WhiteCoat

Open Mic Weekend

Back by popular request …

All weekend everyone is welcome to post any medically-related comments, questions, observations in the comments section.

Only rules are that there are no personal attacks and that the comments are medically related. I don’t want to hear anything about politics, canines, or politics and canines.

Will try to respond Monday or Tuesday with answers.

Enjoy the weekend.

11 Responses to “Open Mic Weekend”

  1. Beth says:

    observation: a month or two ago, my five year old son was exposed to scarlet fever. a couple of days later, he came down with a fever himself. he couldn’t eat anything, really, and wouldn’t drink much, and he really wasn’t himself. this kid’s tough as nails, and he was out of it… the fever stayed at around 101-102, went down slightly after tylenol… i was scared for him. we don’t have insurance (and were broke until the next paycheck), so i took him to the er (i know, i know…). of course he perked up in the ed waiting room. someone took his temperature. someone took his history. the doctor looked him over, and declared him a-okay. she told me to give him a lot of fluid and let him rest, to bring him back if he wasn’t better in a day or two. of course he was better, and he never needed to go there in the first place. i realize i’m an idiot for taking him just for a fever (no rash). i got a bill for this last week– over $400. why so much? we really only took twenty minutes time, total, from the registrar, the nurse, everyone. can i call and request a discount? how do they decide how much to charge?

  2. Gene says:

    You could consider calling and asking for a cash discount since you don’t have insurance. The worst they will say is no. People are always surprised how much a visit to the ED costs, but keep in mind that the price is reflective of 24/7 care and making sure that there are MULTIPLE people around as well as lots of equipment. The ED may be empty at 4am, but staff are still awake and ready for anything.

    If you have an urgent care in the area, it may be cheaper…

  3. Beth says:

    gene: i think i will call to request a discount. to be honest, we called the nearby urgent care center the same day, and their fee was ninety dollars… ninety dollars was more than we had at that point in time. i can’t wait to get health insurance, in some ways. in another way, we’ve still spent less over the course of the year without it, in total health care dollars, because that’s the only time my son has been seen this year, and i’ve only gone in once myself to get thyroid meds…

    • Gen says:

      I would definitely call. Most hospitals will put you on a payment plan or forgive your bill entirely. You may have to submit paperwork about your current income and bills.

      Also, does your child qualify for some kind of Medicaid? You may make too much money for yourself to qualify, but perhaps your child will.

    • Dina says:

      I work in the insurance industry. Definitely ask for a cash/no insurance discount. They will usually give it to you because if you had insurance, they’d get less than they billed, anyway. FYI for future reference, it’s always best to ask for this upfront, as if you agree to pay at the time of service, they are more likely to do it, as they are assured of some payment.

    • WhiteCoat says:

      You can call, but if you don’t give them a number, they’ll likely only give you a discount of 20%. That’s about average for a cash-paying patient.
      In the scheme of things, $400 for an emergency department visit isn’t horrible. It’s not uncommon for ED bills to be north of $5000 when testing and doctor fees (including radiologist) are included.
      If you’re having a hard time with money, Gen’s advice is good. Most hospitals have a program for either discounted or free care based upon income and need. In addition, states have programs for payments of health care costs for kids. Look into those as well. Call your state department of health and human services.

  4. midwest woman says:

    I know your mantra is no matter what system of healthcare we embrace, it won’t improve access.
    Unless I missed it, what are your thoughts on improving access? Living in a rural community, you are SOL with a STEMI or stroke because these little hospitals just don’t have the equipment.

    • WhiteCoat says:

      Rural patients often are SOL if they need complex medical care. I once heard a colleague quote her father as saying “that’s the price I pay for breathing fresh air.”
      When seconds count in a rural medical crisis, help is often only minutes or hours away.
      Yes you can get care for an MI or a stroke, but you’ll also have to pay for a helicopter to get you to the latest and greatest technology.

      Improving access to me means that we create some sort of medical facilities where any citizen of this country can walk in, show verifiable ID and receive necessary medical care at little or no cost. May not be the best care. May not be the fastest care, but at least care should be available. Begin with VA hospitals. Expand to county hospitals. I just find it morally wrong that people who earn less than the poverty level can walk into an ED at any time and get care while those who make $100 more than the poverty level at a job trying to pay all their bills are eligible for exactly no medical care. All this type of system does is encourage those near the threshold for receiving free medical care to earn less money and do less work. Not exactly the principles upon which this country was founded.

      Lower income taxes and institute a flat consumption-based tax to fund such a system. That way, even the “illegals” and foreign tourists who purchase food and gas and other essentials in this country will pay the tax and pay into the system.

      • midwest woman says:

        If you have such small windows for effective interactions, even helicopters don’t seem much of a solution. The insurance for this in Missouri is surprisingly cheap….$50/month.
        A consumption tax will adversely affect the lower income folks. But I agree some sort of tax going to healthcare.
        As for waiting and being slower, so be it. Waiting for a total knee is uncomfortable but not fatal. Americans have to stop wanting everything yesterday.
        As an aside, always find it funny when the old folks hold protest signs that say ” No Socialized Medicine”.
        Thanks for replying.

  5. Need help says:

    My own school was threatening me with force to work for $360 per month when my rent was $635 per month and then blocking me from other jobs when I went to HR to complain that it was not possible for me to take out loans to make up the difference. There is no way I could ever tell anyone to risk being trapped like this after such blatent abuse. I wish I never tried to help the hospital because they hurt me. How do I get help and who could help me, seriously, what do I say?

    • WhiteCoat says:

      First call should be to state/federal department of labor. They should help you sort things out.
      Your comment doesn’t really give details and I’m not an employment lawyer, so it’s hard to comment further. Maybe you also contact an attorney.

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