The hospital emergency room.

[BawanaRik]

The thing with universal cover is that it's universal. Yes, there are some differences, typically associated with geographical location, but cover is for the most part equal. Do some people abuse the system? Sure, though that is true of every system. But most of it goes towards the lifelong illnesses, the elderly, young children and genuine accidents.

Which isn't the case here. As I hope this illustrates.

In general you take better care of the old. Retirement is allegedly much more generous.

Here an average seniors payment is about 650 pounds a month. After working for 50 years. That's an insult, I think.

 

[Tat2dHeart]

In general a doctors office wants to be paid at time of service.

The ER bills. This issue could be eliminated merely by the ER charging for non emergency work at the time of service.

My ER here in Atlanta-ish area and the ones in Florida where I came from all required the co-pay or payment arrangements be made before you got your paperwork to leave the ER when treated there. They didn't block treatment waiting for the info, but you didn't get to leave until you either paid your bill or made some agreeable arrangements to do so (usually with a partial payment at the time of service).

Ever read the Moon is a Harsh Mistress? Good book.

A very good book, indeed.

 

[BawanaRik]

Nope. Who makes the call ? You wanna be the guy that tells the person with their severed fingers in an ice bucket they're out of luck? It's not so easy.

The flu guy, the smelly one, the crazy one. I don't see a problem just letting them wait. and wait. until they get the message and leave.

 

[BawanaRik]

My ER here in Atlanta-ish area and the ones in Florida where I came from all required the co-pay or payment arrangements be made before you got your paperwork to leave the ER when treated there. They didn't block treatment waiting for the info, but you didn't get to leave until you either paid your bill or made some agreeable arrangements to do so (usually with a partial payment at the time of service).



A very good book, indeed.

It's my understanding that around here's it different. It's been almost 40 years since I've been to one.

I like the Air Tax.

 

[BawanaRik]

until you have someone like my wife who suffers from chronic debilitating migraines and get's treated like a drug addict.

Caffergot PB. And she shouldn't be going to an ER for a chronic illness. That's not an emergency.

There doctors that specialize in that. If she's not going there there's a reason the ER is suspicious.

 

[fdeck]

There is no free health care in the world.

As we like to say on this side of the pond, No ****, Sherlock.

This is really just a quibble, but you took my words out of context. I was obviously making the same ironic use of the word "free" as the post that I was quoting.

 

[fdeck]

Reimursement can suck for hospitals.

Must be hard for them to find investors.

That's probably why we tend to get busier every year and aren't quite seeing raises.

If it's any consolation, working harder for stagnant wages has been a feature of our economy for decades.

 

[spade2you]

Must be hard for them to find investors.

Yes, but the 1%er CEOs all have yachts.

I can't see hospitals being a wise investment. The state pays to bail us out constantly.

 

[fdeck]

I can't see hospitals being a wise investment. The state pays to bail us out constantly.

That's a wise investment. Pocket the profit and let the state take the risk.

 

[BawanaRik]

Must be hard for them to find investors.


If it's any consolation, working harder for stagnant wages has been a feature of our economy for decades.

Healthcare isn't working with stagnant wages. The reimbursement to hospitals is dropping.

Doctors are expected to see some patients for 6 bucks.

You can't fill out the paper work for 6 bucks.

The hospitals which are closing are the ones in poor hoods. It's not hard for them to find investors.

It's impossible.

 

[BawanaRik]

Yes, but the 1%er CEOs all have yachts.

I can't see hospitals being a wise investment. The state pays to bail us out constantly.

I read the New Jersey papers and every once in a while a hospital, always in a poor area, closes.

When you have people using the hospital ER as a PCP and not paying their bills it's hard to turn the profits that wise investors look for.

So the board closes the hospital and all the locals are sad.

But they don't realize it was their choice.

 

[DerHoggz]

Healthcare isn't working with stagnant wages. The reimbursement to hospitals is dropping.

Yes, the growing inequality of incomes in the US is very bad, something should be done to address it.

Thanks for pointing that out!

 

[punkjazzben]

If I go to the ER, its covered on Medicare straight away. In most hospitals I've been to, the ER has had several queues and patients are allocated to one based on the urgency of their case. That's just commonsense.

If I go to a clinic to see a GP, Medicare sends a cheque later to cover a decent chunk of the expenses (if the GP didn't just do bulk-billing in the first place, in which case you don't pay at all).

I had to have a gastroscopy recently. I have no idea how much it cost.

I like our system. It's not perfect, but it could be a lot worse.

 

[kesslari]

I used to wonder more about that.
But there are things that are a mess, and things that have a high medical likelihood of going lethal fast.

I went to the ER feeling chest pains (turned out to be OK). I've had a bandmate go with Stroke symptoms (it was a stroke). Both of us went "head of the line" ahead of people who were bloody messes. And I realized stroke or heart attack will leave you dead. Blood cleans up, and if you're in ER waiting room you're unlikely to bleed to death before you get noticed.

Just my experience.

Mike - hope your dad is OK.

I hope your dad's OK.


I drove a guy I work with to the Emergency room after he ran his fingers through a chain/sprocket assembly. His fingertips were flattened, punctured and bleeding. I think it took 3 or 4 hours before anyone saw him. I would have considered that an Emergency, but there was no real sense of urgency on the behalf of the people working there. (They did take the guy who came in as the result of a chainsaw accident right away)



How many posts is it going to take before this thread turns political and is put down by a moderator?

 

[fdeck]

Healthcare isn't working with stagnant wages. The reimbursement to hospitals is dropping.

Doctors are expected to see some patients for 6 bucks.

You can't fill out the paper work for 6 bucks.

The hospitals which are closing are the ones in poor hoods. It's not hard for them to find investors.

It's impossible.

Health care is 20% of our economy. The health care system has twice as much money to play with, per capita, than any other civilized country. What we pay on top of what it should cost is like a 10% tax on the entire economy. Somebody is gouging us. Who?

Are there disparities? Sure. Is the industry good at grabbing the profits and leaving the costs to somebody else? Sure.

I don't believe that simple measures such as reimbursements are good for assessing the financial picture of the health care business. Everybody has 20 different ways to make money. The complexity and opacity of financial relationships in the business make it impossible to figure out how much anything costs, or where the money is going. This is by design, because a hard nosed cost accounting would probably drive the rentiers out of business.

 

[BawanaRik]

Health care is 20% of our economy. The health care system has twice as much money to play with, per capita, than any other civilized country. What we pay on top of what it should cost is like a 10% tax on the entire economy. Somebody is gouging us. Who?

Are there disparities? Sure. Is the industry good at grabbing the profits and leaving the costs to somebody else? Sure.

I don't believe that simple measures such as reimbursements are good for assessing the financial picture of the health care business. Everybody has 20 different ways to make money. The complexity and opacity of financial relationships in the business make it impossible to figure out how much anything costs, or where the money is going. This is by design, because a hard nosed cost accounting would probably drive the rentiers out of business.

Actually a CD Rom used at home would drive them out of business.

Input symptoms output problem Output solution.

But seeing how easily most people can be scammed I suspect things will continue as they are.

But blaming the industry isn't going to do any good. The US is one of the fattest nations on the planet.

I suspect that has a lot to do with healthcare being expensive. I bet it's also the only nation with free healthcare.

Millions get healthcare for free. I do not see that happening else where. When people pay for something they respect it.

 

[punkjazzben]

What's this business about no one in the world getting free healthcare?

No, no one gets 'free' healthcare insofar as public health spending is funded from tax revenue. But, generally speaking, the accepted meaning of 'free' healthcare and education is to have those services funded publicly.

Here we have, similar to the US, a mixed private-public healthcare system. The public funding comes from a 1.5%-ish tax. It provides basic universal coverage to all, free treatment at public hospitals, and most healthcare is free or subsidised by the government. If you want, you can also get private health care for extended coverage and, some argue, better care in private hospitals. If you earn a certain amount and you don't take out private health care insurance, an extra levy is applied so that the system doesn't become welfare for the upper-middle classes.

 

[BawanaRik]

What's this business about no one in the world getting free healthcare?

No, no one gets 'free' healthcare insofar as public health spending is funded from tax revenue. But, generally speaking, the accepted meaning of 'free' healthcare and education is to have those services funded publicly.

Here we have, similar to the US, a mixed private-public healthcare system. The public funding comes from a 1.5%-ish tax. It provides basic universal coverage to all, free treatment at public hospitals, and most healthcare is free or subsidised by the government. If you want, you can also get private health care for extended coverage and, some argue, better care in private hospitals. If you earn a certain amount and you don't take out private health care insurance, an extra levy is applied so that the system doesn't become welfare for the upper-middle classes.

Here's it's a bunch of taxes, none of them anywhere near 1.5%.

It's more like 5% and 5% there. Plus a close to a grand a month premiums and a 5 K$ deductible. Plus co pays.

The system is a cash cow.

Everyone here's thinks more medicine is better medicine. They substitute a 100K$ in testing for common sense.

And they only get paid when you're sick. I think that doctors should only get paid when their patients are well. Not when they are sick.

 

[fdeck]

An issue in the US is that the private portion of our system is utterly massive. For instance huge numbers of people are employed by the health insurance industry. It's like the Dole. If you made that industry vanish, there would be a lot of people thrown out on the streets.

I'm not making light of this. Even absent ideological obstacles, supporting the insurance industry is why we can't just switch to a single payer system. This is why the compromise reached by the Affordable Care Act resulted in such a complex solution. And it's not a complete solution, but just a band-aid, because it doesn't directly address costs. But the hope is that by standardizing the system and fostering competition, costs will become easier to account for, and that will drive excess costs out of the system.

 

[fdeck]

Here's it's a bunch of taxes, none of them anywhere near 1.5%.

It's more like 5% and 5% there. Plus a close to a grand a month premiums and a 5 K$ deductible. Plus co pays.

The system is a cash cow.

Everyone here's thinks more medicine is better medicine. They substitute a 100K$ in testing for common sense.

And they only get paid when you're sick. I think that doctors should only get paid when their patients are well. Not when they are sick.

That's the idea behind an HMO. The HMO was supposed to get paid a flat rate per patient, and thus would be rewarded with profit if they had healthier patients. But this created the perverse incentive to drop sick people from plans or refuse to enroll them. The ACA is probably the closest thing so far (at least in the US) to a system that will benefit from making people healthier.