as it should.




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    Re: Who's packing ERs? Not the uninsured

    I could have told you that. The vast majority of them are Medicaid/Medicare recipients.

    However, given my years of experience transporting people to the ER via ambulance, about 90% of the people we picked up to take to the ER were NON-emergencies. And 100% of the non-emergencies that called the ****ing ambulance to take them to the ER were on Medicaid/Medicare.

    I really wish we'd been allowed to triage.

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    Re: Who's packing ERs? Not the uninsured

    1. this post is very important as it exposes as half baked the president's fundamental premise for paying for his empty headed plan

    2. that is, savings he seeks in reduced ER traffic in reality rise

    3. romney care provides the empirics

    4. in a nutshell, massachusetts massively expanded the rolls of those insured but the number of doctors remains constant or actually shrinks (see: the hill)

    5. people go to ER because they can't get a doctor to make an appt, all resources being overwhelmed

    Advocates of an individual mandate say that a requirement to buy insurance is essential because everyone is currently paying a "hidden tax" when people show up in the emergency room without insurance. (Under existing law, emergency rooms are required to treat urgent care matters without regard to ability to pay. If the patient cannot afford the bill, those costs are then passed to the government or people who have insurance in the form of higher prices).
    A chief aim of the new healthcare law was to take the pressure off emergency rooms by mandating that people have insurance coverage. The idea was that if people have insurance, they will go to a doctor rather than putting off care until they faced an emergency.
    Massachusetts in 2006 created near-universal coverage for residents, which was supposed to ease the traffic in hospital emergency rooms.

    But a recent poll by the American College of Emergency Physicians found that nearly two-thirds of the state’s residents say emergency department wait times have either increased or remained the same.

    A February 2010 report by The Council of State Governments found that wait times had not abated since the law took effect.
    More people are seeking care in hospital emergency rooms, and the cost of caring for ER patients has soared 17 percent over two years, despite efforts to direct patients with nonurgent problems to primary care doctors instead, according to new state data.
    "Just because you have insurance doesn't mean there's a [primary care] physician who can see you," said Dr. Sandra Schneider, vice president of the American College of Emergency Physicians, which, like other national groups, is closely watching the Massachusetts experiment. "I am not surprised at all that visits went up."
    Buy Insurance or Go to Jail? - The Note

    Health reform threatens to cram already overwhelmed emergency rooms - TheHill.com

    ER visits, costs in Mass. climb - The Boston Globe

    Emergency room wait times getting longer - White Coat Notes - Boston.com
    Last edited by The Prof; 05-21-10 at 11:06 AM.

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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by RightinNYC View Post
    Who's packing ERs? Not the uninsured | Reuters



    This is very surprising. How is it that nobody knew this until now?
    It actually kind of lines up with the fact that a small percentage of Americans are actually uninsured.
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    Re: Who's packing ERs? Not the uninsured

    Quote Originally Posted by missypea View Post
    Yikes! I don't think that's a good idea at all. Too many people wouldn't heed the warning signs that often appear before a heart attack, stroke, etc.
    I did not realize my heart was failing when I finally went to the ER. I was rushed right into cardiac care.

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    Re: Who's packing ERs? Not the uninsured

    The United Kingdom has the same problem with packed ERs as we do. People with good insurance feel very free to use ERs frivolously. So do dirt poor people with nothing to lose.

    It's the folks with a high ER co-pay, or no insurance and something to lose that hesitate to use ERs.

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