perfidy

Wow... that just trips gaily off the tongue.

I see that Reuters is reporting that the Government has revised the rules governing what patients may be turned away by hospital emergency rooms, making it easier for hospitals to deny care.

The idea is that many poor people, who don't have insurance, are using the Emergency Room as a primary-care facility, and these rule changes are meant to fix that loophole.

Well, thanks. On the face of it, that's fine and dandy, but it totally fails to address the underlying problem-- that there are as many as forty million people in the USA who don't have insurance and therefore need to rely on emergency medicine.

The problems with this?

• Emergency room visits are damn expensive. This is part of the larger economic trap that poor people get into where they cannot afford high monthly payments on furniture, COBRA, or car insurance, for example, and then get bit in the ass when disaster strikes. I've been in this position, and it's really, really easy to get sucked into a debt spiral as catastrophe costs mount.
• It's really hard to get good baseline health care if you only go to the hospital when you're sick. That means that the 40 million uninsured Americans are not getting the yearly physicals, breast exams, prostate exams, mole checks, and so forth that lawmakers take for granted.
• Clearly, emergency rooms are not the place for primary care, but in the absence of any other reasonable, affordable choice, . . . ?

Basically, I think a baseline national health care program is a pretty great idea. I'm not looking for a full-blown endless-referral system, but just some broken-bone and checkup system that gives economically marginal citizens a chance to stay both economically and physically healthy.

Dean in '04!

[moreover] Politicians and policymakers always seem to forget that most Americans don't have much in the way of "fuck-you" money, as we used to call it in the entertainment biz. That is, savings socked away that can get you through a few months without a job, or cover a disaster. A lot of conservative social policy seems predicated on the existence of such "fuck-you" funds, and it just ain't there. Therefore, economists and politicians tend to wildly overestimate the ability of people to move out of depressed regions or search for a new job if their current one doesn't pay well enough. Just my two cents.