I am watching Michael Moore's "Sicko" for the first time....

Honnête et Sérieux-

I totally disagree with your opinions, but I appreciate your contributions to the thread.

It makes a lot more sense to me for people to be able to go to a clinic and see a pcp and have that paid for- than to wait until they're really sick, go to ER, get admitted and it still ends up being paid for by us anyway.

Hey- "an ounce of prevention" is waaaaaaay more cost effective than a pound of cure.

Here's an example of an ounce of prevention...

Colorado is one state where illegal aliens cannot get outpt chronic dialysis paid for. So here's what these pts do- They clog up the ERs in Denver waiting for their K+ levels to become critically high so they can be admitted as inpts and receive "emergency" dialysis. Some of them even eat contraindicated high K+ foods on purpose so that their labs will sufficiently critical to allow them to be admitted and get dialysis.

If they could get outpt dialysis they could get their 3 x week tx, and be done with it. But- because of the way the system "works" they make themselves much sicker on purpose, and end up getting much more expensive inpt tx, and the ERs are filled w/ pts who are really there working the system so that they can get some semblence of their needed chronic tx.
Most of these pts play it so they do end up getting their dialysis twice a week- as inpts. In the meantime, all of their co-morbidies are getting worse due to the constant up and down of their labs, fluid overload, and lack of routine scheduled dialysis.

This is way more expensive and harmful than just giving them outpt dialysis in the first place.
How stupid is this system?