Romney- Free Care for the Uninsured at Emergency Rooms!

[two-blocked]

Finally, a better plan than Obamacare!
 
Mitt Romney, On 60 Minutes, Cites Emergency Room As Health Care Option For Uninsured
 
WASHINGTON -- Downplaying the need for the government to ensure that every person has health insurance, Mitt Romney on Sunday suggested that emergency room care suffices as a substitute for the uninsured.
"Well, we do provide care for people who don't have insurance," he said in an interview with Scott Pelley of CBS's "60 Minutes" that aired Sunday night. "If someone has a heart attack, they don't sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care."
This constitutes a dramatic reversal in position for Romney, who passed a universal health care law in Massachusetts, in part, to eliminate the costs incurred when the uninsured show up in emergency rooms for care. Indeed, in both his book and in high-profile interviews during the campaign, Romney has touted his achievement in stamping out these inefficiencies while arguing that the same thing should be done at the national level.
And while Romney refused to agree on Sunday that the government's role is to ensure that every American has health care, he has endorsed such an idea in the past.
When asked in a March 2010 interview on MSNBC's "Morning Joe" whether he believes in universal coverage, Romney said, "Oh, sure."
"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way," he said.
 
http://www.huffingtonpost.com/2012/09/23/mitt-romney-60-minutes-health-care_n_1908129.html

[SwampThing762]

two-blocked,

This option for health care for the uninsured has been around for years -- a piece of federal legislation called EMTALA.  IIRC, it was signed by president Reagan.  It essentially requires providers to provide stabilization care and medical treatment to anyone that comes into the ER, regardless of ability to pay for services.   The word has also gotten out that people who come to the ER for services cannot legally be compelled to pay for those services; thus, the people get free healthcare and the hospitals eat the cost of that treatment.  I believe Romney attempted to address that issue with Romneycare.    These nonreimbursed costs of care are the single largest driver of healthcare costs.

If Americans are serious about healthcare reform, a serious examination of EMTALA must be performed, tort reforms must be enacted, as well as reform of the Debt Collection Practices Act, as well as the Fair Credit Reporting Act.   

If providers have the means of actually recovering some of their costs from deadbeat debtors, and protection from lawyer-lottery civil suits, healthcare costs would actually come down.

ST762

[powderman]

Nothing really new except it might include Americans. Criminal invaders have been getting free care for many years now thanks once again to liberals. Not available to Americans though, we still get billed. Next heart attack I'll register as pancho garcia. POWDERMAN. 

[ironglow]

  That rule has been in effect for many years.. Obama had everything his own way for 2 full years and did nothing about it.. Besides, what should one do..cut injured people off and toss them out of emergency rooms?
 
  The following clip was the last paragraph in your opening post:
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When asked in a March 2010 interview on MSNBC's "Morning Joe" whether he believes in universal coverage, Romney said, "Oh, sure."
"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way," he said.
'''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''''
  Do you find something wrong with what Romney said there?

[Swampman]

Nothing new and one of the reasons we don't need Obamacare.

[muznut 54]

I remember Mitt the Bankster a few weeks ago when his polls were down ( But what else is new) saying on the news that he was going to keep some of Obama's healthcare. Now he's flipping again saying the first thing he will do is get rid of it?

[ChungDoQuan]

Yeah, GW had the same theory. What they don't tell you, is the ER HAS to treat you, BUT the ER docs decide who's next. And, if you're not squirting blood or brought in on an ambulance, it ain't you. Non-emergencies will wait until the docs have down time. If you work in an ER, you know that's a joke--- it's not unheard of to wait over 50 hours to see a doc in the ER. I guess that's OK, if you're homeless and don't have anything else to do... Just remember THEY get to say what's an emergency, not you, and first come first serve is non existent.

[blind ear]

The rule is already causing small and rural hospitals to close thier emergency rooms. ear

Edit: The old rule, not the new one. ear

[Swampman]

Still voting for Mitt no matter what and I don't even like him.

[lakota]

Yeah, GW had the same theory. What they don't tell you, is the ER HAS to treat you, BUT the ER docs decide who's next. And, if you're not squirting blood or brought in on an ambulance...

Yes I believe that concept is called TRIAGE. Those who are the sickest or most severely injured will be treated first. Its a universal standard in emergency care and not some republican boogey man. Perhaps you should look it up!

it's not unheard of to wait over 50 hours to see a doc in the ER.  Just remember THEY get to say what's an emergency, not you, and first come first serve is non existent.

I've worked in ER's and also as a pre-hospital care provider. This statement is an outright fallacy unless of course you are talking about an ER in a counrty that has government run health care. First come first served is non existent in an ER as it should be.
 It's an emergency department not your neighborhood free clinic. If you  call 911 at 0300 hrs and demand a ride to the ER  because your toe hurts(yes it happens!) then you should expect to play 2nd fiddle to cardiac patients and trauma patients. "THEY" as you call the ER staff does get to decide whats an emergency and whats not and not you because THEY have the training and knowledge of triage practices not you.

[ChungDoQuan]

Since placing the patients waiting in the ER is part of my job, I KNOW how long non-emergencies wait. It can be Days. Oh, the 50+ hours is AFTER the bed request gets put in--- sometimes they wait a day or two before the request. Oh, yes, I DO triage on occasion, just to help out.

[Swampman]

I see no problem with that.

[lakota]

Oh, the 50+ hours is AFTER the bed request gets put in

Quote from: ChungDoQuan on Today at 10:49:14 AM

"it's not unheard of to wait over 50 hours to see a doc in the ER. "

A bed request wouldnt be put in until AFTER a patient was seen by  doctor. So what is it? A 50+ hour wait  to be seen by a doctor or not? You just said it was a 50+ hour wait to see the ER doc. Now you are saying its a 50+ hour wait to be taken to a floor after being seen in by a doc in the ER and admitted. So which is it? It's not the republicans' fault that all of the hospital's beds are full.I have never seen a person wait 50+ hours to see a doc even in a busy inner-city ER non emergency or not.

[ChungDoQuan]

If they're non-emergent, they often see a PA or NP, then wait for the doc to sign off on them. Trust me, the docs do not get in a hurry to do paperwork. Problem is, the regulations are being questioned right now as to whether a mid level provider counts as "seeing a doctor." There are also questions as to whether the ERs can send the Goomers (Get-out-of-my-ERs) to a clinic instead. The Obamacare law will make that possible, but until all the law kicks in, a lot of things are unclear.

[ChungDoQuan]

People are going to start dying. We have had situations where we were so full the A and B trauma teams were stuck in the ORs, maintaining patients while we downgraded and moved other patients to make room for their traumas in the ICUs. The A team is headed by the trauma attending; if there is a second trauma at the same time, the B team is headed by the trauma chief resident. The general surgery resident runs the C team. So, basically, if they are all tied up and you are the 4th or 5th trauma, (one vanload can also do this) you are SOL. Sure, there are contingency plans--- if you live long enough. Hospitals everywhere in this countries are dangerous places to need.

[magooch]

Some problems are never going to have a solution that fits everyone's idea of what is humane, affordable and right, but economics will probably dictate the logical end if nothing else comes along. 
 
I abhor the idea of govenment mandating that everyone purchase insurance, so I'm good with members only HMOs.  This works fairly well in areas that have a plethora of hospitals, but probably not in sparsely populated areas.  My wife's sister is a nurse in a small town hospital and it's interesting how they deal with folks who attempt to use the emergency room for their primary care.  By law they cannot deny care, but they've figured out a way to discourage the deadbeats.  I don't remember all the details, but it works for them.
 
Logically, why should a very wealthy person have to buy insurance of any kind?  It's very simple; if you allow an exception for wealth, the door is open for any number of exceptions and then the whole idea of universal coverage is blown. 
 
I wonder if more people would buy insurance if they knew for sure they would get no treatment without insurance, or the ability to pay out of pocket and if that would get more people covered than this convoluted federal government scheme we're facing.  We already have Medicaid to cover the really poor and that doesn't really change under any plan.
 
The one sure thing is that what Obama told us about being able to keep the plan you're on if you like it was at best a gross misstatement and more likely a flat out lie.

[ironglow]

People are going to start dying. We have had situations where we were so full the A and B trauma teams were stuck in the ORs, maintaining patients while we downgraded and moved other patients to make room for their traumas in the ICUs. The A team is headed by the trauma attending; if there is a second trauma at the same time, the B team is headed by the trauma chief resident. The general surgery resident runs the C team. So, basically, if they are all tied up and you are the 4th or 5th trauma, (one vanload can also do this) you are SOL. Sure, there are contingency plans--- if you live long enough. Hospitals everywhere in this countries are dangerous places to need.

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
  So where do you live?  Do you have frequent plane crashes, train crashes,  hotel fires or continual bus rollovers?  How often are you faced with overflowing trauma units?  In what way would Obama's socialized medicine help those sudden tidal wave trauma situations?
  Europe made the mistake of going socialist years ago..and now, after several decades of that mistake..Europeans are burning their own house down:  http://www.youtube.com/watch?v=BOAU395mfJw     
   That goes for socialized medicine also:  http://frontpagemag.com/2012/arnold-ahlert/why-the-uk-is-ditching-socialized-medicine/
 
  Now Obama wants to lead us down the same 'primrose path' to destruction..... and if re-elected he will do it!

[lakota]

In large busy hospitals critical cases are kept in ER or ER hallways until a room can be found for them...not pretty.
.
...TM7

Pretty or not the ER is still a critical care unit and can handle these patients. Obama care will not remedy this situation it will only exacerbate it.
 

If they're non-emergent, they often see a PA or NP, then wait for the doc to sign off on them. Trust me, the docs do not get in a hurry to do paperwork. Problem is, the regulations are being questioned right now as to whether a mid level provider counts as "seeing a doctor." There are also questions as to whether the ERs can send the Goomers (Get-out-of-my-ERs) to a clinic instead. The Obamacare law will make that possible, but until all the law kicks in, a lot of things are unclear.

So whats the problem with seeing an NP or a PA? Chances are they both probably have more healthcare experience than the doctor on duty because they already had years of experience before they ascended to those positions. Obama care will not remedy doctor shortages or bed shortages it will only exacerbate them.
 
 

[SwampThing762]

Obamacare does absolutely nothing to address the costs of healthcare.  In fact, Obamacare will increase healthcare costs because Komisar Obamavich has provided the framework for employers to drop healthcare coverage as a benefit of employment.    That will create self-pay patients who will flood the ERs, they must be treated under EMTALA, and there is no legal mechanism to collect any means of payment from them.

Also, CDQ, physicians have a specified timeframe to get a patient into a bed once an admission (obs or ip) decision is made.  Those are HHS regulations.  Thus, your 50+ hours to see a patient assertion is ridiculous.

ST762

[ChungDoQuan]

Some of y'all been out of the country awhile? The ERs are already flooded with uninsured people, mainly the poor and homeless, but there are many people who are able to pay, or at least able to pay for insurance who have figured out how to work the system.  And, EMTALA or not, physically full is physically full; ie, no beds. The mandate to pay will at least get some money from the ones that could pay and won't, and universal coverage will allow coverage for homeless and poor people at the clinic level, where the cost is about 25% of an ER visit. What Obamacare does is cut the cost for those visits from a $200 minimum to about $50. Which way do you want your tax money spent? Right now, you are paying the $200 with no alternative, because, those uninsured people are still coming to the ER, one way or the other. The hospitals have to make up for that by charging you more for their services, which means your insurance, if you have it, goes up, too. A society is not every man for himself. Even if it were, what's going to protect you from the diseases carried by millions of people without health care? Are you just not going to walk on the same sidewalks, not breathe the same air.

[magooch]

The question is: Was it necessary to fix what wasn't broken for many of us who were quite happy with the program we were on?  The very first consideration should have been to do no harm to what was working for the majority.  The last thing this country needs is a redistribution of services and benefits that so many of us have worked and paid for, just so those who either have been unlucky, or failed to do the right thing are rewarded.
If the intent of universal health care coverage were to prevent the spread of disease, it could certainly be done much simpler and more cost effectively than the plan in question (obamacare).