Where Did Healthcare Go?

funinsun · Nov 21, 2007

The state of affairs is shocking I do agree. Working in mental health-from chronic adults to eating disorder patients-you will see the scenario from the documentary repeated daily many times over. I believe I know which film you are referring to.

Eating disorder treatment facilities in particular are notoriously expensive and they are lucky to even spend half of the time needed in inpatient treatment. I know families that have re-morgtaged, sold everything to self-pay to keep their relatives in these facilities past the insurance stipulation. Unfortunately the gravity of eating disorders has not really hit the national consciousness yet and not well understood.

Many those with mental illness are only allotted so many days in inpatient facilities due to the 'deinstitutionalization' trend from the 90's.. When they no longer meet criteria (aren't acting out, hurting staff, expressing SI/HI, etc.) they are sent out-hopefully with services. Unfortunately if they are masking their symptoms, know how to work the system, etc. even with a history that should warrant a longer stay go right back out b/c insurance won't allow more.. With Substance abuse/psych patients in particular when they are released there is a higher likelihood to commit crimes, go to jail multiple times and end up being paid for by the tax payers dollar to be housed there and receive little effective treatment-only to be readmitted again to the inpatient facility again! I think this ends up costing the insurance more money than to let allot them days (when really needed of course).

Kyrshamarks, BSN, RN · Nov 21, 2007

I long for the days when healthcare was given to those who needed it regardless of thier financial situation.
My husband and I watched a documentary last night about women with eating disorders. They were admitted to a rehab center and were discharged when their insurance ran out, not when they were rehabilitated.
I was furious. Is it completely impossible to rage against the machine and treat patients until they are well, regardless of their financial situation?
My heart aches for those who do not get the care they need.

And what days are those? In the past if you did not have the money you did not get treated...at all. History ( near present and ancient.....are full of expamples of people dying due to not being able to go to the doctor or hospital) Nowadays people show up at the ER door they will get treated not to the extent that you may feel that you want them to have but they will get treated

Multicollinearity, BSN, RN · Nov 21, 2007

I was furious. Is it completely impossible to rage against the machine and treat patients until they are well, regardless of their financial situation?

If facilities continued to treat patients even after their coverage ran out, the treatment facilities would close their doors from going bankrupt. Then nobody would get any help.

When you say "rage against the machine" are you referring to the hopsitals or the insurance companies? I'd rage against the system myself, and not the players in the flawed system.

DTCC PreRN · Nov 21, 2007

And what days are those? In the past if you did not have the money you did not get treated...at all. History ( near present and ancient.....are full of expamples of people dying due to not being able to go to the doctor or hospital) Nowadays people show up at the ER door they will get treated not to the extent that you may feel that you want them to have but they will get treated

History and present. A few examples that come to mind are:

Gesundheit Institute http://www.patchadams.org/home.htm

St. Jude Children's Research Hospital - http://www.stjude.org

La Casa Sollievo della Speranza - Founded by St. Padre Pio, Italy

The Clinic For Special Children - http://www.clinicforspecialchildren.org/Welcome.html

I'm thankful that places like these are in operation. It gives me hope.

DTCC PreRN · Nov 21, 2007

If facilities continued to treat patients even after their coverage ran out, the treatment facilities would close their doors from going bankrupt. Then nobody would get any help.
When you say "rage against the machine" are you referring to the hopsitals or the insurance companies? I'd rage against the system myself, and not the players in the flawed system.

I totally agree. I'm angry with the insurance companies.

Multicollinearity, BSN, RN · Nov 21, 2007

I totally agree. I'm angry with the insurance companies.

Then we don't really agree. I'm frustrated with the entire flawed system of health care financing in the United States, not the individual players in that system - the providers and the insurance companies. Why blame the insurance companies for full-filling their roles in the system? And if the insurance companies provided unlimited care to everyone who needed it, they'd be out of business just like a hospital would be for providing care without reimbursement. Look at the larger picture, the entire system of health-care financing.

Also, it might be a glass half-full/empty type of thing here, as well. At least these patients are getting some treatment targeted at their actual eating disorder. Decades ago, they'd be diagnosed with some general 'hysteria' or nothing at all - and then possibly die.

My mom suffered from anorexia for much of her adult life. She never got the kind of treatment that exists now. She actually does well now, despite that.

ktliz · Nov 21, 2007

Just curious... dtcc preRN, was the documentary you watched "Thin"?

EmmaG, RN · Nov 21, 2007

Nowadays people show up at the ER door they will get treated not to the extent that you may feel that you want them to have but they will get treated

ERs are not required to treat unless the patient is deemed to have an "emergency medical condition".

ready4crna? · Nov 21, 2007

History and present. A few examples that come to mind are:
Gesundheit Institute http://www.patchadams.org/home.htm
St. Jude Children's Research Hospital - http://www.stjude.org
La Casa Sollievo della Speranza - Founded by St. Padre Pio, Italy
The Clinic For Special Children - http://www.clinicforspecialchildren.org/Welcome.html
I'm thankful that places like these are in operation. It gives me hope.

You also forgot shriner's hospitals and the VA hospital system for "free care". However, all of the organizations are not truly "free", conditions are placed on anyone wanting to use these examples. You must be a child with certain conditions to qualify for "free" care in most of the places you listed. The closest is patch adams' gesundheit institute that requires/requests in-kind donations for care. "Free" is in quotes above because sombody is paying the bills (facility, physician, nursing, pharmacy, etc.) in every organization you have listed, usually generous donations from people who are working hard for the money they give.

Quality Healthcare has never been free. Kyrsha is right. Even in countries that allow access to all, costs are paid for by the respective societies in which they exist and services are denied on a more frequent basis than in the US. Care without compensation is a utopian dream that has never existed. I am all for helping my fellow man, I volunteer frequently, BUT I also have a family to feed. My services are valuable, as are yours. The problem with the healthcare system is that too many people expect services as an entitlement. I think if one is blessed enough to give they should, but don't make me pay for the three hundred pound,heroin addicted, type 2 DM going in for his third CABG (on disability for extreme obesity).

DTCC- while I know you have not yet experienced the full wonder of the current medical system. The reality of it is this- it is broken from overuse-(see above example). You want money to pay for people in psych treatment? Deny care to the trauma patient who just killed a family of four after having "2 beers". Simple solution which will not sit well with some of my peers. (Disclaimer- yes I know it is unethical, but be intellectually honest- the money saved would easily pay for three months of inpatient psych.) :devil:

And now.... Let the flames begin.

elkpark · Nov 21, 2007

ERs are not required to treat unless the patient is deemed to have an "emergency medical condition".

And they are not even really required to "treat," only to "stabilize." Could be a big difference ...

And they are certainly not required to treat for free -- you still end up with a huge bill.

CRNA2007 · Nov 22, 2007

people might end up with a huge bill, but many simply do not pay the bill.

And they are not even really required to "treat," only to "stabilize." Could be a big difference ...
And they are certainly not required to treat for free -- you still end up with a huge bill.