The image of service in health care is somewhat tarnished by the current debate. Should the quality of care be dictated by government bureaucrats? How good will that work? Who gets what, and who decides?
That bed opening up bit is more real than you know. We, of course, take care of everybody as well as we can, they stay in ER, recovery rooms are opened as needed and used as ICU's but there is a limit. Even hospitals are downsizing to save money.
On the other hand, do you want your health care decisions being made by accountants who are motivated by a profit?
There's something to be said for downsizing to save money. A trip to the hospital is supposed to be restorative and therapeutic, but not a vacation... I recently visited a guy in the hospital and his place there was nicer than my home. Why? I guarantee that the hardwood floors and the artwork were the last things on his mind... Perhaps if we could introduce more efficiency into the system it would be beneficial, freeing up more money for actually healing people's bodies...
Truth is some (many) hospitals do cater to celebrities and other VIPS. A couple of nurses I work with used to work in places that did that. They got fed up and came here.
I will admit my hospital is partial to people to have good insurance. We have to pay for our indigent folks somehow.
I don't understand that. I know it is the case, I experienced it first-hand, having had hospital care from people who knew somehow that I deserved less than others, because I could afford to pay less. Then when I checked in with Medicaid finally confirmed, the hospital and staff held nothing back. Or at least so it seemed to me. I could not even fathom why it is hospital staff's business how the bill is to be paid by a particular individual, but they all seemed to know. Patients deemed to be charity cases get less attention and fewer medical procedures. Why?
Hospital staff must know the insurance. Consulting docs need to know who to pick up as a patient or not and nurses are the ones who are expected to know the answer.
My personal preference is to take care of the indigent. The VIP's have advocates, at times the poor do not. I usually get the VIP's anyway because of my seniority.
There is an upside to fewer medical proceedures, you know they aren't ordering anything inappropriately just to pad the bill.
Maybe we need to give more of this preferential information to patients, so they can make informed decisions as health care consumers. Should we tell the patient, "You'll get good care, because you have good insurance" or "You might as well be dead because we don't care about uninsured poor patients". If hospital care is partial to how much importance they assign to patients, according to some measure of social status, insurance or whatever, this seems truly to be inequity without justification. Or am I just barking at the moon?
Looking back at your original question, I would have to say that financial status must be an important factor in the consideration we then give to end-of-life considerations, nez pas? If I'm rich, maybe I can afford better care, and if I'm poor, perhaps better just to die quickly?
A quick death would suit me. We do give care here regardless of insurance but docs are not agents of the hospital and can do pretty much whatever they want. Even our family med clinic has to have a balance of private insurance and Medical to make it financially viable.
One of the things that bugs me is that in spite of all the problems we do have a pretty good county systems with good, no frills, care. The poor un/underinsured have aaccess to those clinics but when it comes to a trip to the ER we have a shorter waiting time so they come here to a couple of docs we have for unassigned care instead of to the hospital that has their records and has residents that tend to be highly motivated to do a good job.
If I had no insurance and had a choice, I'd go to county and not here.
More care and better care are not synonymous.
The more I hear about care in other places the better I feel about being in SoCal. I've been poor and uninsured and been able to get what I need. We have lots of great services here. Maybe that's why we are going broke.
Havin insurance does not stop some people from using the ER as a drop in clinic. More resources wasted.
The image of service in health care is somewhat tarnished by the current debate. Should the quality of care be dictated by government bureaucrats? How good will that work? Who gets what, and who decides?
9 comments:
That bed opening up bit is more real than you know. We, of course, take care of everybody as well as we can, they stay in ER, recovery rooms are opened as needed and used as ICU's but there is a limit. Even hospitals are downsizing to save money.
Yeah, and we haven't even started free health obamacare yet. I wonder what the future holds.
On the other hand, do you want your health care decisions being made by accountants who are motivated by a profit?
There's something to be said for downsizing to save money. A trip to the hospital is supposed to be restorative and therapeutic, but not a vacation... I recently visited a guy in the hospital and his place there was nicer than my home. Why? I guarantee that the hardwood floors and the artwork were the last things on his mind... Perhaps if we could introduce more efficiency into the system it would be beneficial, freeing up more money for actually healing people's bodies...
Truth is some (many) hospitals do cater to celebrities and other VIPS. A couple of nurses I work with used to work in places that did that. They got fed up and came here.
I will admit my hospital is partial to people to have good insurance. We have to pay for our indigent folks somehow.
Becky,
I don't understand that. I know it is the case, I experienced it first-hand, having had hospital care from people who knew somehow that I deserved less than others, because I could afford to pay less. Then when I checked in with Medicaid finally confirmed, the hospital and staff held nothing back. Or at least so it seemed to me. I could not even fathom why it is hospital staff's business how the bill is to be paid by a particular individual, but they all seemed to know. Patients deemed to be charity cases get less attention and fewer medical procedures. Why?
Hospital staff must know the insurance. Consulting docs need to know who to pick up as a patient or not and nurses are the ones who are expected to know the answer.
My personal preference is to take care of the indigent. The VIP's have advocates, at times the poor do not. I usually get the VIP's anyway because of my seniority.
There is an upside to fewer medical proceedures, you know they aren't ordering anything inappropriately just to pad the bill.
Becky,
Maybe we need to give more of this preferential information to patients, so they can make informed decisions as health care consumers. Should we tell the patient, "You'll get good care, because you have good insurance" or "You might as well be dead because we don't care about uninsured poor patients". If hospital care is partial to how much importance they assign to patients, according to some measure of social status, insurance or whatever, this seems truly to be inequity without justification. Or am I just barking at the moon?
Becky,
Looking back at your original question, I would have to say that financial status must be an important factor in the consideration we then give to end-of-life considerations, nez pas? If I'm rich, maybe I can afford better care, and if I'm poor, perhaps better just to die quickly?
A quick death would suit me. We do give care here regardless of insurance but docs are not agents of the hospital and can do pretty much whatever they want. Even our family med clinic has to have a balance of private insurance and Medical to make it financially viable.
One of the things that bugs me is that in spite of all the problems we do have a pretty good county systems with good, no frills, care. The poor un/underinsured have aaccess to those clinics but when it comes to a trip to the ER we have a shorter waiting time so they come here to a couple of docs we have for unassigned care instead of to the hospital that has their records and has residents that tend to be highly motivated to do a good job.
If I had no insurance and had a choice, I'd go to county and not here.
More care and better care are not synonymous.
The more I hear about care in other places the better I feel about being in SoCal. I've been poor and uninsured and been able to get what I need. We have lots of great services here. Maybe that's why we are going broke.
Havin insurance does not stop some people from using the ER as a drop in clinic. More resources wasted.
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