Who's packing ERs? Not the uninsured

[RightinNYC]

Who's packing ERs? Not the uninsured | Reuters

One in five people in the United States visit an emergency room every year, and most of them have health insurance of some kind, according to a U.S. government survey released on Wednesday.

The survey contradicts a common perception that emergency rooms are packed with uninsured people and illegal immigrants. It also rejects some claims that people are using the emergency department for routine care -- just 10 percent of visits were for non-urgent causes.

"In 2007, approximately one in five persons in the U.S. population had one or more emergency department visits in a 12-month period," the report from the National Center for Health Statistics reads.

"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."

This is very surprising. How is it that nobody knew this until now?

 

[Cold Highway]

Who's packing ERs? Not the uninsured | Reuters



This is very surprising. How is it that nobody knew this until now?

I wouldve thought it would be obvious by now

 

[phattonez]

This is very surprising. How is it that nobody knew this until now?

Because it doesn't help the government ultimate plan of forcing us all to buy their insurance.

 

[RightinNYC]

Because it doesn't help the government ultimate plan of forcing us all to buy their insurance.

That's an easy answer, but even if we pretend that NIH research funding is entirely political, I don't think it really holds water. The Bush Administration had no interest in creating national health insurance, but everyone knew that the Democrats did. If it had wanted to head that off at the pass, it could have just funded this study during its time in office.

I think it's just that no one bothered to do the research until now, which is fairly troubling given its importance to our planned health care reform.

 

[phattonez]

I'm not so sure though. Look at what Romney did, and then this quote:

While the content of the Act is summarized in myriad places, much more interesting is its conservative Republican origins. The Heritage Foundation's Stuart Butler, the intellectual behind urban enterprise zones, in Senate testimony in 2003 proposed a plan for universal healthcare coverage.[29] Here's one surprising portion of the testimony that sounds like it was uttered by a European socialist:

In a civilized and rich country like the United States, it is reasonable for society to accept an obligation to ensure that all residents have affordable access to at least basic health care — much as we accept the same obligation to assure a reasonable level of housing, education and nutrition.

100 Years of US Medical Fascism - Dale Steinreich - Mises Daily

I know, it's not much evidence, but there is precedence for some favor about this idea among Republicans.

 

[Councilman]

20% being uninsured is a lot of people and the costs have gone through the roof for all services in every hospital.

In 1984 I spent 63 days in the UCSF Hospital in Sand Fran. and the total bill was a little over $84,000, and I almost freaked over the high cost. Thank God I had great insurance and my portion was only $100 buck.

Last month I spent the night in a local Hospital no tests past a chest X-ray and blood tests and the bill was over $11,000.

At that rate my 63 day stay would cost close to $700,000.

Knowing this tells me we needed Health care reform. The problem is the Obama plan didn't address the real issues and serves to make thing worse as it also takes over the insurance industry over time and also effects so much more in a negative way.

Obama must go and we can do it starting in Nov. even the Liberal Leftists are gong to suffer if Obama is not stopped and the damage he's already done is reversed.

 

[missypea]

This is very surprising. How is it that nobody knew this until now?

It may have something to do with the way Emergency Departments have been/are being re-vamped.

It's not really publicized but this is how it works:

The "main" ED is where everyone goes. The triage nurse sees them. If they're emergent then they stay. If they're non-emergent they get sent upstairs or down the hall to the "other" ED.

The "other" ED is really an Urgent Care setting.

More and more hospitals have been and are doing this. Anyway, that's my guess for the numbers.


:2wave:

 

[Renae]

Who's packing ERs? Not the uninsured | Reuters



This is very surprising. How is it that nobody knew this until now?

Probably because before now it wasn't politically advantageous to try and lie about the problem. This "Survey" props up Obama's position...

The Seen and the Unseen
EMTALA
The influx of illegal aliens has serious hidden medical
consequences.We judge reality primarily by what we see. But what
we do not see can be more dangerous, more expensive, and more
deadly than what is seen.
Illegal aliens’ stealthy assaults on medicine now must rouse
Americans to alert and alarm. Even President Bush describes
illegal aliens only as they are seen: strong physical laborers who
work hard in undesirable jobs with low wages, who care for their
families, and who pursue theAmerican dream.
What is unseen is their free medical care that has degraded and
closed some of America’s finest emergency medical facilities, and
caused hospital bankruptcies: 84 California hospitals are closing
their doors. “Anchor babies” born to illegal aliens instantly qualify
as citizens for welfare benefits and have caused enormous rises in
Medicaid costs and stipends under Supplemental Security Income
and Disability Income.
What is seen is the illegal alien who with strong back may
cough, sweat, and bleed, but is assumed healthy even though he and
his illegal alien wife and children were never examined for
contagious diseases.

http://www.jpands.org/vol10no1/cosman.pdf

By Kevin “Coach” Collins

To ensure there will be enough resources to provide for its own legal residents Williamson County Texas has started requiring any indigent person seeking County paid for medical services to produce a valid Social Security number.

The County’s Commissioners suspected their local government has been taken advantage of by illegals, and the statistics from the first five months of its fiscal year have proved they were right. Their investigation showed just under 23% of the 1153 indigent people it provided medical services to did not have a valid Social Security number; all but assuring they are not in America legally.

Texas law requires counties to set aside and spend up to 8% of their general tax receipts to pay for medical care for the poor. In Williamson County’s case that amounted to $7.1 million this fiscal year which started last October 1.

When Williamson spent $4 million (more than half its set aside for the entire year) in just six months alarm bells sounded. When the County had to grudgingly set aside another $3million at its April 27 meeting the new regulation was passed.

Collins Report Blog Archive Texas county moves to save its health care system from illegal aliens: no ID now means no service!

ER overload: a survey of the research available shows that uninsured illegal immigrants are an imponderable burden in our nation's hospitals, in particular emergency rooms

ER overload: a survey of the research available shows that uninsured illegal immigrants are an imponderable burden in our nation's hospitals, in particular emergency rooms - New American, The Articles | Find Articles at CBS MoneyWatch.com


But hey, this NEW study says all that stuff before? Poppycock! The real truth is...

 

[The Prof]

it's old news in massachusetts

Costly ER still draws many now insured - The Boston Globe

 

[Deuce]

A small demographic only represents a small portion of ER visits? I AM SHOCKED I TELL YOU!

 

[Harry Guerrilla]

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.

 

[RightinNYC]

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.

 

[Renae]

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!

They love you, they really really love you.

 

[donsutherland1]

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.

 

[missypea]

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.

 

[rivrrat]

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.

 

[The Prof]

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

 

[WI Crippler]

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.

 

[winston53660]

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.

 

[MyOwnDrum]

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.

 

[BWG]

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.

Do you think one of those reasons could have something to do with circumventing the wait list to see a primary physician? Oh wait, we don't have those. Wait lists are only for those 'socialist' UHC countries.

Here's a little anecdote, that in this day of instant communication stunned me. A couple of weeks ago, my 81 year old aunt was feeling a bit poorly, so my cousin took her to an urgent care facility, but they told her they couldn't take her insurance because it was the weekend and couldn't verify it. So what do you do? Go to an ER?

 

[Gipper]

20% being uninsured is a lot of people and the costs have gone through the roof for all services in every hospital.

In 1984 I spent 63 days in the UCSF Hospital in Sand Fran. and the total bill was a little over $84,000, and I almost freaked over the high cost. Thank God I had great insurance and my portion was only $100 buck.

Last month I spent the night in a local Hospital no tests past a chest X-ray and blood tests and the bill was over $11,000.

At that rate my 63 day stay would cost close to $700,000.

Knowing this tells me we needed Health care reform. The problem is the Obama plan didn't address the real issues and serves to make thing worse as it also takes over the insurance industry over time and also effects so much more in a negative way.

Obama must go and we can do it starting in Nov. even the Liberal Leftists are gong to suffer if Obama is not stopped and the damage he's already done is reversed.

It may tell you that we need health care reform. It tells me that we need more competition.

Some could argue that hospitals have pretty stiff barriers of entry and borderline geographical monopolistic powers with regard to health care, but when you can create facilities that compete to the point where they can't charge one million percent over cost, the ultimate consumer benefits.

It would also massively reverse urban sprawl, which is good. In the sticks you may have one hospital to choose from unless you want to drive an hour, but in larger cities you could choose between one of a dozen facilities.

The most powerful vote you could ever have is still in the same place it's always been - in your wallet.

 

[BWG]

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.

My insurance is already set up that way, somewhat. If you are admitted to the hospital the ER co-pay is quite a bit less (don't remember the exact figures off-hand) than if you are treated by the ER and released to return home.

But, yes, maybe an 'off-hours' premium surcharge for routine treatment. Not something like people with angina symptoms.

 

[Catz Part Deux]

Who's packing ERs? Not the uninsured | Reuters

This is very surprising. How is it that nobody knew this until now?

The survey's methodology does not take into account the ER frequent fliers who visit the ER on a regular basis, and do not have insurance. These folks make up a substantial percentage of the people served in an ER on an annual basis. It delivers a misleading conclusion. One in five Americans may very well visit an ER annually, but that statistic doesn't answer two more important questions.

First, what percentage of Americans visit an ER more frequentlythan once? And, what is the daily count of ER "customers" and a comparison of insured versus uninsured.

Hope that helps.

 

[The Prof]

fine, but er COSTS are RISING

they NEEDED to DECLINE

to OFFSET all the extra EXPENSE incurred elsewhere in obamacare

ask the president

ask the globe