Healthcare Reform-ER

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Now that healthcare bill has passed, will it now be allowed to turn away the uninsured at the ER or will it stay the same?

Specializes in ER, ICU, PACU, Corrections, cardiac.

And if we eliminate all non emergency patients, I will be out of a job!

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The plan is to eventually have everybody covered with insurance. If you are gainfully employed and refuse to become a part of any plan then supposedly there would be a financial penalty of some sort.

Yes its in the bill today as signed into law, $750 per adult and $375 per child if you dont have insurance, This will be handled by the IRS however no details on how they are going to do that yet and when it takes effect ie April 15th 2011.

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Yes its in the bill today as signed into law, $750 per adult and $375 per child if you dont have insurance, This will be handled by the IRS however no details on how they are going to do that yet and when it takes effect ie April 15th 2011.

The fine is old news to me because I live in Massachusetts and we've had this fine in place for several years, welcome to my world, lol.

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Specializes in LTC/Behavioral/ Hospice.

This is just a thought, but it could have the opposite effect. Right now, my family physician refers people to the ER if he is overwhelmed and can't see someone who needs to be seen, but it isn't an emergency. Think of physicians being overwhelmed with all these new patients and not being able to get them an appointment in a timely manner. Where can these patients go? The ER, of course.

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You guys do realise many insured people use the ER when they cannot get in with their PCP?With a PCP shortage and a further exodus out of primary care, you honestly think ER visits will decrease?

I have what might be a stupid question, but are we sure there is a PCP shortage nationwide?

Or is it like this supposed "nursing shortage" we keep hearing about but now that I'm in nursing, I fail to find?

I just ask because I can get into my primary doctor the same day. And this is a somewhat rural area, not really known for its overflow of doctors.

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Specializes in ED, CTSurg, IVTeam, Oncology.
You guys do realise many insured people use the ER when they cannot get in with their PCP?With a PCP shortage and a further exodus out of primary care, you honestly think ER visits will decrease?

Well, actually yes. In many poor neighborhoods, where the bulk of the uninsured live, what will likely happen is that the lack of primary care business will disappear. MD's can now set up offices in poor neighborhoods and not have to worry any more about getting paid. If anything, I personally believe that this reform bill will be a principle force in driving a resurgence in primary care medicine. Thirty two million new customers will need plenty of doctors. :up:

Sure; the drunks, homeless, uneducated and uninformed, as well the undocumented, will continue to still show up in droves to the ED just like they've always done. But, IMHO, we're going to see a lot less of the uninsured. So, in essence, ED traffic and overcrowding would be helped (it's still not going to be totally relieved because ED's have been so overly abused for years). But ultimately, this is going to save hospitals money. The bulk of the uninsured catastrophic patient subset (the kind that only comes in when they're so bad they're about to die) would likely be treated a lot sooner, hence using a lot less resources than they generally did traditionally. :up:

Hospitals getting paid is going to be a net positive as it would allow more of them to remain solvent, and more nurses to have jobs. One has to wonder if a plan like this would have been in place, would a hospital like SAINT VINCENTS of New York City been shuttered, having been driven into bankruptcy from years of mounting losses? No one knows, but the "what if's" are intriguingly bitter sweet.

In essence, this reform is funded by a combination of diverted resources from the insurance industry and public tax base. It isn't socialized medicine by a long shot because it's only partially socially funded, and it remains a privately controlled enterprise, albeit now with much stronger government oversight. It was this lack of oversight that allowed insurance companies to run roughshod over consumers, letting them get away with turning their costliest cases over to the taxpayer through rejected claims or dropped customers. This is no longer going to happen. They will still make money, just not hand over fist and laughing all the way to the bank like they were doing since the early 90's. Further, it forces all Americans to be responsible for their health because if one gets sick, it does impact the system that every other American relies on.

It's not a perfect plan, but it goes a lot farther and does more for a lot more people than the HMO's were ever willing to do. Frankly, this should have happened a generation ago. What kept it from happening were the insurance companies then, just like they tried to do again. :down:

Repeal? Not a chance, and that's a good thing.

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Specializes in LTC/Behavioral/ Hospice.
I have what might be a stupid question, but are we sure there is a PCP shortage nationwide?

Or is it like this supposed "nursing shortage" we keep hearing about but now that I'm in nursing, I fail to find?

I just ask because I can get into my primary doctor the same day. And this is a somewhat rural area, not really known for its overflow of doctors.

There seems to be a shortage in my area. We are a moderate sized city, and I've called many of times with a sick child and been told that I need to go to the ER if things get worse because they simply cannot see us today. It can be quite frustrating, because I'm the type of person who will wait until I think that the problem isn't going to clear up on it's own anyways, so when I say I want to get my child in, I've already waited it out and don't think I can wait any longer.

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Specializes in Emergency, Trauma, Critical Care.
I have what might be a stupid question, but are we sure there is a PCP shortage nationwide?

Or is it like this supposed "nursing shortage" we keep hearing about but now that I'm in nursing, I fail to find?

I just ask because I can get into my primary doctor the same day. And this is a somewhat rural area, not really known for its overflow of doctors.

You can get seen same day? I had to wait almost a month to see my PCP, for a simple thing as confirming I was pregnant and referring me to an OB. Throw in the fact that I am high-risk pregnancy. (Have a VSD among other things). I know that I'm definitely not a high enough priority to be seen the same day, but I thought 4 weeks was a bit excessive.

I might buy the shortage of PCP.

Here it takes an average to 2-4 weeks to be seen, and this is a fairly metro area.

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Specializes in Home Care.

There are fewer doctors in primary care because they're choosing to specialize in order to make more money. My pcp is retiring....I'm so sad, he was an old fashioned family practice doc.

As for the new reform, don't get excited...nothing is going to be in place anytime soon.

Oh...years ago when I was working in medical insurance claims, we'd deny ER visits for not being necessary. People got mad and laws were enacted to make the ins companies pay.

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