DISQUS

Anonymous · 1 year ago

Sounds good, but someone who was turned away will turn out to have had a true emergency, just once, out of 1 million visits, and this will collapse.

Either that, or someone will think this unfairly targets the poor and/or uninsured. I think it's a great idea though.

Anonymous · 1 year ago

Not only does this stigmatize and panic those without insurance--what about those with it whose doctors SENT them to the ER because the doctors did not have advance access or sameday appts? And, anyway, out here in AZ, they do come in and ask you to fumble for your purse while you are on the gurney. I also have had ER docs whose first words are, "Will your insurance company pay me, do you think?" So the next time you get snarky about someone charging over to have that delightful many- hour wait and get a pot luck of doctors, please ask yourself what this will accomplish besides increasing the misery.

ck · 1 year ago

I think the triage is a great idea, mainly for one point that the 2nd anonymous poster almost touches on but overlooks.

ERs are a horrible place to be. It's tiring, uncomfortable, and takes hours to get anything done. Nobody I know *wants* to be in an ER. The ones that present are generally worried that something is seriously wrong. That or they're the regular frequent-fliers-every-Sunday.

If you're in the former group and someone tells you after triage it's not urgent, then you should be happy you're not going to waste 4 hours waiting to be seen. And if it is urgent, you'll be happy that the wait isn't extended by non-urgent cases.

Anonymous · 1 year ago

Yes, I was sent home once with an ileus and after vomiting all night from the laxative they prescribed--had to go back. But I digress. Someone in triage saying maybe you could see your doctor tomorrow or go to urgent care if you can't wait is one thing. But this proposal is to sort people by ability to choke up money.

michele · 1 year ago

Second anon, you ask what this will accomplish? I would hope it would help lower ER fees and wait times. When I worked in the ER, I saw people come in for med refills, a women call 911 for an ambulance for a UTI (said she didn't have a ride), a man who came in because he didn't want to wait at his doc's office, a man with a glorified paper cut, similar to the pic above on the right side of the fingernail, who wanted documentation because he incured said papercut at work. Maybe he was afraid his extremity would fall off without the neosporin and bandaid I applied. I could go on and on.

Why do I care, right? Unlike the docs, I got my paycheck regardless of whether or not the patient pays, right? Well, for two reasons. All these non-emerg situations increase wait times for people with actual life or health threatening events. And people who don't pay drive up the ER costs. I am insured, but my deductible is 3k, my dependent's is 5.8k, which is part of the reason I would never go to an ER unless it's an actual, you know, emergency.

The Happy Hospitalist · 1 year ago

anon, if you went to a private office clinic without insurance, they would ask for payment up front for services rendered. How is a non emergent visit to the ER any different?

It isn't.

If you go to the grocery store because you're hungry, you don't have a right to shoplift just because you're hungry.

Anonymous · 1 year ago

My local hospital is already collecting co-pays right in the ED room. When my husband was in the same-day surgery area a few days later for his laproscopic procedure (why he was in ED in the first place), when I got there, WHAM! I was required to pay his co-pay right then and there. Good thing I brought my HSA card with me or they would have been out of luck! I don't mind them collecting the co-pays right then, they should at least warn you first!

Prowler · 1 year ago

"please ask yourself what this will accomplish besides increasing the misery."

Duh, it will decrease the abuse of the system by people who can get stuff for free. We all know that Free = MORE, and because we already don't have enough, FREE = BAD. So, add a little cost TO THE NON-EMERGENT VISITS, and voila.

ck · 1 year ago

Anon 1:46 PM:

I think you misread the proposal. First they triage to see if the presenting complaint is an emergency. If it is an emergency, you're admitted no problem. If it ISN'T, you're told to go home or pay up.

The sorting is based on urgency. The "choking up money" is only if it is not an emergency situation. Ideally, nobody will be paying a fee upfront...because only emergency cases will be admitted.

I think it is a great idea. I used to work in an ER and it was dumbfounding when people were told "It's not an emergency, it will be hours until you can be seen, just go home and rest" only to see them decide to wait it out. These kind of abuses bring down care outcomes for other patients. If there are no beds/rooms available in the ER, what happens to the guy with a massive laceration that requires stitches? He has to wait until the guy with the tummy-ache feels better. In the meantime, the critical period for stitching passes and all you can do is dress the wound. Kinda a crappy way to let the cookie crumble, eh?