The lack of identification is unsettling. Fixing this might help lead us to some real health care reform. I would like to see the real cost of the man-hours involved in tracking people down.

Although I have never given false information when I have been to an Emergency Room, I have to admit that the thought did cross my mind. I worked at a national chain restaurant that did not provide health insurance, and found myself very ill. In my case no tests were run, so it took two visits for someone to realize that I had brochitis, and to prescribe antibiotics. Fortunately I had enough money to pay for the three presciptions I was given, but often people who visit the ER don't have insurance, and don't have the ready cash to pay for prescriptions.

I knew the bill for the visit would be high, but I didn't know that I would be billed for the Doctor separate from the actual ER visit. Good credit score made worse, which is the reason so many people do not give accurate information when they go to the ER. They fear the bill, and in this economic climate, they fear losing out on a job opportunity because some employer decides to do a credit check!

Making it possible for people to see a doctor when they are sick and have no insurance instead of having to resort to an ER visit, would help to end the problem of false or inadequate contact information. I hope the new Healthcare Reform bill does something to help in this regard, but I suspect it is going to take a few years to know for sure.

And remember folks. The cost of the man hours to try and track down sick people are likely picked up or passed on to taxpayers, just as the costs of the ER visits are. Keep that in mind when you hear the talking heads saying Health Reform is too expensive. It is cheaper to pay for preventive care, then it will ever be to pay for someone who doesn't see a doctor until they are very sick, or worse yet, contagious!

I am charged with verifying their phone/address and other demographic information on admission.

BRM516234. That doesn't make a whole lot of sense. Are you saying you immediately verify that information? How do you do that? I've been to the ER several times, they take my information but I've never had them call my wife to see if I'm who I say I am. In a short ER stay, I can't see how you're able to verify such info that fast.

It also makes little sense to admit a person to the hospital for an overnight stay just to wait for blood tests to come back.

As the article says, people give false info sometimes ecause they don't want to pay for it or exposed as an illegal. As a patient, if you want good health care, you have to cooperate. After all, IT'S YOUR LIFE at stake.

BRM-516234 I appreciate your service and maybe that is how it is done in your institution. In mine it is the responsibility of the emergency department to contact patients who have abnormal test results. If the phone number is incorrect then you do the best you can to find them. If you can not locate the patient we have a policy in place that protects us from liabilty. The requirement for correct contact information is listed on the patients responsibilities and rights form that the patient signs upon registration. Kudos to this doctor for going the extra mile but if continues he will be the victim no matter how good his intentions are. You hear about rights often but not responsibilities.

Question? While admitting the patient, why can't the computer be set up to VERIFY their information as they are being checked in? Are these patients are so trifling, that they give bad information on NEXT-TO-KIN, also? At least, make this information could be truthful.

Then again, these patients could be homeless, and really don't have a working phone and some relatives just don't want to be bothered.

Fact is, our media is NOT giving a true accounting of all the disasters from the economic meltdown, Bernie Madoff mess, and other Financial Crooks, that caused great harm to Americans that left them HOMELESS and BROKE! To INCLUDE Americans who loose their jobs WEEKLY!

Americans are hurting, DEEPLY, but we will NEVER KNOW THAT from what is reported in our news.

I could care LESS about American Idol, what the rich are doing, what movie star is getting canned; what I want to know on a daily basis is what our government is doing to make Wall Street PAY for the mess the placed so many Americans in; what they are doing about OUTSOURCING our jobs, causing Americans to loose the roof over their heads, and more importantly, what we can do as Americans to HELP those who SINCERELY need our help, where we can come together as a PEOPLE to support those whose been kicked to the curb!

It saddens me that so many decent Americans are doing poorly, looking for shelters to take them in. If I owned several houses that were vacant, I would allow some RESPONSIBLE and DECENT HOMELESS people to live in them, if only to prevent them from being vandalized!

There is a better and much easier way; why is it that we have elected so many sorry, RICH representatives, who can't begin to relate to the issues of everyday Americans! The Representatives who can relate, are shut up and down, thereby quieting the American Peoples voices and concerns.

There needs to be a COMPLETE OVERHAUL in Washington ... Sooner, rather than later!

and YES samdaman, you can access our information JUST THAT QUICK, providing you have PAID for legal access and the software installed to do so!

The ER has become the nation's healthcare reform vehicle and it doesn't work. Trust, cost effectiveness and follow-up are the weaknesses of this system. Reagan dismantled small community hospitals that used to care for community indigents. Now, like the railroads, they are a by-gone history of american past. In addition to an AMA mandated doctor shortage to keep supply and demand in control so there is demand and higher pay to the few doctors that still exist and have not retired yet. We need so much more reform than we got.

Parents do not want to give legit addresses or phone numbers for their children when they enroll in school.

Countless hours are spent each year by teachers who need to contact a parent and they cannot. No numbers work or the child does not know their parents phone number. Not one time in my life have I never known how to contact my own parents.

E- Verify is a free service that can be used to verify their personal information. If they would just use it they would know if their info was correct or not. And if not then notify the proper authorities and have them come and pick them up after treatment.

Except for those subject to prevention by immunization, acute severe infectious illnesses are largely not prevented by preventative care (maybe by good dental care, but of course that won't be covered under nationalized health care, a.k.a. health care reform). In order to control costs under nationalized health care, someone will lose care for everyone who gains it. Some of the lost care will be superfluous anyway, some of it not.

So an individual comes to an ER with a severe medical problem and provides "false" contact information. The doctor takes blood samples, etc., and sends the samples to a lab for diagnosis after releasing the "patient" to wait on the lab results. The lab results come back and the patient has a highly infectious disease which can be spread by coughing, by touch, or other normal everyday activities. The doctor cannot contact the patient for admittance to a hospital under quarantine measures. The patient continues to infect local residents, is a non-U.S. citizen, and then travels to his/her country of origin where the disease continues to spread.

Sound like a conspiracy theory ?

Maybe, however this could happen to a city near you since a lot of "patients" will not provide proper contact information to ER staff since the individual is an illegal alien (immigrant). Another reason why immigrants should go through the proper channels to become a United States citizen. Yet there are MILLIONSof illegal aliens (immigrants) in our country now and who knows how many are carrying infectious diseases.

I am finding it hard to believe that the author of this article (and this "social worker") are this naive/ignorant.

It is well-documented that emergency rooms are clogged with patients seeking urgent, rather than emergency care, and they are doing this because they lack health insurance and so cannot afford an urgent care clinic and don't have a primary doctor.

They can't pay the bill, so they give incorrect contact information, even incorrect names. This is widely understood in emergency care departments around the country. Hospitals lose hundreds of millions of dollars to people who can't be tracked down for ED services billing.

You can "verify" all you want, but people, especially people who are forced to use the ED for primary medical care, often have addresses on DLs and identification that do not match where they live, if they have identification at all, and it is easy to give out an incorrect phone number.

Considering the pressure on hospitals and ED staff to address urgent rather than emergency medical conditions and the amounts of money lost, not to mention the wait times that the additional demand imposes on everyone whether they have insurance or not, this is really a minor issue, and as others here have pointed out, the patient's responsibility.

I don't want our police wasting time on this unless the patient is dangerous to the general public. If they are walking around with typhoid or TB, yeah, I want them identified and brought in for treatment, but only when they represent a danger to everyone else.

Steve-56, e-verify is limited to determining the employment eligibility of new hires only, and only employers can use it, not hospital staff.

A lot of people on this board have a lot of very high expectations for information systems in hospital emergency rooms. How many of you fought against the Aamerican Recovery and Reinvestment Act and against health reform, which finally provided the funding, incentives and payment structure necessary to implementing Bush's 2004 executive order for improving the country's health information infrastructure?

And I will never, for as long as I live, understand the depth of stupidity behind the demand to vote Dems out of office and put more Republicans in, who are 100% responsible for the financial services sector collapse and the resulting increase in joblessness. Or the unreasonableness of the demand that Dems implement a 100% "progressives" agenda, like there is no need to compromise with dozens of different and very powerful interest groups in order to make any progress at all.

The fact is that unemployment is decreasing, we are adding jobs, we are paying less in taxes than we were under Bush, we implemented health care reform that at least begins to address many urgent issues, and the only reason that more progress is not made is because Republicans stonewall every initiative.

Beginning in July of this year,more and more people who are clogging up our EDs and tying up expensive resources will be able to take their health insurance card to an urgent care clinic, or to their primary doctor instead. They won't have to worry about not being able to pay their bill, because they will have access to affordable health insurance. You will see this, and many other problems associated with a complete failure by the Republican party to address this issue for so many years fall by the wayside, thanks to the courage and success of the Democrats and President Obama in health reform legislation success.

By God, I hope you're right. But I think you have a better chance of bumping into Elvis the next time you're walking down the street.

A lot of what you are talking about is moot. As the law is presently written you can sign in as John or Jane Doe. YOU can not be refused care. Look on the wall in any hospital that is inspected by and certified by The Joint Commission, formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). If you are not certified by the Joint Commision you can lose your federal funding ie; medicare and medicaid. You receive care no matter what your employment,insurance or citenzenship status may be.

JustAThought:

Their problem is that they can't go shopping yet. They want these very serious problems caused by years of corruption and self-indulgent stupidity that has brought our country to the brink of destruction to be fixed overnight so they can go back to using their home equity to pay off their credit card debt before their next shopping spree.

The fact is that unemployment is decreasing, we are adding jobs, we are paying less in taxes than we were under Bush, we implemented health care reform that at least begins to address many urgent issues, and the only reason that more progress is not made is because Republicans stonewall every initiative.

"Oh Yea!" said the Kool-Aid man.

Just~

This year in July? Are yous ure about that? Step beyond the partisan politics and look at your post!

They don't always know if it is a life or death test. Blood test are often taken as a precautionary measure. They can't keep everyone waiting on test at the hospital. It is up to the patient to give valid contact information.

So, if it's a life or death test...don't discharge the patient

Too broad a statement. Life or death tests can detect things that are a concern in years to come if not treated. Holding every patient is unreasonable and WAY TOO EXPENSIVE. Would you keep someone in a hospital bed while they waited for results of an HIV test? Nope.

Blood cultures as do most cultures take 24 to 48 hours to show results, depending on the organism. I know this because I work in a lab. And with the antibiotic resistant bacteria such as MRSA and VRE it is really important to be able to contact patients once they have left the hospital. Also keeping them is not an option, as there might not be any beds available.

Keeping someone overnight to wait on blood tests is just not possible....someone has to staff that room, clean it, feed the person in it, not to mention if no beds are available in the hospial, sometimes the ER has to go on divert, so patients are sent to another ER that is farther away...

I don't think I'd want to go to a hospital where it took the next day to read my x-ray and I had a brain bleed. How backed up could a radiologist be? Lunch taking that long?

As a nurse that would also do follow up calls for ER visits, it can be difficult. First, some patients leave BEFORE we get the labs back. ERs are busy. I had to call the police to go to a patient's house a few times. One patient we suspected he may have leukemia. The phone had been disconnected. Xrays are read before patients are DC'd. But they are read again as a back up. If something was missed on the first read, we call the patient to arrange follow up or ask them to come back. It's not that the radiologist was incompetent, but how great is your vision when you are on hour 30 of a 36 hour shift? Residents are still worked like dogs. All hospitals are like this so it doesn't matter where you go. As a Level 1 trauma center, we could rarely go on divert.

Like others have said, it take 24-48 hours to get a culture back. We may have started the patient on a Rx and found out the bug was resistant to that. We need to contact the patient to give him the results and get him on a better Rx. Most time that consisted of calling the new Rx into his pharmacy. I know people would like to believe that everything is perfect, humans don't make mistakes, and we can diagnose things instantaneously...but this is the real world...not Star Trek.

I talked to my daughter's pediatrician because my daughter is interested in becoming a m.d., and she said rules were in place, in my state anyway, where no one works a 36 hour shift anymore. It's not medically safe for the patients. If your work needs to be double checked, it's time to go home.

That sounds awesome, call someone in...when you get tired, can you just call someone in to finish your job? Who would that be? How will you pay them? NPs and PAs make 2-3x as much as residents. And yes, your pediatrician is right, 36 hours is now illegal. It's a much more reasonable 30 hours, with only 24 hours of patient care. But only for residents. Not for fellows or attendings.

I'm in residency, I wish I would have gone the PA or NP route. Or frankly, the administrative assistant route, because when you are a resident, you are a secretary, a paperwork monkey, an insurance company arguer, and a punching bag.

And the best news is that I won't be able to pay off my loans for at least 20 or 30 years.

Gregor - I thought of the Vietnamese guy with the central line for TPN as a rather odd case. To me, anyone with a a Central line (for TPN? why can't he eat? Who is monitoring his central line and changing the dressings?) who is febrile likely has a complex problem and could very well BE SEPTIC. What was his White count? Anything over 30 (and what of his ESR) would be a candidate for admission or at least a 24 hour hold. OK the blood C&S will take a while, but a preliminary report will tell SOMETHING of gram neg rods, etc. It's easy to play Monday morning QB but my index of suspicion would be high here. But--------I get the point and have been in that situation myself. And once again there IS PATIENT RESPONSIBILITY. What does the lawyer say about that? This is why the EMR/portabiity aspect of modern health care is so important but even with EMR, not all medical providers or their employers are on board. Sepsis is no minor illness of course and likely by now we can assume that 1) the patient survived on the ABX given at the ER or 2) he is dead, a consequence of his septic shock. There are EDs all over the country struggling with the net effects of million dollar write offs and there is no real help in sight from where I sit. While I left the ER years ago for more controlled medical environments with power over my billings, it boggles the mind what happens ever day in ambulatory medicine.

SMD66 --

I've been a patient in an emergency room more than once and I've never had anyone explain to me that my test results would not be available for 48 hours or that my x-rays might be read again the next day. Perhaps if they explained this to patients when they ask for contact information, they might get a higher percentage of valid information. I'm sure many patients think they are giving contact information for billing purposes only.

There is a certain arrogance on the part of many health care providers that involves never telling the patient anything that isn't absolutely necessary. Explanations can go a long way in getting cooperation and fostering trust.

SMD66 the patient sholud not be discharged if the test is determining life or death. Suspected leukemia is found on a CBC. As you know this is a very basic blood test. Labs routinely do these within 20-45 minutes of receiving the specimen. If a patient leaves before the results of a CBC is known then you need a different ED manager because the one you have is not very organized or has not addressed such a routine problem for such a routine test. . I simply have them wait in the waiting room for results. If that is not practical then find a way that is.

Indeed. Tilt at a few more windmills woodsman.

Yes, woodsman. Since we all know that US citizen's and folks that are here legally are all able to pay for ER visits, and would never ever dream of providing inadequate or misleading information to get out of paying for an ER visit or worse yet, an actual in-patient hospital stay!

Well, I suppose you are at least happy you got to post!

FWIW my brother is an ER doctor in a city hospital and illegals are a very tiny percentage of ER visitors... not even close to 90%... maybe 9%. Even of the people they have contact info for about 50% never pay with the average bill being at least several thousand dollars.

My best friend was charged $9000 in Las Vegas for 2 pills and 5 minutes with the ER doc, then released. Thankfully he had insurance as a state employee.

Would it be a safe guess that your brother is not an ER doc in Southern California, Arizona, New Mexico or Texas?

Yeah TIDubai, & guess who paid for his INSURANCE? Uninsured people like me who pay taxes.

But don't worry about the $9,000. That is what an uninsured person is charged. His insurance Co. already has a deal with the hospital & they accept less as a matter of policy.

Ain't America grand?

Illegal aliens are scapegoated for a lot of problems that they have little to nothing to do with. I guess certain types of people are much more comfortable with targeting others for their anger and frustration than really examining an issue and looking at the data to see what the actual causes are and what the effective solutions would be.

Close to 50 million employed and unemployed American citizens lack health insurance and could not begin to manage the costs incurred by even a minor medically urgent condition. As V. Bevis points out, the health insurance industry maximizes profits by agreeing to reimburse hospitals for costs at much lower than the actual cost. They also delay reimbursement for 90 days or longer so they can use the hospital's money to make interest income.

Hospitals started to try to address the loss in income by "unbundling" services, so the patient ends up financially responsible for every cotton ball and tongue depressor used. Billing got continually more complicated, expensive and time consuming to implement.

These and other factors have led to a gradual deterioration in the quality of care for everyone, so that the US is at the level of several third-world countries at important indicators for general quality of care while paying more per capita for health care than any other country - certainly more than countries with a single-payer system and universal health care.

Health care reform begins to address these and other issues. But it is only a beginning. As long as insurance companies are allowed to pursue ever increasing profits with little to no regulation of their practices, there is going to be a problem.

But Republicans want to "protect" these businesses, which means any solutions the Dems come up with are going to be watered down.

The difference between the 'retail' cost of medical treatment and the corresponding 'acceptace of assignment' is vast indeed. There are many patients who have discovered that merely by ASKING the doctor (not the hospital, because they rarely deal) they can be charged the 'assigned' fee. It works for many doctors and I have gone this route myself in several cases where it is obvious that the retail cost cannot be paid by most working human beings. I think when most people get a bill for tens of thousands of dollars they automatically decompensate and throw the bill away. I urge folks to pick up the phone first and try to negotiate with the physicians office. You would be surprised how often the uninsured CAN catch a break. Not always, but sometimes.

My doctor does this as a matter of course. If you are self-pay, the office automatically reduces the price by 30%. If you are also unemployed, you can get an even greater discount.

So does my hospital. Yes, the bills are terrifying, but they reduce the cost and then are willing to take small monthly payments. I guess I've been very lucky, but I've never had doctors or hospitals that were unwilling to work with me.

V. Bevis: Agreed completely. I was uninsurable. That's why I left the USA. I don't get government insurance here, but at least I am able to buy private insurance that I could not do in the USA (pre-existing).

Grammar Police: Nevada actually.

Sorry to be so bitter TIDbai, I'm one of the formerly insured people ( retired nurse; been there, seen more than I WANT to-lol)

Basically I do NOT understand why "Everyone is equal, but some people are MORE equal than others?" (Esp. IF they hve the LUCK to work for companies that offer ANY health care.)

I'm just trying my best to stay healthy for another 19 months until Medicare. BTW, we've had FAR less problems with Medicare (hubby) than with ANY private insurance my husband EVER had! So don't tell me that government can't do SOMETHING right. Same goes for S.S.

Yup. I have decades before I can get Medicare. Hopefully I'll be able to earn enough from my business to stay overseas... there are lots of cheap places to live... and my private insurance covers me everywhere in the world except the USA.

I quite agree! Tests sometimes take 48 hours and if people really want to be treated properly, they should give their correct contact info to be alreted of those results. Police and other resources shouldn't be wated because some idiots are too stupid to realize that. the only time I think such doctors or police should go out of their way is if it concerns a child. It's noth the child's fault their parent is a liar!

And what if the person has a communicable disease?

Doctor's try to keep people healthy, it's what they do, this is part of it, and not outside the mandate of police. It's not a waste of resources at all, especially if it can save someone's life.

Diane: sounds like you belong to the American branch of the Taliban. You must be proud to be an American with such compassion!!!

What if it is an infectious disease like tuberculosis?

Good point Alykatma, but there aren't too many air-born infectious disease here in the U.S.

Good point for those who defraud purposefully. But how about those that are in a bad state of mind (hint, hint, sick at a hospital) that make mistakes?

Can't make a general rule about this one. Some honest people will definitely get caught up in it.

(The other) Diane:

Police and other resources shouldn't be wated because some idiots are too stupid to realize that

So police and "other resources" should be used only for those people who are rich and perfect rather than destitute and frightened and seriously ill.

And if you don't happen to know how hospital tests are scheduled and performed, you are an idiot.

I'm glad the only thing we share is a first name. Maybe it's not even your real name. LOL

Captain and others who have concerns vis a vis communicable dz: it becomes the duty of the publich health department and NOT the treating physician to track down patients whose illness is deemed a public health threat. Their epidemiologists are in far better positions (and have the needed resources which includes legal authority) to find anyone (citizen or non) who threatens the public health. I don't know that this Vietnamese fellow fit that description. As I recall, the danger of his sepsis was to him and only to himself. Nonetheless, there are many people with multi-drug resistant dz walking around all of us on any given day. Wasn't a recent strain of MDR-Gonococcus recently discussed on NV?

I think it's important to deal with medical issues on a basis of patient and public safety (that includes PROVIDER safety) and then work from that vantage point. If a patient showed up with Variola lesions (SMALLPOX), and was febrile I would first hope that some bright bulb in the ER would 1)recognize it or 2) notify Infectious DZ and the HD in that order, urgently. Then that facility would have to be quarantined immediately. The threat of disseminated Smallpox on any community would likely bring on a limited martial law until the infection could be contained and stopped. Pray this never happens, but theoretically it was the concern of homeland security that an infected shill of a terrorist organization would self innoculate, become ill and then hang around an international airport, coughing, wheezing and vomiting in public restrooms, etc. Given the virulence of the Variola virus - it would be a difficult scenario to deal with especially with these non-contactable patrons. Interestingly, I had a scan myself recently and the tech (a very nice young man) kept getting phone calls to help the front desk get information from a patient who did NOT speak English (the tech spoke the patient's native language). The tech was trying to tell him that the staff needed the NAME of his Street and the Number of his house before treatment could be rendered. Earlier while parking to enter the back of that hospital I saw and HEARD this same patient speaking ENGLISH to someone on his cell phone. I know all the department heads there and when my scan was done - I went to the office of the Radiology exec and told him of the scenario. His answer was no surprise: 'it happens all the time.'

Anyone have any LEGAL suggestions to this? The patient had sought care at a federally funded rural health clinic where the provider who saw him ordered a CXR with Community acquired pneumonia as the provisional Dx. So he was obeying his doctor's orders but he DID understand and speak English. Here is where the 'scam' begins..........many clinics KNOW that SS Cards and other forms of ID are FAKE. But as they will tell you "we're not the INS", and when the patient is sick the 'migrant health grant' requires that we see them. PS - the Migrant Health money from the feds was initiated several administrations ago and is NOT a mandate of President Obama's White House.

It's a time bomb which I suspect will someday detonate. I pray that I am wrong here. But the answer is??????????????? We can't deny care to anyone or our hospitals will close.

Then you wouldn't be a very good doctor, would you? Some attempt needs to be made but it shouldn't absorb inordinate amounts of their time. It's not the docs themselves doing it anyway, hospitals have staff for this kind of work.

heyjoe1: fortunately you are not a doctor. Now go back to work at McDonalds.

HEY BERNIE.... I work in healthcare and I agree.... see my post below.... Susan

Most PC's aren't equipped to handle true emergencies, nor are they open at all hours (or have open schedules for patients to just drop in). They'd be for treating whatever the ER docs find.

Plus I'd imagine a large percentage of these particular patients don't have PCPs (because that information is usually requested at the ER, and any findings are shared), and probably no insurance either.

Sue: They would inform the CDC & let them take it over.

i will give you an example... Tuberculosis skin test takes 2 days, culture takes 4-8 weeks,

Eddie,

When you hire an electrician or other union trade to come to your house and do work, when you get billed for $100-200 an hour for there work, do you think the electrician pockets all the money, or does the company they work for get the money and then the electrician get paid a salary from them?

Its the same way in the hospitals with doctors.

Makes a case for socialized medicine, doesn't it.

'Remember, over 51% of the Bankruptcies in this Country are caused by Doctors and Hospitals'

. . .And 87.54% of all statistics are made up on the spot by someone desperate to support an otherwise weak argument.

Outpatient laboratory tests, especially done out of network or paying 'retail' due to lack of insurance is a veritable Golden Cash Cow for Hospitals and Laboratories. There is no excuse for the charges they bill, as you clearly demonstration.

You did get to learn about the medical system, however. Never do anything at a hospital that can't be done at a free standing private facility. You'll end up paying a tenth of the cost if you follow that rule.

Now I'll give you the disco bonus round on your private laboratory test. If you had charged it to insurance or in network at a private lab (Quest/Lab Corp) you'd probably have paid $50 instead of $140 due to the contracted insurance company rate. Even they are charging a 200% mark up at the least.

I've never heard of test results being held up in lieu of payment. Nor is treatment, generally - they'll fix you then bill you. Never seen a pay up front hospital.

So you think that Hospital, Doctors, etc. should work for free. Would you work for free?

There are many reasons why emergency department (ED) visits cost so much. THE NUMBER ONE REASON is that people are using the ED as their primary care physician (PCP). Therefore, the EDs need more rooms, physicians, nurses, technical staff, housekeepers, clerical, and social workers. This demand drives the costs. It takes years for physicians to dedicated to education before they can earn money. Most then have large education bills to pay back. Most physicians are around 28-30 before they can start earning any money. They are not allowed to work in medical school. It is a longer period for surgeons since their residential training is 6-8 years after medical school.

THE SECOND REASON is that Medicare is driving the regulations in healthcare. The ED is probably one of the most regulated departments in the hospital due to the broad care that is given in this single department. The staff has to be well educated in all areas of healthcare. The average physician or nurse can not walk in off the street and work in the ED. Especially if they are a Level I Trauma Center.

When a patient has some sort of exam, i.e. EKG, xray, CT, etc. or blood work performed when they present to the ED most ED have dedicated staff to perform those exams and test on a STAT basis. That is the reason for the additional cost. If the physician staff need those results to make a determination on the physician's impression on the patient's chief complaint.

The ED physicians are required by law to help patient's follow-up with their PCP or follow-up theirselves if there is a finding above and beyond what the patient's chief complaint is. This puts extra responsibility on an ED physician.

There are many reasons why patient's information is incorrect. Sometimes patient's come to the ED and are nervous and give their middle name (the name that they go by in their daily life) or they say their name is Steve and their name is really Stephen. Or the clerical staff ask them their first name and the patient states Stephen and the clerk does not ask how it is spelled and spell it Steven.

Then there are the people that are using their neighor's health insurance card or medicaid card (yes this goes on.) Another reason is that many of the patient's that present to the ED do not have insurance. The ED has a big percentage of visits that are written off as uncollectible. I would not think the staff should work for free. That would be the other option.... work for free unless they secure the payment either from the insurance companies, or the self paying patients. Not many people would go into the medical field if that was the way the system worked.

Healthcare is a mess. I would vote that there would be some way require the patients to prove who they are prior to being treated in an emergency unless it was a true emergency or the patient could not speak for themselves or no one was available to speak for them. There are so many parents that use the ED as a way to secure medication for their child for a fever vs. going to the local discount store and purchase if for under $5.00. To the parents it is easier to go to the ED and keep the cash they have in their pocket. Most of the people I work with in the ED feel that if there was a co-pay that had to be met for non-emergency ED visits would halt most of these silly games. Most of these people are smart when it comes to getting free things, but stupid when it comes to medicating their children.

On another note, people need to get a license to have children........

Greg:

Sorry but you're wrong. It's 87.53%.

I believe that when someone goes bankrupt due to medical bills, it is because they do not have insurance or have inadequate insurance...and health care is very expensive because of all the technology that is used...and where else are doctors supposed to meet with patients??? and they need staff, or should the dr. answer the phones and mail the bills and see patients, and deal with the paperwork all at the same time??get real!

Susan: I fell and busted my face trail running. When I went to the ER for stitches, the first thing they did after a pain shot, was ask to see my DRIVERS LICENSE and my insurance cards. They asked if this was my current address and wanted the name and number of my next of kin. All of the hospitals in my area do the same thing. You must have ID before being treated.

The resaon you were not given your results is because Hospitals have no clue who is calling and it is hard to verify. We are only allowed to give Physician offices results, and even then we verify the fax/ phone number before giving any information, and the person talked to is documented. Due to HIPPA Hospitals can get in alot of trouble for giving results to someone not qualified to take them.

This is Different in a private lab because they are not under the same regulations as Hospitals are.

eddie:

I need to give you a small lesson in healthcare. I work for MD's and I see what they get paid. They do not get a dime for ordering your blood tests. That money goes to the lab. When they charge you for an office visit they get paid the "contracted amount". For example- MD charges $100, the insurance allows $38.44, the doctor writes off the difference between the charge amount and the contract amount. Also, the staff is needed b/c the doctor cannot confirm the appointment you have, call your insurance company, pay his insane malpractice insurance, draw your blood, and still give you face time without the staff. The doctors I work for have worked their butts of, made better grades, and paid a lot more money on education then you did. Do you think that someone who has someone's life in their hands should make the same amount as someone who does your accounting? They deserve much more than $38.44! And their staff deserves the $10 a hour!!!!!

People responsible for themselves?

What cave have you been living in? Don't you realize it's my given right to police everything everyone else does for the benefit of my own amusement as a part of the "inner-party".

Sheesh, next you'll be wanting to not give 50% of everything you produce each year over to Government. This attitude will not be tolerated, sir.

Uh...ER's are not first come first serve, they triage, the more serious cases are pushed to the front regardless of when they arrive. Sometimes it is a matter of convincing personnel that your particular malady is worse than others, and there are failures to recognize truly life threatening situations, but no one dying is waiting behind some one with a cold.

Sorry your daughter lost her baby, but that may have happened even if she had been seen right away...and the reason people are in the waiting room is because they are not as ill as the people who are already being taken care of...as for waiting until you absolutely have to before going to an ER, in a true emergency, you are better off getting there as soon as possible.

Yeah right, ER's are by triage, I shredded my had on my table saw and waited in the ER for 6 hours before I was seen (several colds went first) and when I was seen, the Dr was agast as to the damage I had. He actually wanted to give up and send me to a specialists, but the specialist didn't want to work that late at night. He talked the ER Dr thru it and it didn't come out too bad. It is a persons responsibility to give truthful info when registering at a hospital. If it is a problem, the hospitals should demand drivers licenses from the patient or the guardian.

I wasn't in the waiting room with some of you, so I can't know who got admitted before you. I will say that when we took my fiancé to the hospital, he appeared fine. To look at him you wouldn't have known he was just in a 55 mph car accident on the highway, especially because bruises don't show up until later. As much as they charge for an ambulance, many people prefer to take themselves unless they see it as immediately life threatening. I would have sent him in a ambulance that time b/c he did have serious abdominal pain, but I wasn't at the scene of the accident and he was too confused to answer the question properly.

The last time I went to an ER I appeared fine but had a serious injury. I'm a chemist and I had accidentally been splashed with a toxic chemical. To give you an idea how bad it is, a shot glass full of this is enough to kill you if not treated properly and larger spills have resulted in death within a few minutes. Of course I was trying to maintain my calm b/c freaking out when a chemical is able to cause a heart attack or stroke would not be intelligent or helpful. I'm sure people in the waiting room were confused as to why I got to go first.

I can't say this happened in your case, but I just wanted to give two examples of injuries that didn't look serious but were. I agree they need to get ppl with colds and broken wrists out of the ER and many places are starting "urgent care" clinics to do that and free up the ER. It worked well at the hospital in my home town. And yes, they are only nurses usually in triage, so they make mistakes. I have never forgotten the woman who made us wait 4 hrs with my sister who was semi-comatose... my sister ended up spending a week in the ICU and another 3 wks in the hospital.

0.02: that's when you start a real loud, but concerned diatribe, loud enough for everyone to hear. "The screaming patient gets the tx, needed!"

BTW, I wonder why you didn't have 1st. aide at your work to combat a difficult situation.

One thing I forgot to say. If this problem with illegals continues in this way, the US will definitely be unable to take care of even its own people and we'll see conditions similar to that of the 1930's except much worse. If that happens then count on seeing the illegals starting to be killed by citizens run amok- doing the hard thing that the government refused to do the easy way- ridding the nation of it's leeches. The government will have to round them up just like the Japanese after Pearl Harbor and ship them out en masse just to keep them alive. If you think people are being hard on illegals now, wait till you see what happens when they rightly recieve the blame for dragging our nation into the economic pit they will be in. Absolutely no mercy will be shown then and I wouldn't count on seeing anyone convicted for murder in a courtroom either. They'll be heroes. Americans will not take kindly to being turned into a third world economy because of the illegals.

Well, if it bad enough of a problem, they will just be making the undesirable gene pool a little smaller and that is THEIR decision, not the Dr.

Merlin: Wonder what is going to happen to the E.R.s in Arizona since this law just passed? Giving false names & addresses is still likely, but a lot of cops come to the E.R. esp. in the evening & late at night! Wonder if they will be afraid to even take the chance?

Actually, Dr. Sankoff was your first idiot. ;)

Short-term cell phone contracts, declining use of landline telephones and patients who fear big bills or checks on immigration status all contribute to the problem, said Dr. Jeffrey Sankoff, an emergency physician at Denver Health Medical Center.

Bernie,

Keep on closing your eyes to the facts and the truth of the matter. You ever think of running for office? You've got no business calling someone else an idiot. Read the article before you comment, don't just scan it and decide it says what you want it to say. That is the sign of the REAL idiot on Newsvine.

Bernie: Do you know something I don't? Where do illegal go for their health care?

Skeptic,

Why should the hospital have to go to that bother to accomodate these people? Just another way to make life easy for people of questionable origin or honesty. THEY are responsible for the BS, not the hospital. Let THEM change their ways.

That may or may not be the case in CA (don't know, don't live there), but that's CA. Check with states not near the Mexican border and that's not true.

It happens in Ohio and West Virginia also.

Happens here in Idaho.

sorry, here in Wisc. too!!

Agree this is the truth AT YOUR HOSPITAL IN CA but don't place the same parameter on, say, a community hospital in Vermont. Different animal. Just highlights the point that a NATIONAL system is extremely hard to craft given the huge differences in populations and care-delivery methods across the US.

I agree, California, I have gone to the hospital, and given my new address, only to receive bills with my old address on them. They need to educate the person inputing information into the system.

I'm having the same problem. I sent the hospital letters giving them my new mailing address, and the bills still come to my old one. How hard is it to change an address?

My wish for you then is that you and your family find yourselves in this siutation. What you have today may be GONE tomorrow!

So you would put your financial burden on everyone else huh Bartman, just so long as you are taken care of? Do your children know you have no honor and that your word is worth crap, because if you are lying to the hospital to save some coin that is what you are teaching them. Bartman=douchebag.