Free healthcare.

[Moses]

I don't intend this as a rant, but since healthcare has been actively discussed here on the board recently I thought I'd give you a peek into my last 24 hours.

Last night an 18 year old undocumented immigrant came to our local hospital thinking she might be in premature labor. (she was right). She does not work. She has visited our hospital 6 times in the last year. She uses a different name and address each time. Although she was offered MediCal insurance for this pregnancy, she would rather not deliver her baby in Oakland (I can understand that. I was born there.) So instead, she just drops into our local suburban hospital to get her free healthcare.

State and hospital regulations require that I get out of bed to evaluate the patient and get her admitted to the hospital. So I didn't sleep last night. I was busy writing a medical history and documenting a physical examination, ordering ultrasound and blood work and monitoring the patient and her pre-term baby.

At 2 AM an anesthesiologist was summoned out of his bed and brought to the hospital to give the patient her (free) epidural for relief of labor pain. The anesthesiologist also spent the whole night at the hospital. He spent most of that time doing paperwork related to this patient.

I'm getting ready to start seeing patients who have waited several weeks for their appointments with me. I will be called to the hospital in the middle of my office hours to deliver this premature baby. I will be gone about 2 hours if I'm lucky. My overhead costs about $350/ hour.

At the end of the day, I will have lost another nights sleep and be out-of-pocket at least $700. Like me the anesthesiologist, pediatrician and radiologist will be "donating" their time and effort.

The fact that our work is done for free does NOT protect us from lawsuits if ANYTHING goes wrong with the delivery of this premature infant.

Truth is, this isn't really about money. I donate lots of money to charity and I give away a lot of free care. When I typically give free care, the patient is appreciative and grateful. That's very satisfying for me. Patients like these, however, are compelling me to work for free with no hint of a "thank you" at the end of the day.

The beauty of charity work is that you get that warm, fuzzy feeling of having offered a gift to someone in need. This feels different.

[berettafan]

and we make fun of France for handing over the keys to the kingdom whenever some bad guys like the Nazis show up.

can we at least gift Louisiana to France before the Mexicans take over the entire country? i figure it's only fair seeing as how we would all be watching BBC if the French hadn't stepped up to the plate so many years ago and helped us out.

[widebody911]

A couple things I'm not clear on:
* why are you, personally the one who has to get out of bed
* why do you have to eat the expense?
* Why isn't she and her new bundle of joy on the first bus to Xoacaca Monday morning?

[Moses]

Originally posted by widebody911
A couple things I'm not clear on:
* why are you, personally the one who has to get out of bed
* why do you have to eat the expense?
* Why isn't she and her new bundle of joy on the first bus to Xoacaca Monday morning?

A condition of being granted admitting privileges to the hospital is that I cover "emergency" care one 24 hour shift/week. Once you initiate care, you have to see it through. In otherwords, if the patient is in the hospital for three months and requires several operations, I'm still the guy.

I eat the expense because I am not allowed to deduct charitable services on my income taxes. Nor am I allowed to claim financial loss for my time out of the office and the lost income due to cancelled appointments. Nor am I allowed to deduct my loss as "bad debt" when the patient doesn't pay me.

Patient confidentialty precludes the hospital from reporting the patient to immigration services. In fact, we are not even allowed to ask their citizenship status.

[Burnin' oil]

The local ER is primary care for illegals.

[berettafan]

Originally posted by Moses
I eat the expense because I am not allowed to deduct charitable services on my income taxes. Nor am I allowed to claim financial loss for my time out of the office and the lost income due to cancelled appointments. Nor am I allowed to deduct my loss as "bad debt" when the patient doesn't pay me.

a bit OT here but that paragraph is not really accurate.

[Moses]

Originally posted by berettafan
a bit OT here but that paragraph is not really accurate.

Yeah? Enlighten me! The entire medical community awaits.

[Rot 911]

And let us not forget the baby born of the illegal will be a U.S. citizen.

[Porsche-O-Phile]

Yep. "Anchor baby". An incentive for illegals to get pregnant as quickly as possible once here, because once they have their hellspawn, they can't be kicked out.

[Racerbvd]

Originally posted by Kurt V
And let us not forget the baby born of the illegal will be a U.S. citizen.

Soon to change I hope.

[Superman]

Moses, we appreciate your skills and your services. That goes for all medical folks. We happen to also appreciate your personal friendship, sense of humor, good judgement, etc.

I'm one of those liberals who feels that, since we have the technology (ability), I would prefer that all inhabitants of America receive safe and effective health care. If I rephrase that, it sounds like this: Since we have the ability to provide it, I would prefer that nobody be left suffering or in mortal danger because they are too poor. We are in love with the notion that there are "haves" and "have nots" in America.....winners and losers.....but I don't this to apply in health care. Health and survival as prizes going to the highest bidders.

I am with you guys in terms of illegal alien issues. I'm not sure you're willing to approve the measures and gubmit offices necessary to fix that problem, but in principle I'm with you.

This child will be an American citizen, right? What if an American citizen is too young to care for him or herself? Can the alien mother stay here legally in that scenario?

Moses, I am surprised that you don't get paid for this. Unfunded mandate. If the gubmit requires the hospital to treat her, then the gubmit should pony up. And before you guys get your panties twisted, please notice that we pay for these services either way. If the gubmit is not paying Moses, then Moses' costs go up and so do the prices of his paid services.

We have universal health care, except that we're doing it the most expensive way possible, and also in a way that hides the data from us. We could control costs and services, and make informed decisions, if we reformed this system.

[vash]

something is totally effed up with our system. i work and get insurance so i may be "removed" from the situation.

can somebody break it down for me? why cant we give EVERYONE equal coverage? i mean everyone!!!. rich folks, poor folks and all of us shmucks in between. goverment funded healthcare. am i missing something? in cuba, nobody owns a car newer than the effen 80's, but everyone gets healthcare. make a blanket system that covers everyone, but if you have the extra money, you can "buy" a better service. why not?

moses, thanks for escorting that kid in. i dont know how to feel about the rest of the story. she is a freeloader, i guess.

[the]

Originally posted by vash
am i missing something? in cuba, nobody owns a car newer than the effen 80's, but everyone gets healthcare.

You're not missing anything, it sounds like you have it exactly.

[Chocaholic]

Originally posted by Moses
Patient confidentialty precludes the hospital from reporting the patient to immigration services. In fact, we are not even allowed to ask their citizenship status.

When we as insured taxpaying citizens go to a hospital (ER or otherwise) we are required to sign legal documents guaranteeing payment to the hospital if our insurance company refuses to pay. Unless we're bleeding on the floor, this is required before we receive care. If for some reason, our insurance doesn't pay and we refuse payment...our lives become a living hell as a result of being hounded by collection agencies and having our credit rating comprimised. But, this rarely happens because our insurance does pay, and so do we for co-payments, etc.

If only we were illegal aliens. Then we're free to receive the best possible medical attention without the need for an appointment, a payment guarantee, insurance, etc., all without a collection agency chasing us afterward. It doesn't seem unrealistic to require a signature approving notification of illegal status if the medical bill goes unpaid. Ahhh, but this is America.

Where Moses is concerned, I'm not losing sleep over his investment in this idiocy. It's a known job hazard. We all have them in different forms. No one ever said it would be "fair"...and it rarely is. Keep providing the best care you can...that way you can sleep at night while the burocracy rages on...whether you're paid or not.

[Moses]

Originally posted by Superman
I'm one of those liberals who feels that, since we have the technology (ability), I would prefer that all inhabitants of America receive safe and effective health care. If I rephrase that, it sounds like this: Since we have the ability to provide it, I would prefer that nobody be left suffering or in mortal danger because they are too poor.

Here's the thing... If every uninsured body in America were AUTOMATICALLY enrolled in MedicAid (or MediCal in my state) the care would be far better, and it would actually be CHEAPER!

The cost of NOT providing preventative care is extraordinary. When the unemployed and undocumented use our emergency rooms as a drop-in clinic costs soar. In todays case, this premature baby could cost hundreds of thousands of dollars to care for. This was probably preventable with good prenatal care.

Again, the cost of doing nothing is staggering.

[nostatic]

Bingo. If there was comprehensive wellness care, it would be a lot cheaper in the long run. The "last resort" medical system will eventually bleed us dry and force good docs to go do something else for a living.

[Rearden]

Originally posted by vash
in cuba, nobody owns a car newer than the effen 80's, but everyone gets healthcare.

Cuba spends less than $200 per citizen per year on healthcare. Americans would find that unacceptable.

[GO DAWG GO]

Superman-

We have the ability to provide a free home and car to anyone visiting here, Legal or illegal. Mose's should pay for it right?. I'm subsidizing them already just with my uninsured motorist policy. How about free babysitting? Your missing the essential point. You're clouding the issue with a sense of responsibily to anyone with any means to pay for those who dont. Socialism is great for the have nots.

[911teo]

Moses you nailed it.

And I bring the example of my father visiting from Italy...
They came to stay for 2 weeks. After 4 days my dad feels a pain in his back. The next day he can't get out of his bed.

Well since he's not living here, he does not have a doctor and cannot get any prescription. We ourselves are not very familiar with the system so... we take him to the ER.

Well with kindey stones thare really little to be done... so that pain killer at $3,500 was the most expensive pill I ever bought.

My dad was impressed. He kept saying that this is how things are done... private room, 3-4 doctors that come in and treat you in an instant, effective medication etc.

He said that in Italy he would have had to wait in pain for at least 2-3 hours before someone would see him...

I didn't have the hearth to tell him I had to show them my credit card before they admitted him....

Now that I think about it he could have pretended he was an illegal alien and get threated for free....

Still the system (my father does not have an insurance) in that case prevented us from using a cheaper alternative.

We could pay so no big deal, but there are a lot of folks out there that do not have insurance and the only place they can go to is the ER and we all end up bearing the costs of it.

[Moses]

Originally posted by Rearden
Cuba spends less than $200 per citizen per year on healthcare. Americans would find that unacceptable.

What passes for "healthcare" in Cuba would never fly here.

I'm always amused when the World Health Organization lauds the beauty of Cuban healthcare, particularly the low infant mortality rate.

In the US, when a severly premature infant is born with a pulse then dies, it is an infant mortality. In Cuba the same infant is classified as a miscarriage. Funny how statistics can be manipulated when you need to make a point.