What would we do without emergency room?

Column from the Hendersonville Times-News
http://www.blueridgenow.com/article/20080225/NEWS/802250301
Published Monday, February 25, 2008

What would we do without emergency room?

Life In The Middle
Susan Hanley Lane

What would you do if someone you loved was having a heart attack and there was no emergency room to go to?

Throughout America, hospitals and emergency rooms are having a hard time staying afloat thanks to HMO reimbursement guidelines, government cutbacks and rate freezes on Medicare and Medicaid, and a growing number of uninsured patients.

Like any other business, a hospital must pay its staff if it wants them to keep coming to work. They also have to pay their heating and electric bills, and their taxes.

Most of us take hospitals for granted because whenever we've needed them, they've been there. But an increasing number of Americans are finding out that when hospitals don't get paid, sooner or later they shut down. Go to Google on your computer and type in: emergency room closings. You may be surprised to discover you have about 130,000 entries to choose from. The overwhelming consensus is that emergency rooms, along with everyone else, are feeling the pinch of a tightening economy. But there are only so many things a nation can afford to do without. Emergency rooms are not one of them.

We've been hearing promises about affordable health care for years now. It's becoming a standard election year promise. The unpleasant truth is the solutions to this national health threat will be a tough pill to swallow.

If we ever hope to truly contain the cost of healthcare, we're going to have to change the way we approach 1.) the relationship of lifestyle to disease,
2.) the breakdown of the mental health care safety net, 3.) uninsured populations accessing our health care system, and 4.) the role of large insurance companies in setting reimbursement guidelines.

1.) The relationship of lifestyle to disease: Obesity, diabetes, substance abuse, heart disease, and many cancers are often the result of lifestyle choices. Unless we do the hard work of taking personal responsibility for our own health and the health of our children, these diseases will continue to gobble up a disproportionate share of our health care dollars.

Preventive health care is not just the medicine of the future. It is the fastest way to prevent overuse of the health care system from bankrupting America. What were we thinking when we allowed fast foods to be sold in schools? Do we wonder why obesity is skyrocketing with soda machines in the hallways?

Also, Americans have a right to demand that lobbyists for large corporations, like Monsanto, not be allowed to induce legislators to enact laws that forbid farmers from saving the seeds from their own crops and/or having to buy genetically engineered seeds that do not reproduce themselves.


2.) The breakdown of the mental health care safety net: Quiz question
- What facility has the largest number of mental health care patients in the United States? Answer: The Los Angeles County Jail. This is a national disgrace. A nation that refuses to care for its own mentally ill population is guilty of the basest neglect, no matter how many foreign dollars it borrows to fight the righteous wars of other nations.

Believe it or not, substance abuse comes under the umbrella of mental health care. The lack of a real strategy to eliminate the drug culture that is flourishing across America has resulted in the number of arrests and imprisonments in our large cities doubling within the last decade.

Effective drug treatment, not building new jails, is the most cost effective way to fight the drug war. For every dollar spent on treatment, seven dollars are saved on cleaning up the aftermath of drug abuse in our society.


3.) Uninsured populations accessing our health care system: It is a strain on any emergency room to eat the cost of patient care. But generally, even the uninsured pay income taxes, part of which are funneled back into the health care system by state and local governments. It's not an even trade off, but this system has allowed emergency rooms to survive for many decades.

Unfortunately, in recent years things have changed. The number of undocumented workers who do not contribute to the tax base has soared.
No nation that allows non tax-payers equal access to its emergency rooms can survive when the non tax-payers using those emergency rooms is a significant part of the population. (If you doubt this, type these words into your search engine: emergency room closings in southern
California.)

If we do not solve this dilemma, don't be surprised if someone you love one day has a heart attack (say on a Sunday evening) and there is no emergency room close enough to take him to in time to save him.

4.) Large insurance companies setting reimbursement guidelines for health care providers: When HMO (Health Maintenance Organizations) first came on the scene, we were told they would manage our care.
Instead, they have managed their own health by cost cutting and refusing to pay the kind of fees many health care providers need to charge to stay in business.

Something like the Hill-Burton law of 1946 would place the burden of health care for the uninsured back into the hands of state governments, which could then establish guidelines allotting grants and/or loans to hospitals to sustain reasonable treatment levels based on the most recent census data.

The establishment of free or low fee clinics with emergency rooms, where indigent people could go for care, is another option to solve this problem.
Tax incentives could be granted to physicians, and hospitals who agree to participate.

The answers to our health care dilemma involve tough decisions. But we can do it if we will stop settling for political promises that are nothing more than candy coated lies.