Throwing down the gauntlet

[Shishkabob]

Could I? Yup.


Would I like it? Nope.

 

[Aidey]

I could, and I couldn't. It would be situation dependent.

In the case where a patient wants X done, instead of Y, but X isn't covered by their insurance and Y would work just as well I think I could do it.

"Ma'am your insurance will not pay for a CT to diagnose gallstones, but it will pay for an ultrasound"
"But I want a CT"
"A ultrasound is just as effective and is safer"
"I want a CT"
"Ma'am, becuase your insurance won't pay for it I will not order a CT unless you can pay out of pocket"
"I can't afford it"
"Then I"m sorry, but I won't order it"

However, that isn't a true representation of Vene's question becuase stuff like that happens on a regular basis already (generic vs name brand meds), and it isn't really denying care.

I think I could also do it if the further care was going to be futile, but the family wanted it anyway "just in case". Like an 8th round of chemo in a stage 4 pancreatic cancer patient.

However, I couldn't pull a Jan Brewer and tell 100 people on the transplant list "Sorry, sucks to be you, we aren't paying for your transplant", or anything like that.

 

[JPINFV]

For those who think that a private payer healthcare system is so great, do you have the ability and the fortitude to look somebody's mother, brother, child, father, friend, husband or wife in the face and tell them they are not getting any medical care because they cannot pay?

If so, I invite you over here where we can put it to the test.

So everyone there gets 100% of the treatments they want in a decent time frame with everyone in health care being appropriately reimbursed?

 

[JPINFV]

I don't care how barren life can become. I could never withhold care for lack of compensation.

Would you say that if your income was directly connected to your patient's ability to pay? For example, if your patient doesn't pay, you're on the hook for the supplies and gas used to treat that patient and you don't get paid for how ever long between dispatch and going back in service.

 

[JPINFV]

the purpose of this thread is to find out who is willing and able to be the healthcare provider to tell people who cannot pay for healthcare that they can not have it at the moment of their need.

Are we limiting this only to emergencies? After all, there's a difference between emergency trauma surgery and getting a lap band.

 

[8jimi8]

Would you say that if your income was directly connected to your patient's ability to pay? For example, if your patient doesn't pay, you're on the hook for the supplies and gas used to treat that patient and you don't get paid for how ever long between dispatch and going back in service.

Like i said in a follow up post, i'd take trade in service. Maybe the guy has a gas card and can fill up my tank once a month? Maybe he's got a pretty daughter with a large dowry...

 

[JPINFV]

Maybe he's got a pretty daughter with a large dowry...

Well, this explains the chat room last night.

 

[8jimi8]

Well, this explains the chat room last night.

This explains my life post d/c of the marriage...

 

[Anjel]

I could tell someone they can't have treatment if it wasn't a life threatening issue. Like the man who stubbed his toe and is convinced its broken.

But if someone is having serious life threatening issues. I don't know what I would do. There is no way I could or would leave them there. I really hope it never comes to that.

On the other side of things ambulance "rides" are way to damn expensive. There should be a sliding scale for those low income people with no insurance.

I had to call 911 for myself not to long ago. I had a syncopal episode. Live alone. And when I came to I had no choice but to call an ambulance to take me to the hospital 6 miles away.

Nothing was done tx wise in route. Except a BGL and vitals. No monitor or anything like that. My bill was 850 bucks. I have no insurance.

There needs to be some kind of help for those who can't afford what they NEED.

 

[mycrofft]

I used to do it for a living.

I was a medical case manager (RN) for an alphabetic portion of five specialties, including neuro, ortho, podiatry, related durable equipment, related diagnostics, related rehab, regarding disbursement of the county's Medically Indigent funds. Some folks were cut off because they had a lawsuit started and the lawyer was supposed to pay their medical and recoup it in the settlement (say what?!), and any other coverage at all, no matter how inadequate, made potential recipients ineligible. We received the referrals from the County clinics (all but one or two of which have since been closed) and depended upon private providers who notified us they would see our clients to provide the care...which most did not because they only wanted to use us to make sure any emergency patients they accrued who were unable to pay would yield some sort of money.
Our local major medical centers are nicely landscaped, their directors make millions of dollars annually, and some are even buying up urban real estate and developing it...while crying because they lose so much money.

Private pay medical is huge business and has no true interest, as a whole, to provide care unless it is extremely profitable and they are forced to.

If there is government sponsored health care, those with enough money will still have ways to get above-average health care.

 

[Veneficus]

So everyone there gets 100% of the treatments they want in a decent time frame with everyone in health care being appropriately reimbursed?

No, it is a pay to play system here. If you don't have some means of paying for it, be it insurance, if you are lucky charity, or cash, you don't get it.

There are also varying level of insurance.

 

[thegreypilgrim]

For those who think that a private payer healthcare system is so great, do you have the ability and the fortitude to look somebody's mother, brother, child, father, friend, husband or wife in the face and tell them they are not getting any medical care because they cannot pay?

If so, I invite you over here where we can put it to the test.

Wouldn't be able to live with myself if I did.

But then again I'm an America-hating, pinko, socialist. So I guess that explains it.

 

[Ansible]

I think the whole idea is that we don't end up with a system like that of Marcus Licinius Crassus, where you have to pay to have an emergency dealt with. I would personally be willing to throw down in the debate hall and on the mat/canvas/dirt with someone who believes only those who can 'afford' aid should get it.

The main problem I see with increasing the range of healthcare and treatment is not funding, because money is an arbitrary creation to begin with, but overpopulation, because food will always have value, and we can only produce so much.

 

[sir.shocksalot]

I couldn't tell someone that they won't get medical care because they are poor. I think it's inhumane, I think if you have a medical problem, you have to right to get it treated. The problem with this belief I have is that healthcare is far from free. As much as I want Joe the Hobo's alcoholism taken care of, it is going to cost money; and Joe the Hobo won't pay, so who will?

I wonder how much money is wasted trying to protect MDs from lawsuits? I just read an article, which I can't find now, but it said something like 25% or 50% of tests preformed in orthopaedics are done just to protect from lawsuits.

 

[Smash]

I couldn't. I'm pleased that I will never have to either: thank you universal healthcare.

 

[Bullets]

Vene, Im your huckleberry.

If i have a pt's chart in front of me and i know why they can't get the treatment they "need" then i could do it. Im just that cold and heartless of a SOB to do it.

you dont have the money? tough, you got delt a bad hand, sorry life doesnt work out perfectly 100% of the time, hope a charity picks up your case. If you cant help yourself, then hope someone, like most of us, has the kindness in their heart to take up your case and work with you. Thats what chaity organizations are for

 

[emt seeking first job]

I could see the distance future being like Escape From L.A. No smoking, no drugs, no alcohol, no women - unless you're married - no foul language, no red meat!Welcome to the human race.

Think, as someone who lived through four decades, each with a recession; as well as hearing tales of the 1930s depression, I have faith things will bounce back. The economy is cyclical. Things may get worse, but not as bad as the 1930s. Mansions were left deserted.....I rmember in the 1970s, shopping malls boarded up...

It may have to happen that the country becomes more restrictive on imports and immigration, people may have their nest eggs chipped away, not so many luxury cars, desinger clothes, and lattes to go around, but it will get better for those who survive.

 

[emt seeking first job]

For those who think that a private payer healthcare system is so great, do you have the ability and the fortitude to look somebody's mother, brother, child, father, friend, husband or wife in the face and tell them they are not getting any medical care because they cannot pay?

If so, I invite you over here where we can put it to the test.

Getting back to the OP's ?, no, I don't think I can do it.

My vollie has a policy of not only being free but not even getting people's insurance (which personally disagree with). It is very refreshing to be able to assure people that they will get no bill from us; even when we do a transport home.

 

[thegreypilgrim]

Vene, Im your huckleberry.

If i have a pt's chart in front of me and i know why they can't get the treatment they "need" then i could do it. Im just that cold and heartless of a SOB to do it.

you dont have the money? tough, you got delt a bad hand, sorry life doesnt work out perfectly 100% of the time, hope a charity picks up your case. If you cant help yourself, then hope someone, like most of us, has the kindness in their heart to take up your case and work with you. Thats what chaity organizations are for

Well I hope you never take care of anyone I know.

 

[emt seeking first job]

If you don't have some means of paying for it, , you don't get it.

Even emergency care to stabilize the patient ?

In NYC that is rendered on demand. Am I mistaken to have assumed it was like that everywhere in USA ?