11 July 2007

I stand corrected

I have said before that "Just go to the ER"is not a national health care policy. Apparently, I was wrong. Yesterday, Our Dear Leader said otherwise:

"The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America," he said. "After all, you just go to an emergency room."
Oh sweet Jesus, the man is an idiot and a buffoon. It's bad enough to have the uninformed troglodytes think that "just go to the ER" is a substitute for actual access to health care, but this man ostensibly directs policy. I would say I have higher expectations from the man who inhabits the oval office, but sadly, it would be hard for me to have lower expectations for him.

It is perhaps a bit of unintended honesty, though. I guess it explains 7 years of inaction on the uninsured crisis, doesn't it? If he really believes that all the nation's health needs can be met in our humble departments, what reason is there to fix the system?

1.21.09

12 comments:

  1. This is the biggest single argument for socialized medicine for people who don't care about the uninsured. I don't understand how you can be opposed to it, even if you don't see it as a moral issue. Even if you don't care about these people, even if you think their status as a poor capitalists means they don't deserve healthcare, you should support nationalized healthcare. Why? Because we don't let them die. They get medical attention, just in the most expensive, inefficient way possible. They let the cough turn in to pneumonia, they let the HBP go untreated, and so, and so. The condition is worse than it needs to be and the ER becomes the primary care physician.

    Something I've learned from this blog is that physicians and hospitals are providing healthcoverage for all right now. It should be spread out over the tax base: like education and defense and law enforcement.

    IMHO.

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  2. 1.21.09

    Counting the days.

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  3. I think the guy that has health-care coverage nailed is Mitt Romney. (See, for example, this NPR story.)

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  4. "This is the biggest single argument for socialized medicine...."

    Not necessarily. It may be an argument for ending EMTALA, however. There are other options for such patients than socialized medicine.

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  5. jimii said "They get medical attention, just in the most expensive, inefficient way possible."

    But Jimii, what makes you think that having "insurance" would make any difference? In NY, plenty of medicaid managed care patients (ie. with a designated PCP) forego a visit to their pcp for diabetes or blood pressure control, but go to the ER for a cold.

    Unfortunately, I don't think handing taxpayer-funded coverage to the uninsured will give them any more incentive to use primary care than medicaid managed care patients in NYC.

    One way around this would be to apply high copays to ER visits, adequate office visit reimbursement to PCPs, elimination of EMTALA, and strict application/enforcement of all of these.

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  6. "But Jimii, what makes you think that having "insurance" would make any difference? In NY, plenty of medicaid managed care patients (ie. with a designated PCP) forego a visit to their pcp for diabetes or blood pressure control,"

    Right. And in NY, I would guess plenty of people with private health insurance forego a visit to their pcp for diabetes or blood pressure control. However, right now 40 million people have no choice but to do so. How is it not better for the system to make it possible for those 40 million people to use the more efficient method of care, that is, regular check up, see doc before things get sick, etc.?

    "but go to the ER for a cold."

    What do you do if someone goes to the ER for a cold, BTW? Do you tell them there is nothing wrong with them that you can treat and send them home?

    I'm in Arizona, and "Arizona ranks 48th out of 50 states in having the longest average wait and visit times at nearly five hours." I can't imagine someone would go there for a cold. I suppose they may.
    http://www.kvoa.com/global/story.asp?s=6720076

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  7. Imagine it, cause it's true. Colds, sunburns (that are undetectable to the naked eye), hangnails, and a hundred other minor complaints that don't even require a doctor, they require common sense. I'm not talking about patients that walk in to ED and wait, I'm talking about AMBULANCE RIDES.

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  8. Remember, George Bush was also the man who got high deductible health plans with tax-free medical savings accounts into the limelight. These are excellent choices for the otherwise uninsured. Of course, people would rather complain their way into free-to-them health plans rather than give up the cell phone and the fancy nails and put money into a tax-free savings plan instead. There are options available.

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  9. "Remember, George Bush was also the man who got high deductible health plans with tax-free medical savings accounts into the limelight. . . rather than give up the cell phone and the fancy nails and put money into a tax-free savings plan instead."

    nurse k, I'm not sure how much cell phones and fancy nails cost, but I don't think they cost enough to pay for health insurance. Even bad plans that don't cover anything.

    It is so frustrating that people want to blame poor people for being poor. I mean really, it's because of cell phones and fancy nails that people aren't insured?

    I wish some person would talk about being compassionate to the poor. And I wish that guy was someone with authority. And I wish some other people would write down what he said. And then I wish other people would declare those books to be one book and an important, even a "holy" book.

    I wish that would happen.

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  10. Nurse k,

    I find the argument strange. I an individual is unable to pay the $400 (and up) a month an insurance premium is likely to cost, it is rather unlikely they will be able to put even a similar amount into a HSA. And even if they do, the accumulated value in many HSAs will be wiped out by even a single ED visit. So why they are such great ideas is unclear to me.

    The biggest problem with most HSA type vehicles is they defeat the whole underlying premise of insurance -- risk pooling.

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  11. If wishes were fishes we would all be fishermen

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