Vegas Free-for-All - Brilliant Republican Healthcare Solution: Don’t Take Children With Broken Bones To The ER

Brilliant Republican Healthcare Solution: Don’t Take Children With Broken Bones To The ER

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IndyBoilerman

Dec 27, 2016
4:29am

Block User

So, Mally argues that Obama is stupid, a liar, or a stupid liar. I agree.

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Originally posted by: malibber2

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Originally posted by: alanleroy
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Originally posted by: pjstroh
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Originally posted by: alanleroy
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Originally posted by: pjstroh
People without insurance don't have a doctor...doctors dont like to accept new patients who don't have insurance - so they don't accept them. Its that simple. Cool, huh? that's why uninsured people go to the ER for stuff a regular doctor can do at a far cheaper price.

One of the great promises of Obamacare was that with all the newly insured people, the program would pay for itself because of less abuse of Emergency Care. Unfortunately that has simply not been the case.

Contrary to goals, Emergency Room visits increase under Obacare.

"Three-quarters of emergency physicians say they've seen ER patient visits surge since Obamacare took effect — just the opposite of what many Americans expected would happen"

People thought getting low cost, government subsided health insurance would get them back into the mainstream of American healthcare...with their own Doctors and everything. Then they found out that there weren't enough primary doctors to go around. Then they found out that their deductibles and out of pocket costs meant they were still paying for their own health care that they couldn't afford. So they just continued to use the Emergency Care anyway....because they didn't have a family doctor and still couldn't afford their medical care...and the Emergency rooms have to treat them. Cool, huh?

so if Paul Ryan dispels the Medicaid expansion from Obamacare as he proposes and sends 10 million people back to the streets,....you are saying that won't impact ER visits? And where would you suggest those people go since they don't have a doctor or insurance?

A significant part of our population lives at an income level that makes any healthcare costs unaffordable. The question needs to be asked what level of care should they receive. Because even a $100 bill is going to be beyond their means to pay
I'm just the messenger. How does PJ explain the surge in Emergency Room visits since Obamacare took effect? Maybe I need to repeat that...."Three-quarters of emergency physicians say they've seen ER patient visits surge since Obamacare took effect — just the opposite of what many Americans expected would happen". Sure doesn't seem to be working....does it?

The article I linked implied that even though all these people are now insured they still don't have family doctors. Even though they are now insured, their deductibles and max out of pocket means their health care still isn't affordable. It's unfortunate, but the ACA didn't really address healthcare costs in any significant way. It didn't increase the number of doctors. It didn't decrease emergency room visits. It appears to have become a massive bureaucratic boondoggle. Shocking, huh?

The point missed by a lot of you is that emergency room utilization is up because deductibles and co-pays are up. If you go to the emergency room, they have to treat you right away. You don’t have to pay your deductible or co-pay upfront. (the hospital will try and collect it later) However, If you call in and make an appointment with a doctor during office hours to begin treatment of some condition you will have to pay your deductible and co-pay upfront before receiving any treatment.

In other words, If the doctor determines your treatment is going to cost 4k and you have a 6k deductible, he is going to want 4k upfront before you get treatment. Even though the same treatment may be 8k in the ER you don’t have to come up with any of it upfront. The insurance companies have created this problem because of their shitty products. If they want people going to doctor’s offices first, wave the co-pays and the deductibles at the doctor’s office.

jphelan

Dec 27, 2016
7:49am

Block User

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Originally posted by: jphelan
People who pay a significant part of the bill will forgo the Emergency Room unless it is really an emergency. Urgent care is a suitable substitute in many cases and Medicaid should be accepted at urgent care facilities. Medicaid participants need to have "skin in the game". Maybe co-pays should be withheld from any tax refunds / credits for Medicaid participants? People only make economically wise decisions when there are economic consequences.

My Bronze plan with $6000+ out of pocket cost per year costs nearly $19,000 per year for my wife (58) and me (57). In 2017, I will be paying $732 per month, and my former employer is kicking in ~$850 per month.

This is a Bronze plan, the cheapest I could get. So much for "affordable health care". And I have never had to pay my deductible "up front" before receiving treatment when visiting my doctor or the ER. With Urgent Care, they may try to bill you up front, but only for the part of the bill which insurance will not cover. The minute clinics in WalMart, Target, and CVS are also good options for cheap, immediate care.....when people have skin in the game.

Medical Cost Sharing is another lower-cost option is you don't want need more than $200K coverage or want an abortion / viagra.

IndyBoilerman

Dec 27, 2016
10:16am

Block User

Jphelan, Libs don't want their kind to have skin in the game.

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Originally posted by: jphelan

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Originally posted by: jphelan
People who pay a significant part of the bill will forgo the Emergency Room unless it is really an emergency. Urgent care is a suitable substitute in many cases and Medicaid should be accepted at urgent care facilities. Medicaid participants need to have "skin in the game". Maybe co-pays should be withheld from any tax refunds / credits for Medicaid participants? People only make economically wise decisions when there are economic consequences.

Terry Locke

Dec 27, 2016
11:22am

Block User

Wait. What?

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Originally posted by: IndyBoilerman
Billy, were you taught that "New Math"? US News seems to believe that our population increased 0.7%. Please explain your number of 7%.

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Originally posted by: billryan
US population has grown about seven percent in the last eight years, so ER visits should match that. We also have an aging population that may or may not effect that.
In my case, my Mom was in the ER three times in her last two years, after some eighty years of not being there.

billryan

Dec 27, 2016
11:36am

Block User

Last year, I had an appointment with an eye specialist that took me four months to get.
While I am waiting, a middle aged guy comes in and as a new patient is given forms to fill out. He fills it out,muttering about this not being important and this is none of their business.
He goes up and the receptionist tells him he has a $25 deductible. Guy says he only pays for services after he receives them. Receptionist says office policy is collect up front. He says he'll pay after he talks to the Dr. Receptionist says you can't talk to the Dr until you pay. He goes off and gets loud. Then announces he is canceling his appointment and will be filing a class action suit, that collecting a fee upfront is illegal and so on and so forth. She calls building security on him.
What kind of moron waits months for an appointment, then walks away because he has to pay before his appointment rather than after.

billryan

Dec 27, 2016
11:41am

Block User

Is the $200,000 a lifetime cap?
My Mothers bill for an angioplasty and follow up was $168,000 in 2008. I've seen million dollar caps but never one as low as $200,000. That's like betting you won't have a heart attack or stroke.

billryan

Dec 27, 2016
11:52am

Block User

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Originally posted by: friedmush
Wait. What?

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Originally posted by: IndyBoilerman
Billy, were you taught that "New Math"? US News seems to believe that our population increased 0.7%. Please explain your number of 7%.

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Originally posted by: billryan
US population has grown about seven percent in the last eight years, so ER visits should match that. We also have an aging population that may or may not effect that.
In my case, my Mom was in the ER three times in her last two years, after some eighty years of not being there.

US Census- 2008, 303 million
US Census.-2015 323 million.

Add 20 million to the 303 million base and what is the estimated population growth? Math is hard.

Stewart

Dec 27, 2016
11:53am

Block User

Quote

Originally posted by: billryan
Last year, I had an appointment with an eye specialist that took me four months to get.
While I am waiting, a middle aged guy comes in and as a new patient is given forms to fill out. He fills it out,muttering about this not being important and this is none of their business.
He goes up and the receptionist tells him he has a $25 deductible. Guy says he only pays for services after he receives them. Receptionist says office policy is collect up front. He says he'll pay after he talks to the Dr. Receptionist says you can't talk to the Dr until you pay. He goes off and gets loud. Then announces he is canceling his appointment and will be filing a class action suit, that collecting a fee upfront is illegal and so on and so forth. She calls building security on him.
What kind of moron waits months for an appointment, then walks away because he has to pay before his appointment rather than after.

some people are just stubborn to the point of stupid. in their mind, they think they are standing on principal. meanwhile, they look like a complete FOOL! I wonder if this guy was of Xyz*# ancestry.

Ellen Locke

Dec 27, 2016
12:01pm

Block User

57? I've always had you pegged for much older, dear.

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Originally posted by: jphelan

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Originally posted by: jphelan
People who pay a significant part of the bill will forgo the Emergency Room unless it is really an emergency. Urgent care is a suitable substitute in many cases and Medicaid should be accepted at urgent care facilities. Medicaid participants need to have "skin in the game". Maybe co-pays should be withheld from any tax refunds / credits for Medicaid participants? People only make economically wise decisions when there are economic consequences.

alanleroy

Dec 28, 2016
12:29am

Block User

Ok...If anyone is REALY interested in cutting emergency room abuse I have a few suggestions.

1. Supend 'Frequent Fliers'. Here in Fresno in 2011 it was determined that two homeless men got 1,363 ambulance rides to Fresno hospitals — nearly 1% of all Fresno County's ambulance calls. The top 50, also called super users, tallied 4,367 calls for ambulances that year. We came up with a program to put them on a no-fly list...while not ignoring them if they were really having an emergency...and to address their clear mental health issues.

Fresno County saves millions by targeting Frequent Fliers

2. Address the issue of Opiate abuse. A significant number of ER visits are Opiate abusers seeking more opiates or Opiate abusers who have overdosed. This needs to be diagnosed and addressed at the root cause..instead of just giving out more painkillers or pumping the stomachs of the OD'd. I'd go as far as on-site committal and forced treatment..but there should be some level of real intervention....Hell it's better than death or jail.

3. Modify the EMTALA (Emergency Medical Treatment and Active Labor Act of 1985) which forbids emergency rooms from refusing service to anyone. Perhaps Triage should be able to refuse Emergency services for cases that are not Emergencies...Duh. Perhaps Emergency rooms should be supplemented with adjoining Urgent Care or Family practices.

4. Dr. Google. It won't be long and some Artificially Intelligent App will be able to do all the necessary groundwork to triage, and recommend an appropriate course of medical action. It will order your prescription at Walgreens, schedule you at the ER if necessary or at some lab or other facility. Probably with fewer errors and certainly at much lower cost and better utilization of medical facilities. Smart Phone/Medical Tricorders and Emergency Medical Holograms aren't too far off either.

5. Here's a good one...Bill the country of origin for the Emergency care of their citizens living here illegally. We can do an annual reconciliation where we deduct for Americans illegally living in their countries who use their Emergency Care with no insurance. Although this won't really do anything to prevent ER abuse, at least we'll get paid for some of it.

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