3 ms·

Where to start... 1. Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will rec

Where to start... 1. Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working. 2. Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't. 3. Instead they pass the buck and say "figure it out" to the private industry. 4. Hospitals are squeaking by largely flopping duties on nurses, making their jobs far less enjoyable (wrangling entitled individuals instead of healing people and providing care), and charing double-triple to responsible individuals who will pay for themselves. 5. E.R.s are now becoming "primary care" for large majority of the US population, as they show up, then disappear knowing they won't be stuck with a bill. 6. Members of Congress literally don't give a crap about "common folk" and go on golfing and enjoying their free healthcare for life. Meanwhile commonfolk and the poorest of the poor don't get the same deal. One set of rules for peasants, one set of rules for the 1%.

deleted 4y ago
[deleted]
throwawayarnty 4y ago
I wonder how member of Congress justify that they need a special health care that is different from the public. It seems to make sense and align incentives to have members use the same public systems (eg transport, education, health, housing) as everyone else, otherwise they will never understand how their policies affect real people.
- dragonwriter 4y ago
  > I wonder how member of Congress justify that they need a special health care that is different from the public. There don't. Them not doing so is part of the ACA. Grandparent was just lying.
maxerickson 4y ago
EMTALA dates to the Reagan era¹ and applies to hospitals that have contractual agreements with the Federal government (ones that accept Medicare). What else in your analysis is terribly wrong? 1. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
dragonwriter 4y ago
> Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working. False. I mean, not only is this an exceptionally emotionally loaded description of EMTALA, it was adopted in 1986 which is not, even approximately, the mid-2010s. > Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't. Yet another set of independent physical infrastructure would be even less efficient. The multitude of separate payment and delivery systems is a major source of the US inefficiency > Instead they pass the buck and say "figure it out" to the private industry. No, instead they find hospitals that have a large share of uncovered patients through the Medicaid's Disproportionate Share Hospitals payments program. > E.R.s are now becoming "primary care" for large majority of the US population Some support for this “majority” claim would be welcome. > Members of Congress literally don't give a crap about "common folk" and go on golfing and enjoying their free healthcare for life. Under the ACA, members and staff of Congress don't have special government healthcare plans, they have access to plans they are required to have coverage through plans available to others created under the ACA including exchange plans.
- bpodgursky 4y ago
  > Yet another set of independent physical infrastructure would be even less efficient. I think this misses just how basic much of the care performed in an ER (which is oriented towards critical care for major problems) is. Duplicate infrastructure is OK when the use-cases are totally different. We need better urgent care clinics.
  - maxerickson 4y ago
    Urgent care should be a billing code at the ER. Pretty much the second they triage you out of immediate care, the separate facility and separate providers are increasing costs. Medical providers suffer under central planning and believe that moving low risk, high value care out of hospitals will make things cheaper. The thing that will make things cheaper is to figure out ways to directly make them cheaper.

deleted 4y ago

[deleted]

throwawayarnty 4y ago

I wonder how member of Congress justify that they need a special health care that is different from the public. It seems to make sense and align incentives to have members use the same public systems (eg transport, education, health, housing) as everyone else, otherwise they will never understand how their policies affect real people.

dragonwriter 4y ago
> I wonder how member of Congress justify that they need a special health care that is different from the public. There don't. Them not doing so is part of the ACA. Grandparent was just lying.

maxerickson 4y ago

EMTALA dates to the Reagan era¹ and applies to hospitals that have contractual agreements with the Federal government (ones that accept Medicare). What else in your analysis is terribly wrong? 1. https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...

dragonwriter 4y ago

> Somehow in the mid-2010s congress decided that anyway that walks onto private property, demands care from a private organization, will receive it, even if they declare they will not pay a dime to the staff working. False. I mean, not only is this an exceptionally emotionally loaded description of EMTALA, it was adopted in 1986 which is not, even approximately, the mid-2010s. > Congress could have totally create/build a system of hospitals that provides "one time care" for those people, but doesn't. Yet another set of independent physical infrastructure would be even less efficient. The multitude of separate payment and delivery systems is a major source of the US inefficiency > Instead they pass the buck and say "figure it out" to the private industry. No, instead they find hospitals that have a large share of uncovered patients through the Medicaid's Disproportionate Share Hospitals payments program. > E.R.s are now becoming "primary care" for large majority of the US population Some support for this “majority” claim would be welcome. > Members of Congress literally don't give a crap about "common folk" and go on golfing and enjoying their free healthcare for life. Under the ACA, members and staff of Congress don't have special government healthcare plans, they have access to plans they are required to have coverage through plans available to others created under the ACA including exchange plans.

bpodgursky 4y ago
> Yet another set of independent physical infrastructure would be even less efficient. I think this misses just how basic much of the care performed in an ER (which is oriented towards critical care for major problems) is. Duplicate infrastructure is OK when the use-cases are totally different. We need better urgent care clinics.
- maxerickson 4y ago
  Urgent care should be a billing code at the ER. Pretty much the second they triage you out of immediate care, the separate facility and separate providers are increasing costs. Medical providers suffer under central planning and believe that moving low risk, high value care out of hospitals will make things cheaper. The thing that will make things cheaper is to figure out ways to directly make them cheaper.