--- Nathan Cerny ncerny@gmail.com wrote:
On 9/6/07, Luke -Jr luke@dashjr.org wrote:
Please explain how the E.R. care costs the hospital anything. Just because they bill a large amount doesn't mean it's justified.
And where is this? Last I checked, it was illegal for hospitals in the US to deny you care because you couldn't pay.
I think you answered your own question there. ER is the single most expensive department in a hospital because they have to give care, and they admit people who are uninsured. They also run the longest hours, have one of the highest risks, and are generally very expensive to operate. Most hospitals make up for this loss by inflating other prices (thus the previous comment about a surgery being less expensive in other countries...).
And about the part where it's illegal to deny care...he was referring to a specialist. ER care is open to anyone regardless of insurance or payment.
The 1986 E.R. law stipulates that emergency rooms cannot turn anyone (who presents with an injury or illness) away for inability to pay. However, all they are required to do by law is stabilize your condition. Any care over and above stabilizing your condition is not required, and cash-strapped hospitals frequently send the newly-stabilized patient out the door with a referral everyone knows the patient will never be able to afford.
Example: you have no insurance and specifically no dental coverage. A tooth in your mouth becomes decayed and then infected. You go to the E.R. for care. All they are required to do by that 1986 law is bring down the inflammation and cure the infection. The appropriate minimum non-emergency care would be to take dental X-rays and extract the tooth, but that is not required to stabilize the patient (and is expensive to boot), so the hospital does not perform this additional expensive service. This results in the same patient bouncing in and out of hospital E.R.s with the same re-infected tooth. I think I'm more or less quoting something which happened in Missouri in the past few years, but I might be mistaken.
Contrast this with Canada: you wouldn't have the infected tooth to begin with because it would have been treated back when it was a cavity. The Canadian system allows people to get their teeth taken care of by a dentist long before the patient (in the U.S.) would become a chronic drain on local E.R.s.
Canadian doctors are going back to this system precisely because they can know that they can make a specialist referral and that the patient will see this specialist as soon as possible. Here in the U.S. the patient will put off the specialist until s/he can afford the specialist, which could result in the patient never seeing the specialist. Six months in Canada is a lot shorter wait than eternity in the U.S.
I do not believe this applies to other departments of privately funded hospitals, or to specialists.
That is correct. When you go to see a specialist, you may have a terminal illness but it is not going to cause your immediate death during the specialist visit, so he is not required to see you without arranging payment in advance.
____________________________________________________________________________________ Be a better Globetrotter. Get better travel answers from someone who knows. Yahoo! Answers - Check it out. http://answers.yahoo.com/dir/?link=list&sid=396545469