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If this is not a Financial mess I don't know what is.
Old 02-24-2008, 07:35 AM   #1
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If this is not a Financial mess I don't know what is.

http://www.nytimes.com/2008/01/08/us...hp&oref=slogin

And today I am reading an article that Muhlinberg hospital in Plainfield NJ is closing a 389 bed hospital along with two others in Newark NJ. Gotta say Don't Get Sick! The city hospitals are in big trouble. Which means we are all in trouble. How much a day in Iraq??

</title> <title>Overview

EMTALA Act


Now without a comprehensive universal payer system this ACT justs puts so many hospitals into such debt that they go belly up and close. In the cities there are so many without health insurance . Heck I had to spend a long evening at one of the Raleigh NC hospitals with one of my track kids after an injury and not one of the 50 people in the ER spoke english and most had no insurance.
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Old 02-24-2008, 08:28 AM   #2
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Many hospitals struggle to make ends meet. Inner-city hospitals are in huge trouble, but it's because so many people use them in place of a physician. People come in all the time on Sunday to the ER with complaints like "I've had a sore throat since Wednesday." With no insurance, the hospital eats the cost.

In Dallas at Parkland, they have a free clinic during the week, but the lines are so long that people wait til the weekends.

My dad manages hospitals, and the city not-for-profits are in so much trouble financially he left the public sector and says he "will never own another public hospital."
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Old 02-24-2008, 08:33 AM   #3
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Many hospitals struggle to make ends meet. Inner-city hospitals are in huge trouble, but it's because so many people use them in place of a physician. People come in all the time on Sunday to the ER with complaints like "I've had a sore throat since Wednesday." With no insurance, the hospital eats the cost.
Good point. If you call a doctor for a regular appointment and you have no insurance or any way to pay, they can refuse treatment. But if you show up at an emergency room, by law they MUST see you and treat you even if you have neither insurance nor the means to pay.

This is a perfect example of the Law of Unintended Consequences.
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Old 02-24-2008, 12:26 PM   #4
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It's one of the ways our health care system fails -- people who use the ER instead of a community health clinic for minor cold/cough/flu ailments because that's all they have. Then what should have been a $50 visit with a nurse practitioner in an inexpensive community clinic becomes a $600 visit with several health professionals in an expensive emergency room suite designed to serve the needs of everything from traffic accident on up to heart attack and stroke victims.

Worse yet, many of these people don't have the money they need to pay the bill. So people who do have money pay it for them. That's a pretty underhanded (and extremely expensive and cost inefficient) way to provide socialized medicine, but that's exactly what we do.
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Old 02-24-2008, 12:29 PM   #5
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My dad manages hospitals, and the city not-for-profits are in so much trouble financially he left the public sector and says he "will never own another public hospital."
Could you explain this? How can one "own" a public hospital? I thought the owned hospitals were called "for profit".

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Old 02-24-2008, 04:16 PM   #6
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Worse yet, many of these people don't have the money they need to pay the bill. So people who do have money pay it for them. That's a pretty underhanded (and extremely expensive and cost inefficient) way to provide socialized medicine, but that's exactly what we do.
Two of my relatives are nurses, and they tell me that's the reason an aspirin administered in an emergency room costs $3. So if you do have insurance you're paying for those who don't, or won't.
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Old 02-24-2008, 04:51 PM   #7
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Yes.... any hospital that is trying to 'do the right thing' that is having a problem is sad to hear about...

but...

"Like other public hospitals, Grady is operating on a business model that is no longer sustainable. A third of the hospitalís patients, including those treated as outpatients, are uninsured, among them a rapidly growing group of immigrants. Another third are covered by Medicaid, which reimburses at rates well below Gradyís actual costs. Many hospitals use their privately insured patients to subsidize indigent care, but at Grady, only 8 percent of inpatients fit the privately insured category."

NO hospital will be able to survive is they have 1/3 of their patients not paying for their services... and it seems that immigrants (are they illegal?) are a particular problem all over the country...

I know it would never happen, but if we 'refused' to do any service for anybody that showed up that was illegal that was not 'life threatening', OR anybody that showed up to the emergency room that was not 'life threatening'... then maybe things could get better...

So, those 'sick' people with a cold that show up should be shown the door... thanks for coming, but see ya....

Now, if they had an accident, were bleeding, a broken bone etc... no problem... but something that can wait until the normal office hours... see ya...
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Old 02-24-2008, 07:23 PM   #8
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edited because double post occurred.
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Old 02-24-2008, 07:24 PM   #9
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So, those 'sick' people with a cold that show up should be shown the door... thanks for coming, but see ya..
Will not happen. All it takes is one person with a cold being kicked out and going outside and having an MI and dropping dead. Ask the lawyers on here what would result.
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Old 02-24-2008, 09:06 PM   #10
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So, those 'sick' people with a cold that show up should be shown the door... thanks for coming, but see ya....
The problem is figuring out who has a minor cold and who has a serious problem. Someone with slurred speech could be on drugs or having a stroke, a wheezing child might have a cold or life-threatening esophagitis, someone with a stomach ache could be suffering from too much pizza or appendicitis.

In other words, people don't come in the door with a sign that says "LIFE THREATENING ILLNESS HERE!" Once you've sorted out what ails them . . . well, by then you've already spent the money.
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Old 02-25-2008, 08:22 AM   #11
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Could you explain this? How can one "own" a public hospital? I thought the owned hospitals were called "for profit".

Ha
My bad: I meant his company will never own another in an inner city, nor will they operate one. They own many hospitals but manage several more.

He is a CEO for an outfit with about 30 hospitals.

Seems the drive these days is for doctor-owned outpatient centers.
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Old 02-25-2008, 08:36 AM   #12
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The problem is figuring out who has a minor cold and who has a serious problem. Someone with slurred speech could be on drugs or having a stroke, a wheezing child might have a cold or life-threatening esophagitis, someone with a stomach ache could be suffering from too much pizza or appendicitis.

In other words, people don't come in the door with a sign that says "LIFE THREATENING ILLNESS HERE!" Once you've sorted out what ails them . . . well, by then you've already spent the money.
Exactly. There is no option: all patients who present must be at least "triaged" and triage is not always easy or straightforward. The "reasonable person" rule generally allows this to be best done in an orderly clinic or office setting, but there seems to be a shortage of "reasonable" these days. Throw in the financial incentives or disincentives and it's almost anarchy in that setting.
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As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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