HIPAA violations that occur for personal gain are punishable by up to $250,000 in fines and 10 years in prison. You’ll have to make an awful lot of license plates to buy an Armani shirt in the Big House, there dimwit.
Emergency nurses: They’re overworked, underpaid, they get spit on, kicked, threatened with scissors, and are the front line for disasters. You’re paying them less than surrounding hospitals. Now their benefits are getting cut. It’s a tough economy.
When there aren’t enough specialists willing to provide on-call services, patients often have to be transferred to other facilities for specialty care. In some cases, finding a hospital with a proper specialist that is willing to accept a patient in transfer can take a long time. This patient with aortic dissection wasn’t able to get timely transfer for surgical repair and a suffered cardiac arrest before the dissection was fixed. An emergency nurse noted that the receiving hospital refused to accept the patient because he had no insurance. Now the patient is blind and disabled. Who’s to blame? The system? The hospital? The physician? The patient? (thanks to Max Kennerly for the link)
You hospitals want to save money? Stop treating low income patients in your emergency department. After implementing its Urban Health Initiative, the University of Chicago doubles it operating profits for the year. During that same time period, ED visits dropped 22% and admits dropped 8.5%.
One problem, though. If more hospitals take this approach, where are the poor patients going to get the more “mundane” medical care?
Minnesota Governor Tim Pawlenty suggests that one way to cut health care costs is to change federal EMTALA laws so that “not every ER is required to treat everybody who comes in the door, even if they have a minor condition.”
He’s now getting flamed all over the internet. See here, here, and here for examples.
The thing is, EMTALA laws don’t require every “ER” to treat every patient. Hospital emergency departments are only required to provide a screening exam to everyone and to treat emergency medical conditions. Pawlenty already has his wish, and it’s not so radical, folks. To wit: (I saw that phrase in a lawsuit brief and am getting a kick out of using it, so leave me alone)
More hospital emergency departments are jumping on the “pay before you see the doctor” bandwagon. Burke Medical Center in Georgia stated that it was “following the trend of other facilities” when it implemented a policy of paying your insurance co-pay or $100 before receiving treatment. If you don’t pay and don’t have an emergency condition, you’ll be given a list of outpatient clinics where you can go for care.
In the same vein, do doctors in America turn away the uninsured? Absolutely. Read this HuffPo article to get a good idea of how and why. Good insights.
Nebraska physician advocates personal responsibility as one way to improve this country’s health care problems. I agree.
“Do you know where your son spent the night?” College students go to emergency departments for intoxication and college calls parents to narc on them. “Sent to the hospital.” “Alcohol poisoning.” “Not the first violation.” The schools also call home every time a student is caught with alcohol. Some schools allege that “telling mommy” decreases the amount of binge drinking on campus, but isn’t there some type of privacy issue going on there, though? What’s next, a voice mail message at mom’s work if you don’t finish your carrots in the cafeteria?
If an administrator did this to me when I was in college, I would have followed him all over campus and followed him home, calling his mommy and his wife every time he rolled through a stop sign or looked at me crosseyed. Then I would have written an article to the school newspaper chronicling all of his transgressions. Then I would just randomly go to his office with a notebook, wait in the waiting area, sit there writing for 30 minutes at a time, then get up and leave. Can’t be too careful about those college administrators, you know.
Reserved parking for the four pronged canes to the left, leave your brown paper bags of medicine on the counter. A geriatric emergency department – the wave of the future or a flash in the pan? Will they remain viable with Medicare cuts to physician payments or will hospitals use them as a loss leader to draw in patients for more profitable procedures?