Wednesday, May 18, 2011

Reason Number One for Single Payer Healthcare

By Carl
We already have de facto death panels, led by bureaucrats and bean counters.
Note, this isn't a left issue or a right issue. This isn't a rich or poor issue. This one affects us all.
Emergency rooms are mandated to treat every patient who walks in the door, regardless of insurance coverage. This is to prevent the terminal condition known as "death".
What actually happens is two-fold: first, ERs become the primary care facility for people who are uninsured. That's just a given. A deep cut to the hand from broken glass becomes an emergency room visit (as it probably should, given the abhorrent lack of availability of general practitioners who work with the poor), in addition to the heart attack on the staircase at home.
One you can die from immediately, the other is unlikely unless it gets infected, yet the ER must treat both patients. What ends up happening, in the event that neither of these people has insurance, is you and I pay for their care in the form of inflated premiums and higher medical charges. And even if they do have insurance, you'll notice something else.
The patient with the heart attack by definition will receive inferior care because the hospital must devote at least a few moments to cleaning and stitching the wound. And if the patient with the cut has insurance and the patient with the heart attack does not, this increases greatly the risk of death.
Which brings me to point number two, and the more important one. When ERs become the primary care facility for fifty million uninsured people, that is going to impact the kind of medical care you and I will receive. It's going to suck, period.
Partially because of the simplistic scenario I outlined above, but more, ERs will be looking to cut costs and corners wherever possible and inflate prices wherever possible, in order to make up the shortfall they have from treating the uninsured.
In many cases, as the article demonstrates, it's just not enough. Which only starts a vicious cycle. And now the clock starts on your death.
See, if the local hospital shuts its ER down, you have to travel farther when you have that heart attack. Anyone who's taken a CPR course can tell you, even seconds can make a difference between living, living as a vegetable, or dying.
But let's say you're one of the lucky ones, and your ER remains open, somehow managing to remain profitable. Now it's getting the residue of the one that closed down the road, which means more crowding, more cases and as I pointed out, worse care.
Now, it's easy to poo-poo this: how many people visit an emergency room even once in their lives?
Well, 124 million visits occur annually. Even allowing for twenty percent of those to be repeat visitors, that's still nearly one-third of the population.
Still think it's a remote issue? Well, consider this: the time you visit the ER is the time you really NEED the ER. Seconds, milliseconds, matter.
Private health insurance is a casino game, and the patients are the marks.
(crossposted to Simply Left Behind)

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