Does EVERY LIFE really count??

[ASSEDO]

Interesting topics. I see over-utilization more than under-utilization. Sometimes a decision needs to be made to pull the vent, instead of letting a patient rot on the vent. The outcome would be the same, only quicker.

As far as low income, I see families in all walks of life making weird decisions. Today an elder lady was dumped at our ER as the family wanted her to go to a nursing home. The hospital could not admit her, because she did not meet medical necessity to be inpatient. Family didn't want her because of dementia. Family refused to pay for a sitter.

[talaxandra]

We don't have quite the same divide between non-insured and insired in Australia - or at least, not yet. But I do see a difference between the way patients with and without family/advocates are sometimes treated.

What I'm more aware of at the moment, because I've got a patient in the situation presently, is the difference the assertiveness and English skills of the family make to how paternalistic the medical treatment is.

[TrudyRN]

You know, we always talk about this issue, but I have thankfully never run across it in person. If anything I have seen heroic measures and every possible resource used to save people, uninsured, noncompliant, disabled and all.

I am sorry that this seems to be happening at your hospital.

This has been my experience, too. We spend tons of money on people with little "promise" of ever being contributing members of society. I find myself more disturbed about it with each passing year, probably a result of my own increasingly harder times. No one hands me anything, I work for what I have, I support my family, i pay my taxes (angrily, bitterly, cursing those who steal from me and other peasants) and my bills, and generally live within my small means.

Why, then, should taxpayers be burdened with huge expenditures on convicted criminals, the violently insane, the drug users and other non-compliants, etc? I guess we feel a Christian obligation to do so. I know Christians are to be merciful but we are also supposed to have some sense and be good stewards. Now maybe if we go get a fish with a gold coin in its mouth...

[cmo421]

Why, then, should taxpayers be burdened with huge expenditures on convicted criminals, the violently insane, the drug users and other non-compliants, etc? I guess we feel a Christian obligation to do so. I know Christians are to be merciful but we are also supposed to have some sense and be good stewards. Now maybe if we go get a fish with a gold coin in its mouth...

Human we all are and a basic human right is physical and mental care. WE can argue to the hilt about the taxes,laws,welfare,etc,,,,, Nuclear families are no more,we need them back ,that would help. Until we reach the perfect world,we need to care for each other as we would want our children to be cared for. Make laws preventing abuse of welfare,advocate birth control /abstinence,limit politicians spending and whatever it will take to get us there.

[deeDawntee, RN]

I am bringing this thread back to life because I have just begun a second job at a County Hospital where I have seen something different and profound happening...99% of the patients coming in through the ED (where I work) do not have insurance. The care these patients are receiving is second to none. There are full work-ups and there is never any discussion or behind-the-scenes rumblings about their ability to pay, because they can't.... There is so many ethical issues at play between this County Hospital where preventive care is all but absent and my other job where insured suburban patients are the norm and those who are not insured, in my estimation, frequently do not receive the same kind of aggressive care. It is enlightening and disturbing. I must say though, that my conscience is much quieter where everyone is treated as if their life counted, in spite of social class or ability to pay.