What is needed to visit a hospital in the US?

[bpp3]

I know some people who have heard horror stories on the news about poor patients dying in the ER at American hospitals because they got put at the back of the queue for want of verifiable insurance (don't ask me if this really happens -- it is what they have heard), and they worry about what would happen if they were to become injured while on a trip to the US. They would have trip insurance, but that would pay them back after they returned to Japan, and would not be directly billable by the US hospital. So, they would have to pay the hospital out of their pocket.

How would the hospital treat them in that case? Would they be treated as insured patients, or shuffled around like indigents? Would the insurance booklet (which cannot be used for direct billing, but would show that they do have deep pockets to get reimbursed from, eventually) suffice as evidence that they are good for the bill?

In the case of a business trip, where the employer would likewise reimburse then for any work-related medical expenses (but only after they return to Japan), would some kind of letter of guarantee make any difference in their treatment at the ER?

Or should I just tell them that the US isn't for the weak of heart?

[haha]

Hard to know I would say. What you mention does happen- recently a woman dies in the ER waiting room at Harbor General in LA county ( I think Torrance). She was vomiting blood. Her friend kept begging for her to be seen, but they kept telling them to go elsewhere. Finally he called 911 for her. They wouldn't come either- they said hey. 911 takes you to a hospital, you are already in a hospital. If there were anything wrong with her they would be treating her there.(BTW, this is all on the dispatcher's tape at 911.)

I used to go out walking or running with no billfold- no more I can assure you! I may even get a forehead stamp :"This old mf is insured. Treat with all due care."

Ha

[Alex]

Originally Posted by bpp3

I know some people who have heard horror stories on the news about poor patients dying in the ER at American hospitals because they got put at the back of the queue for want of verifiable insurance (don't ask me if this really happens -- it is what they have heard), and they worry about what would happen if they were to become injured while on a trip to the US. They would have trip insurance, but that would pay them back after they returned to Japan, and would not be directly billable by the US hospital. So, they would have to pay the hospital out of their pocket.

How would the hospital treat them in that case? Would they be treated as insured patients, or shuffled around like indigents? Would the insurance booklet (which cannot be used for direct billing, but would show that they do have deep pockets to get reimbursed from, eventually) suffice as evidence that they are good for the bill?

In the case of a business trip, where the employer would likewise reimburse then for any work-related medical expenses (but only after they return to Japan), would some kind of letter of guarantee make any difference in their treatment at the ER?

Or should I just tell them that the US isn't for the weak of heart?

If you are injured in the USA you will most likely receive quality care regardless of your insurance status. I think much depends on where you are located. You are more likely to have problems with inner city hospitals than those in the suburban areas. In my experience here in California (I do alot of work for hospitals) by law, the hospitals and medical clinics have no choice but to serve you regardless of your ability to pay or insurance status. So I wouldn't worry about it!

PS- If you look like a homeless person or vagrant you will be treated like crap regardless of whether you are seeking medical care or buying dog food.

[ladelfina]

That is one sad story, ha.. I read that she was dying there for 45 min. and that at one point the janitor cleaned around her.. that is just twisted.

Where's Charles Dickens when you need him?

[ladelfina]

Sorry if this seemed to come up as a double post to anyone. I was trying to add something and it seemed to have "timed out" so I thought the previous (original) was also lost.

From the ABC News story, a portion of one of two 911 calls:

911 Operator: "What's wrong with her?," the 911 operator asked.

Prado: "She's vomiting blood."

The operator then questions why hospital officials are not helping Rodriguez.

Prado: "They're watching her and they're not doing anything. Just watching her."

She's vomiting blood? And they're just watching? And the police arrested a woman who was vomiting blood in a hospital

I wonder if she'd have been charged with resisting arrest if she'd survived.

It gets worse. Here's some dialogue from the second call:

"I cannot do anything for you for the quality of the hospital there," the operator says. "This line is for emergency purposes only."

"May [God] strike you too for acting the way you are," the caller responds. The operator says, "No negative, ma'am. You're the one."

Daily Kos: This is appalling on so many levels

Salus aegroti suprema lex

P.S. Alex.. my husband and I (and probably many others here on the ER forum if I can judge by the self-reporting) dress like homeless people. Maybe the hospital can use a B.O. meter if they are not sure about using their noses to distinguish the difference, should that matter.

P.P.S. Remember all the fake "Christianist" rhetoric when you read this.

[ladelfina]

bpp3, when I travel to the US I buy a "specialty risk" insurance over the Internet. I have never had to use it (knock on wood, touch iron) but I keep the receipt/printout in my wallet while I travel just in case and least it should be an indication that someone, somewhere MIGHT be backing me up.

SRI - Specialty Risk International, Inc.

I think there are one or two others in this biz; search on "travel health insurance global" etc. The cost is v. moderate and it only takes a couple minutes to sign up with a CC#; fortunately I cannot speak to the actual benefits/service should one need such.

[Alex]

Originally Posted by ladelfina

P.S. Alex.. my husband and I (and probably many others here on the ER forum if I can judge by the self-reporting) dress like homeless people. Maybe the hospital can use a B.O. meter if they are not sure about using their noses to distinguish the difference, should that matter.

P.P.S. Remember all the fake "Christianist" rhetoric when you read this.

I try to treat all people with dignity regardless of how they dress, but I am probably exceptional in that regard. Most people are quick to judge others by the way they dress. In my experience, if you look shabby, you'll most likely be treated that way. That being said, the hospital staff behaved very badly and I do not condone their behavior. The woman should have been treated even if she smelled like a skunk and was wearing a mummy's gauze.

PS- With regards to dressing like a homeless person - are you saying that you wear smelly and soiled clothing on a regular basis?

[ladelfina]

umm.. well.. clothing with minor holes and wear and sometimes set-in stains or paint blotches I can't get out. We don't "go out" that way, but it's valid "around the house" garb. God forbid we collapse at home and get taken to YOUR Emergency Room and you personally don't take us under your wing... We don't smell, though, that I know.

I'll make a note that when visiting the US I should buy some Fendi or Prada or Gucci as insurance.

[Alex]

Originally Posted by ladelfina

umm.. well.. clothing with minor holes and wear and sometimes set-in stains or paint blotches I can't get out. We don't "go out" that way, but it's valid "around the house" garb. God forbid we collapse at home and get taken to YOUR Emergency Room and you personally don't take us under your wing... We don't smell, though, that I know.

I'll make a note that when visiting the US I should buy some Fendi or Prada or Gucci as insurance.

as long as you don't stink to high heaven, you can probably leave the designer duds at home.

At any rate, these health care horror stories are the exception rather than the rule. Chances are, if you were injured in the USA, you'd be provided high quality health care even if you looked like Aqualung and smelled like rotten cabbage!

[bpp3]

Thanks for the information, everybody. Maybe Haha's story is the one the people I know heard about.

Originally Posted by Alex

In my experience here in California (I do alot of work for hospitals) by law, the hospitals and medical clinics have no choice but to serve you regardless of your ability to pay or insurance status. So I wouldn't worry about it!

Except that Haha's story apparently happened in CA... Although I am sure it is not the norm. (Otherwise it wouldn't have been news, right?)

Originally Posted by ladelfina

bpp3, when I travel to the US I buy a "specialty risk" insurance over the Internet. I have never had to use it (knock on wood, touch iron) but I keep the receipt/printout in my wallet while I travel just in case and least it should be an indication that someone, somewhere MIGHT be backing me up.

I usually buy trip insurance at the airport and carry the receipt and booklet they give me with me for the same reason. I am just wondering if someone who works in a hospital might know if that would actually make any difference (in real life, not in the legal ideal case).

[Trek]

Probably a tough question to really answer as it would likely depend on so many different variables. Which is pathetic in itself.

Something like a broken arm they would likely be treated (after sitting in the ER for at least 2 hours) and maybe could pay the bill with a CC.

For something complicated, maybe internal that would require expensive tests and a prolonged hospital stay, I could see that becoming problematic. However, if the hospital could maybe get something in writing faxed from the trip insurance company at the time medical attention is needed, that might help things along.

Not sure if it's included in the trip insurance, but emergency medical transport back to Japan might be a good idea, if they could be stabilized long enough to get home where they can receive proper care.

I really don't know what I would do if I went back to the States. Probably get some temp insurance and hope for the best. And minimize the time I was there.

[Alan]

We always tell our family and friends that visit us from England to get trip insurance. So far nothing too serious has happened over the last 20 years but the insurance does work, although you need to be able to pay up front. A credit card works as well as insurance for trips to the ER

BIL sliced his foot open really good on a water slide one time and my wife had to take him to the ER. (Turned out he had am imbedded piece of sunglasses lens buried in his ankle).

Cost was a few hundred dollars which he paid for with his credit card and then the insurance repaid in full on his return. The Water Park also refunded the entrance fee money for his family (wife and 2 kids) plus the cost of the ER visit when he sent them a copy of the bill.

[ladelfina]

U.S. hospitals try to pick up the ER pace - Yahoo! News

Too bad about that perforated bowel.. here're some movie passes, though!

yiiiiikes