Pawlenty: Let ER's turn away patients to cut costs

[deminks]

http://thehill.com/blogs/blog-briefing-room/news/83113-pawlenty-let-ers-turn-away-patients-to-cut-costs

Emergency rooms should be able to turn patients away to cut costs, Minnesota Gov. Tim Pawlenty (R-Minn.) said last night

Appearing on Fox News's "On the Record with Greta Van Sustren" last night, Pawlenty said the federal law that mandates ER treatment should be repealed.

"Well, for one thing you could do is change the federal law so that not every ER is required to treat everybody who comes in the door, even if they have a minor condition," Pawlenty said. "They should be -- if you have a minor condition, instead of being at the really expensive ER, you should be at the primary care clinic."

Supporters of the federal law would content that many people go to ERs precisely because they do not have the insurance to pay for a primary care physician.

(end snip)

That is just plain stupid. I can't express how stupid that really is.

[RagAss]

1. A heart of gold.

[Arkana]

70. Fool's gold, maybe.

[47of74]

2. Pawlenty is an evil man

And I hope the voters of Minnesota flush that floater when election time comes about by putting a Democrat in office.

[Bjorn Against]

27. Pawlenty is not running for reelection as Governor, he is running for President.

It will be up to voters across the nation to reject him, but rest assured those of us in Minnesota are going to be a thorn in his side. I will link to an action we took against him last year, but this year we are going to really piss him off.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=160x35870

[amborin]

50. is he the one who refused to take his own wife to the ER? she had to get a neighhor or something?

[woo me with science]

63. Here's the story:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=160x26168

[Arkansas Granny]

68. Good grief. That's horrible. She's lucky her appendix didn't burst

while he was taking his shower and stalling about taking her to ER. She could have developed a serious infection or even died. He sounds like a real treasure.

[Raineyb]

72. What an asshole he is.

And she thought this was an example of marital humor? I don't find a thing funny about it.

Something is seriously wrong with those people.

[indepat]

62. Possibly the quintessential asshole and jerk?

:P

[SpiralHawk]

3. "Let them die sick, starving and naked on the street. Sneer." - Republicons

And to think that Republicon Homelanders like to pretend they are following in the Footsteps of Christ...

"Heal the sick, feed the hungry, clothe the naked." - JC

[Zoigal]

4. Pawlenty and others of his ilk aren't in touch with reality.

[Raschel]

35. What's Tim's problem. We only want the kind of healthcare our public "servants" have.

[The Gunslinger]

54. They are in touch with reality

They just think that only the elite should be treated as human. That is their reality. Pure evil.

[dwp6577]

5. are there no prisons? are there no workhouses?

unbelievable ahole

[Walk away]

6. Yes, I have seen an Emergency Room filled with sick children.

I had to take a client to a small hospital in Secaucus one night after a fall. As we waited the room filled up with parents and their little children. The kids were coughing and obviously running temperatures. Most were crying and all of the parents were doing their best to keep them quiet and comfortable.

The woman at the desk explained that many of these families were not legal and no doctors would take them as patients. They were forced to come through the ER and came to this one because the nearby urban ERs were even more crowded. Apparently, they had waits as long as six hours for these children to see a doctor.

These people work for a living, usually cleaning houses or day labor. They are paid very little and they are not eligible for services. Can you imagine hospitals turning away sick children? Pawlenty is a monster and the people who support and vote for him are beneath contempt.

[MadMaddie]

7. See that's the catch because they are not legal they can't

go to a regular doc and get treated. They wait until whatever illness it is progresses to a serious or health threatening point.

Something else you never hear the Pawlenty's of the world say is what about contageous disieses? These people can infect others by simply not going to the doctor. When I say these people I am referring to those that have health care but they dare not use it, dont' have health care or illegal immigrants.

I am so sick of people like Pawlenty they have no idea of the ramifications of their selfish wishes.

[Trillo]

46. That happens with citizens with insurance as well.

For some of us, it's tough to justify the deductible for a sniffle or a strange ache or pain. It's gotta be really serious. The question is, does this potentially severe illness justify a very expensive trip to a doc, simply to be told to take two aspirin and call in the morning if we don't feel better. When you reach a certain age, you get kind of sick paying $75 or thereabouts for precisely that advice that you've received so many prior times.

Of course the docs all say to get in to see them immediately just to be safe. Sorry doc. I live in the real world where money is very scarce and the deductible is a *major* deterrent.

[SmileyRose]

8. Phenomenal post in an important thread

kick and recommend

[Arkana]

71. I wonder if Pawlenty realizes

he just wrote an attack ad for any Presidential opponent in 2012.

[Swamp Rat]

9. How much does it cost to keep Dick Cheney alive?

[Foo Fighter]

38. Too much. n/t

[Juche]

10. He said for a minor condition

In that case, I actually agree.

[Uncle Joe]

14. A "minor condition" excuse

will end up killing people.

[gateley]

16. The reason they're probably at the emergency room, is that they can't get into

or pay for a Primary Clinic. They don't know where else to go. I'm touched by your compassion.

[Juche]

25. Thanks. I'm glad you know that 100% of ER visits are for life threatening issues

ER visits are far far more expensive than primary care visits.

If someone/anyone can figure out how to create 24/7 urgent care clinics and primary care clinics that have universal access, and steer the people who make non life threatening visits to the ER to those instead, I'm 100% for it.

I think urgent care clinics cost something like 1/4th the cost of an ER visit. Primary care is even cheaper as far as I know.

Bernie Sanders found that for $14 billion over 5 years you can give primary care access to 25 million people. Doing so saves $23 billion from medicaid alone. No idea how much it'd save from private spending and health insurance savings.

Point is, if we create a system of universal access to urgent care clinics and primary care clinics, it would probably pay for itself in lower ER spending. And it would improve quality of life.

http://www.independentpoliticalreport.com/2009/12/independent-senator-bernie-sanders-denied-single-payer-promotes-clinics/

For the health centers, the $14 billion in the bill that the House of Representatives approved on Nov. 7 would increase the number of centers from 20 million to 45 million over the next five years.

The investment would more than pay for itself by saving Medicaid $23 billion over five years on reduced emergency room use and hospital costs, according to a study conducted by George Washington University.

[Bjorn Against]

30. Pawlenty is not talking about providing universal access to urgent care clinics

We all know that the Emergency Room is not a very good place for all types of medical services, the problem is that for the poor in this country it is the only place they can receive health care because they are denied access anywhere else.

Pawlenty does not want universal access, in fact he is proposing to eliminate the public health insurance plans of 20,000 Minnesotans leaving them with nowhere to go except the emergency room, and now he is suggesting we take away emergency room services from them as well.

No one said that "100% of emergency room visits are life threatening issues" despite your strawman, but Pawlenty never said anything about providing these people with any other type of care so these people need the ER for non-life threatening issues under our current system.

[gateley]

45. I only know that so many people fall through the cracks to qualify for

clinic care -- Don't have any kids, make more than is allowed (but not enough to buy insurance), things like that. Where else are they going to go?

I totally agree with what you're saying, but we don't HAVE a plan for universal access to clinics.

We've totally fucked it all up.

I apologize for snarking, I've had a really bad day and of course it's not your fault (obviously!) :banghead:

[NickB79]

66. The local Urgent Care clinic requires someone without health insurance to pay $100 before admission

Before we were married and she got on my health insurance plan, my wife had a bad flu that progressed to bronchitis. First thing they asked was if she had health insurance, and then, how will you be paying today?

$100 wasn't a big financial problem at the time, but for someone living paycheck to paycheck that could easily be unaffordable.

[Little Star]

33. What, they should diagnose themselves or their children?

How the heck are they suppose to know it's a minor condition unless they see a doctor?

[Juche]

43. They should see a doctor

Which is why I support free primary care and urgent care clinics, or at the very least heavily subsidized ones.

Bernie Sanders had a bill where for $14 billion over 5 years (so about $3 billion a year) you increase access to public primary care from 20 million to 45 million. 25 million people getting primary care for 3 billion a year. It is a pretty good deal.

An investment of $50 billion a year would probably provide universal primary care and urgent care to almost everyone who wanted it. Maybe less than that.


So my point is again, establish public financing of universal primary care and universal urgent care (the same way we have universal access to medicare at 65). Then let people go to the primary or urgent care clinic instead of the ER for non-life threatening illnesses. It will cost less. The savings from lower ER visits alone would probably pay for universal primary care and universal urgent care. Not to mention the higher quality of life and fewer uncontrolled chronic illnesses.


http://sanders.senate.gov/newsroom/news/?id=30b2a415-4ade-4367-af7d-4c3306e31b58

WASHINGTON, December 19 – A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today.

The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).

He said the additional resources will help bring about a revolution in primary health care in America and create new or expanded health centers in an additional 10,000 communities. The provision would also provide loan repayments and scholarships through the National Health Service Corps to create an additional 20,000 primary care doctors, dentists, nurse practitioners, physician assistants and mental health professionals.

Very importantly, Sanders also said the provision would save Medicaid tens of billions of dollars by keeping patients out of emergency rooms and hospitals by providing primary care when then needed it.

[Lyric]

47. And when we have universal access to capable and adequate free clinics

THEN we can talk about ERs being allowed to turn away people with "minor conditions". It makes no sense to support the latter until we have the former. That road would lead to increased suffering and higher costs to taxpayers because the "minor" condition that the hospital turned away will have become a major (and expensive) one five days later--one that they CAN'T turn away.

Stating that you support and/or agree with Pawlenty's idea of implementing restrictions without first ensuring free alternatives is both a bad fiscal idea and a cruel human one.

[Lyric]

36. Hey genius--a "minor condition" can turn into a serious one

pretty quick if proper treatment isn't given--not to mention the human suffering in the interim. People don't go to ERs because they like it; nobody really WANTS to wait 10 hours in an uncomfortable chair and see a doctor who's a total stranger. Uninsured, low-income people go there because they can't afford the "You Must Pay at Time of Service" primary care doctors. Without ERs, these people wouldn't get treatment for conditions like a minor abscess or a case of strep throat while those conditions are still easily treated. Instead, they'd suffer pain and misery until the abscess spreads to their bones and muscles, or the strep turns into rheumatic fever and damages their heart, thus sending them BACK to the ER and costing the taxpayers A LOT more for their treatment than it would have cost to treat it early.

Brilliant plan! Just brilliant.

:eyes:

[Juche]

42. Some of you people are dogmatic and rude

You guys can be as bad as the people you criticize. The article was red meat, and anyone who disagrees with the misleading argument being presented is insulted. Pawlenty never said turn away car crash victims. He said turn away people with non-life threatening illnesses.


http://www.editorsweb.org/wellness/emergency-room.htm

Going to an emergency room instead of scheduling a doctor’s appointment has become a trend in this country. In 1996, a whopping fifty-five percent of the 90 million visits to emergency rooms in were unnecessary. Translated into dollars and cents that means 40.5 million people paid up to three times as much for routine care as they would have paid at a physician’s office. They probably wasted a lot of time too because emergency rooms are not set up to care for routine illness, and they do not work on a first-come, first-served basis as many people mistakenly believe.





Here is a simple explanation of my view:

Much of why people go to the ER is for things that could be treated in primary care or an urgent care clinic. As a result we should have universal access to public urgent care clinics and primary care. That would cost less (since those clinics are cheaper than the ER), and it would free up the ER to focus on serious issues like car accidents, violent crimes, etc.

I'm not saying Pawlenty supports universal primary care. But if we gave universal primary care to everyone it would cost less than our current system where people put off a doctor until it is too late.

Pawlenty wants to turn people with non-life threatening illnesses away from the ER w/o giving them an affordable alternative. I don't agree with that. I think we need more public funding for urgent care clinics & primary care to take the strain off of the ER.

My view is more along the lines of Bernie Sanders than Pawlenty. Sanders also supports more primary care so people do not need to use the ER.

[Lyric]

53. I'd rather be rude than deliberately blind.

You say, "Pawlenty never said turn away car crash victims. He said turn away people with non-life threatening illnesses."

Did you not read what I said? At all? What part of "untreated minor illnesses tend to turn into expensive major ones" did you fail to comprehend? How does it make ANY fiscal sense whatsoever to turn someone away for a minor case of staph cellulitis, only to have to admit them five days later for a major, life-threatening case of it? The money the taxpayers saved with the initial rejection is chump change compared to the costs of treating a full-blown, major case of staph cellulitis that's spread to an entire limb. Oral antibiotics given early enough to be effective are damned cheap compared to a hospital admission and IV antibiotics after the infection has gotten really bad. And I take issue with the idea you seem to be espousing, which is that it's universally easy to tell a "non life-threatening" condition from one that IS life-threatening. That is often not the case at all. Triage nurses do their best, but they cannot catch everything. They aren't doctors. Only a doctor's examination can tell for SURE whether or not someone's chest pain is just heartburn, or if it's a heart attack. Only a doctor's examination can tell for SURE whether or not that pain in your belly is severe constipation or an infected appendix that's about to rupture. How many lost lives and lawsuits will result from things that Triage misses?

We go on and on about how important preventative care is--well this IS part of preventative care. Being seen when a condition is still minor is incredibly important in order to keep it from BECOMING life-threatening. Ordinarily, people get this kind of early care from a primary doctor, but primary doctors are not available to many, many poor people. They require payment up-front that poor people simply do not have. When the choice is to either go to the ER or not see a doctor at all, how can you POSSIBLY argue that the latter should be the preferred course of action? Even if we were cruel enough to completely discount any and all human suffering as a variable in this equation, it's still a terrible idea from a purely economic perspective--at least for the taxpayers who end up reimbursing the hospitals for unpaid care. I'm sure it'd be damned profitable for the hospitals, though.

As for your comments about Sanders and access to free clinics--hey, great! I'm all for it. But we need those things in place BEFORE we go forbidding the poor from the only health care option that many of them have. Unless and until everyone in this country has access to health care from a primary doctor, supporting Pawlenty's idea is an incredibly cruel and narrow-minded thing to do.

And yeah, I can definitely be rude when someone expresses support for something that is inherently and immediately harmful to myself and my low-income, ten-generations-of-poverty family, and then tries to back it up with sloppy thinking that doesn't cover half of the potential problems involved. These issues are numbers on a chart to some people, but for us, they're as close and real as it gets.

[Lucy Goosey]

49. Symptoms that seem to indicate a "minor" condition can sometimes indicate a major one...

My mother had a persistent cough. Just coughing. Minor? Most likely. Her doctor initially gave her meds for bronchitis.

When the cough didn't go away after 3 weeks, she had X-rays, and then further tests, and then she was diagnosed with lung cancer. Treatable lung cancer.

If she had had to wait ER worthy symptoms, like coughing blood, she probably wouldn't have been diagnosed before the cancer had spread. As it stands, she's in remission 4 years later. If the cancer had spread, there's something like an 88% chance she'd be dead by now.

And her only symptom was coughing. Thank god she didn't have to rely on an ER that would have turned her away for such a seemingly minor issue.

[pipi_k]

65. Sometimes a "minor condition" can be deadly

In fact, a few weeks ago my mom's boyfriend had a couple of annoying symptoms.

He went to the ER, where it was discovered that he had a 99% blockage of his carotid artery.

He survived because he got immediate surgery.

[Uncle Joe]

11. What a pathetic waste of DNA.

:puke:

Thanks for the thread, deminks.

[gateley]

12. That just about sums it up. Our Fellow Americans. nt

[Beaverhausen]

13. and he is a Christian?

[gateley]

17. No, he's a "Christian". nt

[FiveGoodMen]

15. ...so that the rich can be richer.

Eat the fucking rich.

Now. Hurry.

They're getting spoiled as we speak.

[Trey9007]

18. Hospitals already do this

But, they still must see the patient to determine if it's something minor, and the bill for the work the ER does, to simply determine if it's minor, is very high.

[Peregrine Took]

22. So true - they have to first determine the "minor" condition. What an idjit!

[City Lights]

19. We could save a bundle by cutting off The Death Defying Dick! nt

[subterranean]

20. Did he think about why they go to the ER instead of the primary care clinic?

Because the primary care clinic can turn them away if they don't have insurance! I don't suppose he offered any solutions for that.

[moondust]

21. delete

[Donnachaidh]

23. "Are there no prisons? Are there no workhouses?"

"If they would rather die, they had better do it, and decrease the surplus population."

Ebenezer Pawlenty.

[CatWoman]

31. HAHAHAHAHAHAHAHAHAHAHAHAHAHAHA

:thumbsup:

[Bjorn Against]

32. Actually prisons are the only "service" for the poor that Pawlenty is trying to increase funding for

[Dappleganger]

24. Let them eat cake!

Jesus, does he know that keeping people from using the ER to see a normal doctor will kill the RW-meme that America has the best universal health care system in the world??

[Lisa0825]

26. I would be OK with that IF and ONLY if....

there was good health care accessible to all, regardless of coverage, ability to pay, or citizenship status. If primary care or minor emergency/urgent care clinics we able to see these patients, it would be much cheaper than an ER visit. But those clinics (to my knowledge) are not required o see anyone who comes in the way an ER is, so there would have to be funding for those clinics to see them.

The problem with Pawlenty and his ilk is that they want these people to be turned away completely, not provided for in other ways.

[Bjorn Against]

28. Pawlenty also wants to cut public health assistance to 20,000 Minnesotans...

He tells us that health care costs too much so he is trying to end the GAMC program which provides health care to Minnesota's poorest citizens as well as slashing MinnesotaCare which used to be one of the nation's top public health programs until he took over.

To add insult to injury he is also trying to get corporate taxes cut by 20% at the same time he says we can't afford health care for the poor.

Don't worry though he is not going to cut all services for the poor, in fact he is proposing a big increase to fund our prisons.

On edit: I also want to add that Pawlenty is running for President, so if you live in another state do not think you are safe from him.

[Raschel]

34. Tim and his family been living off of the tax payers for too long. Cut his pension and

healthcare now.

I'm on Minnesota Care because I worked all of my life and get too much in S.S. Disability to qualify for medical assistance.

I'd like to wap him upside the head with my bra prosthesis.

[Foo Fighter]

41. Yeah, but look at all the great things Pawlenty has done for the state of MN.

Sure, he might be killing off social programs left and right and slashing aid to the poor but hey, at least the infrastructure is in great shape. I mean, just look at the roads and bridges and...oh wait...

Didn't he want to eliminate all corporate taxes at one point? In comparison to that, "only" cutting them by 20% probably makes him think he's the Great Compromiser. And hey, at least he's sticking to his "no new taxes" pledge. Well except for that Twins Stadium thingy but that's OK because some rich guy is the beneficiary of that tax so that makes it alright.

Here's an idea. Tell the Twins to take out a loan for their stadium but keep the stadium tax in place and use it to fund GAMC, MinnesotaCare, and other programs for the poor. Not sure if it would be enough to fund them but at least it would be a start. The poor need those programs a LOT more than a baseball team needs a new stadium.

Pawlenty running for President ought to be enough to make everyone become Republican for a day just to vote against him in the primary.

[kitkat65]

29. Look what I found!

/>

[Beaverhausen]

37. that's perfect

sad but true

[Lyric]

39. And who benefits from a policy that allows hospitals to wait

for cheaper, minor conditions to turn into expensive, major ones? Gee...I wonder.

He's not looking to save taxpayers money. He's looking to kill off a few poor parasites and increase hospital profits. I wrote an article a while back titled "They No Longer Need Us. Now What?" Well THIS is apparently "What." They're going to kill off the working class, one case of flu-turned-pneumonia at a time.

[johnaries]

40. Talk about Death Panels! And what about the Hippocratic Oath?

"He'll die in 5 minutes if we don't do something: Quick! Check his insurance!"

And, as always with Conservatives, how about a hypocrisy check? They make a big deal out of "refusing services if it is against their personal beliefs". Well, what if they have sworn a Hippocratic Oath and it's against their beliefs to let someone agonize or even die if it's within their power to help them? :shrug:

[Marr]

44. Don't these guys also say that "everyone has access to healthcare" because anyone

can walk into an emergency room...?

[depakid]

48. Interestingly enough- there were several teabaggers I spoke with who advocated letting folks die

in the streets.

No shit.

(Not that they would have known enough to engage in a conversation about EMTALA).

[stray cat]

51. AN OPT OUT for the mandate - you can decide to opt out of health care and not buy insurance

that takes care of the problem people have with mandates

[The Gunslinger]

52. And these people claim to love America.

[patrice]

55. Without a strong PO, the only way to achieve cost efficiencies will be to take it out of HCProviders

[RB TexLa]

56. If I didn't have insurance I wouldn't go to an ER to purchase medical services.

[Lance_Boyle]

61. No, you'd go there to get service FOR FREE, ultimately billed to those

who have insurance. Pawlenty is not entirely wrong in seeking to eliminate the "ER as Primary Care" problem. It's a damned expensive problem. I guess none of the people here berating him for this bit of common sense care about reducing runaway medical costs.

[NickB79]

67. The problem is, you can't change ER practices until you make Primary Care more affordable

Through health-care reform, something Pawlenty is largely opposed to. Without first improving access to Primary Care, you would deny medical care to large numbers of poor and uninsured that use ER's as their ONLY available health care service.

Talk about putting the cart before the horse. By proposing limits to ER visits without supporting health care reforms that expand medical coverage to all, Pawlenty is actually making things far WORSE.

[bridgit]

57. Look...republicans are bat shit green alien hooker fucked a passed out brain dead bat boy...

from a drug & alcohol stupor KAH-razzzyyyyy!!! And if Pawlenty continues as is his want to; then he can dial up The National Enquirer and stake his claim to *the truly weird* cause that ma'fucka is off the shrieking fucking hook and into the psychotic-ass snake pit admittedly where he belongs cause that is for ER triage not the baggers

[w8liftinglady]

58. to quote my friend Jesus(per an earlier DU thread)

For I was hungry and you gave me nothing to eat, I was thirsty and you gave me nothing to drink, I was a stranger and you did not invite me in, I needed clothes and you did not clothe me, I was sick and in prison and you did not look after me.' They also will answer, 'Lord, when did we see you hungry or thirsty or a stranger or needing clothes or sick or in prison, and did not help you?' He will reply, 'I tell you the truth, whatever you did not do for one of the least among you, you did not do for me.'"

-Matthew 25:41-45

[Whisp]

59. Sarah McLachland on Pawlenty:

I looked into your eyes
They told me Pawlenty
I already knew
You never felt a thing
So soon forgotten all that you do
In more than words i
Tried to tell you
The more I tried I failed

[Blue Owl]

60. But don't cut Michele Bachmann's farm subsidy welfare check

Timmy you stupid, stupid man.

Notice how he's appearing on Van Sustren's show instead of Maddow's nowadays.

What a fucking wimp.

[geardaddy]

77. +1

[libodem]

64. Hmmm,

Now what was Congressman Grayson's figure for how many people die every year in America from lack of health care 47,000 or 4,700? But I read another figure that said roughly on average someone dies every 12 minutes from lack of affordable care.

We are way down, on the list of countries in the world, in health care and life expectancy. If you can find a job all they want to do is work you to death.

Listening to NPR last night I heard a discussion about prisoners of conscience, in Cuba, starving themselves to death in prison.

How bad of a country do you have to be to make your citizens want to kill themselves? Life has less and less meaning in America. We need to just get on the euthanasia band wagon so we can off ourselves in fucking comfort. Our soldiers come come and commit suicide in record numbers. I wonder how many regular citizens look at the state of the union and see Dick Cheney touting torture as an American value and wonder why we fought World War II? Makes you just want to get it over with. Life has no meaning in America.

Sit outside the emergency room and fucking die.

(And I know this was allover the place, I'm just pissed off about a lot of stuff, today.)

[Ex Lurker]

69. in one sense he has a point

ask any ER doctor or nurse. They are overrun with people who have no business being there. Some of whom have nothing wrong with them and used the 911 system as a taxi service. It would be helpful to all concerned if they could be kept out of the system.

[geardaddy]

73. Fuck you Timmy the Tool

:grr:

[fascisthunter]

74. yeah, Let's start with you first when the time comes

[Javaman]

75. And that is a little peek into the repukes version of their health care plan.

"Fuck them, turn them away. They should be more careful!"

[Skidmore]

76. "...change the federal law so that not every ER is required to treat everybody who comes in the door

..Gov. Tim Pawlenty (Michigan)

Would make a fabulous big sign along a major thoroughfare.

[geardaddy]

78. I wish he were Michigan's gov.

and not ours, but I wouldn't wish that on Michigan.