Easy to get but cant do anything with them. Our medical centers are overwhelmed right now with outofstate Medicaid. The patients who have it think that they are entitled to everything but somehow cant seem to find anyone in their state who will take it. Their own medical centers have cut back so far that they are on "divert" for almost everything. As a result, the patients have to go out of state where they have to be seen because of EMTALA. Of course this Medicaid pays next to nothing so our centers are even farther in the red.
There is this belief that the problem is that we have so many uninsured and we have to get them insurance. The insurance is worth not when it does not pay what it costs to take care of the patients. Sure, you can jump up and slap your back and say you got people insurance, but you have done is make it worse. The state that the Feds tout about healthcare reform, has actually just pushed its patients out of state and stuck someone else.
If we want to make medicine cheaper, we have to make it more efficient and more competitive. We cant be efficient when the nurses who do most of the healthcare have to spend 85% of their productivity doing Federal CMS JACHO mandated paperwork. Where patients are not able to negotiate the price of their own care. Where diagnostic tests and procedures are determined because of potential lawsuits rather than evidence based studies. When the healthcare industry has to support the trial lawyer industry. Where the Federal Government is the one who actually sets the prices of all medical care. (All Medicaid, Tricare, BCBS etc fees are tied to the Medicare rates).
If the Feds expand Medicaid, the rest of healthcare will collapse. It is like a 25 guage IV in a septic patient. Not really good for much.
2 comments:
Well Said Throckmorton!
I wish you could be a guest on the political talk shows or write an editorial ..get your views heard in a larger arena... and other docs too. You all seem to have excellent ideas ..that really ..just seem like *common sense*.
I don't think anyone stops the runaway bad ideas and then they snowball. But I also think with the instant media ..people are beginning to be held accountable and the average person is becoming more informed... if they take the time to follow.
Still ..we need more voices like yours to speak out for the good of our medical system.
"25 guage IV in a septic patient." gets past me.
The hospital I worked at would often get NY and PA MDCD patients.
"We cant be efficient when the nurses who do most of the healthcare have to spend 85% of their productivity doing Federal CMS JACHO mandated paperwork."
I wish you could tell my manager that. Last time I had a nuclear implosion about the paperwork, I was told that's nursing, suck it up. I felt like that old saw "who needs enemies when you've got friends".
Enjoy your comments on White Coat's blog.
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