So much for the "best healthcare"

[glassgowkiss]

this is what happens when healthcare is for profit.

[prole]

We haven't tried the Ron Paul approach yet!

[glassgowkiss]

Yeah, you are right. BTW I would like to see ethics investigation into Ron Paul statement. The best thing would be, is to strip him off his medical license for ethics violation.

[kevbone]

BTW I would like to see ethics investigation into Ron Paul statement.

 

Please elaborate.

[glassgowkiss]

BTW I would like to see ethics investigation into Ron Paul statement.

 

Please elaborate.

r u THAT stupid or u just pretend to be?

[kevbone]

BTW I would like to see ethics investigation into Ron Paul statement.

 

Please elaborate.

r u THAT stupid or u just pretend to be?

 

You call me stupid (why the personal attacks?) and you write like you are texting.....

 

If you need me to spell it out. Please post the quote you are referring too.

[prole]

[glassgowkiss]

BTW I would like to see ethics investigation into Ron Paul statement.

 

Please elaborate.

r u THAT stupid or u just pretend to be?

 

You call me stupid (why the personal attacks?) and you write like you are texting.....

 

If you need me to spell it out. Please post the quote you are referring too.

"I will practice my profession with conscience and dignity; the health of my patient will be my Number One consideration;"

"....As it turns out, Paul was not speaking purely in hypotheticals. Back in 2008, Kent Snyder — Paul's former campaign chairman — died of complications from pneumonia. Like the man in Blitzer's example, the 49-year-old Snyder...was relatively young and seemingly healthy when the illness struck. He was also uninsured. [The Kansas City Star quoted his sister at the time as saying that a "a pre-existing condition made the premiums too expensive."] When he died on June 26, 2008, two weeks after Paul withdrew his first bid for the presidency, his hospital costs amounted to $400,000. The bill was handed to Snyder's surviving mother (pictured, left), who was incapable of paying. Friends launched a website to solicit donations. full text

[Peter_Puget]

I am confused! Are you claiming that medical care was withheld from Kent Snyder because he did not have insurance? Are you claiming that the hospital expected Kent's mother to pay his bill simply because she was his mother? Or are you claiming this a case of a hospital treating a patient without any real expectation of being reimbursed and then giving the bill to his mother since she was the one handling his estate?

[billcoe]

No, he is saying that this is all Bush's fault. Duh. *Cough* Cough*

 

 

 

LOL!

[sobo]

I am confused! Are you claiming that medical care was withheld from Kent Snyder because he did not have insurance? Are you claiming that the hospital expected Kent's mother to pay his bill simply because she was his mother? Or are you claiming this a case of a hospital treating a patient without any real expectation of being reimbursed and then giving the bill to his mother since she was the one handling his estate?

Ding ding ding! We have a winner! Choke on that, CPB/GGK!

[j_b]

I am confused! Are you claiming that medical care was withheld from Kent Snyder because he did not have insurance?

 

Standards of care are usually different according to whether one has insurance (admission to hospital, referrals to specialists, expensive procedures/medications, etc). You are very confused, indeed.

 

 

Are you claiming that the hospital expected Kent's mother to pay his bill simply because she was his mother? Or are you claiming this a case of a hospital treating a patient without any real expectation of being reimbursed and then giving the bill to his mother since she was the one handling his estate?

 

We (the public) eventually pay for this bill so Libertarian fantasies about charity supported health care is just that, a fantasy (or is it a pony?)

[glassgowkiss]

I am confused! Are you claiming that medical care was withheld from Kent Snyder because he did not have insurance?

If youy don't have the means to pay, a hospital has the right to refuse the admission. I think you are indeed very confused on how healthcare works and how it is structured. ER will not turn down a patient, but they also do emergency care only. So say you are uninsured and diagnosed with cancer (or any long term illness)- you are fucked. In case they will agree to taking you- you ill have to guarantee the re-payment of the bill- in writing. It is possible in this case the mother of the mentioned guy was the guarantor of the bill

Are you claiming that the hospital expected Kent's mother to pay his bill simply because she was his mother? Or are you claiming this a case of a hospital treating a patient without any real expectation of being reimbursed and then giving the bill to his mother since she was the one handling his estate?

see above, but it's obvious to me you don't even have a clue how things work in a hospital or healthcare in general.

[Peter_Puget]

So "It is possible" that your example might actually illustrate a point that you're are trying to make but you're just not sure.

 

 

 

 

[glassgowkiss]

So "It is possible" that your example might actually illustrate a point that you're are trying to make but you're just not sure.

The point is that you are a clueless fuck, that talks about a subject you have zero knowledge of.

[kroc]

I think the ability of hospitals to turn down non-insured patients is overstated. There are many patients in hospitals for months and months that will never pay a cent. They can not be discharged because they are not healthy enough to get by on their own and nursing homes can and do refuse placement.

 

These patients always have specialists following them and often multiple surgical interventions.

 

I work in Seattle, not harborview; every unit has one or two of these patients.

 

The cost is eaten by the hospital, required by law to admit and provide all nessary care. I can attest that this is truly done and not just lip service.

 

 

[glassgowkiss]

I think the ability of hospitals to turn down non-insured patients is overstated. There are many patients in hospitals for months and months that will never pay a cent. They can not be discharged because they are not healthy enough to get by on their own and nursing homes can and do refuse placement.

 

These patients always have specialists following them and often multiple surgical interventions.

 

I work in Seattle, not harborview; every unit has one or two of these patients.

 

The cost is eaten by the hospital, required by law to admit and provide all nessary care. I can attest that this is truly done and not just lip service.

 

Not entire true: "Researchers from Harvard Medical School say the lack of coverage can be tied to about 45,000 deaths a year in the United States ". Source here: Full text To put it into the perspective it is a larger number then yearly death toll from mva's (about 42K/year).

Can I ask you also- to what capacity are you working in the hospital and which hospital are you working in?

The topic of this was drug rationing due to lack of production. Fear of rationing was the fear argument used by republifucks and opponents of a single payer system. However is is a current reality, and not caused by financial shortages, but greed of pharmaceutical corporations.

[Peter_Puget]

I think the ability of hospitals to turn down non-insured patients is overstated.

 

Very true for at last a couple of reasons 1) legal requirements and 2) operational considerations.

 

GK links to an article that doesn't fully support his contentions. Here is a link for you GK: new term for GK!

 

By the way drug shortages have been increasing over time and are international in scope.

[j_b]

In 2008, an estimated 15.4 percent of the U.S. population was uninsured.1 When there is no insurance coverage, hospitals bill patients directly. The resulting burden of payment for uninsured individuals and their families can be substantial, particularly during an economic downturn. Likewise, when these bills remain unpaid, the cost of uncompensated care represents a financial burden to hospitals and, ultimately, contributes to increases in health care costs to society overall.

 

[..]

 

- In 2008, the uninsured accounted for 2.1 million inpatient hospitalizations, or 5.3 percent of all U.S. community hospital stays.

 

- Compared to insured stays, uninsured hospitalizations were typically shorter (3.8 days versus 4.7 days) and cost less (average cost per stay of ($7,300 versus $9,200). Even when the elderly were excluded, uninsured stays remained shorter and less expensive than insured stays.

 

http://www.hcup-us.ahrq.gov/reports/statbriefs/sb108.jsp

 

5.3% inpatients without insurance to be compared with 15.4% (in 2008) of the US population without insurance (and much more inadequately insured). Some uninsured are healthy people, but many uninsured have chronic conditions due to lack of treatment until an emergency demands a trip to the ER.

 

Also note that the report points out that society pays for the uninsured through increased health care costs despite some here pretending that hospitals somehow eat the cost without passing it on to the public and/or their customers.

[Peter_Puget]

A study by the Department of Veterans Affairs Iowa City Health Care System and University of Iowa researchers showed factors associated with reduced hospital costs and length of stay that accompany care by "hospitalists" — doctors who devote their time to taking care of hospitalized patients rather than having an outside clinical practice.

 

The team analyzed 1,706 patient admissions in 2000-2001 to the four general internal medicine services at University Hospitals in Iowa City. One service was staffed solely by hospitalists; the others by non-hospitalist physicians in internal medicine.

 

The investigators found patients cared for by the hospitalists averaged a one-day shorter length of stay at 5.5 days compared to 6.5 days. They also had a 10 percent reduction in hospital costs.

 

link

 

 

[KaskadskyjKozak]

In 2008, an estimated 15.4 percent of the U.S. population was uninsured.1 When there is no insurance coverage, hospitals bill patients directly. The resulting burden of payment for uninsured individuals and their families can be substantial, particularly during an economic downturn. Likewise, when these bills remain unpaid, the cost of uncompensated care represents a financial burden to hospitals and, ultimately, contributes to increases in health care costs to society overall.

 

[..]

 

- In 2008, the uninsured accounted for 2.1 million inpatient hospitalizations, or 5.3 percent of all U.S. community hospital stays.

 

- Compared to insured stays, uninsured hospitalizations were typically shorter (3.8 days versus 4.7 days) and cost less (average cost per stay of ($7,300 versus $9,200). Even when the elderly were excluded, uninsured stays remained shorter and less expensive than insured stays.

 

http://www.hcup-us.ahrq.gov/reports/statbriefs/sb108.jsp

 

5.3% inpatients without insurance to be compared with 15.4% (in 2008) of the US population without insurance (and much more inadequately insured). Some uninsured are healthy people, but many uninsured have chronic conditions due to lack of treatment until an emergency demands a trip to the ER.

 

Also note that the report points out that society pays for the uninsured through increased health care costs despite some here pretending that hospitals somehow eat the cost without passing it on to the public and/or their customers.

 

You got it all figured out, Cliff! Too bad you are pissing in the wind!

 

 

[kroc]

Hi GGK,

Im an RN at Swedish first hill. I don't doubt the study you linked but the idea the increased death rate is due to getting a quick patch job in the ER is unclear. It seemed to me that the study implied lack of primary care for cronic/long term health problems was the concern.

 

I'm not going to argue that our health care system is the greatest. There is a nationwide shortage of IV pepcid as of this weekend. WTF? I don't understand the mechanics of these shortages but most of the health care system is not defending this status quo.

 

My disagreement was the idea that insurance dictates care on the hospital floor. J_B stated this as well. This is not the truth that I see.

 

The sad reality is that patient X has high blood pressure, diabetes, renal insufficency and gets no treatment because he is uninsured. Then his leg gets infected from a toe wound that doesn't heal, he gets septic and is taken to the ER then the ICU where he is saved from certain death that was only 2 days away at best. Once the infection is decreased enough to operate, his foot/leg will be amputated. He will stay at the hospital for about 3-4 weeks because he/she has no money and needs 24 hour care. Help to the bathroom, dressing changes, etc. During his stay he/she goes through the ER, ICU, and a surgical floor. He/she is seen by hospitalist, infectious disease specialist, vascular surgeon, and nephrologist. This is a common scenario

 

Who pays? Everybody really, but my point is that the fact that the pt is uninsured changes nothing in the above example.

[j_b]

Hi GGK, My disagreement was the idea that insurance dictates care on the hospital floor. J_B stated this as well. This is not the truth that I see.

 

Actually I didn't say that. I said that uninsured patients were less likely to be admitted to a hospital when needed, referred to specialists, and to receive expensive procedure/medications. But, as it turns out there is some evidence for insurance also determining the amount and quality of care within some hospitals (apparently not yours based on your observations). The study I quoted in my previous post does find that the uninsured spend less time in the hospital and are the object of less expenditure than insured patients even though the uninsured are usually in a worse state by the time they are admitted. In a similar vein, The Kaiser report 'Sicker and Poorer: the Consequences of Being Uninsured' says:

 

"Although not explicitly linked to the concept of needed services, Burstin, Lipsitz, and Brennan (1992) found that the uninsured were more than twice as likely as the privately insured to receive substandard care, defined as adverse events due to negligence, when hospitalized. Their conclusion was based on the review and analysis of over 30,000 medical records from 51 New York hospitals in 1994. Moreover, the analysis controlled for hospital characteristics as well as underlying risk and other patient characteristics, suggesting the patient’s insurance status rather than the choice of hospital was the primary reason for the observed difference."

http://www.kff.org/uninsured/upload/Full-Report.pdf

[112]

Im an RN at Swedish first hill.

That is where I had my nephrectomy.

 

I am insured. However, I am for single-payer universal health care and don't understand why any reasonable person wouldn't be.

 

[glassgowkiss]

I'm not going to argue that our health care system is the greatest. There is a nationwide shortage of IV pepcid as of this weekend. WTF? I don't understand the mechanics of these shortages but most of the health care system is not defending this status quo.

Well, the mechanics are pretty simple, a lot of the generics and older drugs have lower pricing, making them less profitable. So assholes at the top of Phizer decide to ditch less profitable production and increase production of viagra or other shit like that, as they can charge a top dollar for a boner. But this was the argument against single payer- it will lead to rationing of services and pharmaceuticals.

 

 

The sad reality is that patient X has high blood pressure, diabetes, renal insufficency and gets no treatment because he is uninsured. Then his leg gets infected from a toe wound that doesn't heal, he gets septic and is taken to the ER then the ICU where he is saved from certain death that was only 2 days away at best. Once the infection is decreased enough to operate, his foot/leg will be amputated. He will stay at the hospital for about 3-4 weeks because he/she has no money and needs 24 hour care. Help to the bathroom, dressing changes, etc. During his stay he/she goes through the ER, ICU, and a surgical floor. He/she is seen by hospitalist, infectious disease specialist, vascular surgeon, and nephrologist. This is a common scenario

 

Who pays? Everybody really, but my point is that the fact that the pt is uninsured changes nothing in the above example.

OK, some get saved, some don't. And your example is very true and accurate. But even you have to admit something like diabetes is an easily treatable condition and such person should not have an infected wound in the first place, don't you think? So yes, at the tail end patient X get the same care as insured patient Y, but the over all quality of care is not the same as a whole. And insured patient would be much less likely to end up in the ER. He/she would not be treated by hospitalist, infectious disease specialist, vascular surgeon, and nephrologist in the first place. And like Frank said "this is the crux of the biscuit".