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(WISTV)   No money for a cab? Just call an Ambulance. Fark: Over 100 times in the last 7 yrs   (wistv.com) divider line 75
    More: Stupid, Dorchester County, taxiing, Greenville County  
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5365 clicks; posted to Main » on 26 Apr 2013 at 1:18 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-04-26 04:46:41 AM  

Relatively Obscure: Fark_Guy_Rob: They don't really ration it though. They just get around to you when they can. It's incredibly common to wait months to get a simple, routine thing sorted out. And even though you are still a paying customer (your taxes after all, I mean, assuming you work) you are so far removed from paying that the staff really just doesn't care. I showed up to my appointment after waiting two months, then waited FOUR HOURS in the waiting room....'Sorry, we're a little backed up today' is all the said.

Oh you poor dear.


It's not about the severity of suffering....it's about the relative level of quality and service.  Private medical centers aren't run that way; with the possible exception of an emergency room (and that's already iffy since a lot of people using the ER aren't going to pay for it either).  In the US - I could schedule an appointment, with a specialist in 2-3 days, pay a $30 copay, show up, wait five minutes, and be done.  With free health care in the EU - I can schedule an appointment with a GP, pay 40 euro (~50 USD) be told to try X and come back, come back in two weeks, get a referral to a specialist, wait for the letter, have no say in which hospital I'm assigned or which doctor I'll see.  I'll have to cancel the entire day from work (a luxury not everyone can afford), take public transportation (if available, and it's not cheap) or hire a taxi (even more expensive), and spend several hours in the waiting room because they don't care enough to schedule patients appropriately.
 
2013-04-26 05:19:01 AM  
Mugshot! Is she white?
 
2013-04-26 05:39:33 AM  

Fark_Guy_Rob: In the US - I could schedule an appointment, with a specialist in 2-3 days, pay a $30 copay, show up, wait five minutes, and be done.


I think, perhaps, you have an overly romanticized view of US healthcare.

I've only been referred to specialists on a few occasions, but I've never been able to get an appointment within 2-3 days of the referral.  It's always been at least a month.  Usually more.  And, even when I get to the office, the process has never been quick or easy.

When I've had to deal with socialized medicine, my experience has been very positive.  I have to say, having experienced both, that I prefer the socialized system to the US model.  And, I'm not alone: in the US, Medicare (socialized medicine) users give their healthcare higher marks than young people using the private market:  Older Americans enrolled in Medicare health plans have better access to care and are less likely to have problems paying their medical bills than people who insure themselves or receive coverage through their employers, according to a new study...Although only 8 percent of people with Medicare rated their insurance as fair or poor, 20 percent of adults covered by an employer-sponsored plan and 33 percent of those who purchase their own insurance reported dissatisfaction with their coverage.
 
2013-04-26 05:43:05 AM  

weirdneighbour: It's $75.00 a ride here in Ontario, or at least it was year or so ago.
/yes, in a real ambulance


Mine was only $45. All kinds of firefighters and paramedics,  Yay, insurance!
 
2013-04-26 06:51:08 AM  
Ferguson apparently never even went into the hospital to get treated.

When you come in on an ambulance can you just hop out and walk away? I would think you'd have go in and get checked out just for liability.
 
2013-04-26 07:13:21 AM  
FTFA: "Officials say what Medicaid doesn't pay, taxpayers will have foot the rest of the bill "

What's wrong with this sentence?
 
2013-04-26 07:42:01 AM  

Green Scorpio: FTFA: "Officials say what Medicaid doesn't pay, taxpayers will have foot the rest of the bill "

What's wrong with this sentence?


Because if she didn't have money for a cab you can't get blood out of a turnip?
 
2013-04-26 07:44:00 AM  
A few years ago, we had a lot of homeless folks taking the "Ambulance Taxi" - until the cops started showing up and arresting a few of them. Criminal fraud charges, mostly. Just having the cops show up at the emergency room and check for warrants was enough.

Word got around really fast.
 
2013-04-26 07:52:23 AM  

abhorrent1: Ferguson apparently never even went into the hospital to get treated.

When you come in on an ambulance can you just hop out and walk away? I would think you'd have go in and get checked out just for liability.


Nope, if I transport an alert and oriented adult says "stop here and let me out" there is nothing I can do about it (within limits for patient safety, I'm not letting them out on the highway).

One of the problems is that if I'm dispatched by 911, and the patient says they want to be transported, there is no mechanism for me to say no.  I MUST transport them.  I've been called for a "laceration" which was trivial self inflicted wound by a drug seeker.  The patient got a Hello Kitty bandaid, a 15 minute ride, an ALS workup and a $1k bill.
 
2013-04-26 08:12:49 AM  
When I worked for the county, we had this a lot.  The EMTs said that several times, they would transport someone to the County hospital and once the person was inside, they would jump off of the gurney and walk out of the hospital.  One of the fire captains told a couple of "frequent flyers" that the county was going to start deducting $50 for each ambulance ride out of their welfare checks.  The two women stopped calling for rides, but the captain got in trouble for telling them that.
 
2013-04-26 08:22:33 AM  

Dr. Nick Riviera: Good for them for having her arrested.  I dealt with that crap a lot when I did EMS.  There were multiple times they had to call in an ambulance from a distant station for legitimate emergencies in our district because we were tied up transporting some homeless guy with a vague medical complaint who wanted a free ride/wanted to go some place with air conditioning/wanted to get out of the rain, etc.


My first job was at a hospital. We had a mental patient (note: this facility did not have a psych ward) who rode the ambulance to the ER every day that a certain young lady was working the front desk. She was a full time employee, so pretty much 5x a week, every week, unless he was busy doing something else like being incarcerated or confined someplace that did have a mental health ward. He was Medicare and Medicaid, so your tax dollars at work. Of course, the ER staff had to make certain he was not actually having a true health problem each time, so he would be checked out and then sent home . . . on the ambulance.
 
2013-04-26 08:24:21 AM  
Old Man Winter

Yeah, about 15 years ago, I got knocked out playing football with friends. They helpfully called an amberlamps and the ride was 1800 dollars. Big bucks for a uninsured college freshman. I could pay the hospital or the ambulance-mafia, apparently I choose poorly.after a year, they ambulance bastards turned it over to collection and I got the snot sued out of me.
Even now, with nice insurance, if I got injured and an ambulance shows up, I would deck anyone who tries to stuff me in it. An assault charge and a free ride from the police would be infinitely cheaper.
100 times?


The wife was sitting with her idiot friends and got chest pains. So the idiots called an ambulance to take her to the hospital. I get a bill from O'Fallon Ambulance for $980. Total distance was 8.7 miles. I call them and give them my insurance information and figured that would be it. At the time, this was Insurance that I was paying almost $300 a week for. A few weeks later, I get an adjusted bill for $960. "Why, yes Mr. Freakstorm. Your insurance company paid $20. Now the remainder. Will that be cash, check, credit card or kidney?"
 
2013-04-26 09:36:08 AM  

Walter Paisley: detritus: Walter Paisley: The public transportation in the Charleston area may be different, but many cities have free bus passes for people on Medicaid or SSDI as well as shuttles that pick up people with disabilities from home.

If you can ride the bus to cash your welfare check, you can ride the bus to work.

So disabled people must walk?


Being disabled doesn't necessarily preclude one from being able to walk.  Governments, particularly in Western societies, need to do a better job managing resources.  They can't be all things to all people.
 
2013-04-26 09:39:55 AM  

eraser8: Fark_Guy_Rob: In the US - I could schedule an appointment, with a specialist in 2-3 days, pay a $30 copay, show up, wait five minutes, and be done.

I think, perhaps, you have an overly romanticized view of US healthcare.

I've only been referred to specialists on a few occasions, but I've never been able to get an appointment within 2-3 days of the referral.  It's always been at least a month.  Usually more.  And, even when I get to the office, the process has never been quick or easy.

When I've had to deal with socialized medicine, my experience has been very positive.  I have to say, having experienced both, that I prefer the socialized system to the US model.  And, I'm not alone: in the US, Medicare (socialized medicine) users give their healthcare higher marks than young people using the private market:  Older Americans enrolled in Medicare health plans have better access to care and are less likely to have problems paying their medical bills than people who insure themselves or receive coverage through their employers, according to a new study...Although only 8 percent of people with Medicare rated their insurance as fair or poor, 20 percent of adults covered by an employer-sponsored plan and 33 percent of those who purchase their own insurance reported dissatisfaction with their coverage.


My experience jibes more with Rob's.  I've never had trouble seeing whomever I needed to see and pretty much everyone I know.  Not being able to see a specialist is not a complaint I think I have heard before, but hey, most of my friends are pretty healthy.  Perhaps it is different for someone with a myriad of exotic health problems.
 
2013-04-26 10:27:33 AM  
Pumpernickel bread:
My experience jibes more with Rob's.  I've never had trouble seeing whomever I needed to see and pretty much everyone I know.  Not being able to see a specialist is not a complaint I think I have heard before, but hey, most of my friends are pretty healthy.  Perhaps it is different for someone with a myriad of exotic health problems.

What actually determines things like wait times is the availability of the specific resources that you need, not the payment model that is used. I've got a rare genetic neurological condition which there are very few doctors in my area qualified to treat (even most neurologists aren't qualified, outside of specialists at the teaching hospital). Because there is basically one guy that I can see, there is a significant wait time for appointments, and most are scheduled more than a year in advance.  This is in the U.S. It doesn't matter how much money your system spends, or how good your insurance is, if there just physically isn't enough of the medical resource you need. If you haven't had to deal with something like that, then frankly you've been lucky and are not qualified to discuss the failings of our healthcare system based on your personal experience.

Payment system is LINKED to availability of resources, in that if you pay more in one area you tend to get more people providing a service in that area. That's part of why the U.S. has a primary care doctor shortage and an over proliferation of specialists. And the fact that we spend twice what most countries do per capita on health care sometimes means we have more resources. The payment model is more about how the resources get divided up than about what resources there are. In socialist countries, care is mostly rationed based on priority of medical need. In the U.S., it's mostly on ability to pay. If we spent the same amount we currently spend on healthcare on a single payer system, we'd have the most resourced single payer system in the world. But we choose not to, mainly because most people think it's more important that they get seen immediately for their minor complaints than that some other people get seen at all for life-threatening problems. That selfish, entitled attitude is the root of the issues with the American health care system.
 
2013-04-26 11:10:30 AM  

DrPainMD: Oldiron_79: KrispyKritter: that ride starts at $750 where i live.

Well hers were paid for by medicaid according to TFA. So your tax dollars paid for this shiat.

In other words, it was economic stimulus. All government spending stimulates the economy.

Signed,

Paul Krugman


So it will trickle down?
 
2013-04-26 11:54:09 AM  

bigbabysurfer: drgloryboy: We had a patient who would go out to the restaurant of her choice (or the bar of her choice) and when she had enough to eat or drink she would then have a pseudoseizure, someoene would call 911, ambulance shows up while she is putting on her act, and she would then get out of paying her bill. Once she was in the rig, any paramedic who didn't recognize her or pseudoseizures would give her a nice ativan buzz on the ride to the hospital where she would promptly refuse treatment.

CSB:

I had a guy pull this years ago - it was in a Waffle House that just happened to be next to a police station.

We (the ambulance crew) knew the guy was faking - he was lying on the floor, cracking his eyes open just enough so he could see what was going on.

The waitress is describing what happened ("he fell onto the floor and just started shaking") to us and the cops when one officer asked, "Did he pay his bill?"

"No."

"How much was it?"

The waitress found his bill - "$14.50"...that's a LOT of food at a Waffle House, at least it was in the mid 90s.

The officer said, "Hold on," flipped the guy over onto his stomach, pulled his wallet out, found a $20, gave it to the waitress, and said, "Keep the change."

I still had to take the guy to the hospital, but DAMN, that dude was PISSED.  It was awesome!

/CSB


I was going to comment something else, but this is too wonderful not to go YEAH, baby
 
2013-04-26 02:36:54 PM  

Fark_Guy_Rob: AverageAmericanGuy: So when health care is universal and "free", we will be rationing ambulance service based on the judgment of some government bureaucrat? I'm not sure I'd be too happy about getting left at home because I called for an ambulance one too many times.

I have 'free' medical care.

They don't really ration it though.  They just get around to you when they can.  It's incredibly common to wait months to get a simple, routine thing sorted out.  And even though you are still a paying customer (your taxes after all, I mean, assuming you work) you are so far removed from paying that the staff really just doesn't care.  I showed up to my appointment after waiting two months, then waited FOUR HOURS in the waiting room....'Sorry, we're a little backed up today' is all the said.

Since it's 'free' I couldn't do anything.  If I leave, I can't just go somewhere else.  I need to be referred, prioritized by medical need, and assigned a place in a queue.  If I walk out after waiting THREE HOURS, I can't come back tomorrow.  Now, I have to start over again.  It could be another month or two.

And, since it's 'free' I don't even get to schedule a time.  No, they contact me, via post/letter, and tell me when and where it is.  I don't have a car....but I need to go to the hospital on the other side of town?  Too bad.  I can spend 40 minutes on the phone trying to get my location changed, but even that will add another 1-2 weeks as the NEW hospital will need to send out a letter after scheduling me into their queue.

Yay!  Free health care!


Wait months for an apointment, Check.
Wait hours in the waiting room, Check.
Pay out the nose, Check.
No treatment for non-life threatening issues after job loss, Check

Looks like we have it worse here in the US. A four hour wait is not unexpected at any hospital I've been too, rural or urban.
 
2013-04-26 03:39:04 PM  
A

life of the sausage party: Wait months for an apointment, Check.
Wait hours in the waiting room, Check.
Pay out the nose, Check.
No treatment for non-life threatening issues after job loss, Check

Looks like we have it worse here in the US. A four hour wait is not unexpected at any hospital I've been too, rural or urban.


In fact, they don't even have to FULLY treat you for life-threatening issues either, as long as you're healthy enough to get out of the hospital for the time being. All that is required of hospitals, regardless of ability to pay, is that they stabilize you if you come in for emergency treatment. After you're stable, they can and will kick your ass out on the street if you can't pay, especially if you're someone that they think will never have any hope of paying and that no one will care about (e.g., a homeless person with no family contacts). They have to treat you for your life-threatening conditions while you're hospitalized, but they don't have an obligation to provide free follow-up care later after you're discharged.

EMTALA (the law that requires this) falls far short of actually requiring free comprehensive health care be provided for people who can't afford it. To do that, we'd need to have an actual universal health care system. Instead, we like to pretend that we aren't totally heartless by providing for people's "emergency" needs, without actually doing anything to make sure that they really get better in the long term. And, of course, this massively overburdens emergency departments and greatly drives up the cost of care there, since so many people then rely on the EDs for basic general health care. We would probably greatly reduce overall costs and overcrowding at EDs simply by providing alternative ways (e.g., single payer) for people to get free health care for minor complaints. But the right wing insists that we not do that because it would give "moochers" free care (nevermind that they're already getting free care in the most inefficient way possible).

And I would say that four hours in the waiting room is a SHORT wait in most American emergency departments.  So we have the same problem in the one place where we channel all the people who can't afford health care. I've taken people to emergency rooms for actual emergencies (not bleeding out, but serious problems that need to be treated) and had 8+ hour waits before. That isn't with an appointment, but still, it's not like we're immune to the issue of not having enough resources to treat everyone quickly because of capitalist magic pixie dust or something.

The only people who think our system is "better" than the higher quality single payer systems in other countries are a) people for whom cost is no object; b) people who have never had a serious medical issue; c) people who have always had generous health insurance paid for by someone else; d) people who are profiting from the inefficiency of the current system; or e) all of the above.
 
2013-04-26 03:42:57 PM  
Also, the hospital is allowed to sic collection agencies on you, ruin your credit, sue you, and take everything you own (subject to the law and/or bankruptcy) in order to recover payment for that "free" health care they provided you when you went to the emergency department. So actually, it's not free at all. It's just that those consequences may not matter as much to you if you don't own anything.

They have to treat you, but that doesn't mean they can't go after you later for payment.
 
2013-04-26 05:14:09 PM  
Have a similar story......
Called to the local strip joint for a seizure. Arrived to find a dancer in the bathroom on the floor doing her best seizure impression. I just watched her for a few minutes, noticed her regular breathing rate and the occasional eye opening to see if we were watching. When she stopped, i checked her pulse,it was in the normal range, and i told her if she pissed herself i might just believe her. She sat up and and flipped me off


As a county ER nurse, I ask that you please not tell such things to their faces. We have seizure fakers of all kinds (you know, the ones who never hit their heads when slamming themselves on the ground), and some have learned that incontinence is a sign of a real seizure. We have a couple who will deliberately shiat themselves. If possible, try to provoke or tempt them with questions like, "Would you like a sandwich?" and please discuss signs of fake seizures out of their earshot. Such ignorance will make the guesswork of real vs. fake seizures much easier, especially with repeat offenders.
 
2013-04-26 06:06:02 PM  

Mnemia: Also, the hospital is allowed to sic collection agencies on you, ruin your credit, sue you, and take everything you own (subject to the law and/or bankruptcy) in order to recover payment for that "free" health care they provided you when you went to the emergency department. So actually, it's not free at all. It's just that those consequences may not matter as much to you if you don't own anything.

They have to treat you, but that doesn't mean they can't go after you later for payment.


Not really. It depends on the state. Some states prevent Hospitals from going after property, others prevent them from reporting anything to a credit bureau either directly or through collections.

Tennessee has a fun little law that says no matter how much you send to pay in a healthcare bill, if they cash the check, it's considered a payment. So for a 40 Grand bill, if you sent in a monthly check for a dollar, it'd be considered paid to date if they cash the check.

More than one state says that it can only go after the estate of a deceased, and not their living relatives.

You're also assuming that the patient using EMTALA as "free" healthcare has any material assets the hospital would go after.

A trick many hospitals use, especially For-profits, is to write off uncollectible bills as charitable donations, and pocket the difference from Uncle Sam.
 
2013-04-26 08:04:45 PM  
100 in seven years? Pffft.  Amateur.  In my current response area, I've hauled the same guy 43 times in SIX MONTHS (yes, I did just search my run reports before posting this).  When I search by his name, he hit 100 between Jan and July of 2012.
 
2013-04-27 01:09:30 AM  

Myria: Dr. Nick Riviera: I dealt with that crap a lot when I did EMS.

It's scary to think about an EMT who calls himself Dr. Nick Riviera...

/never called 911


What is even scarier is that I am now a doctor who calls himself Dr. Nick Riviera.
 
2013-04-27 02:52:28 AM  
Not amused.

andersoncab.files.wordpress.com
 
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