ER Overload

I work in a 60 bed metropolitan ED. I can't tell you how many patients i see at 3 am for an STD check that came in by ambulance and are showing their medicaid card for their "insurance." it's amazing to me to see people that A. thnk that medicaid is "insurance" and B. get mad at me when i try to give them resources for our many free medical clinics in the city. i still wonder how all of these young, healthy people are getting medicaid cards and are not getting jobs or an education?

I work in a level 1 trauma center ED in a large city hospital. I understand that our population of uninsured is not as high as one would think, however our Medicaid population is a majority of our patients. i can't tell you how many STD checks I do in a shift. People actually believe that Medicaid is health insurance and it is their right to have it. I see so many 20 yr old males that have no medical problems with a Medicaid card. How do they get a card when they have nothing preventing them to go out and either get a job or an education?

Another thing.......If I walk into a store & want to buy something I need money to buy it or pay for it later after putting it on credit. Why should health care be any different? The values in this country stink & laziness is being passed down from generation to generation. In my experience, people in the inner city need to teach their kids the value of a good job & a good education. THAT will help you get health insurance & NOT live off of the state.

I am an EMT who worked in the city for many years. I transported people with a toothache at 2am, people with hiccups & a guy who got scared because his heart was pounding really fast while he was having sex. The one thing they all had in common was a blue "Forward" card otherwise known as a Medicaid card. I could tell you a thousand stories like this one & point you to 100 other EMT's who could do the same. They think that it's their God given right to have free health care & do nothing to earn it.

Teachers have ~30 students per day, and spend their whole day with their students. Doctors do not, and guess how many patients a Doctor will see per day?

This is a slanted article. Obviously, the person who wrote this has not been to the ER recently. Ask any nurse that works in an ER, and they will tell you that a HUGE number of patients are uninsured with less than an emergency need.

The face of the uninsured is ever-changing. It's illegal immigrants to the people who legally emmigrated to this country with the hope of a better life with better healthcare. It's the mother's who have children knowing they can get on Medicaid and the mother's who work 2 or 3 jobs and take out insurance on their children and not themselves -- so at least their children can have medical care. It's the people who didn't finish school or graduated with only a high school diploma and perhaps cannot get the jobs that offer health benefits. It's also people, like myself, who went to graduate school -- a program that didn't offer comprehensive health coverage -- and cannot afford to pay for individual policies. Incidently, I bought my own insurance plan -- the only one where I could afford the monthly premiums had a $1000 deductible. Being a fairly healthy person, it was unreasonable to pay the monthly premiums plus whatever doctor's visits I used out of pocket until I reached $1000, so eventually I cancelled the policy. There is a huge gray area where, unfortunately, a lot of honest, hard-working people are getting lost in. It is this gray area that needs to be addressed when discussing healthcare reform.

I do agree that many changes in the health care system have contributed to the current ER crisis. Managed care, operating costs, and shortage of staff have all played parts, however, I do disagree with the above article stating the uninsured actually avoid the ER due to the fact their visits are expensive and therefore uninsured patients actually visit the ER less. What's failed to be mentioned is that many of the folks who are uninsured who do receive care and are later billed for their visit do not pay their ER bill. Therefore, their visits do actually become free (or rather their visits are paid by the rest of us) Illegals also strain the system and aren't mentioned in the above article. In Prince William County VA where I live the county has cracked down hard on illegals this year (with all the usual outcry from the liberals.) One result of this crackdown has been that ER wait times have DRASTICALLY reduced at area hospitals. I do believe that everyone should have access to quality health care. I also believe that the government needs to improve the health care system in this country and should make efforts to manage costs and demand through legislation that carriers do not exclude pre-exisiting conditions. I believe that health care coverage should be mandatory just like car insurance if for drivers and that everyone needs to pay into the insurance system in order for the system to work. That way everyone going to the ER is actually paying to use it which will reduce wait times and overall costs for the insured. As far as the illegals and those who refuse to carry insurance; state run clinics should be available to provide the most basic care to protect those who are left out of the health care system. This way ER rooms can limit their efforts on those who can be expected to pay.

I don't know if the article is correct, but I do know ER's are packed & I experienced this first-hand when I was at the ER with Apendicitis (although I didn't know it was my appendix at the time) and I sat in the ER waiting room for 5 hours & then it took another 4 hours to be diagnosed & then 3 hours later I was in surgery. 12 hours total! Now, we know that 8 hours in to the ordeal my appendix ruptured! I had to spend a week longer in hospital & ended up with 3 incisions, instead of one. Had I not spent 5 hours in the waiting room, my appendix would not have ruptured! Something has got to change!!!

This all sounds great, but you have not mentioned the main reason for ER over crowding, THE ILLEGALS! The ER is packed with them, most can't speak English, so the nurse or doctor has to find some one to translate. Here in Texas they come across the border just to go to the free emergency room. There is the problem in a nut shell! Mary Carmichael, Dr. Newton, and Robert Johnson need to pay a visit to Texas before they write another BS article.

This all sounds great, but you have not mentioned the main reason for ER over crowding, THE ILLEGALS! The ER is packed with them, most can't speak English, so the nurse or doctor has to find some one to translate. Here in Texas they come across the border just to go to the free emergency room. There is the problem in a nut shell! Mary Carmichael, Dr. Newton, and Robert Johnson need to pay a visit to Texas before they write another BS article.

As a person who has worked in and inpsected ERs for many years, I can not disagree with the above comments..I do feel I need to add some specific comments that apply. It is true there are many areas that the ER has no or little control over, However, some of the important areas they can control, they fail miserably to manage. Areas such as control of the timing of services, movement to the next level (bed) and orterh

As a person who has worked in and inspected ERs for many years, I can not disagree with the above comments. I do however feel there are some additional statements that do not favor the ER or the physicians attending them. The barriers that are under the control of the ER are not being addressed properly. Such things as managing the time and services utilized and moving patients on to the next level. Specificlly

People always complain about one thing or another. The fact is that many uninsured never see a doctor in years and years, I being one of those "uninsured". Lucky for me too, because my not having insurance sure helped those who do and since I never went to the doctor or hospital I never cost the taxpayer any money either, except one problem exists with this behavior, I neglected my health because I never had insurance and couldn't afford to see a doctor on a regular basis to the point that high blood pressure caused my kidneys to fail. Now I am on medicare and medicaid, having to consume ungodly amounts of prescribed medicines and undergo dialysis three times a week. I have had more surgerys in the past eight months than in my entire lifetime combined, all at the cost of the taxpayer and not an insurance provider. The reform that needs to happen is in the insurance industry. Everyone should have access to health insurance or health care, period! Doesn't matter if they've worked a day or 10,000 days... they are fellow human beings and deserve to be healthy in the supposed richest nation on earth. Yes, she did say we were freeloaders. My first ER and hospital visit in over 25 years cost me $25,000... since then my bills have added to in excess of $100,000... I could never pay this off in three lifetimes.... so what am I suppose to do? I guess die and make everyone happy... So snguyen you should re-read this story, because the author did start the comments off by saying we were freeloaders and then another story was added onto it. The first was the presumptions and the second was the interview. I was offended. I've worked all my life, since I was a kid mowing yards, served in the USN and a defense contraqctor and when I was young was always very healthy, but things change and there should be a system in place for those changes we make throughout our life. Neither candidate has a good plan and I doubt either will implement one during their tenure anyhow. BTW, Im restricted on how much money I can make as well now or else my medicaid will be cut-off and then I can't get a transplant, so the rest of my days is linked to this crappy healthcare system. Plus no one knows what is what. If it wasn't for the internet I'd be lost since no health care providers have given me any really good information.

Technically by law, its true, they have to treat you, but with new systems being implimented by a lot of hospitals, I find co-workers (I'm a nurse) checking into medical histories and making judgements about people based on some note from some doctor some long time ago. The only way to care for people is to treat each occurence as something totally new and unique, worthy of full exploration. For example, someone who comes in with back pain they have had and lived with for a long time, could have kidney problems. Or they could have just slept on it wrong. Do you want your E.R. doctors making snap decisions about your back if your situation was the same? Not to mention the fact that personally, everytime I have been sick enough to require a trip to the doctor, they have sent me straight to the emergency room. I think the whole scenario needs a change. More doctors for preventative care, and more money for emergency rooms. To heck with the entire "Urgent Care" or whatever they are offering at your local doc's office. There is a classic example of a waste of medical funding. Entire facilities with doctors who won't go farther than a bandaid, and you wind up at the E.R. anyways, but now you are paying 2 bills instead of one.

Technically by law, its true, they have to reat you, but with new systems being implimented by a lot of hospitals, I find co-workers (I'm a nurse) checking into medical histories and making judgements about people based on some note from some doctor some long time ago. The only way to care for people is to treat each occurence as something totally new and unique, worthy of full exploration. For example, someone who comes in with back pain they have had and lived with for a long time, could have kidney problems. Or they could have just slept on it wrong. Do you want your E.R. doctors making snap decisions about your back if your situation was the same? Not to mention the fact that personally, everytime I have been sick enough to require a trip to the doctor, they have sent me straight to the emergency room. I think the whole scenario needs a change. More doctors for preventative care, and more money for emergency rooms. To heck with the entire "Urgent Care" or whatever they are offering at your local doc's office. There is a classic example of a waste of medical funding. Entire facilities with doctors who won't go farther than a bandaid, and you wind up at the E.R. anyways, but now you are paying 2 bills instead of one.

I smell lawyers here too, in addition to the problems mentioned. Physicians and Hospitals have to pay huge mal-practice premiums that make their low reimbursements all the more inadequate. No where other than surgery, can things go more unintentionally wrong than in an emergency room. Enter the ambulance chasers.....

Some-Girl, I think you're overreacting. She's not saying that the uninsured are freeloaders. What she said was that those were common misconceptions that people have. If you'd actually read through her answers, she proves that they're NOT freeloading because people with insurance have to bear the entire costs of the ER visit and so they minimize the number of times they have to go. If you want information, all you need to do is read through the article before you decide to look elsewhere.