This is just sad. We all know how many people suffer due to a lack of insurance - we see it here every day.
EMTALA exists to prevent this from happening. However, hospitals use it only as a starting point. If you are uninsured, and are in need of emergency care, the hospital is only obligated to make sure you are stable before dumping you on a charity hospital which will follow-up on the remainder of your care. As long as the primary hospital fulfilled their legal obligation, they are free to do as they please.
(Nov. 16) -- It's federal law: All seriously injured emergency and trauma patients must be given equal lifesaving care, whether or not they can pay for it. But that's not happening, according to a new report. The study, conducted by Children's Hospital Boston research fellow Dr. Heather Rosen and colleagues from three other hospitals, found that uninsured trauma victims ages 18 to 30 are dying at an annual rate 89 percent higher than insured victims with identically severe injuries.
As the health reform tornado continues to swirl on Capitol Hill, the data could provide fresh ammunition for those pushing for expanded health insurance coverage.
The study, published today in the Archives of Surgery, examines the survival rates for patients brought to about 900 U.S. trauma centers between 2002 and 2006, analyzing some 690,000 patients who had suffered penetrating trauma -- such as wounds inflicted by a gun or knife -- or blunt trauma from vehicle crashes and falls. Earlier research found 18,000 extra deaths a year among uninsured victims of such injuries. Rosen and the other researchers chose to focus on the 18-to-30-year-old subset because they had fewer existing conditions -- comorbidity -- that muddy the evaluation of the cause of death.
in response to Starshine...Sheshe030 here;___I have worked all my life carrying picets and manning phones as well as writing letters but always to na avail. Finally a chance to get a comprehensive health plan for all. I'm afraid I have to play te devils advocare here for a moemnt. I personally am so in favor of a public option and I will tell you why. If the government or stae entitys penalize those who do not have insurance (and they will) what happens to the millions of people that can't afford it? So many familys can barely feed themselves never mind health insurance. And it is those people that through no fault of their own that will drive health care costs up by usuing the emerbency rooms as their PCP. A public health option not only gives these people insurance but a kind of dignity as well. A public option is not going to break us, at least not a fraction as much as the hospitals and drub companies are already. The option will insure low to no income folkes and when people have insurance they do tend not to run to the doctor as much than if they didn't have it all. So, yes I am being very verbal in this option and I believe in it, otherwise only thise working will be able to afford any kind of insurance at all. sheshe030
WE do need a health care system that works for everyone. While I cannot agree with the author's view on VA- I have heard too many horror stories - I can agree with their view on cancer patients.
Too many times cancer patients lose their jobs when they are diagnosed. What are they supposed to do then? They can't work, so they can't afford health care, and in turn cannot afford the health insurance they need to get well! If/when they do get well, it can be almost impossible to get another health care policy because of a pre-exisitng condition! It is a never ending cycle.
My employer has our annual enrollment period coming up for benefits. I have to say that it scares the hell out of me. Rising costs and fewer benefits, have left me wondering what will happen next. Currently our copay for mental health services is at 50% - all other companies have a $10 copay. If they don't cover these services next time, what then? While I know that currently I do very well compared to most - but I have been in the position in the not so distant past where I had no health insurance and had $500+ out of pocket expenses per month - every month. I do NOT want to be put in that position ever again - especially when the employer has the resources to prevent that from happening.
I recently spoke to my mother who was upset over her rising health care costs. Being retired, she and my father are on a limited income and a huge chunk of that income goes to health care insurance. She was wondering if she should change insurers or even considered going back to work. I had to advise her to keep her current coverage - whatever the cost - because it is a good policy. If she drops it now, she will never get it back. And she may end up paying more out of pocket with a new, less expensive policy.
I think its time the health care industry does change. Rather than line the pockets of the insurance industry, start by assisting the actual people of the US.Stop making it easier for insurance companies to deny people coverage or to deny their claims based on a technicality. Patients should be able to get the care they need from a caring physician who is more involved in their patient's needs, rather than their reimbursement rate.
I'd like to say,when I was working as a nurse for 16 years I saw a lot of bogus charges to medicare and medicaid from nursing homes I worked at and hospitals.
One doctor at this nursing home would not examine the patient,just asked the nurses what they needed and charged for visits,many services were charged that patients never received.Music therapy,occupational therapy,etc etc.these were services ordered by the nsg.home/hospital.I reported as many as possible.My own mother suffered with dementia and was bedbound the last 2 yrs.of her life and the facility was charging medicare for all kind of services my mother could not possibly participate in,we reported them.You know,the nsg.homes are the worst at racking up charges,getting kickbacks from hospice companies,rehab.services and the list goes on and on.
hospitals are b.s.cause you get charges like ten dollars for two tylenol,8 bucks for a band aid, and insurance rates go up for all this b.s. however there is a system in place that keeps doctors from ordering unnecessary tests in a hospital.
I was lucky enough that when my spouse died I was given medicare at 53y/o,I do have a son age 20 and we cannot afford insurance for him.if insurance rates are high it's because so many have put bogus charges on them the innocent have to pay,however I do pay for my medicare and am against a government healthcare system.
I can't blame any doctor I go to for abusing the system,I go twice a year cause I had cancer and need to get lab work.and I tell my friends do not let them operate on your back,knee,etc w/o getting a second or third opinion.most physicians are ethical but there's a bad apple in every bunch.you just can't go along with a doctor unless you're in an emergency situation.I mean if you know your diagnosis and trust the treatment,that's different.hope I made a point w/o offending anyone.
This is why I believe so strongly in AmeriPlan - not that the company is perfect, but it is something - an alternative for people who fall into the cracks. I actually hope we come up with something so great that it will put AmeriPlan out of business....but until that happens, I am here to try to help people get the care they need at prices they can afford.
Here we go again - about the Health Care Reform... and why we need it:
"...the part of America's health care system that consumers like best is the government-run part.
Fifty-six to 60 percent of people in government-run Medicare rate it a 9 or 10 on a 10-point scale. In contrast, only 40 percent of those enrolled in private insurance rank their plans that high.
...68 percent of those in Medicare feel that their own interests are the priority, compared with only 48 percent of those enrolled in private insurance.
...Until the mid-19th century, firefighting was left mostly to a mishmash of volunteer crews and private fire insurance companies. In New York City, according to accounts in The New York Times in the 1850s and 1860s, firefighting often descended into chaos, with drunkenness and looting.
So almost every country moved to what today's health insurance lobbyists might label 'socialized firefighting.' In effect, we have a single-payer system of public fire departments.
We have the same for policing. If the security guard business were as powerful as the health insurance industry, then it would be denouncing 'government takeovers' and 'socialized police work.'
...The truth is that government, for all its flaws, manages to do some things right, so that today few people doubt the wisdom of public police or firefighters. And the government has a particularly good record in medical care.
Take the hospital system run by the Department of Veterans Affairs, the largest integrated health system in the United States. It is fully government run, much more 'socialized medicine' than is Canadian health care with its private doctors and hospitals. And the system for veterans is by all accounts one of the best-performing and most cost-effective elements in the American medical establishment.
A study by the Rand Corporation concluded that compared with a national sample, Americans treated in veterans hospitals 'received consistently better care across the board, including screening, diagnosis, treatment and follow-up.' The difference was particularly large in preventive medicine: veterans were nearly 50 percent more likely to receive recommended care than Americans as a whole.
'If other health care providers followed the V.A.'s lead, it would be a major step toward improving the quality of care across the U.S. health care system,' Rand reported.
...But the biggest weakness of private industry is not inefficiency but unfairness. The business model of private insurance has become, in part, to collect premiums from healthy people and reject those likely to get sick - or, if they start out healthy and then get sick, to find a way to cancel their coverage.
A reader wrote in this week to tell me about a colleague of hers who had health insurance through her company. The woman received a cancer diagnosis a few weeks ago, and she now faces chemotherapy co-payments that she cannot afford. Worse, because she is now unable to work and has to focus on treatment, she has been shifted to short-term disability for 90 days - and after that, she will lose her employer health insurance.
She can keep her insurance if she makes Cobra payments on her own, but she can't afford this. In her case, her company will voluntarily help her - but I just don't understand why we may be about to reject health reform and stick with a dysfunctional system that takes away the health coverage of hard-working Americans when they become too sick with cancer to work.
...A public role in health care shouldn't be any scarier or more repugnant than a public fire department."
You know I just had to chime in on this one. Working as a medical biller, I have to submit billing to insurance companies sometimes 5 and 6 times BEFORE I get a response from them. Often times the response I get is: patient is not a member, patient only has pharmaceutical benefits, there are billing errors, etc. The reason why they do this is because we have 90 days to submit the bill to the insurance company or it has to be written off.
I know in some cases organizations will forward the bill to the patient. This is unfair to the patient. It is not the patient's fault their insurance company sucks.
This is why I tell people to have their insurance information when they register at their doctor's office, the hospital, or the ER. Make sure it is correct and up to date. If it isn't, someone is going to screw up and the patient will get a bill - usually one they cannot afford. It is much easier to prevent the problem, then to try to fix the problem after the fact.
You have to understand it all begins with registration. Most people in registration (if they are new) are basically there to take information - that is all. They cannot tell you anything, about your benefits, that is NOT on the computer in front of them. It is rare that they know anything more than which is the primary insurance and which is secondary. It is up to the patient to know this information.
It is up to the patient to check with the doctor to verify if:
They are a participating physician with the insurance company they use.
Will the procedure be covered?
Is all your personal information correct? ( names [spelling], address, phone, insurance id #) including ss# - yes, I know some people do not want to give out their ss# , but believe me, not only does it make the whole process easier, but the odds of your information getting stolen from a hospital are just as high as it getting stolen from your bank or credit card company.
If the information gets screwed up in registration, you can bet it is going to stayed screwed up - until you are notified by the billing/business office or receive a bill.
If/When you do receive a bill - go through it with a fine toothed comb! If there is anything wrong, send a letter! Yes, you can call, but letters are kept on file and keep a copy for yourself. Make sure you follow up to verify any misinformation has been corrected.
If the business office has the incorrect information, it takes time to correct it. I deal with 1000's of accounts and several different insurance companies. Trying to get them all paid on a timely basis is an impossible task if I have incorrect information.
Once it is corrected though, you can bet we do our best to fight the insurance companies to pay their share - which is NEVER 100% of the bill.
Yes, there are co-pays and deductibles - which are the patient's responsibility. In most cases these are NOT written off. You can, however, make payment arrangements with the business office. Most billers will be more than happy to make arrangements and work with you.
What I have noticed though is that a lot of people choose a higher deductible when choosing their insurance coverage. The reasoning behind this, I suppose, is because it makes their premiums lower. DON'T DO THIS! Sure you may be paying $10 for your insurance premium, but what are you going to do when you have to have emergency surgery and have to come up with $5000???? Pay the higher premium and lower deductible.
If you have to go to the ER and your insurance has run out - DON'T lie and show an old insurance card. Tell registration you have NO INSURANCE. Tell them you will need help with your bill. Most hospitals can make arrangements for a discount on your bill or write the bill off altogether - this will depend on your finances. They will work with you BUT YOU HAVE TO ASK!!!
Another note: Hospitals cannot refuse you treatment if you are uninsured and in need of emergency care. They have to stabilize you before they transport you to another facility.
Also be sure that you need an ER. Some insurance companies have a 24 hour help line on the back of their card. If you are unsure about needing a doctor, call the 24 hour help line first. A few instances where you should get help immediately: IF your child has swallowed something, there is uncontrolled bleeding, symptoms of a heart attack or stroke - CALL 911 or get to an ER immediately.
2 cases where your health insurance is NOT needed: when you are injured at work or injured by a car. In either of these cases, your personal insurance CANNOT be billed - it is considered FRAUD. Even if you smash your fingers in a car door (in NYS - check your states to be sure) you have to give your car insurance information. If you are injured at work, your employer has to give their workers compensation carrier's information.
One last thing and I'll shut up...
In cases of single parents:
IF you are a single parent make sure you get child support and medical coverage for your child. If you are married and get separated, get medical coverage from your spouse. It is not only your legal right and their obligation, it is a necessity. There is nothing worse than needing to take your child to the doctor and worrying how you are going to pay for it. The thought shouldn't even cross your mind.
Yes, this is a lot to remember, but if everyone utilized the resources available to them and worked with the institutions things might be a little easier for some. I know how the insurance companies behave and their refusal to cover their patients infuriates those of us in the billing industry as well. After all, where do you think we get our insurance from?
I don't think people are making a big fuss about it as we all know it has existed at least some of us but for those that don't here is something to think about.
I agree with you Emil and why because it is more profitable for the big drug companies, insurance companies, elected officals look at their pay to support something for them and not for us. And until the American people hound the reps, the President and other officals nothing much will change.
I know my doctor is heart and lung as a rule will not give out anitbotics for little cold etc nor have you be one them for long time. I was had it with another doctor out here for cellulitis and my doctor said you had enough of them stop taking them. I had allergic reactions to the stuff and ended up in emergency and the doctor there gave me repeats of the same. I had to stay around to tell him he messed up and rewrite the prescription. I learned long ago if at the doctors or hospital better write your questions out and ask. One old lady was in the bathroom her doctor came in how are you and left. She got out of there quick and called him back with her notes as I had written. Point - you better be quick to respond and have a brain or they will overdose you , give you things you don't want drugs. Man, I called my doctor in middle of the night on somethings pulled or forgot about in the hospital.
My doctor has always had patients that were of the lower class and gave each one 20 minutes or more of his time. His practice was in areas of the lower income. It wasn't here 5 min. gotta get to the other like skin cancer doctor I had. I had to trip him about to make him look at things he missed.
I wish I had a better answer.
The rich always get better treatment and sometimes not in case ie of Micheal Jackson. Here he told them what he wanted and it ended in death.
Hey the post office got me out due to my leg problems, took two years and wrecked my nervesl Once they saw the picture of it at the end I had two weeks vacation and never had to go back but I should have been given a job there. But better to pay little retirement and weed out people as they were doing to make way for the optical readers machine to do the work I was doing.
So where do people work when machinery takes over that are out of work??
It is like let the sick die off and that will take care of the social security money that won't be around.
Yes our officials are stupid to lose money on non productive individuals .
I know of one lady lost her daughter to misdiagnoses by HM0 one I wouldn't use.
If I had cancer I think the cure is worse that the disease or would hit it to as in my blog rationale therapy .
Take care Emil and let's write the reps as Micheal Moore points out in his films and others say the same. He questions the health care system and go to Cuba and the people he took got help , here they didn't.
I am confused why people are raising such a fuss about government death panels. Do they not realize that the very same panels already exist within the insurance industry making those very same decisions on whether or not you receive care based on their profit and loss?
Here is what happens - when health care is considered a "business" as any other business...
Our health depends on our income - rich kids and grandmas are healthier than poor kids and grandmas.
Doctors are more loyal to their business partners - insurance and drug companies.
A case of cancer is a "business" case - to be decided by private insurance "death panels."
Private insurance "death panels" decide grandma's life or death.
You get to be healthy only when you have a steady job with a large enough employer.
No job, no income, no health care (why would we, as a society, "loose" money on non-productive individuals... we're not stupid... uhh?).
Sick people are "out of business", sorry - but, at least we (as red-blooded Americans) were warned - our smart ass mothers and fathers have always told us that life was not fair. I wonder who told them so - must be their employers.
I wonder too... why is it that our elected officials are stupid enough to opt out of the wonderful "business" based health care system. Why would they have their own goverment health care? Hmmm... why would they let government "death panels" decide life or death for their own grandmas?
I have heard of people going without health care coverage and relying on the health food store to keep them well as they can't afford medical insurance. But hadn't heard about the couple in the article over divorcing over the medical bills.
I just heard from my doctor when he called as I have known him since I was 24, he said his business is down by half as people lose their there jobs and the health insurance with it.
Thank you for bring this article to our attention, Emil.
"Long-term care constitutes a difficult and expensive challenge in any health system. But the American patchwork, full of cracks through which people fall, has a special problem with medical expenses of all kinds bankrupting couples. A study reported in The American Journal of Medicine this month found that 62 percent of American bankruptcies are linked to medical bills. These medical bankruptcies had increased nearly 50 percent in just six years. Astonishingly, 78 percent of these people actually had health insurance, but the gaps and inadequacies left them unprotected when they were hit by devastating bills. M. still helps her husband and, quietly, continues to live with him and care for him. But she worries that the authorities will come after her if they realize that they divorced not because of irreconcilable differences but because of irreconcilable medical bills... 'It's just crazy,' she said. 'It twists people like pretzels.' The existing system doesn't just break up families, it also costs lives. A 2004 study by the Institute of Medicine, a branch of the National Academy of Sciences, found that lack of health insurance causes 18,000 unnecessary deaths a year. That's one person slipping through the cracks and dying every half an hour. In short, it's a good bet that our existing dysfunctional health system knocks off far more people than an army of 'death panels' could - even if they existed, worked 24/7 and got around in a fleet of black helicopters."
Here we go again - about the Health Care Reform... and why we need it: "...the part of America's health care system that consumers like best is the government-run part. Fifty-six to 60 percent of ... see full post
