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Old 01-20-2010, 06:04 PM
 
43,012 posts, read 89,076,504 times
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Quote:
Originally Posted by TouchOfWhimsy View Post
(I called my doctor, and he suggested just going to the ER, because he'd have to send me to a lab for an xray and to the hospital for a cast anyway.)
This reminds me of another reason people prefer to go to the ER. When going to the doctor's office, there are separate copays for the visit, lab tests, x-rays, etc. Everything falls under one copay at the ER. A healthcare worker actually recommended I go to the ER for that very reason once. I was rather shocked that people do that, and I was more shocked that a healthcare worker was telling people to do that.
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Old 01-21-2010, 11:50 AM
 
Location: Raleigh, NC
3,406 posts, read 9,000,207 times
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Quote:
Originally Posted by duttygal86 View Post
Another thing that IRKS me to no end: In one room you will have a single mom, with her very sick child, she works and makes 10 bucks an hour, so her kid dosent qualify for Medicaid. In the next room you will have a ILLEGAL ALIEN, with Medicaid, no social security number and her children are being taken care of......The situation is rediculous.
OK, this is the sort of statment I was getting at. I'm not a healthcare worker, and I know that rules vary from state to state, but I'm having a hard time believing that any state denies Medicaid coverage for children if the parent or parents don't have the coverage. And I'm having a harder time believing that someone can just walk into a DSS office and receive Medicaid without any proof of identify, proof of address, proof of employment, and a valid SSN. If that's true, what's to stop all of us from doing that?
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Old 01-21-2010, 12:17 PM
 
8,649 posts, read 14,884,580 times
Reputation: 4563
Quote:
Originally Posted by superk View Post
OK, this is the sort of statment I was getting at. I'm not a healthcare worker, and I know that rules vary from state to state, but I'm having a hard time believing that any state denies Medicaid coverage for children if the parent or parents don't have the coverage. And I'm having a harder time believing that someone can just walk into a DSS office and receive Medicaid without any proof of identify, proof of address, proof of employment, and a valid SSN. If that's true, what's to stop all of us from doing that?
Illegals have children here, children become Americans, new citizen's parents; mother does not work, dad is not around or makes very little money, new citizen gets free healthcare paid for by American taxpayer...
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Old 01-21-2010, 01:25 PM
 
29,988 posts, read 35,889,753 times
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Yes, people mis-use the E.R. or wait until symptoms become so bad that they must. My boyfriend even does it and he has great insurance. I've know folks who purposly take their children to the E.R. at the local children's hospital rather than the Dr.'s office so that they did not have to pay the bill...they were able to pay they were just gaming the "system" and taking advantage of those who have the good will to donate funds to the children's hospital to cover expenses for those who cannot pay their bills.

Because of the fear of lawsuits many Dr.'s offices will not preform simple procedures and send patients needing minor stitches to the E.R. . That is what happened to me the last time I use an E.R., about 9 years ago:

I cut my finger deeply with clean scissors at home while multi-tasking and when the bleeding did not stop after 5 min. of applying pressure I called my Dr.'s office. My Dr.'s office refused to see me and sent me to E.R. without even offering to evaluate the cut. No X-ray required and the stitches (no aneshetic) averaged $100/stitch including the generic brand band-aid. Time spent in actual exam room of E.R. was <10 min.. Branted about 205 of this was disallowed under my insurance but I picked up the remaining $$ out of pocket. Next time I need stiches and I have not severed an artery I pull the "crazy glue" out of the first aid kit!

My parents did not take us to the E.R. as children unless it was a true emergency. As an adult, with the exception of the above, I have not used the E.R. except when taken for evaluation following particulary terrible vehicular accidents. Broken bones were set/splinted at the Dr.'s office in those days. Not anymore.

Tort reform would lead to the ability of doctors to reduce their malpractice insurance and thus not only reduce costs but reduce the need for people to go to the E.R. for relatively small things like minor stiches, minor x-rays, etc..., IMO. However, first people need to use the brain God gave them and use the E.R. in an appropriate manner. An increase in the availability of urgent care centers would also help with this.
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Old 01-21-2010, 02:04 PM
 
Location: Texas
14,078 posts, read 17,050,871 times
Reputation: 7707
Quote:
Originally Posted by superk View Post
OK, this is the sort of statment I was getting at. I'm not a healthcare worker, and I know that rules vary from state to state, but I'm having a hard time believing that any state denies Medicaid coverage for children if the parent or parents don't have the coverage. And I'm having a harder time believing that someone can just walk into a DSS office and receive Medicaid without any proof of identify, proof of address, proof of employment, and a valid SSN. If that's true, what's to stop all of us from doing that?

I can't say if you have to prove employment or not, but you do have to prove who you are and how much your income is, at least here in Texas.

And, yes, they can and do deny coverage to children if the parents aren't covered. In fact, I have a grand-daughter who is not on Medicade, but her son was...until they kicked him off.
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Old 01-21-2010, 02:07 PM
 
Location: Texas
14,078 posts, read 17,050,871 times
Reputation: 7707
Quote:
Originally Posted by Houston3 View Post
Illegals have children here, children become Americans, new citizen's parents; mother does not work, dad is not around or makes very little money, new citizen gets free healthcare paid for by American taxpayer...

The children born here are born as American citizens, per the Constitution. You may not like that, but the Constitution says what it says and I would hope no one would want to trifle with American citizens being those who native born (or naturalized).

As for the childs parents? No, they do not automatically become citizens.
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Old 01-21-2010, 02:12 PM
 
Location: Texas
14,078 posts, read 17,050,871 times
Reputation: 7707
Quote:
Originally Posted by lifelongMOgal View Post
Yes, people mis-use the E.R. or wait until symptoms become so bad that they must. My boyfriend even does it and he has great insurance. I've know folks who purposly take their children to the E.R. at the local children's hospital rather than the Dr.'s office so that they did not have to pay the bill...they were able to pay they were just gaming the "system" and taking advantage of those who have the good will to donate funds to the children's hospital to cover expenses for those who cannot pay their bills.

Because of the fear of lawsuits many Dr.'s offices will not preform simple procedures and send patients needing minor stitches to the E.R. . That is what happened to me the last time I use an E.R., about 9 years ago:

I cut my finger deeply with clean scissors at home while multi-tasking and when the bleeding did not stop after 5 min. of applying pressure I called my Dr.'s office. My Dr.'s office refused to see me and sent me to E.R. without even offering to evaluate the cut. No X-ray required and the stitches (no aneshetic) averaged $100/stitch including the generic brand band-aid. Time spent in actual exam room of E.R. was <10 min.. Branted about 205 of this was disallowed under my insurance but I picked up the remaining $$ out of pocket. Next time I need stiches and I have not severed an artery I pull the "crazy glue" out of the first aid kit!

My parents did not take us to the E.R. as children unless it was a true emergency. As an adult, with the exception of the above, I have not used the E.R. except when taken for evaluation following particulary terrible vehicular accidents. Broken bones were set/splinted at the Dr.'s office in those days. Not anymore.

Tort reform would lead to the ability of doctors to reduce their malpractice insurance and thus not only reduce costs but reduce the need for people to go to the E.R. for relatively small things like minor stiches, minor x-rays, etc..., IMO. However, first people need to use the brain God gave them and use the E.R. in an appropriate manner. An increase in the availability of urgent care centers would also help with this.

In the first place, tort reform is a euphomism for letting incompetent doctors off the hook.

In the second place, there are times when nothing else is available but the ER. For instance, my wife had a mild toothache for a couple of days, but when she awoke on Saturday, it had caused the entire left side of her face to swell. That's an abcessed tooth which has reached life-threatening proportions, so I finally talked her into going to the ER. There isn't a dentist in town who is in his office on Saturday, so what else could we do?

So, what was the result? Of course, we waited several hours to see the intern and left there with a paper prescription for anti-biotics which could not be filled that day because all the pharmacies were closed by the time we got out of the ER. They wouldn't fill it at the hospital, even though I know that hospital has a 24 hour pharmacy for their patients.

Total bill for that piece of paper? $900.

How can anyone say we don't need to reform the health care system?
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Old 01-21-2010, 02:48 PM
 
43,012 posts, read 89,076,504 times
Reputation: 30261
Quote:
Originally Posted by superk View Post
OK, this is the sort of statment I was getting at. I'm not a healthcare worker, and I know that rules vary from state to state, but I'm having a hard time believing that any state denies Medicaid coverage for children if the parent or parents don't have the coverage.
Children don't automatically qualify for Medicaid just because they're children.
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Old 01-21-2010, 03:08 PM
 
Location: West Coast
1,295 posts, read 3,492,974 times
Reputation: 675
Quote:
Originally Posted by stillkit View Post
In the first place, tort reform is a euphomism for letting incompetent doctors off the hook.

In the second place, there are times when nothing else is available but the ER. For instance, my wife had a mild toothache for a couple of days, but when she awoke on Saturday, it had caused the entire left side of her face to swell. That's an abcessed tooth which has reached life-threatening proportions, so I finally talked her into going to the ER. There isn't a dentist in town who is in his office on Saturday, so what else could we do?

So, what was the result? Of course, we waited several hours to see the intern and left there with a paper prescription for anti-biotics which could not be filled that day because all the pharmacies were closed by the time we got out of the ER. They wouldn't fill it at the hospital, even though I know that hospital has a 24 hour pharmacy for their patients.

Total bill for that piece of paper? $900.

How can anyone say we don't need to reform the health care system?
Are you saying we need to reform the fact that the hospital has a 24 hour pharmacy and they should let you use it? Or is it the bill? You have to remember to staff an ER with specialists, RN's, imaging on site, ready to go ORs, and the whole thing costs a lot of money. This is why it is an emergency room, you only use it as a last option.
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Old 01-21-2010, 03:12 PM
 
Location: NW. MO.
1,817 posts, read 5,773,864 times
Reputation: 1345
Quote:
Originally Posted by superk View Post
One of the statements I keep seeing over and over on the Healthcare Reform debate is that some people "abuse" the system by using Emergency Rooms and hospitals to treat mundane problems that should've been dealt with outside with a family doctor, paid for by the patient's insurance.

Does this really happen with any frequency? I know that a hospital must see and "stabilize" any patient who comes in, but I haven't read anything that says they must actually treat them.
One problem with the health care system is the lack of decent care in the clinics...

One year my 17 y/o son became very ill. I took him to the clinic 2 times in one week. Told them his symptoms. Sent him home Monday so Wednesday I called back in the morning and told them I had to get him back in. Sent him home on Wednesday. Friday morning he looked horrible. I took him to the ER. His kidneys were in danger of failing, his blood sugar was over 900, he was suffering with acute ketone acidosis. He was in ICU for a few days.

Recently I was sick for two months not knowing what was wrong with me. Digestive issues going on for months. I went to the clinic and they tested for a bacteria that can cause ulcer. Test negative. Go back with same symptoms and no resolution. Prescribed a medication. No resolution and digestive issues getting worse. Finally after multiple severe pain episodes I go to the ER. Tests finally done and diagnosed accurately.

Each and every wasted trip to the clinic was billed to our insurance.

I go to the clinic first always because I have a hefty portion left to pay after insurance if I do go to the ER but come on here. I'm paying for multiple visits to the clinic and nothing is solved.

I just have to ask, what care have these people gotten at the local clinics?
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