09 July 2009

Let Them Go to the Emergency Room

Over on Connexions there is a - what's the euphemism? - 'robust' debate about health care, sparked in part by my husband's experiences getting his torn retina fixed on the NHS

This article by the American Associate of Retired People (AARP) on the subject of 8 Myths about Health Care Reform is worth reading.

One of the arguments that gets put forward frequently is that people without health insurance still get good quality health care in the Emergency Room. The AARP article addresses this issue in 'Myth 6':
Myth 6: "The uninsured actually do have access to good care—in the emergency room."

It's true that the United States has an open-door policy for those who seek emergency care, but "emergency room care doesn't help you get the right information to prevent a condition or give you help managing it," says Maria Ghazal, director of public policy for Business Roundtable, an association of CEOs at major U.S. companies. Forty-one percent of the uninsured have no access to preventive care, so when they do go to the ER, "they are most likely going in at a time when their illness has progressed significantly and costs more to treat," says Lumpkin. Hospitals have no way to recoup the costs of treating the uninsured, so they naturally pass on some of those costs to their insured patients.


Judy said...

I think that the "W" said at one point "the poor can get their colonoscopies at the ER." Ah yes - let them eat cake.

I so wish some of these folks who think everything is fine here would actually have to deal with the system. Insurance is fine - till you need it. There is such a fear of socialism here. Yet when I point out that in fact we do have socialized medicine for some - Medicare - the naysayers just ignore that.

PamBG said...

Judy - You won't find too many British people who are against the national health service. These comments were made by people in the States. One commenting that the poor do have access to good quality health care. The other one (who I'm willing to bet has not wiped his parents' bottoms or cleaned up their vomit) lectured us on the selfishness of the baby-boomer generation and how each family should take care of their own.

I can only assume that people are very certain that 'it's not going to happen to them'.

Judy said...

The only negative comment I have heard about the British system has been from cancer patients. For example, a drug I was freely given (at a cost of ten thou a pop and yes, I spent time examining my conscience about the morality of taking this drug which had proven to extend life for about 6 months.) The British folks on my listserv could not get this drug unless they paid privately. I think they can get it now (2 years hence.) I am not so sure that is a bad thing. But it is that kind of thing that scares Americans - that the well insured will not have access to the newest and best.

PamBG said...

But it is that kind of thing that scares Americans - that the well insured will not have access to the newest and best.

Yes, I understand that. And there are no easy answers to that one. Of course, in an ideal world, we'd all want the best treatment for ourselves and our loved ones. Every 'system' has trade-offs and the NHS does work on the basis of overall cost-effectiveness.

On the other hand, it seems to me that the trade-off in the US system is being dropped by your insurance provider. Which is better? I don't know. I'd love to see some sort of system in the US where everyone was entitled to some kind of basic level of healthcare beyond just showing up in the ER.

What's been interesting in the discussion on the other blog[1] was someone actually taking the position that 'If someone can't pay for medical care, it's perfectly moral that they do without it.'

[1] I've not cited a thread because the discussion got spread among several threads on related topics.