A plot of Machiavellian Machinations

[Boring 7]

So working at the Hospital has kept my mind on the medical industry a lot of late, and I thought I would bing up a villainous plot I've been rolling around in my head for some time.

Now in the United States (because that's what I'm talking about) we currently have no "universal coverage" health insurance. In spite of this, our medicare and medicaid (which insure the elderly and the poor respectively) actually spend more money per capita (and by that I mean total spent/total population of the country, not just those covered) than any other country in the world.

How does that work? Easy: Medical expenses are the leading cause of bankruptcy in our country, medical bills continue to skyrocket, medicine is more expensive in this country than any other.

Is it because our health care is "better"? Well not really, we rank high, but rarely highest, by just about any scale. In some cases more of our patients with a specific problem or treatment survive than elsewhere but that is often because other countries have higher-risk patients that actually get treated instead of being told, "you're prob'ly gonna die anyway, might as well save your family some cash so they can eat."

So why? Well the answer is that we *do* have Universal Health Care, it is called the Emergency Room. No matter who, what, or where you are, if you can flop your way into that ER waiting room they cannot turn you away. So you get treated for your emergency (because until it is life-threatening they will simply refer you to a clinic to go to in the morning, a clinic which can turn you away if they know you cannot/will not pay) which is always made the worse because you waited until it was an emergency to get it treated ("an ounce of prevention is worth a pound of cure" is very, very true) and when you do not pay because you are a junkie, or poor, or selfish, or all of the above then the hospital covers the bill by increasing the prices of its treatments for all the people who can pay.

SO! Universal coverage is OFF THE TABLE because it smells like socialized medicine and scares the republicans. Fine, we still have a problem, so what is the solution?

My solution is: Close the ER! Now I know what you're thinkin'; "how do we do that, it is a room for emergencies?" Well when they start making judgement calls at the door like, "you look shifty" they'll get charged with racism or classism because poor people and miniorities are disproportionately the people who can't pay, so they'll quickly shift to a system of, "you only get health care if you have health insurance".

This means that insurance costs will go up, and medical care will go down as demand for both increase and decrease respectively.

But wait! There's more! Get rid of the ER and recruitment rates (another problem we are having) for the military go up! How? Simple, the military offers coverage! In fact, they offer really fucking good coverage because if your GI dies of colon Cancer that million dollars you wasted on training his ass to shoot big expensive guns with disturbingly amazing accuracy is completely fucking wasted! So all they have to do is advwertise medical coverage and suddenly people will think, "you know, I have a better chance of dying from no health insurance than I do from getting shot by a brown person, I think signing up might be a good idea."

How can I be so evil?

Well, I pretend I am Dick Cheney, and it just comes naturally.

[Drigovas]

So why? Well the answer is that we *do* have Universal Health Care, it is called the Emergency Room. No matter who, what, or where you are, if you can flop your way into that ER waiting room they cannot turn you away.

True, but they can just let you sit there until you no longer need care, or at least thats how we roll in california[that made huge news here, though had a certain twinge of ironic humor amongst the piles and piles of wrongness] Seriously though, part of the purpose of emergency rooms is that many normal hospital facilities do not have proper people on staff round the clock to deal with certain things, and because heart attacks don't wait for normal business hours. Don't know about in other places, but here in california, the ER rooms are destroying our health care systems so much so that hospitals are constantly being bailed out from the brink of financial collapse. Lots of places actually are closing emergency rooms for just this reason [because the ER is the wound from which the hospital is hemorrhaging money], and it's making for fatally long ambulance trips, since hospitals who don't have ERs just won't accept patients at all from ambulances.

Honestly, sounds like your plan will just naturally fall into action without having to actually force ERs to close [because the last few unfortunate hospitals with ERs will be bled dry by them].

[Boring 7]

That story left unanswered questions for me the first time I saw it. Having pulled ER shifts, I can tell you if you have three rooms and they are all full and a fourth person comes in bleeding out, too fuckin' bad. The person really will "just sit there not doing anything" because they do not have medical training, and even if they do they definitely do not have the equipment to save your bleeding ass.

And from the sounds of things, that was exactly what happened.

But a more relevant question to you, is that actually legal? I am a paper-pusher, not a lawyer, but I was under the impression the hospital *has* to have an Emergency Room.

Not to mention, if they do not, even the people with insurance will die if they have a gunshot wound. . .

[Sonofzeal]

Or, you could all emigrate to Canada.

Seriously, Canadians complain about waiting times and lack of specialized equipment as much as anyone, but when push comes to shove our healthcare is reasonable, and socialized. Taxes are higher, but you never need to worry about necessary healthcare bankrupting you.

Jooooooooin uuuuusss.....

[Starwind]

My reply is a bit double edged.


First I work in a hospital as a care provider. There are only 2 hospitals here. One of them WILL NOT take patients from the clinic for the poor people. We do. This is causing ALOT of money that could be used for better equipment, hiring the staff we need, and many other things to be taken from us. We have some of the best staff but we don't have better setup. This is because this clinic will send us people who live drunk on the street and have NO way to pay. This isnt just from the ER. This is from the clinic direct admit from a clinic. ALL my nurses know our "frequent fliers" that are admited for a day, two days, maybe even a week. I have NO issue with the ER even though my floor is where they usually go.

The opposite side of this, I have an incurable degenerative disease. If it wasn't for my insurance I would have to pay $1700 a month for a drug that hopefully will slow the progression, AND this is a disease that I don't qualify for disability yet because I can still walk, talk, and feed myself. So no coverage for me. Thankfully the hospital insurance has a "no preegisting conditions" time for sign-up. It was the ER that helped me get my diagnosis and the hospital STILL hired me after knowing I have this condition. On the bright side they really can't fire me unless I kill someone. So you can see where I somewhat agree with you, but in the most part no because if they come into the ER and the only thing wrong with them is there drunk, they stick em on a bed in the hall to dry out for the night.

[Boring 7]

Or, you could all emigrate to Canada.

Seriously, Canadians complain about waiting times and lack of specialized equipment as much as anyone, but when push comes to shove our healthcare is reasonable, and socialized. Taxes are higher, but you never need to worry about necessary healthcare bankrupting you.

Jooooooooin uuuuusss.....

One of the bigger reasons you lack specialized equipment and have long lines is because more people actually get treatment. This is why I want to smack anyone who says, "socialized medicine will mean lines and stuff so people will have to wait all the time and less people will get treated."