Emergency Rooms in America: A Deadly Prognosis

Discussion in 'The Club House' started by sculker, Mar 12, 2008.

  1. sculker

    sculker New Member

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    :mad:

    Emergency Rooms in America: A Deadly Prognosis
    Wednesday, March 12, 2008

    By Donald Snyder


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    In a crowded Arizona emergency room, a 10-year old boy struggles to breathe. He is having an asthma attack.

    Within 15 minutes, he is dead.

    Had he not been turned away from two children’s hospitals closer to his home, he might be alive.

    However, those ERs were too full to take the boy.

    “The boy might be alive today if he was treated at one of the children’s hospitals instead of the ambulance being diverted to my crowded emergency department 20 to 30 minutes away,” said a doctor who formerly worked in that emergency department, speaking on the condition of anonymity.

    The practice of diverting ambulances from overcrowded emergency rooms has become widespread — and the delay in treatment can have fatal consequences.

    Consider these overwhelming statistics:

    — One ambulance per minute is diverted — that’s 500,000 per year, according to the Institute of Medicine of the National Academies.

    — In 2000, Columbia University in New York City found that fatalities from heart attacks increased by as much as 47 percent as a result of diverting ambulances.

    — In Houston, Texas, the average rate of diversion was 14 percent in 2001. Today, the rate is 40 percent, said Dr. Guy Clifton, a professor of neurosurgery at the University of Texas in Houston.

    — Americans are using emergency rooms more than ever in today’s society. In 2005, 115 million Americans went to the ER, up five million from the year before, according to the Centers for Disease Control.

    — Between 1994 and 2004, there was a 20 percent increase in the demand for emergency care, according to the CDC, which is most likely due to an increase in the nations’ uninsured and growing elderly population.

    During those years, 9 percent of the nation’s ERs closed, having lost money from inadequate reimbursement, according to the CDC.

    — A recent Harvard study found the average waiting time for a patient to see a doctor in the ER jumped from 22 minutes in 1997 to 30 minutes in 2004. The same study showed patients with coronary episodes waited 8 minutes in 1997; in 2004, they waited 20 minutes.

    — Of 1,000 doctors polled by the American College of Emergency Physicians last year, 200 said they knew of a patient who died because of failure to deliver prompt care in an overcrowded emergency department.

    Combine these factors and the system is at a breaking point.

    Dr. Brian F. Keaton, chairman of the board of directors of the ACEP, practices emergency medicine in Akron, Ohio. His story illustrates the situation faced by many doctors.

    “I have people who come to my clinic with a headache caused by high blood pressure. I give them the medicine to bring the blood pressure down and a prescription,” Keaton said in an anguished tone.

    “Many of them don’t have the money to fill it. I have no place in the system to care for them until they end up back here with a stroke because they weren’t taking their medication.”

    Bellevue Hospital Center, the nation’s oldest public hospital, treats many of New York City’s disenfranchised residents. Few of these patients can afford private doctors.

    One night last February, a doctor moved effortlessly from one cubicle to another inside Bellevue’s emergency department; her voice rising above the din of frenzied activity.

    “He lives paycheck to paycheck and sometimes runs out of his heart medication and gets sick,” the doctor said about a distinguished-looking, white-haired man who sat on a bed, seemingly unfazed by the noise around him.

    The doctor moved on to another bed, where a sleeping man was covered by blankets to warm his cold body. She recorded his temperature and added two more blankets. He was found sleeping in a doorway in the bitter cold.

    This is a snapshot of an American emergency system in meltdown.

    “Today we have a crisis that we cannot continue to survive in,” said Dr. Linda Lawrence, president of the ACEP. “We often don’t have beds for emergency patients. We don’t have enough heart monitors to go around. The nursing staff is badly stretched. We’re at a breaking point.”

    One cause of emergency department gridlock is the practice known as “boarding.”

    Admitted patients are left in the emergency department for extended stays until hospital beds become available — and patient care suffers.

    “Studies show that patients are not receiving antibiotics on time when they have serious infections and that patients are not receiving adequate pain control,” Lawrence said.

    Robert Roth, a New York resident, wrote a letter to the New York Times about his mother’s boarding experience at an emergency room.

    “My mother, who is 89, recently had two extremely traumatic experiences in the emergency room,” he wrote. “One time she waited over 36 hours, the other time over 20 hours before they found a room for her. Both times she emotionally came apart and her condition dramatically deteriorated.”

    One possible solution is to create more public clinics for preventive care, which would reduce the use of emergency departments for routine visits.

    Bellevue has a large outpatient clinic, which treats 500,000 to 600,000 patients a year, said Dr. Lewis Goldfrank, chairman of emergency medicine at the hospital.

    “Every patient who comes to the emergency department is a failure of the public health system,” Goldfrank said. “Many of the patients have chronic diseases that are monitored and treated at the outpatient clinic.”

    The American College of Emergency Physicians supports Congressional passage of the Access to the Emergency Medical Services Act. This bill would recognize the need for more money to sustain an ailing system that must provide care to everyone, including those who can’t pay by creating a national bipartisan commission to examine the delivery of care in the nation’s emergency departments.

    The act also calls on the government to collect data on the widespread practice of boarding so that new guidelines can be applied. A vote on the bill is expected by April.

    “The system is sick and in danger of breaking,” Keaton said. “When it fails, it will be a catastrophic failure.”


    http://www.foxnews.com/story/0,2933,337295,00.html
     
  2. Righteous

    Righteous New Member

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    well ...hmmmmmmmmm.... let me see.... speaking of somebody that uses the ER alot nowdays and not cause I want to but because I have Congestive heart failure I've seen the good and bad of it, I seen alot of people wait beacuse they be just sick...flu...etc. But people like me soon as they see I have CHF theres no waiting, I am took back ASAP, they tend to take the life threating people first and if you got the flu I would expect to wait. I was not turned down once but left under pain for a gall bladder that erupted once all because the guards said I cant leave my truck parked in the ER lane and wanted me to go park it pain or no pain, I left and drove 30 min to another hospital where i dam near drove thru the door and the guard didnt say a word and parked my truck for me later. Think the problem lies where to many people go to the ER for something they dont need and just need to stay at home.
     

  3. allmons

    allmons New Member

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    You are so right, Mr Righteous!

    ER's are designed for the worst human problems, but we are just overwhelmed by the sheer volume of people who come to the ER for minor, clinic level problems.

    Hell, I can't believe people with the regular flu and colds go the ER for ANY reason. We have never been able to cure a viral infection and we still can't! All these people do is SPREAD the flippin' flu to the hundreds of people who are in the waiting area.

    If they are dehydrated or can't control a fever ( by the way, if a fever isn't over 101.5, we don't usually treat it - it helps the body chase out the virus! ) or there is any respiratory difficulty, then the ED is the place for you (after hours). See your doctor or clinic in the daytime, however, to keep some pressure off the ER's.

    Lastly, be aware that ER's see many patients that you don't know about. My ER gets all the county DOA's to process and place in the morgue. Our living patients rarely know these bodies are even there. Every ER has multiple entrances, and there is no way the public can know who all comes in for treatment. Then there are the multitude of poor and illegals who use ER's for ALL of their healthcare ( including child birth! ).

    Righteous, ER's were built and designed for people who have serious problems, like yourself. You should be seen first. Hope your condition improves, my friend. And for goodness' sakes, take your medicines as prescribed!

    ;)
     
  4. MarkoPo

    MarkoPo New Member

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    As a registered nurse I can attest to this problem. Like mentioned above ER overcrowding is partly due to non-critical cases being seen by ER docs. I don't want ot de-rail this thread but I see the biggest problem coming from people with Medicaid or no insurance. They use the ER because it is free and an office visit would cost them $25.00. This is one reason I am against socialized medicine. A hospital has to see a patient no matte their ability to pay. Doctors on the other hand can turn patients away from their office if they owe money. The hospital I work at made it a policy to ask for the co-pay if any before being seen. This had reduced the load of or ER slightly.
     
  5. nancy97056

    nancy97056 New Member

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    Winchester 20 gauge

    I'm brand new to this web site. I just inherited a Winchester 20 gauge double barrel shotgun. It is Model 24, Serial #26391. How do I find ou the history of this gun, and how can I value it for insurance purposes? HELP!
     
  6. hillbilly68

    hillbilly68 New Member

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    Again, no one is willing to take responsibility or consider the second and third order effects of their self centered behavior. ERs are for emergencies like the man said. Think its bad now, wait until "universal" health scam is implemented. Better get that MD you have been putting off for so long.
     
  7. Boris

    Boris New Member

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    There is to be expected to be some delay at ER notwithstanding, by virtue of the triage etc., I do not understand your arguement against socialized medicine, I have called medical services in the US a couple of times and I spent more time explaining how the bill was going to be paid before being treated! I was stiched up with a knife wound in my side in Nairobi one year and it was free......... I attended an ER in Anson, Texas with an infection in my gum, doctor looked at it (approximately 2 minutes 30 seconds), the bill was $123......14 tablets at $94, give me national health care anytime.....
     
  8. hillbilly68

    hillbilly68 New Member

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    Thought it would be clear, I guess further background is necessary. I and our friend from above Mark appear to be capitalists, not s*******ts. Think the system is overcrowded and underfunded now? Just consider the "free" medical care if it comes. Yes there are flaws in the system, I agree. But it is the best care money can buy. How many doctors are going to dig themselves into debt to become hostage to a national system? The medical community is operating at a shortage as it is, it would only become worse. We have successfully bankrupted S.Security for our offspring, how long would it take to bankrupt a national healthcare system? Who pays? We do. Another step toward destroying the middle class. Not to get off the subject of the original thread, but it is relevant to the point. SEN Davy Crockett once delivered an excellent speech on the temptation of the leadership to tap into the national treasury to provide assistance. The speech is titled "Not Ours to Give". No Sir, anything "socialized" can go elsewhere.
     
    Last edited: Mar 13, 2008
  9. Boris

    Boris New Member

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    I would hold your judgement until you experience it. You already paid as much in taxes as we do, the problem is you have no idea where yours is spent! We I lived over there, although for only a short time I was amazed at the double taxation, and no one I ever asked knew where it went. Most of the country roads where dirt, and in the town I lived in there where only four paved roads.

    I am a conservative, but as I have said in the past there is not a conservative politician anywhere over here that would even consider attacking the national health system. He simply wouldn't get elected, the care is some of the best in the world, and we are rightly proud that care is free to all at the point of need.
     
  10. Samhain

    Samhain New Member

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    Davy Crockett speech

    http://www.pointsouth.com/csanet/greatmen/crockett/crocket2.htm
     
  11. hillbilly68

    hillbilly68 New Member

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    I have experienced it, fairly arrogant of you to assume me to be uninformed and inexperienced. I make no such judgment of you, I only offer an opinion based on my experience and research, my assumption is you are doing the same. Also, arrogant of you to say that I don't know where my tax dollars go. I do know where my tax dollars go (at least the released values published by our government) and I am very disturbed when I see what is slipped into the budget lines. I could care less about the indigo snake or his protection funded by my tax dollars. I do care about the amount of fraud that is in the welfare, social security and medicare system. If you refer to the "double tax" as being the income, sales, and property tax (to be accurate, we are actually taxed more than twice in some cases) you are correct. I only hope that others share my frustration with seeing our money being given away to others that have no intent of contributing to our society. I have no issue with helping someone when they are down, but we have not the backbone politically to say "no more, you are a drain on society, we have given you chances and you have wasted them all." Once we kick the door open for another "freebie" the quality of our health care will begin to circle the toliet bowl. Do I think everyone should have access to health care? Absolutely, no question in my mind. We are out of money, the well is dry. Socialized in my country? To put it as succinctly as possible..hell no.
     
  12. kirby62

    kirby62 New Member

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    I'm new so i'm not trying to make emenies. I can see both sides of this health problem. socialized meds would be great but nobody wants to pay for it. I spend alot of the winter months in Canada and the health care is good but the taxes there are horrible. it makes life hard for anyone that is not rich. The people that are clogging up the ER need to get on medical assistance. it's free (our tax dollars) well sort of.. they just need to get off their butts and do the paperwork. I am sorry this is going to make people mad but think about this. We need leaders that put our best interests first ie Ron Paul. So we can raise taxes to provide for people who can't. I know everyone could shell out more for taxes if they knew it was worth it
     
  13. MarkoPo

    MarkoPo New Member

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    Mr. Boris my biggest problem with socialized healthcare is exactly what you are talking about I will try to break this up into two parts so you can understand my point more clearly. First you said your ER bill was $123.00 and 14 pills $94.00. First those were YOUR charges. In socialized healthcare my tax dollars would pay for anyone who walks through the door of the ER. I feel that is your responsibility to be fiancially responsible for your bills. If I go to the doctor I fully expect to pay his fee or I don't go. I would never expect my neighbor to pay my bill. I don't hold anyone more accountable than myself. If you rack up a bill pay it. Simple right?
    Secondly the cost of healthcare and drugs. The hospital you went to didn't make a fortune off your visit. The doctors make around $200 an hour to work ER. You have to pay the nurses at about $30.00 an hour and all the support staff, like X-ray, respiratory, lab, even housekeeping. If you regulate the cost of treatment, you will effective drive some medical staff to seek employment in other fields. I can't afford a pay cut can you? How many people are going to pursue medical school knowing they will be indebt close to half a million dollars when they graduate, if they can't make the big bucks? As far a prescription drug cost go, look at what it cost to develop a single drug. Usually upwards of 10 million dollars and usually 15 to 20 years per drug! If you mandate lower drug costs how many new drugs do you think will be developed? You would think it was wrong to put a profit limit on any free enterprise business right? Why should drug companies be any different? The American government is making over .50 cent per gallon of gas sold in this country. There are no politicians demanding lowering gas tax or OPEC to lower the cost. This would be unethical. I hate paying $3.43 for a gallon of gas, but even the oil companies have a right to make a profit. If you restrict drug companies you are just putting a demise on the future delelopments of new drugs. Money is an incentive to all things great. I value my job as a registered nurse, and I don't think the goverment has any business in the private sector to begin with. There is nothing in the constitution that guarentees health insurance. The only 2 jobs of the government are to defend this nation and protect and follow the constitution, and it is the President's job to make sure the government does their job. If this was followed we wouldn't be arguing of what to do with my tax dollars.
     
    Last edited: Mar 13, 2008
  14. Boris

    Boris New Member

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    I have no way to convince you that this neo conserative propoganda is incorrect, but the inflated cost of your medical care is due completely because you are all at the mercy of self intersted parties. In a civilized country in the 21st. century are you telling me that health care for it's people should be totally placed in the hands of insurance companies whose sole motorvation is the profit for the shareholders, in drug companies that are in a position to charges what they like for their product?

    You know and I know that there are a large proportion of the population who are good hard working people but for one reason or another, usually poor wages and conditions of service, have no health care. In the event that you have to resort to your health care provider, will they stand for all these inflated medical bills? If you have a serious existing medical condition will you be able to afford the medical care you deserve?

    Health care is the state of the nation, and should be free at point of need.............

    It's alright spouting that the goverment has only two duties, the protection of the consititution and the defence of the country, it's neo-conservative rubbish. You are paying huge amounts in tax and you have no idea where it is going, I truely hope that you are and remain in good health, otherwise you will be handed over to the money grabbing self interested parties.

    Oh by the way it's just Boris, no need for the attitude pal..........
     
  15. kris

    kris New Member

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    health care

    marcopo. in aust i have to pay $500 per year as an earning adult ,because i earn over $50000 a year i have to pay an extra $500 to qualify for medicare. this allows me to access free health care at hospitals or doctors offices. this includes all treatment and drugs. if a doctor writes a prescription for medicine from his office it will cost a maximum of $28.00. even if more than one medicine required. wife has had two kids in public hospitals 3 days stay each time,obgyn and midwife all free. any civilised country should have universal healthcare!!!!!
     
  16. hillbilly68

    hillbilly68 New Member

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    First, it isn't "free". That is what you cannot seem to grasp. Do you think that a company out of the goodness of its heart will simply donate meds and equipment for the good of mankind? If they did, they wouldn't be around long to do so anyway. Free? C'mon. What you mean is it is free to those who do not contribute to the system. Do I drive on the roads in my country for free? No. I pay a large fuel tax in order to use them. The list goes on. Talk about not knowing where the money goes or comes from. Someone will pay for it.

    Secondly, the "neo conservative rubbish" comment about my Country and her Constitution...well you lost your say on that one in 1776.
     
  17. jeepcreep927

    jeepcreep927 New Member

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    Apparently free is a "relative" term. It's "free" to those who don't contribute. I see perfect examples of what people who don't contribute consider "free". 21 year old guys who willingly accept EBT(electronic version of foodstamps) just because they don't have a job despite being able bodied. Yet they wear $50 jeans and $150 sneakers. It's easy to drive a brand new $25,000 car when your housing is either state owned or subsidized, you don't pay for food and you don't pay for health care and the state pays the heating bill all winter. And I wonder why my taxes go up every year if this stuff is "free". Well stated Hillbilly.
     
    Last edited: Mar 15, 2008
  18. Boris

    Boris New Member

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    The subject was healthcare, not welfare, if you guys can not grasp the point we have been trying to make than thats OK..... I have no idea of the point you are making, the concept is 'Free to all at the point of need', in other words if you are a legal resident, and a national of the country you reside, then working people contribute through their taxes, and if you need to seek medical assistance it is provided. The care is as good as anywhere in the world and better than most.

    No shortfall in insurance cover putting your home at risk, no one is denied medical cover because of an exsisting medical problem, or because they are disadvantaged as they have been born in some way disabled..... If you can't grasp the concept that's fine...... It works, it's fair and my taxes are no more than yours overall, being concervative does not mean uncaring, or selfish...:)
     
  19. jeepcreep927

    jeepcreep927 New Member

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    I realize it's not the same benefit, for lack of a better term, but it perpetuates the latter.
     
  20. MarkoPo

    MarkoPo New Member

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    Coud you please define self interested parties for me here? Do you me the insurance companies or the institutions that have to charge just to keep the doors open?

    Yes that is exactly what I am saying. The government doesn't develop and manufacture drugs, they are made by independently owned companies, which many do have share holders. In America, businesses are responsible to their shareolders first, consmers (you and I) second.

    That is a common misconception here. Everyone in this country has healthcare available to them. Yes I am fortunate, I have a good job with some of the best health insurance available; I work in a hospital. There is already a lot of free and reduced fee services in this country. The VA for example will treat vetreans of the military. Oh, I also work for a drug and alcohol rehabilitation facility. We have many clients who have no insurance, no job, no money. We provide them with free medication, free housing, and free psychiatric services. I give away thousands of dollars worth of psychotropic medications a week.

    I don't understand your point about healthcare being in the state of the nation, it's not a right by any means. If you mean it should be free, do you mean free to you or free to me? If the goverment pays the bill, that is my tax dollars, so it is far from free to me. I am all for individual rights. You pay for yours, I'll pay for mine. If you call that neo-conseratism I guess that's what I am. I appreciate the gesture that I remain in good health, as do I hope your health is well also. Yes I pay a lot of taxes, I think my wife and I paid around $15,000 last year in taxes. I know a lot of it goes to support social welfare, the overpopulation of prisons, funding the defense of our great nation, and paying the members of Congress. As far as calling you Mister, that was by no means to disrespect you. I applogize if it conveyed an attitude in your eyes.
     
    Last edited: Mar 15, 2008