21 y.o. survives - barely - page 2

The Ottawa Citizen 2007... Read More

  1. by   shannonFNP
    Here's my annual women's exam break down without insurance from teh doctor I have been seeing regularly: I do receive a sample of birth control pills, and the decreased fee of $150.00 for the actual office visit. Then I get my lab bill. It's $100 for the pap, $485 for my FSH and LH test. So, without insurance, I will STILL give you the "excuse" even though you "speak this often", it is still EXTREMELY hard to have to pay $700. But you best believe me, if I'm hurt, or I've got a 107 degree temperature, I'm coming to your ER whether I can pay a copay right then and there or not. My situation is not fixable until I graduate school and can get a full time job again. I'm not going to come in to the ER without insurance because I've got a stomach ache or I'm looking for an excuse not to go to work. People DO abuse the ER, I KNOW. But I'm not going to be grouped into those people because I don't have insurance, or all of the money to pay for my visit. I can barely work 12 hours a week while I'm in school, for crying out loud.
  2. by   HM2VikingRN

    Source: http://www.cbpp.org/pubs/health.htm accessed today.

    From EPI:

    Low-wage workers and their families face rising levels of economic insecurity. Analysts estimate that anywhere from a quarter to a third of U.S. workers--35 to 46 million--hold low-wage jobs that provide few prospects for advancement and wage growth.1 Further, such jobs typically offer few of the employer-sponsored benefits--such as health insurance, paid sick leave, retirement plans, and the flexibility to deal with family needs--that higher-income workers often take for granted.
    ...
    In 2006, about one in four workers in the United States held a job that paid less than $10 an hour.4 If both parents in a family of four work full time (40 hours per week, year round) at the newly increased federal minimum wage of $5.85 an hour, their total annual earnings will be about $24,000 a year--the federal poverty line for a family of four is $20,650. But nowhere in the country can a family meet their basic needs on poverty-level earnings; the poverty level is widely acknowledged to be inadequate as a measure of financial need.5
    In fact, research indicates that across the country, families typically need an income of about twice the official poverty level--or roughly $41,000 for a family of four--to meet basic needs. In a high-cost city like New York, the figure is up toward $60,000, whereas in rural areas, the figure is typically in the low $30,000s (see Table 1).6

    These figures are based on the National Center for Children in Poverty's (NCCP) Basic Needs Budgets which include only the most basic daily living expenses. For example, although they include the cost of employer-sponsored health insurance premiums, they do not include out-of-pocket expenses for copayments and deductibles, which can be quite costly, particularly for families with extensive health care needs.


    Bottom line is that many of the people targeted on this thread are low/lower income. If we want to give them a shot at working their way into a better situation we have to devise a health care system that works. Requiring copays ends up making their health status worse not better. The data shows that improving the health status of low imcome families leads to improved economic status.

    Last edit by HM2VikingRN on Oct 25, '07
  3. by   MAISY, RN-ER
    According to our President everyone has access to healthcare in their nearest ER.

    This is the same president who does not want to provide healthcare to uninsured children.

    This president's political party fought health insurance in the 90's offered by the Clinton administration-and continues to do so today(unless you consider those who are running for election and are now trying to court former voters who had stable jobs and insurance prior to off shoring jobs to other countries since this party has been in office.) Sorry getting off topic.

    ER visits are becoming the norm-thank your doctors who no longer treat anything that may cause their malpractice insurance to rise. Pulled a muscle in my chest-CP go to ER. Coughing with cold-SOB go to ER, stiff neck-Mengitis go to ER. OMG! Our ER is swamped with primary care visits, OnWays from physicians and sick people!!!! It isn't hard to believe anyone waits or has poor outcomes from those visits.

    Our ER is suburban, but we've been seeing a lot of city people due to hospital closings. Those 8-12 hour city waits are coming to a suburban ER real soon! Even with urgent care, we are getting swamped. It can be pretty scary with the mix of illness, and urgent among those in the waiting room. People are returning after just being discharged- hospitals stays aren't long enough for recovery. ER patients are just sicker and require larger workups.

    Our ER is good in the respect that we will hold patients until there is room on the floor-no floor nurse is stuck with more than 7 patients-other hospitals will keep the ER empty and just keep shipping patients upstairs-staffing or not. At least our patients are safe. However, this causes the waiting room back up.

    I would like you all to consider the following scenario: we see a patient for an abscess>refer patient to surgeon>patient has no insurance or medicaid>can't even make appointment without appropriate insurance with receptionist>abscess gets infected returns to ER>give antibiotics>becomes tunnelled wound/cellulitis/emergency surgery>patient admitted>iv antibiotics, maybe surgery>gets discharged>referral to surgeon who wouldn't take patient with medicaid or no insurance to start with>START ALL OVER.
    THIS HAS HAPPENED AT LEAST 20 TIMES THIS PAST YEAR! How much money in just this one instance has been spent on fixing a problem caused by no preventative care? This is an urgent care patient that starts out with a nuisance and ends up with life threatening problems.

    This is not the htn patient, the cardiac patient, or the diabetic patient whose chronic problems require medications and care that will otherwise end up to be a major expenditure if not available! This is not the elderly patient that lives alone, has no pt, or home health care visits that are not covered and ends up weak or with multiple falls that costs beaucoup bucks to fix.

    While I don't want to pay for everyone's healthcare, and understand the frustration of those who pay for their own. I have to state for the record: It would be cheaper to insure and provide preventative care to those who need it-than try "to put Humpty together again". Don't let the egg break in the first place!

    As for those who think those $75-$100 copays should come from welfare checks-I have to ask....Are you kidding? You might as well take the food out of their mouths! or the heat from their apartments! or the clothes off their backs! and on and on!

    Then there is that special poster who has nothing but apparent contempt for the poor and uninsured. Healthcare is a privilage not a right! Not sure if a she or he, but in either case-there will be no sympathy there. Unnamedneeds proof that anyone suffers in America, and if someone does-it's probably their own fault. A hefty copay=go die in the cold/heat if you are not educated, or majored in underwater basketweaving. Sucks to be you mentality -obviously the have nots chose the wrong life.


    Maisy
    Last edit by NRSKarenRN on Oct 29, '07
  4. by   Pixi_Lixi
    Hi there guys,
    We all know that the consensus of the medical and epidemiological research around the world is that extensive primary care initiatives are the best and most cost effective way to manage and improve heath.

    Maisy, I think we are feeding a troll here. No intelligent person who has examined this subject can seriously believe what that person is posting. Hard to believe they are really a nurse either.
    Last edit by NRSKarenRN on Oct 29, '07
  5. by   HM2VikingRN
    I provide data and referenced sources to support my position and thoughts. If you want a handy health statisitcs tool see this website:

    http://www.who.int/whosis/database/core/core_select.cfm. More information than you could ever use for studying health indicators....:>>>:spin:
  6. by   FireStarterRN
    Quote from HM2Viking

    Source: http://www.cbpp.org/pubs/health.htm accessed today.

    From EPI:

    Low-wage workers and their families face rising levels of economic insecurity. Analysts estimate that anywhere from a quarter to a third of U.S. workers--35 to 46 million--hold low-wage jobs that provide few prospects for advancement and wage growth.1 Further, such jobs typically offer few of the employer-sponsored benefits--such as health insurance, paid sick leave, retirement plans, and the flexibility to deal with family needs--that higher-income workers often take for granted.
    ...
    In 2006, about one in four workers in the United States held a job that paid less than $10 an hour.4 If both parents in a family of four work full time (40 hours per week, year round) at the newly increased federal minimum wage of $5.85 an hour, their total annual earnings will be about $24,000 a year--the federal poverty line for a family of four is $20,650. But nowhere in the country can a family meet their basic needs on poverty-level earnings; the poverty level is widely acknowledged to be inadequate as a measure of financial need.5
    In fact, research indicates that across the country, families typically need an income of about twice the official poverty level--or roughly $41,000 for a family of four--to meet basic needs. In a high-cost city like New York, the figure is up toward $60,000, whereas in rural areas, the figure is typically in the low $30,000s (see Table 1).6

    These figures are based on the National Center for Children in Poverty's (NCCP) Basic Needs Budgets which include only the most basic daily living expenses. For example, although they include the cost of employer-sponsored health insurance premiums, they do not include out-of-pocket expenses for copayments and deductibles, which can be quite costly, particularly for families with extensive health care needs.


    Bottom line is that many of the people targeted on this thread are low/lower income. If we want to give them a shot at working their way into a better situation we have to devise a health care system that works. Requiring copays ends up making their health status worse not better. The data shows that improving the health status of low imcome families leads to improved economic status.


    Thanks for the interesting data!
  7. by   frodo
    As a staff nurse at local hospital,our insurance claims will not be paid in ER if it is not a true emergency, what may not be an emergency to the paper pushers, may very well be an emergency to me.
    Thank you Hm2Viking for the link for health indicators, very interesting.
    Last edit by frodo on Oct 26, '07
  8. by   Angie O'Plasty
    What about urgent care centers? Seems these would be more appropriate for a lot of the situations where people use the ER for things that aren't true emergencies and would help with the overcrowding situation. I was recently reading an article about a community health center that was opened in a city and provided care to people without insurance, and it decreased ER usage because they used the CHC for those non-emergency situations that still needed to be addressed. There also needs to be some education of the public around what is appropriate and inappropriate use of the ER--I think sometimes people just panic.
  9. by   GingerSue
    thank you for the link,
    after reading the link
    first question - why no surgeon to be found in Hull, Gatineau, or Ottawa?

    Ottawa is the capital city of Canada - no surgeons?

    Obviously some problems with the ambulance staff - but anyone can miss an exit off the expressway, so I can understand missing the Decarie exit.
    But then taking him to the wrong hospital - the Children's hospital?

    Although the surgeon, who was waiting for him, got involved in another trauma case, - should that surgeon have waited for Dany so that Dany would not have to wait? What should that surgeon have done?
  10. by   frodo
    our county health dept is enlarging and having two more doctors to help with the medicare and aid people and people who have no insurance. the physicians in our town mostly are private and not associated with gov agencies and therefore limit their pts to somany medicare and aid and no insurance. my moms dr quit and we had a hard time finding a dr for her andshe has the extra insurance that goes with medicare. its sad!

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