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    Friday, October 22, 2004

    Healthcare Debate: BoiFromTroy nails down the problems with our system:

    Our Country's health care system is far too complex to point the finger at any one group and lay the blame.

    The problem with healthcare starts with that it is not a free market system. If a person needs it, they have no choice but to get care, and it is next to impossible to compare costs and quality of services before they are delivered.

    Most Americans get their health insurance through their employer--giving them little or no choice as to what type of coverage they get. Interjecting employers into the healthcare mix only makes the system more burdensome and expensive.

    Healthcare is a necessity for Americans, like food and water, but it is likewise not a right. In order to help Americans get access to the system, health care costs should be tax deductible for all Americans--including those who do not itemize.

    Second, we need to stop the frivolous lawsuits in the system. Medical liability reform will not only eliminate about 1% in direct costs from these frivolous lawsuits, but it will also allow doctors to avoid having to take preventitive measures designed not to prevent disease, but to prevent lawsuits--which is a far greater cost to the system.

    Third, States which impose unnecessary burdens on healthcare providers, such as staffing ratios or what not, will not be reimbursed for these additional costs through Medicare. Neither their residents nor the taxpayers of other states should have to pay for needless regulations that benefit only a small group--in this case, the unions.

    Finally, we need to start making sense in health and insurance practices. An uninsured person can generally only get treatment at an emergency room, which is far more expensive. On some insurance plans, it is free to go to an emerhency room, but costly to go to an urgent care center. There is an economic incentive to the individual to choose the treatment which costs the most to the system. That is crazy and needs to be fixed.

    Although I disagree that the uninsured are forced to go to emergency rooms for care (they can just as easily go to a physician's office), his basic premise is spot on. Simplify the system. Remove the middle man.

    UPDATE: An uninsured RN disagrees:

    In response to the post, you commented: "Although I disagree that the uninsured are forced to go to emergency rooms for care (they can just as easily go to a physician's office), his basic premise is spot on. Simplify the system. Remove the middle man."

    I'm sorry, but I have to disagree with you. I'm a registered nurse AND one of the millions of uninsured. If a patient cannot pay for medical care and/or the patient has a large, outstanding bill, the physician's office can (and quite often will) refuse to see the patient until the bill is paid or other arrangements are made to pay it. Emergency departments cannot refuse treatment because of inability to pay. So yes, the uninsured are most certainly forced to choke up busy ER's for treatment.

    That's true about emergency departments being unable to refuse care. And it's true that physicians will often sever a relationship with a patient who has large outstanding bills they refuse to deal with. However, it's been my experience that most physicians are willing to work with their patients to get those bills paid. Some physicians will accept work in kind - carpentry, landscaping, lawn mowing, etc. or even produce. More commonly, they'll agree to small payments over time. I have a patient who has been paying me $5 every couple of weeks to settle his bill. And for most primary care doctors, unlike specialists, it would be pretty hard to rack up a big bill. The average office visit costs $50 to $60. Since most of the uninsured come from the ranks of the young and employed, it's hard to believe that they're the driving force behind emergency room crowding. (Unless they just haven't taken the time to find a doctor to see, which actually probably is the reason they seek care at the ER. It doesn't take any planning to just show up in the local hospital, any time, day or night. And in my experience, that's the driving force behind crowded ER's, both from the insured and the uninsured.)

    posted by Sydney on 10/22/2004 07:30:00 AM 1 comments


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