# There has GOT to be a better way. **URL:** \ **Category:** The BBQ Pit\ **Created:** [July 24, 2002, 4:45pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598 "2002-07-24T16:45:23Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Biggirl](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biggirl/32/3294_2.png) [@Biggirl](https://boards.straightdope.com/u/Biggirl)\ **Post date:** [July 24, 2002, 4:45pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/1 "2002-07-24T16:45:23Z")
I went to the emergency room yesterday. I contributed to the skyrocketing cost of medical care in this country. I pulled resources better spent on those who truly need it. I took a day off from work, inconveniencing myself and my employer, who will pay me for a day in which I did no work. I had no choice, but it didn’t have to be this way. Not to mention the 8 hour wait because I was not really in need of emergency care. My mattress bit me. A spring sprung right through the bedding and poked a hole in my side Tuesday night. By Friday I knew it was infected so I called my doctor. The office is closed and will remain closed for a week. The next appointment available to me was in a week and a half. I am diabetic. I have already had cellulitis and I am not about to go through that again if I can help it. My doctor’s office advised me to go to the ER if I felt the wound was really infected, so I did. I have worked in the health insurance industry. I _know_ how much unneccessary ER visits costs. The football injury on Sunday afternoon. The panicky new mothers with feverish infants at 2 am. The exploding cysts. The cost to everyone for my stupid visit, multiplied by several thousand stupid emergency room visits is staggering. **THERE HAS GOT TO BE A BETTER WAY!** This mini-rant bought to you by one disgusted American healthcare user. Yeah it was infected. Had it drained, got antibiotics. Cost? About $5000 ---
**Author:** ![KneadToKnow](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kneadtoknow/32/3999_2.png) [@KneadToKnow](https://boards.straightdope.com/u/KneadToKnow)\ **Post date:** [July 24, 2002, 4:51pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/2 "2002-07-24T16:51:08Z")
Do they not have those doc-in-a-box places where you live? ---
**Author:** ![wring](https://avatars.discourse-cdn.com/v4/letter/w/838e76/32.png) [@wring](https://boards.straightdope.com/u/wring)\ **Post date:** [July 24, 2002, 4:54pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/3 "2002-07-24T16:54:12Z")
Does your doctor not have some one on call? ---
**Author:** ![gigi](https://avatars.discourse-cdn.com/v4/letter/g/a587f6/32.png) [@gigi](https://boards.straightdope.com/u/gigi)\ **Post date:** [July 24, 2002, 4:59pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/4 "2002-07-24T16:59:19Z")
Holy shit, $5000 ??? :eek: How does that break down? Luckily there is a walk-in clinic in the hospital here which doesn’t get much business so they are happy to see me and never give me trouble about not having a referral from my PCP. I just have to pay the office co-pay and extra for x-rays, etc. I hear you on the wait–12 hours for me for pinkeye (I didn’t know what it was and was scared enough in the middle of the night to go to the ER) in DC as the gunshot victims went by. ::still trying to wrap my mind around $5000:: ---
**Author:** ![Biggirl](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biggirl/32/3294_2.png) [@Biggirl](https://boards.straightdope.com/u/Biggirl)\ **Post date:** [July 24, 2002, 5:01pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/5 "2002-07-24T17:01:25Z")
\*\* KneadToKnow \*\*, what’s a doc-in-a-box? **wring**. Apparently not. Her office told me the next available visit was next Saturday. Waaay too long a wait. I would have _really_ needed emergency services by then. ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [July 24, 2002, 5:01pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/6 "2002-07-24T17:01:55Z")
I know at the clinic in my hometown, they had an “urgent care” clinic where stuff that falls under the “not-quite-emergency” label was seen; you’d walk in, check in at the desk, and patients would be triaged based on complaint and arrival time. I wonder if a medical center in your area might have a service like that. ---
**Author:** ![World\_Eater](https://avatars.discourse-cdn.com/v4/letter/w/f04885/32.png) [@World\_Eater](https://boards.straightdope.com/u/World_Eater)\ **Post date:** [July 24, 2002, 5:04pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/7 "2002-07-24T17:04:48Z")
If I had an exploding cyst (ugh!), I certainly wouldn’t consider a ER visit unneccessary! Most people cut themselves and see blood gushing out, they dont sit there and think, gee it looks a lot worse then it is, I don’t want to bother anyone, I’ll just wrap it up here. Of all the things my tax dollars go to, at least I can go to a place to get medical treatment whether its deemed neccessary or not. The system isn’t perfect by a long shot, but it’s a hell of a lot better then some other places. ---
**Author:** ![Hemlock](https://avatars.discourse-cdn.com/v4/letter/h/c5a1d2/32.png) [@Hemlock](https://boards.straightdope.com/u/Hemlock)\ **Post date:** [July 24, 2002, 5:06pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/8 "2002-07-24T17:06:19Z")
Two things I don’t get… 1. A week and a half to see a doctor??? Doesn’t your regular doctor delegate patients to another doc when he’s off on a golf game or something? 2. $5,000 ??? Even if that’s a typo and it should be $500, I’d still want to know where the money’s going Something wrong in both cases. ---
**Author:** ![jk1245](https://avatars.discourse-cdn.com/v4/letter/j/49beb7/32.png) [@jk1245](https://boards.straightdope.com/u/jk1245)\ **Post date:** [July 24, 2002, 5:07pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/9 "2002-07-24T17:07:39Z")
Just to pile on here… Yesterday I called my friendly GP’s office to schedule my annual physical that I faithfully undergo once every seven years. Anyway, I am told “I can get you in on the 26th of November” I respond with “Umm, November? Anything maybe a little sooner?” The receptionist then gets a bit snippy and says “Well, we have a new doctor starting in September. I could maybe get you in to see him” So I take the new doc appointment and make a mental note to check and see what other health plans are offered by my work. It does seem that there should be a better way. ---
**Author:** ![Biggirl](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biggirl/32/3294_2.png) [@Biggirl](https://boards.straightdope.com/u/Biggirl)\ **Post date:** [July 24, 2002, 5:15pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/10 "2002-07-24T17:15:01Z")
Let me clarify a bit. The cost to _me_ is $35-- my ER co-pay. I have medical insurance. However, I worked for Empire BC&BS and I know that the hospital charges for ER services was $3500. That did not include doctor’s charges or lab fees. And that was about 10 years ago. ---
**Author:** ![IzzyR](https://avatars.discourse-cdn.com/v4/letter/i/2acd7d/32.png) [@IzzyR](https://boards.straightdope.com/u/IzzyR)\ **Post date:** [July 24, 2002, 5:22pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/11 "2002-07-24T17:22:18Z")
> [@](#): > > \*Originally posted by Biggirl \* > However, I worked for Empire BC&BS and I know that the hospital charges for ER services was $3500. That did not include doctor’s charges or lab fees. And that was about 10 years ago. I would think this is off by at least a factor of 10. Probably more. ---
**Author:** ![IzzyR](https://avatars.discourse-cdn.com/v4/letter/i/2acd7d/32.png) [@IzzyR](https://boards.straightdope.com/u/IzzyR)\ **Post date:** [July 24, 2002, 5:37pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/12 "2002-07-24T17:37:57Z")
Looked around just a bit. [http://www.nur.utexas.edu/cwc/body1.htm](http://www.nur.utexas.edu/cwc/body1.htm) “The average cost of an outpatient emergency room visit for the most frequently diagnosed problems among children is $200” [http://www.pharmacy.umaryland.edu/~mpc/About\_Us/FAQs/faqs.html](http://www.pharmacy.umaryland.edu/~mpc/About_Us/FAQs/faqs.html) “The average cost of a usual poisoning related emergnecy room visit in Maryland is between $500 and $1,000” [http://www.cbsnews.com/stories/2002/07/12/earlyshow/saturday/main515023.shtml](http://www.cbsnews.com/stories/2002/07/12/earlyshow/saturday/main515023.shtml) “The emergency room visit, plus ambulance, to Medicare, might cost $2,000 or $3,000” None of these are definitive, of course. In any event, the larger point that Biggirl is making is true - ER visits are extremely expensive and are unnecessarily wasteful - for this reason many insurance plans charge special copays ($35 or $50) for ER visits that do not result in admission. ---
**Author:** ![Geobabe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/geobabe/32/3908_2.png) [@Geobabe](https://boards.straightdope.com/u/Geobabe)\ **Post date:** [July 24, 2002, 5:38pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/13 "2002-07-24T17:38:25Z")
**DeniseV** beat me to it; don’t they have urgent care clinics in NYC? They were all over Northern VA, and I think they’re fantastic. Perfect for things like your infected wound-- I’d always go to one when I got a UTI, since that’s something that’s not life-threatening, so it doesn’t warrant a trip to the ER, but also can’t wait a week or more for an appointment with the doc. ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [July 24, 2002, 5:38pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/14 "2002-07-24T17:38:34Z")
Humm. Here in Canada there are walk in clinics. You just walk in, see a GP and away you go. Kinda like one of those SuperCuts hair places - no appointment necessary. The wait is usually about 1/2 an hour. If it’s longer you can leave and come back at the appropriate time. They’re usually located in malls, so it’s a good chance to do som shopping. 🙂 Last I heard, a vist to a walk in clinic gets bill to Alberta Health for $19. An emergency room visit has a base bill of $278. Clearly not $5,000, but still quite a bit more. (My SIL is Japanese and when she moved here she was on a visitors visa and had to pay for her health care, hence I know the rates - this was about 6 years ago, however). ---
**Author:** ![gigi](https://avatars.discourse-cdn.com/v4/letter/g/a587f6/32.png) [@gigi](https://boards.straightdope.com/u/gigi)\ **Post date:** [July 24, 2002, 6:22pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/15 "2002-07-24T18:22:38Z")
> [@](#): > > \*Originally posted by World Eater \* > \*\*If I had an exploding cyst (ugh!), I certainly wouldn’t consider a ER visit unneccessary! Most people cut themselves and see blood gushing out, they dont sit there and think, gee it looks a lot worse then it is, I don’t want to bother anyone, I’ll just wrap it up here. \*\* It’s funny how the health insurance (HMO) company I have writes up what is emergency-room worthy. Even a broken bone after hours has to wait until your PCP can look at it. Only if the situation is life-threatening can you go straight to the ER without the PCP’s referral and expect to pay only the co-pay. from the FAQ’s for my plan: > [@](#): > > Yes, we cover emergency care. Emergency care is defined by your contract or benefit certificate, but generally means those health care services that are provided in an emergency facility or setting after the onset of an illness or medical condition that manifests itself by symptoms of sufficient severity that without immediate medical attention could be reasonably expected by the prudent lay person, who possesses an average knowledge of health and medicine, to result in: a) placing the Member’s physical and or mental health in serious jeopardy; b) serious impairment to bodily functions; or serious dysfunction of any bodily organ or part. > > Urgent care may not be covered to the same extent as emergency care. Urgent care is defined by your contract or benefit certificate, but typically means services received for an unexpected episode of illness or injury requiring treatment which cannot be postponed, but is not emergency care. Urgent care conditions include, but are not limited to earache, sore throat, fever not higher than 104º. Treatment of an urgent care condition does not require use of an emergency room at a Hospital. > > You need to check your contract or benefit certificate to see whether urgent care is covered. Typically, urgent care is covered if provided in a non-emergency room setting, by a network provider. This last part must be why the walk-in clinic is OK. That’s where I go for ear infections, flu, to check on whether a sprain is in fact a break, etc. Biggirl, I’m glad you had insurance for this! $5000 seems like a lot, but it must be that ER thing. Even having a baby is “only” the $8-10K range, right? ---
**Author:** ![Biggirl](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biggirl/32/3294_2.png) [@Biggirl](https://boards.straightdope.com/u/Biggirl)\ **Post date:** [July 24, 2002, 6:41pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/16 "2002-07-24T18:41:52Z")
Hmmm. Living in New York _must_ be incredibly expensive. Hospital charges here are very, very, **very** expensive. 10 years ago one inpatient day costs around $1500. Again this is only hospital charges. Let me clarify further-- hospital _room_ charges. Doctor’s fees, medicine, lab and x-rays— all seperate charges. And boy did our customers explode if they ever saw an itemized inpatient bill. 7 dollars for asprin. $350 for crutches. There was a study done that said that many private hospitals subsidize other portions of their facilities by charging Medicaid ER rates for non-emergency ER visits. Let me see if I can find that. P.S. Here in NY there _used_ to be a patient rights bill. This bill stated that all charges must be posted in plain sight in the emergency room. This apparently does not apply to websites, because none that I visited posted their fees. ---
**Author:** ![Helen\_s\_Eidolon](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Helen\_s\_Eidolon](https://boards.straightdope.com/u/Helen_s_Eidolon)\ **Post date:** [July 24, 2002, 6:51pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/17 "2002-07-24T18:51:48Z")
I was wondering why **alice** was quoting prices! Yeah, all healthcare stuff here is covered. Also, our ERs are pretty damn overtaxed (at least in Montreal) but we have walk=in clinics and CLSCs (provincially-run walk-in clinics) sprinkled about the city. ---
**Author:** ![Biggirl](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/biggirl/32/3294_2.png) [@Biggirl](https://boards.straightdope.com/u/Biggirl)\ **Post date:** [July 24, 2002, 7:01pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/18 "2002-07-24T19:01:13Z")
[Here it is.](http://www.cgr.org/articles/mp_entries/getEntryFieldbyPath/993746918.396/story_pdf/NYS%20Medicaid.PDF) According to this report NYS spends more than any other state for Medicaid. 2.5 times the average for Medicaid yet physicians are reimbursed at one of the lowest rates in the country. This really does speak to hospital costs here. Urgent care centers would help that considerably. ---
**Author:** ![Podkayne](https://avatars.discourse-cdn.com/v4/letter/p/edb3f5/32.png) [@Podkayne](https://boards.straightdope.com/u/Podkayne)\ **Post date:** [July 24, 2002, 7:08pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/19 "2002-07-24T19:08:57Z")
**gigi** , a broken bone doesn’t count as serious dysfunction of a body part? ---
**Author:** ![IzzyR](https://avatars.discourse-cdn.com/v4/letter/i/2acd7d/32.png) [@IzzyR](https://boards.straightdope.com/u/IzzyR)\ **Post date:** [July 24, 2002, 7:23pm UTC](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598/20 "2002-07-24T19:23:41Z")
> [@](#): > > \*Originally posted by Biggirl \* > According to this report NYS spends more than any other state for Medicaid. 2.5 times the average for Medicaid yet physicians are reimbursed at one of the lowest rates in the country. > This really does speak to hospital costs here. I would dispute this. Medical costs in NY are higher than the national average, but not by a tremendous amount. In quickly scanning through the linked report, I did not see them attribute the high cost of Medicaid to high medical costs - rather, they linked it to over-utilization of services. They noted - among other things - that Medicaid is a far more generous plan than any of the private insurance plans that they looked at. They recommended introducing managed care and (I think) more careful screening for eligibility) [Next page](https://boards.straightdope.com/t/there-has-got-to-be-a-better-way/120598.md?page=2)