An innovative new way to finance health care

Bob Vineyard at the InsureBlog shakes his head in disbelief at the “reasoning” behind emergency department overcrowding as detailed in a New York Times article.  (The Times article excerpts are in italics, Vineyard’s observations in standard text):

One  emergency  room  doctor  in Iowa,  Dr. Thomas E. Benzoni, said he recently saw a mother come in with her two children for what he thought was routine care. When he asked her why she had not gone to her family doctor, she said she did not have health insurance.

You don’t need health insurance to go to a doc for routine care. This is tantamount to saying you can’t get your oil changed in your car because you don’t have auto insurance.

“I don’t know what else she was supposed to do,” Dr. Benzoni said.

Here’s a thought. Why not pay for the office visit out of pocket?

Certainly much less expensive than paying ER charges for a routine visit. That can turn a $100 office visit into a $500 trip.

Until hospital ER’s do a better job of triage, and turning away those who do not truly need emergency care, this problem will only get worse.

It is like the folks who call 911 to get the phone number for Domino’s Pizza.

Time to stop coddling these folks and force them to grow up.

One obvious snag here is the whole “turning away those who do not truly need emergency care”.  Sometimes it is only after a proper work-up is performed that the urgency of the visit can be determined.  But Vineyard is right that simply going to a primary care physician or even a walk-in clinic and paying out of pocket would cost a lot less.  So why do people go to the ER instead?  Two reasons:

Thanks to the Emergency Medical Treatment and Active Labor Act, hospitals that accept Medicare or Medicaid payments must see patients regardless of their ability (or willingness) to pay.  Many doctors offices ask for the full payment for the visit up front before seeing the doctor.  Emergency departments cannot do that.  Naturally, this incentivizes patients to go to the ER, secure in the knowledge that no payment will be demanded at the time of the visit.

As for the other reason.  Um, well…why don’t we just let a quote from another New York Times article from earlier this year speak for itself:

Dr. [Eric] Coleman [director of the Care Transitions Program at the University of Colorado] said…that as many as half of all patients are considered to lack the ability to process and understand basic health information that they need to make decisions.

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