How hospitals are killing E.R. patients.
This is from Joel A. Harrison, author of our recent feature, Paying More, Getting Less, which provides a novel argument in favor of a single-payer health care system.The issue of long waits at emergency rooms has been in the news, and even the Institute of Medicine has looked at the problem of "divert status," where ambulances are told by the nearest emergency room they are filled up and they need to go to another more distant emergency room. One story told of an ambulance spending 45 minutes before finding an emergency room willing to accept a patient.
Keep in mind that divert status has nothing to do with being insured! Some of the reasons are: 1. Because emergency rooms can't refuse treatment, they lose money on the uninsured, and many hospitals are closing their emergency departments; 2. Patients who are uninsured or underinsured use emergency rooms for primary care and/or wait until their conditions get serious, thus ending in emergency.
Now a new article in the online magazine Slate adds one more nail in the coffin of the profit-motive in health care, which puts us all at risk. Notice that in "socialized-medicine" England, the government requires and enforces that 98% of patients be seen within 4 hours. Of course, since everyone has health insurance and a family practitioner, one of the reasons for crowding is eliminated.
Notice also that American hospitals are fighting tooth and nail against even keeping waiting statistics. A recent report by the Commonwealth Fund put United States dead last in ability to get medical attention at night and on weekends among advanced industrialized nations, and poor placement in getting to see primary-care physician within 48 hours.
Waiting Doom
How hospitals are killing E.R. patients.
By Zachary F. Meisel and Jesse M. Pines
Last month, Esmin Green, a 49-year-old mother of six, tumbled off her chair and onto the floor of the Kings County psychiatric E.R. waiting room in New York City. Members of the hospital staff saw her lying there but did nothing for about an hour. When Green was finally brought into the E.R., she was dead. An autopsy revealed that she died from a pulmonary embolism, which occurs when a blood clot forms in the leg, breaks off, and travels to one or both lungs. This can also kill long-haul airplane passengers who sit in one spot for hours: The blood sits stagnant in their legs for so long that it clots. You could say that Green, too, had been on a plane ride of sorts. She'd waited for a psychiatric-unit bed to open up for more than 24 hours, roughly the same time as a trip from New York to Tanzania.
The surveillance video of Green collapsing and lying untended, as hospital staff at Kings County fail to respond to her collapse, is inexcusable by any stretch. And so Nancy Grace, for one, focused on the negligence. But what's largely missing from this story is the likely cause of Green's pulmonary embolism. The answer lies in a far more systematic and widespread danger in hospital care: E.R. waits. Why was Green sitting and waiting while blood pooled in her legs? Despite increasing evidence that crowded E.R.s can be hazardous to your health, hospitals have incentives to keep their E.R. patients waiting. As a result, there has been an explosion in E.R. wait times over the past few years, even for those who are the sickest.
Read the rest of the article...
Labels: health care, single-payer, Slate
The Doctors' Revolt
Ida Hellander, executive director of Physicians for a National Health Program, emailed us recently with praise for Paying More, Getting Less, from our May/June issue. She called the article "very clear and compelling. It will be very, very useful to all of us in the single payer movement... Thanks again for publishing this article. I've wanted something like this for many years!"In fact, a solid majority of U.S. doctors now support a single-payer system, as reported in a web-only piece posted to the American Prospect website on Tuesday:
The Doctors' Revolt
Doctors, the traditional advocates for the medical status quo, are increasingly in favor of major reforms to the U.S. health-care system.
Roger Bybee | July 1, 2008 | web only
Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.
The latest sign is a poll published recently in the Annals of Health Research showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.
The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program. Read more...
Visit the new health care links page on our site for more articles from D&S on health care, and for links to national and state-level organizations working for single-payer.
Labels: American Prospect, health care, Physicians for a National Health Program, single-payer