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Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients

Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients they believe cannot pay except in the case of a life-threatening emergency. What this means is that in the USA it's common for people to have to allow earlier-stage, less expensive to treat problems develop into serious problems before finally going into the ED to seek treatment. Which increases all of our health care costs overall. Not only does the problem that eventually gets treated end up being more expensive than it needed to be, but the place where the care is provided is also the most expensive option. And since they don't pay, health care providers are forced to raise everyone else's rates to cover the cost of this unnecessarily expensive care that they had to provide. Long story short, the range of things that health care providers have to treat is much wider in countries with more socialized systems than it is in the USA. And that is yet another reason why the USA has such enormously high health care costs despite providing poorer quality of care.

carbocation 14y ago
> Actually, it does refuse to treat people quite regularly. Let's not play with words like that. People in the US get treatment—you even say so later, despite your ominous lead sentence. They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about, not the (false) specter of non-treatment.
- potatolicious 14y ago
  > "They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about" You two aren't disagreeing. You say we should talk about the epidemic of people unable to afford primary care, pushing treatment later and later, eventually into the ER where they may not even be able to be saved - and even if they do, suffer long-term health effects due to the delay in treatment. And he's saying that this is because the system does refuse to treat people - especially at the primary care level. These two topics seem to line up just fine.
  - carbocation 14y ago
    Yes, that's why my point was to ask that we refrain from falsely hyperbolic statements (people don't get treatment) so we can focus on the myriad true problems that most agree exist, some of which you pointed out.
- revelation 14y ago
  Now thats playing with words. Do you really think the people on the ground in a US hospital are completely distanced and isolated from the costs that accrue once they admit someone without insurance?
  - carbocation 14y ago
    At my hospital it generally only affects placement after discharge, but I'm sure it's variable. My primary point was that while most things can be debated, it's absurd to claim that people don't get treated in the US.
cpleppert 14y ago
>>Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients they believe cannot pay except in the case of a life-threatening emergency. This isn't actually accurate at all. Hospitals with emergency departments must stabilize patients in an emergency. Thats it. The emergency room has no responsibility to treat the underlying cause. It isn't a loophole that people take advantage of because you still don't get treatment. I suppose you could show up to multiple emergency rooms and hope one treats you but that isn't something you do if you are chronically hurt. People who can't afford to get treatment or aren't on medicaid or charity care don't get treated period. You can test this by just comparing the emergency room rates in Massachusetts before and after coverage expansion. More people went to the emergency room once they had coverage than previously.
- bunderbunder 14y ago
  You're right, that's exactly the case. Sorry if I explained it poorly. The spot where this gets really fantastically expensive is when you get to the "wash, rinse, repeat" part of the situation. After all, someone who is just being stabilized and discharged without significant treatment of the underlying cause is much more likely to just get sick again. There's a hospital in the town where I grew up which managed to shave millions off of the cost of operating their emergency department in a rather instructive way: They identified their most expensive repeat patients, and started just paying to send them in for regular medical care for whatever health problems it was they had. Yeah it meant that they were giving out free health care to these folks, but that turned out to be nothing compared to the cost of having them show up in an ambulance every other week.

carbocation 14y ago

> Actually, it does refuse to treat people quite regularly. Let's not play with words like that. People in the US get treatment—you even say so later, despite your ominous lead sentence. They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about, not the (false) specter of non-treatment.

potatolicious 14y ago
> "They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about" You two aren't disagreeing. You say we should talk about the epidemic of people unable to afford primary care, pushing treatment later and later, eventually into the ER where they may not even be able to be saved - and even if they do, suffer long-term health effects due to the delay in treatment. And he's saying that this is because the system does refuse to treat people - especially at the primary care level. These two topics seem to line up just fine.
- carbocation 14y ago
  Yes, that's why my point was to ask that we refrain from falsely hyperbolic statements (people don't get treatment) so we can focus on the myriad true problems that most agree exist, some of which you pointed out.
revelation 14y ago
Now thats playing with words. Do you really think the people on the ground in a US hospital are completely distanced and isolated from the costs that accrue once they admit someone without insurance?
- carbocation 14y ago
  At my hospital it generally only affects placement after discharge, but I'm sure it's variable. My primary point was that while most things can be debated, it's absurd to claim that people don't get treated in the US.

cpleppert 14y ago

>>Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients they believe cannot pay except in the case of a life-threatening emergency. This isn't actually accurate at all. Hospitals with emergency departments must stabilize patients in an emergency. Thats it. The emergency room has no responsibility to treat the underlying cause. It isn't a loophole that people take advantage of because you still don't get treatment. I suppose you could show up to multiple emergency rooms and hope one treats you but that isn't something you do if you are chronically hurt. People who can't afford to get treatment or aren't on medicaid or charity care don't get treated period. You can test this by just comparing the emergency room rates in Massachusetts before and after coverage expansion. More people went to the emergency room once they had coverage than previously.

bunderbunder 14y ago
You're right, that's exactly the case. Sorry if I explained it poorly. The spot where this gets really fantastically expensive is when you get to the "wash, rinse, repeat" part of the situation. After all, someone who is just being stabilized and discharged without significant treatment of the underlying cause is much more likely to just get sick again. There's a hospital in the town where I grew up which managed to shave millions off of the cost of operating their emergency department in a rather instructive way: They identified their most expensive repeat patients, and started just paying to send them in for regular medical care for whatever health problems it was they had. Yeah it meant that they were giving out free health care to these folks, but that turned out to be nothing compared to the cost of having them show up in an ambulance every other week.