But that’s the point. The premise is that all of those people needed care (they wouldn’t go to the ER otherwise) but only people with insurance coverage (in this case Medicaid) are more likely to go (hence, healthcare cost is indeed a big factor, since all insurance does is cover costs).Per capita
Why do I care about per capita? That's just saying person A pays for person B and the per capita is they paid the same amount.
About medicaid
Payer Trends
Previous analyses have shown that utilization of the ED is also related to insurance coverage (for
instance, Sun et al. 2018 and National Center for Health Statistics 2019 are two examples). Adults under
the age of 65 with Medicaid were approximately twice as likely to report having gone to the ED in the
past year compared to those who are privately insured (National Center for Health Statistics 2019).
Previous work has shown that between 2006 and 2015, the share of ED visits for children was highest
among those with Medicaid and increased substantially, while the share covered by private insurance
declined. Similarly, among adults 18-64, the share of ED visits covered by private insurance decreased
and the share covered by Medicaid increased for most years between 2006 and 2015 (Sun et al. 2018;
Moore et al. 2017).
Qualifying for Medicaid is also not simple unless you’re really poor (this is largely because States foot a part of the bill), and unlike Medicare, they can actually seize assets to recover payments later on. Another reason people avoid enrolling in Medicaid if possible.
So you're saying people on medicaid need more medical care than people not on medicaid? The article seems to indicate that people on medicaid typically don't engage in preventive care, and only go to the ER because they feel it's a one stop shop, so lack of education as well.
How does putting the entire nation on medicaid resolve that?
Well, of course it is, people don’t sign up for Medicaid unless they really need the help, which normally happens when they’re already in the ER and in trouble.
Nobody I know suggested putting the nation on Medicaid, but having an option to buy into MediCARE. That’s generally what a ‘public option’ means.
I'm not suggesting people on medicaid should buy insurance. I am suggesting putting everyone one medicaid basically lowers the standard of care, it doesn't help those already on medicaid. The standard of care has to be lower because there are more people using it more often for things they could otherwise see their PCP for. Cost is cost, ER or PCP but the ER is a mission critical component of the hospital, it's not really a doc in a box clinic like you see in strip centers.
What PCP? 1 in 4 Americans don’t have one and that’s been on the decline as well (https://mobile.reuters.com/article/amp/idUSKBN1YK1Z4). Plus, sometimes it takes a month or more to get an appointment. This gets tilted further by the in-network/out-of-network nonsense, which reduces the pool of medical professionals you can go see.
If you do have one, something as simple as an infection can go from the doctor phoning in a prescription to your pharmacy without seeing you, to the guy that wants to charge the $150 for the visit. This is also where employment-based insurance can kick you in the ass and has even happened to my wife: you find a good doctor you’re comfortable with, but you switch jobs and suddenly this guy is out of network and you have to go hunting for a decent doctor again. That kind of is truly an America-only issue.
My point is that people with a PCP don't visit the ER as often. Put everyone on the universal ER waiting room list and that just makes it worse.
I just switched doctors but my daughter is a PA so her office is basically my primary. I used military doctors for a few years. Even with a card for the VA I won't go near it. My older PCP was my doc for 20 years but he was too focused on geriatrics and kids, steroids and antibiotics for everyone. My wife was an insurance administrator for most of her career, I've heard all about it forever.
You think this is the solution to the problem? Expand on how that would work nationally. Always good to hear well thought out ideas.
Economics 101:ST Left: Employer provided HC coverage doesn't work!
also
ST Left: ICUs are overrun with patients! Hospitals at their breaking points!
Conclusion: If we just had socialized medicine where everyone could go to the hospital without concern for cost, there'd be so much more available ICU space and hospitals wouldn't be stuffed to the breaking points.
ST Left
Subsidize anything, and you get more provided units than the naked demand/supply would normally dictate.
ST right: HAHA subsidies don't do anything.
Then Medicaid folks should have plenty ICU space.Economics 101:
Subsidize anything, and you get more provided units than the naked demand/supply would normally dictate.
ST right: HAHA subsidies don't do anything.
There are reasons people here don’t go visit their PCP (if they have one to being with). That’s what I was pointing out. It’s more than one, and include being able to take time off work for preventive care, having to pay out of pocket due to deductibles, not being able to foot the bill for super expensive medications, and others I mentioned before. Some of those things have made people avoid care until it’s an emergency, which at this point is a cultural problem that would also need to change, tbh.
FYI, my wife is an RN. I also worked on medical systems with doctors for many years. Doesn’t mean I know more or less than anybody else, but I’ve seen the nitty gritty of running a practice.
Medicare Advantage is a scam that benefits insurance companies and harms the public.
In return, insurance lobbyists shower the US Congress with campaign cash.
more PE bill padding shenanigans
https://fortune.com/2022/10/12/obste...outine-births/KHN reviewed the bills of a dozen patients in five states who said they were hit with surprise emergency charges for being triaged in an OBED while in labor. That included a woman in Grand Junction, Colorado, who said she felt “gaslit” when she had to pay $300 in emergency charges for the care she received in the small room where they confirmed she was in full-term labor. And in Kansas, a family said they were paying $400 for the same services, also rendered in a “very tiny” room—even though HCA Healthcare, the national for-profit chain that runs the hospital, told KHN that emergency charges are supposed to be waived if the patient is admitted for delivery.
Few of the patients KHN interviewed could recall being told that they were accessing emergency services, nor did they recall entering a space that looked like an emergency room or was marked as one. Insurance denied the charges in some cases. But in others families were left to pay hundreds of dollars for their share of the tab—adding to already large hospital bills. Several patients reported noticing big jumps in cost for their most recent births compared with those of previous children even though they did not notice any changes to the facilities where they delivered.
Clara Love and Dr. Jonathan Guerra-Rodríguez, an intensive care unit nurse and an internist, respectively, found a charge for the highest level of emergency care in the bill for their son’s birth. It took months of back-and-forth—and the looming threat of collections—before the hospital explained that the charge was for treatment in an obstetrics emergency department, the triage area where a nurse examined Love before she was admitted in full-term labor. “I don’t like using hyperbole, but as a provider I have never seen anything like this,” Guerra-Rodríguez said.
ER docs fighting back against the corporate practice of medicine, which is technically still illegal in 33 states.
https://khn.org/news/article/er-doct...k-to-ban-them/A group of emergency physicians and consumer advocates in multiple states are pushing for stiffer enforcement of decades-old statutes that prohibit the ownership of medical practices by corporations not owned by licensed doctors.
Thirty-three states plus the District of Columbia have rules on their books against the so-called corporate practice of medicine. But over the years, critics say, companies have successfully sidestepped bans on owning medical practices by buying or establishing local staffing groups that are nominally owned by doctors and restricting the physicians’ authority so they have no direct control.
These laws and regulations, which started appearing nearly a century ago, were meant to fight the commercialization of medicine, maintain the independence and authority of physicians, and prioritize the doctor-patient relationship over the interests of investors and shareholders.
Those campaigning for stiffer enforcement of the laws say that physician-staffing firms owned by private equity investors are the most egregious offenders. Private equity-backed staffing companies manage a quarter of the nation’s emergency rooms, according to a Raleigh, North Carolina-based doctor who runs a job site for ER physicians. The two largest are Nashville, Tennessee-based Envision Healthcare, owned by investment giant KKR & Co., and Knoxville, Tennessee-based TeamHealth, owned by Blackstone.
Court filings in multiple states, including California, Missouri, Texas, and Tennessee, have called out Envision and TeamHealth for allegedly using doctor groups as straw men to sidestep corporate practice laws. But those filings have typically been in financial cases involving wrongful termination, breach of contract, and overbilling.
Now, physicians and consumer advocates around the country are anticipating a California lawsuit against Envision, scheduled to start in January 2024 in federal court. The plaintiff in the case, Milwaukee-based American Academy of Emergency Medicine Physician Group, alleges that Envision uses s business structures to retain de facto ownership of ER staffing groups, and it is asking the court to declare them illegal.
Private insurers practicing the good old art of capitalism and the red team fails to cry "death panels" ?
Im not getting the disconnect.
Oh, its hypocrisy again.
Solved.
The red team does not actually examine their stances in any sort of critical or credible manner.
Insurance companies are the real death panels.
ing ghouls at UHC
https://www.propublica.org/article/u...rative-colitisWhen McNaughton’s mother reached a United customer service representative the next day to ask why bills that had been paid in the summer were being denied for the fall, the representative told her the account was being reviewed because of “a high dollar amount on the claims,” according to a recording of the call.
The US pays way more, for worse outcomes.
Last edited by Winehole23; 03-25-2023 at 11:03 AM.
Ain't Capitalism great?
Philosophy of the tiest possible product for the highest possible price.
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