Universal Health Care ! CA (Industry: public school, colleges, pharmacies)

[JGC97]

Originally Posted by StanleysOwl

Most people who experience sudden distress don't feel they have the option of waiting for 9-5 weekday business hours to schedule appointments that might be weeks out. Most emergency room visits are for concerns that, in the patients' experience, are crises. It's a problem, but threatening them will exacerbate anxieties and in some cases sh8t will hit the fan. One example would be: septic infections. These arrive in emergency rooms with some regularity and over 25% of serious septis results in death if not dealt with aggressively on very short timelines. The symptoms are often mistaken for a variety of more benign problems - even simple anxiety attacks. Other problems that can be simple or terrible and hard to know which are: stroke and heart attacks. Food poisoning and other epidemiological threats are critically important to be diagnosed and reported to public health a.s.a.p.

I understand all that and I'm not referring to those where it's a true emergency. I'm referring to the countless number of people who actually use a doctor visit as a social event. Before you poo poo that notion, let me assure you I've witnessed it, personally. My first job was that of an emergency room registration clerk, 3:30 to midnight. Whereas on a normal night, we might get two, maybe three ambulance calls but on holidays, it was one every hour. Loneliness was the major factor for those. The prescription for those cases was just a little kindness and compassion ... and a ride home.

I'm not saying that everyone that comes through those doors doesn't need help immediately but I see a difference between urgent and emergency which is why we see a lot more urgent care facilities popping up in communities. I'm glad to see them, too. It relieves pressure off the ER physicians and nurses so they can attend to those who are truly in a life or death situation. Urgent care for a urinary tract infection, ear infection or sore throat. Emergency room for chest pain, difficulty breathing, gunshot wound. You get the picture.

For too long, some patients use the ER as a doctor's office and it has to stop, as population grows. Either that, or build more medical facilities to accommodate them.

[expatCA]

Originally Posted by HereOnMars

I understand all that and I'm not referring to those where it's a true emergency. I'm referring to the countless number of people who actually use a doctor visit as a social event. Before you poo poo that notion, let me assure you I've witnessed it, personally. My first job was that of an emergency room registration clerk, 3:30 to midnight. Whereas on a normal night, we might get two, maybe three ambulance calls but on holidays, it was one every hour. Loneliness was the major factor for those. The prescription for those cases was just a little kindness and compassion ... and a ride home.

I'm not saying that everyone that comes through those doors doesn't need help immediately but I see a difference between urgent and emergency which is why we see a lot more urgent care facilities popping up in communities. I'm glad to see them, too. It relieves pressure off the ER physicians and nurses so they can attend to those who are truly in a life or death situation. Urgent care for a urinary tract infection, ear infection or sore throat. Emergency room for chest pain, difficulty breathing, gunshot wound. You get the picture.

For too long, some patients use the ER as a doctor's office and it has to stop, as population grows. Either that, or build more medical facilities to accommodate them.

ER's are also used by a lot of people who complain about severe pain so they can get a drug. Some have a friend who will check drug free for the prescription. A friend who is a nurse changed her area of work as she got so tired of seeing young people coming in with drug problems.

[JGC97]

^^ Yes, expat. That too.

[StanleysOwl]

Originally Posted by CountryZebra

As someone who went into healthcare, I haven't had good experiences with the VA hospitals. They are depressing places to work at. I don't have numbers to pull up for comparison though, I just have my subjective experiences.

They certainly are depressing to work in or to be treated at. But that has nothing to do with the level of care and expertise and systems for patient management. That has to do with the miserable condition of the patients - who, if they weren't veterans, many would never be able to afford care in other hospitals. The next closest depressing environment are county hospitals which serve a lot of indigents more than private hospitals.

[StanleysOwl]

Originally Posted by HereOnMars

I understand all that and I'm not referring to those where it's a true emergency. I'm referring to the countless number of people who actually use a doctor visit as a social event. Before you poo poo that notion, let me assure you I've witnessed it, personally. My first job was that of an emergency room registration clerk, 3:30 to midnight. Whereas on a normal night, we might get two, maybe three ambulance calls but on holidays, it was one every hour. Loneliness was the major factor for those. The prescription for those cases was just a little kindness and compassion ... and a ride home.

I'm not saying that everyone that comes through those doors doesn't need help immediately but I see a difference between urgent and emergency which is why we see a lot more urgent care facilities popping up in communities. I'm glad to see them, too. It relieves pressure off the ER physicians and nurses so they can attend to those who are truly in a life or death situation. Urgent care for a urinary tract infection, ear infection or sore throat. Emergency room for chest pain, difficulty breathing, gunshot wound. You get the picture.

For too long, some patients use the ER as a doctor's office and it has to stop, as population grows. Either that, or build more medical facilities to accommodate them.

Get that and agreed. But how can an impersonal set of rules separate those users? If the insurance companies threaten they will not cover visits that prove non-emergent most of those you cite will stop coming in .... but so will many with legitimate problems who are uncertain of underlying causes.

[k374]

to15% payroll tax? are they mad? good luck with that.. will decimate everything from business to middle class. These guys must be smoking some good crack.. the taxes are already the highest in the nation so jack it up another 15%, ridiculous!

when will these liberal morons stop expansion of the largest welfare state?

[payutenyodagimas]

Originally Posted by davidt1

2017 VA budget = $74.5B

2016 Medicare spending around = $699B

Don't know how many patients or Congress stuff.

That VA budget, divide by how many veterans are entitled for the service. Then compare with the premiums each pay now.

Then compare. Which is cheaper?

[JGC97]

Originally Posted by StanleysOwl

Get that and agreed. But how can an impersonal set of rules separate those users? If the insurance companies threaten they will not cover visits that prove non-emergent most of those you cite will stop coming in .... but so will many with legitimate problems who are uncertain of underlying causes.

Well then, I supposed insurance companies will have to decide whether they want to take that risk. After a few lawsuits, they'll have to re-think their "refusal to pay" policies. As the population continues to grow, decisions about how to treat them will have to made.

[CA4Now]

Originally Posted by HereOnMars

For too long, some patients use the ER as a doctor's office and it has to stop, as population grows.

We had an elderly neighbor who was a widow, and would call one of us to take her to the ER for minor issues. One time she called on a holiday, and I told her that she was not going to be getting the care she needed from an ER, that she needed to see her regular doctor, and that I would take her the next day. I mentioned the long wait we'd have, and what I assumed would be the enormous cost of an ER visit.

She told me that ER visits cost her $10. I was shocked. No wonder she went there so often.

[StanleysOwl]

Originally Posted by HereOnMars

Well then, I supposed insurance companies will have to decide whether they want to take that risk. After a few lawsuits, they'll have to re-think their "refusal to pay" policies. As the population continues to grow, decisions about how to treat them will have to made.

Yeah. Exactly. It's a conundrum. Great idea to get rid of the non-emergency malingerers. Disaster for a minority of seriously threatened second-guessers. What to do what to do? Maybe better hospital intake triage protocol at the front desk. Turn away what doesn't fit obvious emergency or mystery?