AUSTIN, Texas â Just nine people accounted for nearly 2,700 of the emergency room visits in the Austin area during the past six years at a cost of $3 million to taxpayers and others, according to a report. The patients went to hospital emergency rooms 2,678 times from 2003 through 2008, said the report from the nonprofit Integrated Care Collaboration, a group of health care providers who care for low-income and uninsured patients. http://news.yahoo.com/s/ap/20090402/ap_on_re_us/frequent_er_patients
They should just give the triage nurse a cash register. When Mr/Mrs Mental illness comes in with anxiety of chest pain, the nurse could recommend a 6 hour wait and 4 hours of tests OR take this $50 in cash and if you still have chest pain in a week stop back. I'd offer a little more for gunshot wounds, paper work is tedious and most people would rather be doing something else anyways.
The real issue is not that 9 people abused the system. The issue is why 2678 visits cost $3million+, when we KNOW most of those visits were probably bunk. That's outrageous. Bring back the free market to health care and college tuition, so these health care companies can't keep robbing us.
The reason is liability resulting from tests not done. For example, Mr Drunk comes in to the ER for the 20th time this month. He is delirious and was found on the ground passed out. You know he is drunk and just need to sleep it off but if you don't get the CT scan then the 1 time that you don't will be the time he has a head bleed and you arse will get raped in court. Or you know he is drunk and just needs to sleep it off but the one time you don't get the blood work done is the one time he will be having a mini stroke/ MI and you will again get arse raped in court (of course in court Mr Drunk will appear as a nice clean cut respectable member of society who now is ruined from any further productive life by your failure to order a half dozen tests to rule out everything from ebola to god knows what. Newsflash, there is no standard or care, standard of care is what the lawyer can convince the jury it is in court and if applied across all patients cost of care would be ten fold what it is today). And before you all go blaming the docs (have you ever thought to address tort reform with your representatives as you lament the state of healthcare? probably not right, well that is 15-20% of healthcare care costs right there) they don't get paid one dime more if someone comes in and gets no tests or 20 tests. The Hospital also loses money on these types of patientâs and are constantly harassing docs who order too many tests (hospital doesnât care if it gets sued as most hospitals are non profit and have low caps on malpractice losses) as they generally don't have any insurance and even those that do it doesn't cover the cost. Eventually who ends up paying for these types of patients is the tax payer and to some extent those who pay health insurance premiums. The medical home concept and integrative medicine are a necessary part of health care reform so that chronic patients like these would rarely end up in the ER and so that primary care providers could actually take charge of a patient's overall care rather than play the hand off game they are forced to by their employer who only gets paid (poorly) for the 15 min office visit. The employer gets paid better for the time the patient spends with the specialist so that is how they have set the system up. Never mind that the specialist only sees his focused aspect of the patient's problem and not the whole patient's well being. Example: A patient fond to have blood in urine high white count handed off to urologist, biopsy done, bladder cancer found. Patient also had some mass along auditory nerve but urologist in charge at this point, primary care doc out of the picture. So beautiful life saving surgery done, new internal bladder constructed, state of the art stuff, cost over $150K on the insurance credit card. Remember the tumor in the head, turns out it was advanced brain cancer, and was in the lungs etc patient dead in 9 months, bladder cancer wouldn't have killed him even if untreated for at least another year or more. A medical home concept with a primary care doc overseeing/managing the whole process would have led to a much better outcome for the patient in terms of quality of life and far less cost to the system. Medical Home with different billing structure, ie not just for office visits, tort reform, getting rid of HMO's and health Insurance companies, all part of the health care solution. Some primary care docs in private practice (the few that are left) are now charging a retainer of $500 a month or more per patient in addition to the health insurance reimbursement (they don't take Medicare nor Medicaid which reimburse at 40% of private insurance) and thus are able to limit the total number of patients they have in their practice. This gives them the time to provide a real medical home and studies show that these patient's fare far better in terms of medical outcome than the ones who are simple reliant on their health insurance. The sad fact is that in this country you don't get what you pay for in healthcare because someone paying $20K a year for health insurance isn't going to get the level of care they deserve unless they are lucky enough to be in a practice that embraces, or can afford to embrace, the concept of the medical home. On the other hand, they may get the same or worse level of care as someone who pays nothing for healthcare.
in a related story: Former Texas nurse charged with killing 5 patients By PAUL J. WEBER â 3 hours ago SAN ANTONIO (AP) â A former nurse has been charged with injecting 10 patients with bleach, killing five of them, at a Texas dialysis clinic that temporarily closed last year after deaths mysteriously spiked. http://www.google.com/hostednews/ap/article/ALeqM5hHvETNsob9ac-d7IYjpQ-aOLgm2AD97A0LD80
http://www.galenpress.com/demon_doctors.html http://content.nejm.org/cgi/content/short/352/18/1843 http://www.trutv.com/library/crime/serial_killers/weird/swango/index_1.html
Some time ago, here in NY, lotsa low income people went to the hospital just to stay warm in the winter. Sat around in the waiting room, etc. Don't know if that's still the case, but with the econ in the dumper ...
DRs are about equal to senior AIG management in my mind.....maybe they are innocent? Maybe OJ Simpson is innocent too.