Emergency in the Emergency Rooms

redstate.org ^ | 28 September 2005 | Nick Danger

[NautiNurse]

You'd never know this by reading the news, but yesterday 3,500 emergency physicians showed up on the steps of the U.S. Capitol in white lab coats to petition the Congress for some relief from what ails them.

They have some serious concerns, some of which impact all of us in various ways.

While hospitals are required by law to provide emergency care to anyone regardless of ability to pay, hospitals do not receive reimbursement from the government for those who cannot pay. It might surprise you to learn that in many cases, neither do the doctors. Many emergency room physicians are paid on a fee-for-service basis. If the hospital does not get paid, they do not get paid. Those who claim a "right" to health care are often asked what gives them the right to demand slave labor from doctors. We now know that this question is not hypothetical.

The size of this problem varies from region to region, but it is not unusual for a hospital, and its emergency physicians, to go unpaid for 40% of the work they perform. At some hospitals, 97% of the people treated in the emergency room cannot pay. Since there is no such thing as free money, at least some of this cost must inevitably be loaded onto the patients who do pay, driving what the rest of us call "the high cost of health care" which shows up in our medical insurance premiums. The government then blames these high rates on greedy insurance companies, greedy hospitals, and greedy doctors.

Although the American College of Emergency Physicians (ACEP) is too polite to say so in its press release, a great deal of this problem arises as a consequence of the federal government's failure to, erm, restrict access to the United States by people who have not gone through our formal immigration process. This too is driving our medical insurance premiums upwards, and in some areas of the country is driving most of the increases.

According to ACEP, the number of emergency department visits increased 26 percent in the past decade, while the number of emergency departments decreased by 14 percent, resulting in dramatic increases in patient volumes and waiting times at the remaining facilities. The majority of the nation's 4,000 hospital emergency departments report that they are operating "at" or "over" critical capacity. Incoming patients are "triaged" into hours-long waits in the hallways, while others who have been seen are "boarded" in other hallways because there are no open beds in the hospital to receive them.

It's easy enough to see why the number of emergency rooms is declining. Finding doctors who will agree to work for free becomes difficult after a while, and some who have been agreeably doing it, tire of it.

To add insult to injury, liability insurance premiums for emergency physicians grew on average by more than 50 percent from 2002 to 2003 to $53,500, with some paying more than $100,000 annually. Physician specialists practicing emergency medicine are among those who have the highest premiums, because they perform procedures that have more risks of complications or because their patients have more serious illnesses or injuries. In spite of the impression most of us have that medicine is a lucrative profession, a doctor who is not paid for 40% of his work but who must still pay $100,000 annually for liability insurance is in a bit of a fix.

What the doctors were seeking from Congress is passage of HR 3875, The Access to Emergency Medical Services Act of 2005, which you can read about here.

For the Federal government to mandate that emergency rooms see anyone who shows up, while offering no reimbursement for those who cannot pay, and simultaneously leaving the borders open to millions who almost certainly cannot pay, is not a recipe for happiness. It is a recipe for long waits, high medical insurance premiums for all of us, and a very unfair burden on the doctors who do this work every day, knowing that in many cases they will never be paid.

[NautiNurse]

Story written by FR's Nick Danger. I attended the rally at the Capitol yesterday. Crowd estimates were between 3500-4000+ ER physicians, and ER nurses too. It was a sea of white lab coats, and it was a sight to behold.

These men and women are dedicated to providing each and every one of us with the best emergency care available in the world. However, they can not continue to work for free, in overcrowded facilities. Thus, they traveled at their own expense to Washington D.C., to alert the nation to a very dangerous situation. Unfortunately, this rally did not rate the local D.C. news.

More info www.acep.org, see breaking news. Ladies Home Journal has a relevant article in their October 2005 edition, they supported this event too.

Took this photo while the crowd was still gathering yesterday morning:

[NautiNurse]

Most of you know I have been out-of-pocket for the past several days. This is why...

Heard first hand Hurricane Katrina reports from the Chief of Emergency Medicine at Charity Hospital in New Orleans, and an Emergency Physician member of the DMAT team at the New Orleans airport. These are amazing people, and they need your help.

[Bahbah]

So this is what you have been up to, my dear. Well, good for you. Just remember, liberals care so much about the poor that they want to help these critical care givers to join them. We should all be equal, n'est pas? That is a great picture, by the way. I hope to heck they get some attention.

[who knows what evil?]

Great article...hope others take notice.

[abner]

Wow to you AND to Nicks great article!

[OldFriend]

And of course, this too, was on all the news broadcasts.

[NautiNurse]

And of course, this too, was on all the news broadcasts.

Nada

[dakine]

Is this the Hurricane list?

Absolutely no interest in this ping...

[pitinkie]

Yes my Hubby went to Texas with his DMAT instead of being there..its important!

[NautiNurse]

So this is what you have been up to, my dear.

heh--and you thought I was on vacation...

;o)

[Flyer]

Y'all kick ass!

[OldFriend]

I'm just practicing lying so I can get a job with the MSM.

In all seriousness tho, our state has a fund to pay hospitals for uninsured patients.

[don-o]

This is vital infrastuucture that needs to be shored up.

Bill would be chump change compared what we are sending to Blanco.

[NautiNurse]

Bill would be chump change compared what we are sending to Blanco.

Yep

[Kimmers]

This is not just the case with ER docs it is happening all specialties. My husband was a professor in a teaching hospital and also had a private practice. We had not been paid out of the practice in over two years.It is going to be increasingly difficult to find good medical care,docs are retiring early or in some cases becoming truck drivers, true story.

The bigger concern, is who is left in the teaching hospitals. These docs are quitting to go into private practice. It used to be the best and the brightest used to teach, now if your smart you go into private practice.

[blam]

Congratulations on your a Nick's efforts.

[NautiNurse]

In those cases where there are some funds set aside for the uninsured, that money is not also allotted for the physicians. The hospitals have no obligation to share the wealth with the doctors.

[Dog Gone]

I've known about this problem for years. As the son of doctor who was on call all times of the day or night, I know how often he was called into the ER in the middle of the night and never got paid a cent. A younger brother of mine followed in his shoes, and it's the same deal only worse today.

The question is how often and how long do you expect doctor and other health care professionals to work for free? There is a limit.

[Radix]

I did not get to see the news today, again as is usual the case lately for me. Are you saying that 3500 Physicians protested and it was not on the news?

Pardon me for being out of touch on contemporary news items, but this seems like a big deal to me.

[Nathan Zachary]

I have a perfect solution. Lets let even more illegal immigrants into the country.

/s

The hospital should at the least be allowed to bill medicaide and therefore pay the ER staff. Fingerprinting these illegals should also occur at this time, just so they can be kept track of, regardless of what they change their names to

I'm also in favor of taxing ritch, big mouthed liberal hollywierdo's and politucians who pay little or no tax but whine about poor people, and expect the working poor to pay taxes to support these freeloaders.