Post #316,960
11/9/09 10:13:01 AM
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$29,000 for 5 minutes in the ER raises health care questions
SACRAMENTO Â For five desperate minutes, emergency room doctors at UC Davis Medical Center frantically tried to revive Scott Hawkins.
In those five minutes, the 23-year-old California State University, Sacramento, student was hooked up to life support monitors, air pumped into his weakened lungs as he bled on a gurney.
Hospital officials said Hawkins was given the highest level of emergency care, with a phalanx of surgeons, specialists and nurses at the ready. His parents called the effort "heroic."
Five minutes later, doctors pronounced him dead.
Few question the extent to which doctors tried to save the student's life on Oct. 21, but the amount billed for his emergency care has provoked outrage  a further example, critics said, of what is wrong in a health care system that is roundly maligned for its escalating costs.
The charge for those five minutes: $29,186.50 Â including a single-ticket item for $18,900.50, described on the itemized bill as "Trauma Rescue Service."
source: http://www.mcclatchy.../story/78533.html
"Chicago to my mind was the only place to be. ... I above all liked the city because it was filled with people all a-bustle, and the clatter of hooves and carriages, and with delivery wagons and drays and peddlers and the boom and clank of freight trains. And when those black clouds came sailing in from the west, pouring thunderstorms upon us so that you couldn't hear the cries or curses of humankind, I liked that best of all. Chicago could stand up to the worst God had to offer. I understood why it was built--a place for trade, of course, with railroads and ships and so on, but mostly to give all of us a magnitude of defiance that is not provided by one house on the plains. And the plains is where those storms come from."
-- E.L. Doctorow
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Post #316,967
11/9/09 11:18:51 AM
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Not that I'm justifying this specific item
But:
At what point is this type of item justified?
They might have had 20 people sidelined for a couple of hours to deal with it. His 5 minutes of care turned into dozens of reports, hundreds of pieces of paper or computer entries, etc.
Merely allocating a single Dr's time for 5 minutes of actual real emergency activity triggers a hell of a ripple effect.
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Post #317,175
11/12/09 2:15:35 AM
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Can pretty much guarantee
That every item on the list is, if you know the details, justified. Except for a small number of errors that probably aren't a significant factor.
It's all good people doing the best they can.
System failure.
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Post #317,191
11/12/09 10:27:54 AM
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I just saw this
The GF is a nurse.
The state just introduced 5-20 minutes of paperwork per day per resident that she has. It concerns interviewing for pain, medicating for pain, judging the result, documenting the results, justifying the result.
This seems to make sense. Obviously, they are worried about the old folks in pain. They want to know what works and who's paying attention. it's just a little bit effort, right?
She has between 18 and 22 residents. She is already very busy. Do the math of the additional time required. Start multiplying the cost of this piece of paper (or computer entry) per resident. Do you think management takes into account each of these additional pieces of paper when determining how to staff? Don't forget to multiply by all residents in all the homes in the state when determining extra hours. Yeah right.
Now add each of these pieces of papers that someone else thought was a good idea, without understanding the cost.
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Post #317,195
11/12/09 12:04:44 PM
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Solving the wrong problem
I think most of us (including your GF) would say a 22-to-1 patient/nurse ratio is way too high. If they don't have time to do things that they should be doing, the correct solution is not to just not do those things.
--
Drew
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Post #317,210
11/12/09 4:54:44 PM
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oh, agreed, but
it really doesn't matter.
Staffing is determined by budget, not the other way around.
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Post #317,226
11/12/09 10:04:43 PM
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Yes and no
I can guarantee that every item on there is, and has been, justified by a bean counter somewhere.
The funny part is that probably 1 in 100 will never pay anywhere close to that amount. Most insurance companies negotiate costs, so that a $30,000 charge becomes a $3,000 charge. (Yep, a 10-1 reduction)
Say that's 70% of the people treated. Of the 30% remaining, more than half are broke / can't pay. (They then write off the $30,000 as a business loss.) Another nearly half has some money, so they get some return on it, but they still write off the rest.
Oh, and I forgot the ones who died. They have to collect from the estate of the deceased (if they didn't have insurance). You can be pretty wealthy (at least in Florida) but if you die, lots of stuff gets transferred over before it ever enters probate. (Houses, cars, etc.) Only at the probate level do they get even a chance at any cash.
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