Rising Healthcare Costs Begin with the Ignorant

Bob Smith has a headache. It's been bothering him for almost a week, and the thirty one year old hasn't received a call back from his primary care physician since he placed a call with his service six hours ago. What does Bob do? He calls 911, and decides to use the emergency room as his interim primary care.

Such ignorance is more common place than many people think, or acknowledge, and it affects the healthcare system in a variety of negative ways.First and foremost, the ambulance industry nationwide, whomever contracts for a municipality, or is a municipal or third service, is transporting these patients with benign and insignificant complaints to the emergency room, while truly critical patients with legitimate life threatening illnesses, may have to wait an extended period of time for help. Why? Simply because the closest ambulance to you is busy taking Sarah Smith to the hospital for her one week of abdominal pain. This then crowds an already crowded emergency room, straining resources, and pushing staff's patient/caregiver time to the bare minimum, thereby risking errors.

The ambulances then attempt to receive reimbursement for the transport, and find only some insurance companies will cover the non life threatening transports. Or, in some cases, only reimburse partial care provided by the ems crews based on the treatment diagnosis. That is only a fraction of the problem, and a small one to boot. Most patients I have personally encountered with ignorance as their chief complaint have no insurance at all, and quite a few will announce proudly, "I'm gonna get right in, and I don't have to pay". They actually think that they will be escorted directly into an emergency room after the quick and free ride from the ambulance, where they will receive prompt medical attention for their sore throat, but the sad part is, they are right. So now the ambulance companies, or municipal services bill the insurance - less patients, only to go into collections, and so begins the cycle. Why do these patients assume that the ambulance ride is free? Simple. They won't pay the bill. A patient with a benign and non life threatening complaint usually yields around the four hundred dollar mark, while a somewhat more serious patient can easily top fifteen hundred dollars. That's a lot of money if a percentage of these patients go to collections.

Meanwhile, in the emergency rooms, as mentioned before, resources are being strained to the limits, while waiting room overcrowding is becoming more and more common place. Is this crowding due to more illness? Probably not, just a lack of patience, and inaccessible primary care physicians, or both. It isn't unheard of in the Boston suburbs for a patient to become frustrated while waiting an average of four to six hours for their sore throat, to call 911 from the waiting rooms payphone, and claim they have chest pain, only to be transported by ambulance to another hospital, where they will "get right in". Disgusting.

Lastly, the state of Massachusetts recently put into place mandatory healthcare/insurance for all who were uninsured. They even placed penalties on for those who were not insured by the deadline, and proof of insurance is mandatory for some paperwork taxwise to avoid these penalties. However, this insurance lacks the obvious resources to back it, and it's clients. Namely, available physicians. Most doctors who do primary care have well more than a thousand patients, and sometimes are by themselves. The patient with this mandatory healthcare then has to wait weeks for an appointment, for minor complaints, and when the patient either becomes exasperated, or the ignorance combines with their frustration, they seek primary care from the emergency room. Rumors of "clinics" operated by large chain pharmacies for minor complaints have surfaced, only to be attacked and investigated by those who believe the pharmacies are in it for financial gain.

In closing, I suggest we all think before we go to the emergency room, or dial 911. Ask ourselves some important questions. Is my sore throat life threatening? Will my genital warts make my head fall off? After all, you may not care who pays your ambulance and hospital bill, but in the end, I do.