Conservatives really do want to let people die

Bryan Fischer may not be the best barometer of general-consensus conservative thought (although I personally believe he's no more, or not much more, radical than the rest of them; he just doesn't filter his bigotry because he's not running for office himself), but when he's echoing a theme we've seen from right-wingers before, only in more blatant form, it's hard not to take it seriously.

This time, he was offering a proposal on how to fix the healthcare system in this country.  His solution?  Remove the legal requirement that emergency rooms treat people who can't pay, and watch costs fall as all the sickest and poorest people exit the system - by way of death!  Quoting from the transcript on Right Wing Watch:
Hospitals should be allowed to set their own policies for services just like all other businesses, none of whom are forced to sell cars, food, or clothes to people who can't pay for them.
Because buying a car you can't afford is totally the same thing, and is absolutely morally equivalent to needing lifesaving medical care you can't afford!  o.O  One of these things is not like the other ones...

He then went on to whine that the whole trouble with the ER system is that people are using it "like corner medical clinics, for routine, non-emergency care, because they know they can get care that somebody else will be obligated to pay for."

Okay, first of all, no, they're not.  Nobody is making the trip to the ER, to sit there for anywhere from one to eight or even twelve hours, just for routine, non-emergency care.  That is a flat out fucking lie.

Second of all, you have to wonder if Fischer has ever gone to an emergency room when he hasn't had insurance.  (The answer I'm sure is "no", mostly because I'm sure he's never not had insurance - if he had, he wouldn't be so much of an ass about it.)  Like, does he realize they will usually bill you anyway?  I have known someone who had to go to the ER in a true emergency, her insurance didn't cover it, and she was getting bills for $10,000 for months that she couldn't pay.  It's not like they just patch you up and send you on your way with a friendly wave and a smile.  They do actually bill you later.

So knowing that, nobody goes to the ER for "routine" care.  What you do is you walk a knife's edge, when you start feeling sick or noticing some kind of something wrong with your body.  You google it.  You use WebMD's symptom checker.  You talk to your friends, see if anyone knows anyone who has had whatever symptoms you have, and how that turned out.  You gather information, self-diagnose as best you can, hoping and praying it's nothing major; you track the minutiae of your physical changes, and you are always asking and re-asking yourself the Big Question: "Is it serious enough to need treatment?"  The hope is that whatever is wrong with you will go away on its own - and often, it does.  The body is an amazing self-healing machine, sometimes.  If it doesn't, that's when you walk the knife's edge, pushing on without treatment for as long as you can, while hoping that whatever it is doesn't turn out to be fatal, hoping you aren't doing permanent damage to yourself by waiting.

And then, if it reaches a point where you can't function anymore, you know where you go first (unless it's a real emergency, like broken bones or something)?  To an urgent care clinic.  Not the ER.  The urgent care is usually only a couple hundred bucks, and they'll usually see uninsured patients (which many doctors refuse to do, so if you don't have insurance, you literally cannot see a doctor even if you're able to pay for it out-of-pocket).  Even if it's something really bad and they can't help you, they can usually at least tell you what it is, which you can use to decide if it's bad enough to go to the ER.

So no, nobody is treating the ER "like a corner clinic".  Fischer, please, shut up.  You are entitled to your own opinions, but you are not entitled to your own facts, and you are not entitled to make up scenarios in order to demonize people coping with a struggle you've never experienced.

Not that that's ever stopped you.


blackjewelsgirl said...

Actually there are a lot of people, at least where i live, that do use the ER as a walk in clinic.  I worked in the ER for several years and it was quite common for people to come in for refills on their meds, pregnancy tests, and general healthcare that was in no shape or form could be qualified as an event that required medical attention immediately.  Also quite often if people did not have a mode of transportation they would call an ambulance for transportation to the ER.  Now, in no way am I advocating that ER's should turn people away that cant pay.  That is immoral at best. But I dont believe that they should be excused from all responsibility for paying for the services that they utilized.  They should be financially responsible for paying some percentage for the services rendered.  What this gentleman suggested as a solution is wrong but people also need to realize that yes there is a serious problem with people using the ER as a "corner clinic".

Sonneillon said...

Yeah, I also have to chime in and say I've heard from mostly EMT's who have gone into great detail about how people use the emergency room as a corner clinic.  My husbands had to go there several times, and has always observed a problem of people with non-emergency conditions being there.  I am in no way agreeing with Bryan Fischer.  What I think is that for many people emergency room care is the only place they know they can go.  If more communities had accessible medical care, people might not go to the ER for non-life-threatening conditions, but some people are stupid, so I actually don't hold out a lot of hope.

Erin Smith said...

Just because you personally don't see them paying a bill does not mean they don't pay it. And it especially doesn't mean they don't get billed, and then sent to collections, and then hounded for *decades*. My sister is still getting collection calls from the birth of her child, and that was 14 years ago. My mom still gets credit collection calls for my father, and he died in 2001.

And it DOES affect your life. Just try getting a job so you can pay those damn outrageous bills when every company does credit checks and won't hire people with a poor credit rating.

But I guess since you don't see it, it means everything is roses and champagne and free chemo! yay!

Jadelyn said...

The use of credit checks as part of pre-employment screening is one of the more ridiculous things out there, imo.  It has that same weird illogic that banks use when they charge higher fees to people with less money.  Shouldn't having bad credit mean you need the work more, not less?  And what does my credit card history have to do with whether or not I'd be a good worker?  o.O  I always boggle at the un-logic there.

Jadelyn said...

Apologies for the lateness of my response, all.  

I apologize if I was off in thinking that nobody was using the ER that way - I based my conclusion off of myself as an uninsured person, and the vast majority of my friends and social circles who are also uninsured (like calls to like, I guess?  Or I just happen to hang out with a bunch of other young, broke, uninsured people), and none of us ever go to the ER if we can avoid it, for exactly the reasons I listed in my post.  

But even if the ER *is* being overused that way, I think the appropriate response is to ask WHY?  And how can that be relieved, without denying services to those without insurance (because, let's face it, that's what "can't pay at the ER" really means, given that hospital/ER bills are always in the thousands of dollars range, and without insurance to cover it, well, pretty much nobody keeps that much cash hanging around)?  

My mom suggested something in conversation about this topic - her family lives in Denver, Colorado, and every time she goes to visit them she notices that they have dedicated urgent-care clinics all over the place.  Not just like we have them in my area, where there's like two or three doctors offices that *turn into* an urgent care after 5 PM, but places that are actual urgent care clinics all day every day, to help fill the gap between "can't go to a regular doctor" and "not an emergency worthy of the ER".  I think, if there really is such an epidemic of people overusing the ER, maybe that's a way to cut down on such, instead of suggesting that hospitals be legally permitted to boot people out to die on the doorstep because they didn't come in with an insurance card or cash equivalent in hand.  

blackjewelsgirl said...

As you know there are a bunch of urgent care clinics here in murfreesboro and there are a lot of people that use them, insured or not.  And you would think that with them being prevalent that would be the obvious choice but in a huge number of cases thats not the case.  I can give you a long list of the reasons I have heard while working in the ER if you'd like :)  I've thought about this a fair amount and still feel that they should be charged for services if they come to the ER and are uninsured. But i think the more appropriate way to approach it would be to either 1) pay a percentage of their bill or 2) offer them the same discounts on the bill that the ins. companies enjoy.  I dont feel it is just to ask someone that is uninsured to pay for instance 10k for services that the insurance co. would only be required to pay 3k for.

Jadelyn said...

Actually, I *didn't* know that - I had the luck not to ever be sick enough to need a doctor while I lived out there, so I had no idea what there was besides the hospital. ;-)  I am a little curious what people cite as reason to go to the ER for non-emergency things, *if* they have access to other avenues of treatment.  

I absolutely agree about the unfair disparity between what the hospital (or doctor's office, as I have heard they do the same thing) charges insurance companies versus individuals for the same procedure.  Again, like I said to Erin above, it's that weird "they can't afford it - let's charge them extra for it!" un-logic.  I would bet that's a large part of why uninsured people can end up with so much medical debt - not only are you having to try to cover it out of pocket, but the same procedure is costing two or three times as much to boot.  >.<

blackjewelsgirl said...

okies i'll give you the short list :)
Pregnancy test- because i didnt want to wait til tomorrow to go to the clinic and i dont have money to go buy one ( heard this one a lot!)
Refills- i didnt have time, didnt want to, forgot to go get my prescription refilled and i'm out of my meds
Elderly- I have a soft spot for the elderly in the ER and although to us the reason i heard about a quarter of the time from them may sound like an unreasonable reason to go to the ER, i felt sorry for them.  The reason- I was lonely and scared.

I can go on if you'd like :)

Jadelyn said...

Is it strange that I can empathize with and understand all three?  Pregnancy - no, it's not an emergency, but it's scary contemplating whether you might be and I can definitely see how it could turn into "I have to know right now" kind of thing; refills - well, I would wish people would refill them ahead of time, for sure, but if you didn't and it gets to that point then, depending on the med, maybe it is really critical that it's taken care of right away; and the elderly, that's just really sad to hear. :-/  

blackjewelsgirl said...

The pregnancy thing yes i can see the the i need to know right now mentality but in reality 8 hrs isnt going to change the result and its not an ER visit necessity.  The meds- yes if it was a med that is on a critical time schedule or a life or death situation, i can totally understand the ER visit.  Problem was though it rarely fell into those 2 categories.  And the elderly...well you can see why i could never personally fault them but still it wasn't a ER visit necessity.  Those were the ones i always spend a little extra time with just because it broke your heart.


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