Thursday, August 07, 2008

Options Expand For Avoiding Crowded, Pricey ERs

When a heavy metal door swung over her 14-year-old son's foot, ripping the nail almost completely off his big toe, Tina Mobley didn't want to take her chances in a crowded hospital emergency room or wait for an appointment at the pediatrician's office the next day. Instead, she drove to an urgent-care clinic inside a Wal-Mart in Yulee, Fla., near her rural home. Within minutes, the doctor on duty numbed the pain with an injection, removed the nail, and cleaned and bandaged the injury.

Patients who need immediate care for injuries and illness, be it a nail-gun puncture or a severe stomach bug, are increasingly turning to walk-in urgent-care clinics. These facilities aim to fill the gap between the growing shortage of primary-care doctors and a shrinking number of already-crowded hospital emergency departments, with no appointment necessary and extended evening and weekend hours. Urgent-care clinics are staffed by physicians, offer wait times as little as a few minutes and charge $60 to $200 depending on the procedure -- a fraction of the typical $1,000-plus emergency department visit. Some offer discounts and payment plans for the uninsured; for those with coverage, co-payments vary by insurance plan but may be less than half the amount of an ER visit, which range from $50-$200.

MP: Another example of a consumer-friendly, market-driven, convenient and affordable health care option that didn't require Congressional approval, Senate hearings, new legislation, sweeping government reforms, or a government takeover of the U.S. health care system. Never underestimate the power of the invisible hand to provide real, workable, consumer-friendly solutions.

In contast, Senator Obama's proposals for health care reform include new government mandates, increased government regulations, and government subsidies. Never underestimate the power of the visible foot of government to provide imaginary, unworkable, consumer-unfriendly solutions.


At 8/07/2008 8:45 AM, Blogger K T Cat said...

As Peter Drucker pointed out a long time ago, this is the only way we're going to reduce the cost of health care. The politicians want to make villains out of this group or that in order to win your votes, but this is economics solving the problem.

Thanks for posting this. I'll throw you a link later today.

At 8/07/2008 9:29 AM, Blogger Free2Choose said...

Sorry...but my reading experience was negatively impacted by the description of the ripped nail on the big toe. I was wincing so hard I couldn't focus properly. Great post anyway.

At 8/07/2008 10:01 AM, Anonymous Anonymous said...

Here’s some free information, so do what you want with it:

Those with insurance better read their policy and follow all the rules. Many policies require pre- authorization for ALL medical visits. Some allow for discretion in emergencies; however, they, not you, get to define what constitutes an emergency.

I sit next to a union benefit’s representative and hear complaints almost everyday from active and retired workers whose insurance company will not pay a bill for one reason or another. A lot of these bills are for thousands of dollars and already into the collection process. Any help is often too little and too late. It’s your money; be careful. These are problems that lead to personal bankruptcy.

Sure, it would seem that everyone should know what their insurance covers, but the numerous complaints don't reflect that notion.

At 8/07/2008 10:16 AM, Anonymous Anonymous said...

From the WSJ: “Some offer discounts and payment plans for the uninsured. . .”

Doctors have to be careful to not charge an insurance company more than an uninsured patient. That’s one of the problems. Insurance companies can negotiate a discount off the price that doctors quote for a procedure, but patients often legally can’t. Charging an insurance company more is fraud.

At 8/07/2008 11:41 AM, Blogger bobble said...

"In contast, Senator Obama's proposals for health care reform . . ."

if i have strep throat, these are great, especially the no-appointment part. we should have more of these clinics.

but to propose this as an alternative to health insurance of some kind, be it private or govt is absurd.

how much do they charge for a heart bypass? how much for brain surgery? cancer treatment? ohhhhh, that's right, they don't do that.

a ripped toenail or a strep throat isn't going to bankrupt me.

At 8/07/2008 2:28 PM, Blogger Spencer Weinstein said...

That's right. For those larger expenses you should have a HSA with the savings you put in to pay for the deductable and the plan to pay the rest.

Coupling clinics and HSAs with high deductables lets everybody win, and it both already exist and both are getting better!

At 8/07/2008 4:21 PM, Anonymous Anonymous said...

Healthcare now is expensive because of a high demand and limited resources (i.e. doctors).

There are not enough doctors to deal with every illness so when emergency rooms become crowded with kids like these the price of healthcare goes up as it takes time to deal with them.

Retail health clinics offer a viable alternative,or you could say, and increase in supply, and will naturally lower all healthcare costs. Maybe not eliminating the problem of expensive treatment, but certainly making it cheaper.

At 8/07/2008 7:04 PM, Blogger The Happy Hospitalist said...

Why are urgent care centers better? EMTALA or lack there of. Urgent care. A great alternative if you have insurance. You can't force an urgent care to see you for free like you can an ED. As more folks head to urgent care (with insurance), the EDs will become an increasing haven for the uninsured and Medicaid. Losing propositions no matter how you look at it. The insured subsidize the government unfunded EMTALA freebies, and as they leave, so does the support for emergency medicine.

The playing field is not equal. Urgent care thrives and survives because they take need not provide their service for free.

What happens to the poor in the current environment?

Access for the poor is denied as ED's close

At 8/07/2008 7:37 PM, Anonymous Anonymous said...

When I feel sick, I call 911.

Legally they have to take me to the ER (for FREE). Sometimes we take the whole family (when we all are "sick"). Then I can demand anything I want and refuse to leave until I get it. I don't always get what I want but I usually get something good out of the ordeal. Since I don't have a job it doesn't matter how long it takes. The ER docs are used to this behavior, frustrated, and usually just give in to my demands.

I get all kinds of crap, that costs less than a pack of cigs, for FREE. What is really cool is that the expensive stuff is FREE too.

I'm taking a month vacation soon. I hope the have a good ER there. I'm almost out of Tylenol.

Plus, they have something called "triage" at the ER. That's just a code word, I think. It takes longer to get what I want when they use "triage". Racists.

At 8/08/2008 5:51 AM, Anonymous Anonymous said...

THe ER has to make every attempt to collect before they can write it off. Don't put that money for your vacation in the bank, they will find it, and it will be gone.

At 8/09/2008 11:35 AM, Blogger Matt S said...

I'm still not convinced that the invisible hand is the be all and end all solution to everything.
Why can't there be a nice compromise between "socialist" solutions and "free market" solutions? After all, I'm not paying for a private fire department or police force yet, and I don't think we as a nation really want to go there (except some folks whose property is apparently too important to trust with lowly public defenders from crime and fire).

And, as I recall, there's a chapter in Wealth of Nations where Adam Smith says that there are a few human concerns that supercede the sometimes selfish and rapacious quest for wealth.


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