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	<title>Comments on: The Healthcare Ponzi scheme</title>
	<atom:link href="http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/</link>
	<description>A blog from inside the emergency department</description>
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		<title>By: Why Rationing of Care Won&#8217;t Work in the US &#171; WhiteCoat&#8217;s Call Room</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-8491</link>
		<dc:creator>Why Rationing of Care Won&#8217;t Work in the US &#171; WhiteCoat&#8217;s Call Room</dc:creator>
		<pubDate>Tue, 26 May 2009 12:54:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-8491</guid>
		<description><![CDATA[[...] and that he needs dialysis. If dialysis is necessary, grandpa will receive emergent hemodialysis thanks to EMTALA. He might even need a day or two in the hospital to make sure that he is &#8220;stabilized.&#8221; [...]]]></description>
		<content:encoded><![CDATA[<p>[...] and that he needs dialysis. If dialysis is necessary, grandpa will receive emergent hemodialysis thanks to EMTALA. He might even need a day or two in the hospital to make sure that he is &#8220;stabilized.&#8221; [...]</p>
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		<title>By: Emergency Care - Where&#8217;s The Line? &#171; WhiteCoat&#8217;s Call Room</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-7028</link>
		<dc:creator>Emergency Care - Where&#8217;s The Line? &#171; WhiteCoat&#8217;s Call Room</dc:creator>
		<pubDate>Wed, 25 Feb 2009 07:51:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-7028</guid>
		<description><![CDATA[[...] about it at one of my previous posts, at ShadowFax&#8217;s place, over at Kevin&#8217;s blog, or at Scalpel&#8217;s blog. The Chicago [...]]]></description>
		<content:encoded><![CDATA[<p>[...] about it at one of my previous posts, at ShadowFax&#8217;s place, over at Kevin&#8217;s blog, or at Scalpel&#8217;s blog. The Chicago [...]</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6940</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 20 Feb 2009 16:31:06 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6940</guid>
		<description><![CDATA[&quot;i’m not a hospital. why would i be the one suing the patients?&quot;

I&#039;m referring to any provider trying to collect.  I can&#039;t really decipher the rest of the paragraph.

&quot;guess the answer to every question is “more lawyers.”

I didn&#039;t ADVOCATE it.  I just said that a class action is the most efficient way.  What would you suggest they do?  If they would rather represent themselves in small claims court, that doesn&#039;t bother me.

I don&#039;t care if you give me credit or not.  What I do care about is that healthcare is getting ready to be nationalized, and you&#039;re fussing about something unrelated.]]></description>
		<content:encoded><![CDATA[<p>&#8220;i’m not a hospital. why would i be the one suing the patients?&#8221;</p>
<p>I&#8217;m referring to any provider trying to collect.  I can&#8217;t really decipher the rest of the paragraph.</p>
<p>&#8220;guess the answer to every question is “more lawyers.”</p>
<p>I didn&#8217;t ADVOCATE it.  I just said that a class action is the most efficient way.  What would you suggest they do?  If they would rather represent themselves in small claims court, that doesn&#8217;t bother me.</p>
<p>I don&#8217;t care if you give me credit or not.  What I do care about is that healthcare is getting ready to be nationalized, and you&#8217;re fussing about something unrelated.</p>
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		<title>By: paul</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6923</link>
		<dc:creator>paul</dc:creator>
		<pubDate>Thu, 19 Feb 2009 23:36:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6923</guid>
		<description><![CDATA[i&#039;m not a hospital. why would i be the one suing the patients?
i know what hospitals can do though, while they&#039;re waiting for your proposed lawsuits to pan out and the lawyers take their money- just shift the cost of the lawyers onto the paying patients by making their bill higher! excellent, this will work out smashingly.

interesting how in another thread you advocate for patients hiring lawyers to get a class action suit going against california to get their $50 back, and in this thread you advocate for hospitals to hire lawyers to go after patients who can&#039;t pay their medical bill. guess the answer to every question is &quot;more lawyers.&quot;

i guess if you&#039;re willing to admit that &quot;some&quot; malpractice lawyers are part of the problem, you deserve &quot;some&quot; more credit then i give you though.

anyway. another discussion proving to not be worth my time. bye.]]></description>
		<content:encoded><![CDATA[<p>i&#8217;m not a hospital. why would i be the one suing the patients?<br />
i know what hospitals can do though, while they&#8217;re waiting for your proposed lawsuits to pan out and the lawyers take their money- just shift the cost of the lawyers onto the paying patients by making their bill higher! excellent, this will work out smashingly.</p>
<p>interesting how in another thread you advocate for patients hiring lawyers to get a class action suit going against california to get their $50 back, and in this thread you advocate for hospitals to hire lawyers to go after patients who can&#8217;t pay their medical bill. guess the answer to every question is &#8220;more lawyers.&#8221;</p>
<p>i guess if you&#8217;re willing to admit that &#8220;some&#8221; malpractice lawyers are part of the problem, you deserve &#8220;some&#8221; more credit then i give you though.</p>
<p>anyway. another discussion proving to not be worth my time. bye.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6916</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Thu, 19 Feb 2009 21:37:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6916</guid>
		<description><![CDATA[&quot; so you’re proposing that the time it takes. . .&quot;

Absolutely.  That&#039;s what businesses all over do.  Including hospitals.  I&#039;m curious as to how you know exactly what will happen when you&#039;ve apparently got no experience doing it.

1.  Yes
2.  Some, yes.
3.  Yes]]></description>
		<content:encoded><![CDATA[<p>&#8221; so you’re proposing that the time it takes. . .&#8221;</p>
<p>Absolutely.  That&#8217;s what businesses all over do.  Including hospitals.  I&#8217;m curious as to how you know exactly what will happen when you&#8217;ve apparently got no experience doing it.</p>
<p>1.  Yes<br />
2.  Some, yes.<br />
3.  Yes</p>
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		<title>By: paul</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6912</link>
		<dc:creator>paul</dc:creator>
		<pubDate>Thu, 19 Feb 2009 18:45:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6912</guid>
		<description><![CDATA[sue the nonpayers. that&#039;s an interesting solution. so you&#039;re proposing that the time it takes to recover the money from them and the costs of hiring lawyers to file these suits will all be offset by the amount we&#039;re actually able to collect from these people. you are also assuming that these people actually provide accurate contact info, which is pretty naive.

i can tell you 3 things that would happen if this tactic was taken- one, the poor/uninsured would either go bankrupt trying to pay these bills or die in the streets with untreated medical problems, since the ED will no longer be a safety net for them. two, physicians and hospitals will be vilified for trying to collect money from the indigent. three, the lawyers hired by the hospitals will make a killing.

i&#039;d also like to address your comment that &quot;you guys are as much to blame as the public at large.&quot; i happen to be a physician that believes we physicians are definitely part of the problem... but before i elaborate on that, i&#039;d like to ask you 3 questions. they are all &quot;yes or no&quot; questions, and you may give as lengthy a response as you&#039;d like to each question- all i ask is that you clearly state whether your answer to each is &quot;yes or no.&quot;

1. i believe that physicians, patients, insurance companies, cms (the government), hospital administrators, clipboard-wielding organizations such as JC, drug/device companies, and survey-makers like press ganey all have some responsibility and are part of the problem in the giant clusterf*** that is american health care. do you agree with me? yes or no?

2. leaving aside who is more to blame than who, i believe that malpractice lawyers are also part of the problem, and deserve a share of the blame for the current situation we are in. do you agree with me? yes or no?

3. are you a lawyer? yes or no?]]></description>
		<content:encoded><![CDATA[<p>sue the nonpayers. that&#8217;s an interesting solution. so you&#8217;re proposing that the time it takes to recover the money from them and the costs of hiring lawyers to file these suits will all be offset by the amount we&#8217;re actually able to collect from these people. you are also assuming that these people actually provide accurate contact info, which is pretty naive.</p>
<p>i can tell you 3 things that would happen if this tactic was taken- one, the poor/uninsured would either go bankrupt trying to pay these bills or die in the streets with untreated medical problems, since the ED will no longer be a safety net for them. two, physicians and hospitals will be vilified for trying to collect money from the indigent. three, the lawyers hired by the hospitals will make a killing.</p>
<p>i&#8217;d also like to address your comment that &#8220;you guys are as much to blame as the public at large.&#8221; i happen to be a physician that believes we physicians are definitely part of the problem&#8230; but before i elaborate on that, i&#8217;d like to ask you 3 questions. they are all &#8220;yes or no&#8221; questions, and you may give as lengthy a response as you&#8217;d like to each question- all i ask is that you clearly state whether your answer to each is &#8220;yes or no.&#8221;</p>
<p>1. i believe that physicians, patients, insurance companies, cms (the government), hospital administrators, clipboard-wielding organizations such as JC, drug/device companies, and survey-makers like press ganey all have some responsibility and are part of the problem in the giant clusterf*** that is american health care. do you agree with me? yes or no?</p>
<p>2. leaving aside who is more to blame than who, i believe that malpractice lawyers are also part of the problem, and deserve a share of the blame for the current situation we are in. do you agree with me? yes or no?</p>
<p>3. are you a lawyer? yes or no?</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6895</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Wed, 18 Feb 2009 20:38:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6895</guid>
		<description><![CDATA[You sue the nonpayers for what they owe.  You have all their contact info.  

Here&#039;s where you need to really spend your lobbying time.  You need to lobby to set up income levels where govt support is warranted.  For example, if you can afford it, you don&#039;t get a public defender - you have to pay for it yourself.    Same with healthcare.

The problem is, and you guys are as much to blame as the public at large, is you&#039;ve bought into the healthcare is a right line.  You speak of your industry of this monolith, instead of simply people procuring services and advice from a professional on individual bases.  No other professionals, except for legal services in limited situations - ie indigent criminal defendants, have clients with &quot;rights&quot; to access their services.   

You need to steer the national conversation to a basic level of care to the poor, and everyone else starts paying.  Take credit cards, set up payment plans with your customers, and if they don&#039;t pay, garnish their tax returns and wages.  Just like any other creditor who provides goods or services to them would.]]></description>
		<content:encoded><![CDATA[<p>You sue the nonpayers for what they owe.  You have all their contact info.  </p>
<p>Here&#8217;s where you need to really spend your lobbying time.  You need to lobby to set up income levels where govt support is warranted.  For example, if you can afford it, you don&#8217;t get a public defender &#8211; you have to pay for it yourself.    Same with healthcare.</p>
<p>The problem is, and you guys are as much to blame as the public at large, is you&#8217;ve bought into the healthcare is a right line.  You speak of your industry of this monolith, instead of simply people procuring services and advice from a professional on individual bases.  No other professionals, except for legal services in limited situations &#8211; ie indigent criminal defendants, have clients with &#8220;rights&#8221; to access their services.   </p>
<p>You need to steer the national conversation to a basic level of care to the poor, and everyone else starts paying.  Take credit cards, set up payment plans with your customers, and if they don&#8217;t pay, garnish their tax returns and wages.  Just like any other creditor who provides goods or services to them would.</p>
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		<title>By: paul</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6889</link>
		<dc:creator>paul</dc:creator>
		<pubDate>Wed, 18 Feb 2009 12:38:24 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6889</guid>
		<description><![CDATA[okay,.. so do you consider nonpayers to be consumers? because if you &quot;bring em on&quot; the hospital will run out of money and close.

i think you&#039;re missing the point if you think we all don&#039;t want to see patients. the same logic could be applied to you- by suggesting means to relieve overcrowding, you are saying you want to see less patients.]]></description>
		<content:encoded><![CDATA[<p>okay,.. so do you consider nonpayers to be consumers? because if you &#8220;bring em on&#8221; the hospital will run out of money and close.</p>
<p>i think you&#8217;re missing the point if you think we all don&#8217;t want to see patients. the same logic could be applied to you- by suggesting means to relieve overcrowding, you are saying you want to see less patients.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6885</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Wed, 18 Feb 2009 02:39:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6885</guid>
		<description><![CDATA[Someone finally gets it! You&#039;re providing a service that people want to buy.  Price it accordingly!  The consumers want your services, let THEM, not the govt., decide what it&#039;s worth.

The government gravy train you rode for 30 years is over.  It was good while it lasted.  Your predecessors had a great standard of living from it.  But let it go before you don&#039;t have a choice.]]></description>
		<content:encoded><![CDATA[<p>Someone finally gets it! You&#8217;re providing a service that people want to buy.  Price it accordingly!  The consumers want your services, let THEM, not the govt., decide what it&#8217;s worth.</p>
<p>The government gravy train you rode for 30 years is over.  It was good while it lasted.  Your predecessors had a great standard of living from it.  But let it go before you don&#8217;t have a choice.</p>
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		<title>By: Don Kamens</title>
		<link>http://www.epmonthly.com/whitecoat/2009/02/the-healthcare-ponzi-scheme/#comment-6879</link>
		<dc:creator>Don Kamens</dc:creator>
		<pubDate>Wed, 18 Feb 2009 01:18:27 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=2064#comment-6879</guid>
		<description><![CDATA[I hate to say this. Likely I will get tarred and feathered, or at least stripped of my scrubs...but we&#039;ve been skewered and burned by training, and the stress of in-pressing patients.  Still....our hats (should we have any) need to be turned around..about faced....do a 180.....

Instead of finding every last reason NOT to see a patient. Bring &#039;em on.  Face it. Health care is consumer driven, and the consumers--justifiably-want the ED.  

Bill ourselves as diagnostic centers if need be, tap into the ARRA 2009 somehow to direct funds toward overcrowding relief by rewarding back-door decompression by hospitals. Fund more residencies...staff for a larger volume.

Build it..and they will come....]]></description>
		<content:encoded><![CDATA[<p>I hate to say this. Likely I will get tarred and feathered, or at least stripped of my scrubs&#8230;but we&#8217;ve been skewered and burned by training, and the stress of in-pressing patients.  Still&#8230;.our hats (should we have any) need to be turned around..about faced&#8230;.do a 180&#8230;..</p>
<p>Instead of finding every last reason NOT to see a patient. Bring &#8216;em on.  Face it. Health care is consumer driven, and the consumers&#8211;justifiably-want the ED.  </p>
<p>Bill ourselves as diagnostic centers if need be, tap into the ARRA 2009 somehow to direct funds toward overcrowding relief by rewarding back-door decompression by hospitals. Fund more residencies&#8230;staff for a larger volume.</p>
<p>Build it..and they will come&#8230;.</p>
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