Comments on: The ER: One-stop shopping http://www.kevinmd.com/blog/2007/08/er-one-stop-shopping.html Tue, 14 Feb 2012 11:46:00 +0000 hourly 1 By: Michael Rack, MDhttp://www.kevinmd.com/blog/2007/08/er-one-stop-shopping.html#comment-79205 Michael Rack, MD Sat, 18 Aug 2007 20:27:00 +0000 http://clients.emmense.com/kevinmd/2007/08/the-er-one-stop-shopping.html#comment-79205 Well-insured patients go to the ER because ER's aim their adverstising towards them- "Fast-track" programs are aimed at well-insured patients with minor problems. Well-insured patients go to the ER because ER’s aim their adverstising towards them- “Fast-track” programs are aimed at well-insured patients with minor problems.

]]> By: Panda Bearhttp://www.kevinmd.com/blog/2007/08/er-one-stop-shopping.html#comment-79203 Panda Bear Sat, 18 Aug 2007 19:00:00 +0000 http://clients.emmense.com/kevinmd/2007/08/the-er-one-stop-shopping.html#comment-79203 The problem is that we are a terrifically over-doctored society which now does not have enough doctors, mid-levels, and nurses to go around. Not everything is an urgent medical problem...except that people believe it to be. Many of the problems we see are actually lifestyle problems more than anything else, as in, "Mr. Smith, your back hurts because you weigh 400 pounds and there's really not much more we can do for you unless you lose weight."<br/><br/>Or, "Mrs. Jones, you are on home oxygen because you smoked a pack a day for fifty years and, as you still insist on smoking there is no way you are ever going to feel better."<br/><br/>And we do still get a lot of freeloaders in our ED, that is, people who could afford to pay for a doctor's visit or even insurance but don't because we do, in fact, encourage inappropriate use of Emergency Services by giving them a way for free to everyone with no questions or even a co-pay required.<br/><br/>But as to the original point, subsidizing free care in the ED through EMTALA (or actually not subsidizing it directly but instead making everybody with insurance soak up a piece of it)causes everyone, including primary care physicians, to take more of it in classic economic behaviour. The problem is that we are a terrifically over-doctored society which now does not have enough doctors, mid-levels, and nurses to go around. Not everything is an urgent medical problem…except that people believe it to be. Many of the problems we see are actually lifestyle problems more than anything else, as in, “Mr. Smith, your back hurts because you weigh 400 pounds and there’s really not much more we can do for you unless you lose weight.”

Or, “Mrs. Jones, you are on home oxygen because you smoked a pack a day for fifty years and, as you still insist on smoking there is no way you are ever going to feel better.”

And we do still get a lot of freeloaders in our ED, that is, people who could afford to pay for a doctor’s visit or even insurance but don’t because we do, in fact, encourage inappropriate use of Emergency Services by giving them a way for free to everyone with no questions or even a co-pay required.

But as to the original point, subsidizing free care in the ED through EMTALA (or actually not subsidizing it directly but instead making everybody with insurance soak up a piece of it)causes everyone, including primary care physicians, to take more of it in classic economic behaviour.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/08/er-one-stop-shopping.html#comment-79200 Anonymous Sat, 18 Aug 2007 18:44:00 +0000 http://clients.emmense.com/kevinmd/2007/08/the-er-one-stop-shopping.html#comment-79200 What does this say about the "If you subsidize something, you get more of it" explanation?<br/><br/>So this phenomena is not the inevtiable consequence of the socialists giving poor people Medicaid/SCHIP coverage?<br/><br/>I am so confused. Did Michael Moore do this? What does this say about the “If you subsidize something, you get more of it” explanation?

So this phenomena is not the inevtiable consequence of the socialists giving poor people Medicaid/SCHIP coverage?

I am so confused. Did Michael Moore do this?

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