Thursday, March 25, 2004

MisManaged Care

Saw a couple of real assholes yesterday (not literally). One guy was totally working the system to allow the taxpayers of the State of ___ and the County of ___ to pay for his care. This guy came to the emergency room because he had had a cold for a week and wanted some thing for the cough. So of course I ask, "What have you tried?". He then rattles off two or three items, none of which even have cough on the label. Great. "Why didn't you go to your regular doctor?". Doesn't have one. No big surprise. Neither do I. Whatever. 9 days out of 10 in our ER this guy gets a rx for an antibiotic (No, he doesn't really need it) and a rx for some damn good cough medicine. Most patients are incredibly thrilled by this combination, particularly the magic antibiotics for their viral infection. This guy wants to know if there's a shot he can get right then. Anybody want to know why? Keep in mind this guy is otherwise perfectly healthy, reportedly has a job with decent income (just no health insurance), and is dressed decently. If he gets a shot in the ER the hospital sucks up the cost because this guy will never pay the bill (98-99% of our ER patients never pay the bill)(that statistic excludes those who never make it out of the ER). If he gets a prescription on the way home he has to pay about $25 to fill it.

More math: had he gone to a regular doctor his visit would have cost about $30 or so and about $25 or so to fill the prescription. An ER visit is well over $1000 and a shot of antiobiotic would have been 2-3x more than the pill form. So, this guy cost the system over $1000 and paid for none of it, when he could have gone to a regular doctor and paid around $50, even with no insurance.

After seeing this gem I was walking down the hall and the triage nurse was leading another dude down the hall. His mouth was running the entire time about how his wait was so long and we should get our act together. Then it came, "Y'all need to take some of that money y'all've got and build a bigger unit." If it had not been quittin' time, I would have gladfully seen this guy just to get the rest of his opinion on our financial situation. Then I could have asked him just how often he comes to our ER for "belly pain" and how often he pays his bill, because it's sure as hell not from him that we get any money.

Now for irony. Obviously I'm opposed to most forms of state-controlled healthcare. It's bad. Evil. It's bad healthcare and on top of that would seriously impede my financial statements. Those are my reasons. They're obvious. The ironic part is that these two rednecks I saw in the ER yesterday, I'm sure, would vote down any plan or even political candidate that suggested such a system, even though they abuse the current system and treat it like state healthcare, since it's the taxpayers paying for them as is.

Enough, I have to try some more mortgage lenders.

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