California Emergency Rooms Overwhelmed With Wait Times Averaging Five And A Half Hours

Remember when national health care was going to finally clear our emergency rooms? It has not exactly worked out that way, particularly in California. While there are clearly other benefits from national health care, the hope that people would turn to regular medical visits rather than ER visits has not materialized in California where the average wait time is five and a half hours. An astonishing 57% of patients left before seeing a doctor due to the delay — that constitutes roughly 352,000 persons leaving without fully addressing their medical conditions.

Emergency room visits grew 20 percent from 2012 to 2017. That translates to an additional 2.4 million patients on top of the already over-taxed hospitals.

Given the hundreds of billions spent on health care, it is incredible to think of having to sit for an average of 5 1/2 hours to just see a doctor. What is worse, the wait times are even longer in four states — Maryland, New York, New Jersey and Delaware.

I have been critical of our health care system for years, particularly with the ridiculously high medical and drug prices. The horror stories of absurd medical bills are now routine. The question is what he have gotten from hundreds of billions of dollars in the most expensive health care system in the world.

183 thoughts on “California Emergency Rooms Overwhelmed With Wait Times Averaging Five And A Half Hours”

  1. Without care from the medical industry these poor souls will be deprived of invasive expensive tests and procedures. I predict more vibrant health and greater longevity for those who refused to wait for Mass medicine.

  2. OT: Planned Parenthood Clinic shut down for health and safety violations

    4251 Forest Park Avenue, St. Louis, MO 63108
    Health Violations
    • Expired meds, IV fluids, and supplies. Some as old as 6 years (repeated violation)
    • Staff using single dose injectable medications for more than one patient to “save money” (repeated violation)
    • The bin with emergency supplies in it “covered in dust” confirming that the supplies had not been checked in quite some time
    • The staff did not log their abortions over 18 weeks gestation as required by law.
    • Fire extinguishers were not tested
    • No background checks on employees
    • Patient’s not given their Patient Bill of Rights as required by law
    • Medications not stored properly (repeated violation)
    • Staff did not wear personal protective equipment to ensure protection from bloodborne pathogens as they cleaned surgical instruments. The likelihood of splashes and splatters is great.
    • Tears in the exam tables; these tables could not be cleaned to ensure that women were not exposed to infections
    • There was dust covering equipment and supplies all over this clinic
    • The refrigerator had not been cleaned in over 1 1/2 years according to a staff member (health care assistant) who had been working in the clinic for that period of time. He had no idea who was responsible for that.
    • The clinic did not send fetal tissue for pathology evaluation as required by Missouri law
    • Failed to properly sterilize instruments that are used from woman to woman
    • Medication refrigerator temperature was recorded as “out of range” with no intervention or resolution for several days. Anything stored in this refrigerator was compromised.
    • Staff used heating pads on patients in recovery that were clearly marked “for household use only”
    • No infection control training on staff
    • No orientation on staff
    • Failed to maintain an accurate record:
    • Medication orders were not timed, dated or signed by the doctor
    • Lactate Ringers were not recorded as ordered
    • Medications documented as administered by nurses had no dosage and were not timed, dated or signed by a nurse
    • Oral sedation was given, but the name of the medication and who administered it was not recorded
    • One woman was recorded as receiving medication to increase uterine contractions nearly five hours after she had been discharged from the center.
    • Patient’s vitals were not recorded every 15 minutes before patients were discharged
    Report 2009 Report 2013Report 2015 Report 2016Report 2016
    DISCLAIMER: All of the inspection reports on this site were acquired through public records request to state departments of health and public records online.
    Design by Alice Paul Group – Website Development by 805collective

    https://checkmyclinic.org/clinics/planned-parenthood-st-louis/

    1. Alan, should we believe these ‘violations’ were found in good faith? Like they weren’t found by Republican-serving investigators looking to close the clinic?

      What is the clinic’s safety record? How many 9/11 calls were logged from that location? How many women sued the clinic for malpractice? ..These are questions objective analysts would ask.

      From what I have read so far, nothing about this clinic stands out as dangerous or alarming. What is alarming, though, is the state of Missouri wants to subject every doctor linked to this clinic to open-ended depositions!

      In other words, the state of Missouri wants to literally embark on legal fishing trips to intimidate doctors who perform abortions.

      What if bartenders were subjected to open-ended depositions? “Have you ever served a visibly intoxicated customer?” ..How many bartenders would care to answer that..??

      How many butchers would care to answer this question: “Did you ever present for sale meat you knew was less than fresh?”

      How many cops would care to answer: “Did you ever seek to detain someone without justifiable cause?”

      The point is professionals in any number of fields could be totally intimidated by open-ended depositions. And I’m surprised the national media has not given more coverage to Missouri’s devious antics here.

      1. Look at the safety violations. They can be checked on. It wouldn’t be the first any clinic abortion or otherwise was shut down for such complaints.

        Don’t you care about the safety of women? Repeated violations of old medications (up to 6 years old)? If the clinic was taking adequate care it would be able to document that these complaints were phony but I don’t think so. Repeated violations of improperly stored medications. This doesn’t seem to be the first time this clinic was in trouble. “Report 2009 Report 2013Report 2015 Report 2016Report 2016”

        Peter, time to reevaluate your thinking processes.

        1. Alan, these anti-abortion restrictions are going to blow-up on Republicans (as they usually do).

          Already Trump and House Minority Leader McCarthy have voiced unease at Alabama’s draconian restrictions with no exceptions for rape or incest. This is causing a split among conservatives. Even most Republicans believe there should be exceptions.

          In any event this current push for abortion restrictions is almost guaranteed to incite a backlash among women voters in next year’s election. And if you don’t believe me, look at public opinion polls. Less than 30% of America wants total abortion bans.

          The truth is that outside the deeply red states, support for legal choice remains fairly strong; especially among educated women. What’s more, there’s a good reason Republicans never tried for a national abortion ban. Their own pollsters have told them (repeatedly) that a national ban would be a political loser.

          1. The abortion issue will blow up on all sides. There is no escaping it. The issue of infanticide is very powerful.

    2. Nothing as crazy as a commie/lib/dem American hating judge approving the continued use of basically Dirty Coat Hangers on unsuspecting women, when instead the judge could have temporally closed the joint because of possibility of irreparable harm to people in the community!

      What the heck, a week or so?

      1. Yes, Oky, but does Peter care about the safety of the women? No. That clinic had previously been cited. All they had to do was maintain good records which is normal for a medical clinic and the clinic could have proven that the claims were knot truthful by following the expenditures. That clinic apparently didn’t do that either.

        Take note where Peter’s concerns are. They are ideological concerns and not concerns for the safety of patients.

      1. Darren, I don’t think you have any control over this but just to let you know my auto save for information disappeared again so WordPress must have a problem.

        1. What do you mean by autosave? If it helps, if when writing a large comment and WordPress is giving you difficulty you might try composing your comments in another medium such as msword or notepad and when complete then copy & pasting it to the wordpress comment text field. That way if wordpress chokes up, you still have what you originally typed without resorting to typing it in again.

          1. Darren, I probably am using the wrong word. Just below the box we write our comments in is the following: “Fill in your details below or click an icon to log in:”

            Below that is the email and name which always pops up as long as one presses the ” Save my name, email, and website in this browser for the next time I comment.”

            In the past after posting the name and email remained so it didn’t have to be reentered. (I use an Apple and Safari). Suddenly for each posting I had to reenter the information so I stopped enterring the address and I was placed with the generic icon and my name that I filled out each time. Just as suddenly it restarted saving my name / address and now once again has lost it so unless I spend the time typing my address it provides a generic icon. That is why others might also be using a generic. It seems like a WordPress problem but blamed on the wrong people by others.

            Thanks.

  3. Yea for open borders, can we please get sick and diseased people here faster? Leftist will destroy the country, if you let them.

  4. Prescriptions for painkillers have dropped about 20% over the past 8-10 years, as the so-called called opiod crisis grows.
    Contrary to what Peter “remembers”, I never said that no one dies from ODing on legally prescribed drugs.
    What I have said and am saying here is that denying people like your husband (and many others) pain relief is a major result of “the war on opiods”.
    When regulators have physicians and hospitals looking over their shoulders and gun-shy about prescribing pain-killers because they fear they’ll run afoul of some agency, that WILL impact access to effective pain management.
    It won’t stop illegal manufacture or importation of fentanyl or black tar heroin or other illegal drugs, but the regulators can put themselves on the pack for cutting back access to legimate pain medication.

    1. Tom, we realize painkillers are a necessary evil for chronic sufferers of debilitating pain.

      But the opioid epidemic is ‘not’ a Culture Wars issue. Nor is it a manufactured crisis. The epidemic, in fact, effects some of the most conservative states in this country.

      Already litigation has revealed that Purdue Pharma, makers of Oxicontin, kept pressuring its Sales Force to really ‘push’ the drug. Purdue kept pushing Oxycontin despite warnings from in-house studies that the drug was indeed highly addictive.

      Massachusetts has put together a devastating legal case against Purdue Pharma. Legal analysts believe the company’s future is at stake. Members of the Sackler family could possibly lose their fortunes. Evidence shows they profited enormously as abuse of Oxycontin surged.

      So ‘yes’, painkillers must be available to those who really need them. But the opioid crisis is genuine. For reasons that make no sense, painkillers were overmanufastured and overprescribed for a period of years.

      According the Center For Disease Control, more than 200,000 people died from prescription opioids between1999-2017 in the United States. That’s a disturbing statistic. And it’s a trend that began in the not-so-distant past.

      1. Peter, you should look at the breakdown of overdosing and death from the types of opiods.
        It might surprise you to learn that NON- OPIODS are also getting out of reach for patients who need them because of the “just say no” mentality that is taking hold in health care providers.
        What Karen S. described is becoming more and more common as gun-shy health care providers breathing down their neck.
        It’s fine to say, “well sure, we need to provide pain relief for those who really need it”, but I can tell you that it doesn’t work out that way.
        When you have detached beureacratic regulators driving health givers decisions on whether or nor to provide pain relieve, you get the kind of experiences Karen S. mentioned.
        If I had time, I could give you a lot more similar experiences.
        And, again, no one has yet to explain how drastically restricting legimate access to prescription drugs…..some of which are not even opiods…….is going to stem to flow of the street drugs that are responsible for most opiod deaths.
        You can pretend all you want that those in actual need will not be affected, but that is a fantasy.

        1. https://www.npr.org/sections/health-shots/2018/07/08/622729300/patients-with-chronic-pain-feel-caught-in-an-opioid-prescribing-debate
          I’ve seen this farce and groupthink play out before in different ways and in different places.
          Anyone naive enough to believe that this so-called call “War on Opiods” isn’t going to interfere with access to painkillers for patients with established, legitimate need does not have an accurate picture of what actually goes on.

          1. https://www.cato.org/publications/commentary/arizonas-opioid-policy-still-not-working
            If people want to “get real” about the impact of the “war of opiods”, they should do a bit of research.
            If politicians and regulators simply want “feel good” legislation to pretend that they’re actually getting something done, states like Arizona are providing a good model.
            And what’s going on in Arizona is hardly unique, so a lot of states are already on board with this kind of fantasy/ policy.

          2. i totally agree with you tom we knew 2 cancer patients who literally bit the bullet back in the early 90s because of overzealous opiate restriction policies.

            and the pain docs are scared now and under a lot of microscopic investigation and prosecution

            harm reduction is a good policy
            but it’s kind of like telling global warming peopel to focus on mitigation of effects rather than endlessly parsing causes. they are more interested in policy debates than just handling the problems.

            it’s great to want to treat the cause and not band aid a problem — but some problems are intractable causes and bandages are better than nothing.

    2. Tom:

      “What I have said and am saying here is that denying people like your husband (and many others) pain relief is a major result of “the war on opiods”.” I agree. The standard of care for patients in pain with visible injuries or obvious causes needs to be completely overhauled. It amounts to torture to withhold pain relief while working on a patient.

      I agree that these measures do not stop the illegal manufacture, smuggling, or sale of street drugs.

      My idea on preventing pill shopping, instead of restricting care to the injured, is to link medical records to each individual person in America, accessible to medical staff in any provider’s office. The EMR system that sprang out of Obamacare is just as onerous, unhelpful, unreliable, and uninformative as one would expect any government designed system to be.

      A new record system would be very helpful in having information on allergies and medical history readily available. Honestly, I think we should have one single real ID that would access not only our identity and driving record, but also medical records and insurance. Why have a separate insurance card? Why not use a single ID number to access all of our records, with proper HIPPA restrictions in place on who can see what.

      1. https://www.nytimes.com/2018/04/19/health/opioid-prescriptions-addiction.html

        “The number of new monthly prescriptions for medications that treat opioid addiction nearly doubled over the past two years, according to new data, while prescriptions for opioid painkillers continued to decline.

        The changing calculus reflects a stepping up of efforts among policymakers and the medical establishment to address the nation’s opioid epidemic, which is killing more than 115 people every day. But it also underscores questions about whether some pain patients are now being undertreated, and whether tightened prescribing over the last few years has contributed to the surge in overdose deaths from heroin and especially fentanyl.

        Although the number of people taking medications to combat addiction is rising, it remains a small fraction of the roughly 2.6 million people believed to suffer from “opioid use disorder,” or addiction. The federal government has estimated that about 20 percent of them are getting some kind of treatment, but of those, only about a third are getting buprenorphine, naltrexone or methadone, the three medications approved by the Food and Drug Administration.”

        Methadone, itself, is problematic. While it does not make the user high, it is lethally addictive. People get hooked on methadone instead of heroine, and then they can’t get off of it or else they could die.

  5. Medical care in Chicago is Great, but they need to spend more time at their local gun range & tighten up their pattern.

    ie: Shootings were up about 25% this Memorial Day but one less dead.

    Come On Chicago, You people should be doing much better with these Post Birth Abortions!

    lol

    1. Oky, Professor Turley is a Chicago native. So I don’t know ‘who’ you think you’re dissing here. It reads like a statement from some yahoo who’s never been to Chicago.

      1. Hollyweird CA isn’t the only Commie Democratic controlled 3rd world sh*it “No Go” I won’t be going to any time soon!

        A short list is LA, San Fran, other areas of Cali, all of Chicago, Detroit, NYC & surrounding area, like NJ, , Baltimore Md, & let me not forget the American hating commie sh*ithole DC.

        I’d like Trump to order the State Dept draw up master list/maps of all the NO GO Zones in the US, including like the ones I know of here in the Tulsa & OKC areas.

          1. I know myself & I’m sure most Americans are very thankful you American hatin trash types are staying in your self made sh*itholes.

            So thank wrackos for staying away with your authoritarian govt crap, violence & diseases.

            1. Oky, funny to see you can’t take what you’re dishing out, but America is lot f….n bigger than Oklahoma, and you’re the one who hates it.

              1. Anon,

                I don’t hate America, I hate those Commie/Nazi authoritarian types that are bent on destroying this Republic govt.

                It’s clear to anyone looking to see what their utopia looks like as everywhere they take control, the Dem controlled coastal cities & large inner cities, they’ve turned into complete sh*itholes.

                IE: the education system…. NYC is spending about 20,000 per student, yet NYC schools have a 96-7% illiteracy rate.

                In DC about 2/3rds of that Shole’s students are illiterate.

                Yeah, those kids aren’t stupid enough yet, what govt should do is make it mandatory those kids/parents have to take another 20-30
                untested Big Pharma Vaccines & unfiltered sewer water. LOL;) Sarc off

                BTW: Those damn Dems are pulling that same crap with Oklahoma’s schools.

                There is no way I’d have a kid in their controlled schools.

                Every years public school’s results get worst & worst, for decades, & they come to us taxpayers if only we had more of your money. I say Fire them all.

                1. Oky1:

                  Education is a passion of mine. This video of a teacher giving her resignation made me cry. Kids should be safe in schools and have access to a high quality education, regardless of where they live. Teachers should be safe in schools.

                  https://youtu.be/-SRCY8FqoyQ

                  1. Karen S,

                    If your husband has a sense of humor & people ask what happened about about his painful horse accident have him tell them 1st thing about horse is that cowboys warn everyone for the novice get a short horse as if you fall off it’s not as far to the ground. LOL;)

                    If he;s not in good humor don’t tell him this.

                    Yes, I saw you said that was a draft horse.

                    I just remembered recently a cowboy friend of mine telling a guy that that was taking his kids out riding this week.

                    On the topic of the failing US Ed system that subject needs more then a bit of writing but I’ll throw a few things out.

                    I saw your teacher’s video earlier today, very sad , so many well meaning people but they don’t know that the globalist plans have been for some time to balloon up the size of these out of control bureaucracies & make it so expense govt that it collapses this Republic type govt.

                    I contacted a local school superintend years back & was able to ask why the schools were not handing out readable Vaccine Inserts so the young parents could see for themselves the harmful risk the vaccines the public schools/big Pharma/Gov’t could cause to them & their young kids, ie: Death , Lower IQs, retardation, etc..

                    He was good enough I thought to be honest with me.

                    He said yes he knew all about this issue, the schools/big phama/govt should be warning people of harmful dangers of Vaccines.

                    But he had two years left to work before he could retire & didn’t want to risk his teachers retirement fund.

                    That’s not the only place we’ve heard of people not doing the right because of worry about it causing them to lose their retirement fund.

                    The same thing happened with US intel that knew 911 was about to happen & did nothing.

                    ( Is P Turley doing that same type thing right now over Trump??)

                    Dr. Steve Piezencik (sic) was the one that brought up the story of hearing the 911 /retirement stories & I like his solution.

                    Pay the workers directly their retirement money as they work, no more promises to pay later. People should then lose the fair to do the right thing at that moment in time.

                    I think the Fed govt has about 2 mil or more workers, I’m not sure how many State/city workers there are but many of those govt pension promise are going to collapse as they are already running out of fraud & have lost the ability to raise taxes.

                    This is already affecting public Ed. retirements.

                    More….

                    1. Steve Picenik, however you spell it, i always wonder about that guy. I wouldn’t trust him to watch my dog while I was out of town, I can say that much.

                  2. Sorry, allegies in my eyes again, it’s hard to see to spell ck.

                    Karen S, Mr Kurtz, et al:

                    I’m not sure why wordpress doesn’t allow a place to reply such as here to Mr Kurtz so I’ll just do it here on a high up post as it’s related to the topic.

                    Mr K, regardless of both our concerns might be about Dr Pieczenik, I’m positive most people respond & act when certain stimuli is offered, like say a retirement plan, thus they’ll compromise their moral compass.

                    Like that Deputy Sheriff or security guard down in Broward Co Fl last year (?) & he’s hiding behind his car as he hears shooting inside.
                    Later it was said he did so because he was about to retire soon.

                    Skip ahead for a minute, Dr Pie seems to still be around.
                    https://www.youtube.com/user/stevepieczenik

                    Back to the brain damage & other health that continue to be cause by the illegal “Untested” big phama’s vaccines, the quickest way get an overview of the importance of the issue is to place the name Del Bigtree into youtube’s search feature.

                    This goes directly to the education issue & the students & leadership brain damage & other behavioural issues.

                    Just a piece of it used to be called mental retardation, a few years back the “pros’ ,snicker, went to the PC correct term of Autism Spectrum.

                    What it really means is 1st the Govt/pharma give all they can get is the Proven Not Be “Safe & Effective” as they still wish to claim, and with some people/parents/teachers/kids the vaccines cause as bad reslut that has the same effect as beating the hell out of the head with a ball bat.

                    The research from the CDC’s own docs & others, & ( cleared) Dr Wakefield is showing it’s much worst with males.

                    Anyway, if interested in starting look at this vaz issue; search Del Bigtree.

                    Back to the master issue Education:

                    Ed is currently going deep into transformation from the brick & mortar class rooms to internet based home school type system.

                    It’s to the point to where there is no limit on the number of kids/people one teacher can teach using remote offsites as long as there are plenty of teachers aids/supervision.

              1. I noticed George Soros’ & the Dems hired goons, the commie/fascist antifa don’t seem to hang out in Oklahoma &

                come, I think, the 1st of Nov 2019 Okla has the new Meet & Greet Constitutional Carry Law.

                Hopefully the violent idiots will move on to blue state gun free kill zones.

                Regardless all these Mid west/Southern states will be become much more peacefully.

                  1. PS Oky1, we all know about the beaches and skiing in your state, as well as the restaurants – I didn’t know you could get that many kinds of barbecue before – and vibrant cultural life. I’m sure that’s why Cindy vacations there so often.

                    1. Anon………My family moved to Okla when I was 6 months old. I was Baptized there.
                      We moved to Texax when I was 8………then I moved back to go to college there at 18.
                      My first 2 years of teaching were there. I am very connected to that glorious state.
                      Okies are great people with no pretense. What you see is what you get.

                    2. Cindy, in reality I have no problem with Oklahoma or other “fly-over” states – I like my breakfast with grits and biscuits and know the difference between collard and turnip greens – but I do have a problem with America hating nativists like Oky1 bashing other American states and cities that I also know, appreciate, and some, love. In fact most Americans like those places better than Oklahoma obviously or the rents in Tulsa would be a big problem like they are in NYC and SF. If you applaud his ignorance and venom – you seem to – you’re just as bad an “America hater” as he is, much as he pretends others are.

                  2. So you’re now making the case that the Commie Dems need to get the hell out of Trump’s way so he can close the Mex/US borders from criminal wetbacks from 3rd world’s & Drug Kings drug routes through Oklahoma.

                    Or is it you are arguing that at least Red State Okla stills charges/arrest criminals unlike Blue state commie sh*ithole states/cities just turning a blind eye & releasing drug king pins/ robbers/rapist/murders.

                    BTW: Did you not read my post above where I said we here also have some no go zones?

      2. PH , Anon et al;

        Maybe there is some common ground Trump, Trump supporters & others & anti-Trumpers can agree & act on.

        Prez Trump, Trump Jr, Mitch McConnell & other Deep State Repubs are hating once again on Alabama’s Judge Roy Moore.

        I’m thinking about going against Trump again in favor of Moore unless I hear something provable against Moore.

        So if you people think Trump/McConnell/others are correct & Jones defeats Moore again this time maybe you guys support Moore with money/favourable comments through the primaries?

        https://www.politico.com/story/2019/05/29/roy-moore-hits-back-at-trump-in-defiant-interview-1487921

        1. Oky, no surprise. Donald Trump turns on everyone at some point. He’s done with Roy Moore. Roy Moore shouldn’t be surprised.

          1. I’m waiting to see what Jeff Sessions decides. He’d be strong candidate for 2020 if he decides to run.
            And if Trump is re-elected, he and Romney might not be reliable GOP Senate allies for Trump.

          2. PH, et al:

            As Tom Nash points out there’s the J Session problem, but has a Alabama problem.

            Roy Moore big Sin was he came out in support for the Fed govt complying to the USC’s 10th Amendment.

            The DC dems/repubs establishment couldn’t stand the thought of having their stolen power cut back & restrained by that silly USC.

          3. Trump backed Moore’s GOP Republican primary opponent. The allegations against Moore, and the involvement of Gloria Allred, started after Moore won the nomination and it was too late for the GOP to put forth another candidate.
            That, and outspending Moore about 10-to-1 on TV ads, allowed Doug Jones to defeat him by a narrow margin. Some of the money flowing into Doug Jones’ campaign coffers may have even come from Alabama residents; I never saw a breakdown of in-state/ out-of-state campaign contributions.
            Lisa Bloom, Allred’s daughter, didn’t have much luck with her much- touted press conference that was to produce a supposed victim of rape by Trump. That press conference just happened to be held within a week of the election.

            1. Notice those Dem Azzholes just tried to pull that same fake type sex crime with ML King, about years After he’s was murdered!

              Easier to fake false claims about someone if anyone close is dead.

              & about those MLK files, were they nor supposed to be released in something like 2026?

              What complete BS.

  6. 43 MILLION AMERICANS CARRY MEDICAL DEBT

    At least 43 million other Americans have overdue medical bills on their credit reports, according to a 2014 report on medical debt by the federal Consumer Financial Protection Bureau. And 59% of people contacted by a debt collector say the exchange was over medical bills, the most common type of contact stemming from an overdue bill, according to the CFPB.

    Edited from: “Mired In Medical Debt? Federal Rule Changes Proposed For Debt Collectors”

    Today’s NPR
    …………………………………………………………………………………………………………………….

    This statistic doesn’t sound like ‘National Health Care’ prevails in America.

    1. That is their business. That is distinctly not the concern or burden of American taxpayers. Likewise, student and every other form of personal or corporate debt. Article 1, Section 8, Congress has the power to tax merely for “…general Welfare…,” deliberately omitting and, thereby, excluding any power to tax for individual welfare. Congress has no power to tax to satisfy the debt of someone’s favorite freeloading parasite. Charity is industry conducted in the free markets of the private sector. Go start a charity. You can do it. I have great confidence.

      1. All of the people demanding the government take complete control and responsibility for the decisions and choices they make in their lives are going to be a bunch of shocked and sad you know what’s at the devistating reality of the consequences for their lives when those in government actually do.

    2. Millions of Americans perhaps more than 43 million have debt due to purchases of lousy stuff they didn’t need that were bought from China. Millions of Americans have more debt because of the ACA. The high premiums prevented millions of Americans from paying off the debt for those lousy goods and then millions found that after paying the premium they couldn’t afford the deductible. Millions of Americans will not give up their expensive Starbucks coffee and many of them believe have Starbucks is a right not a privilege. Millions of Americans are subsidizing illegals because Democrats think illegals should have more rights than Americans.

      1. i too have a hard time understanding starbucks habits. i can get a wonderful coffee from beans off the shelf at the grocery store for much less. even the overly priced starbucks beans from the store are so much cheaper than store prepared coffee

        is it so much better to have a teenager brew it for you? i guess i wouldn’t know because i hardly ever buy

        about the only thing i ever get from starbucks is a double shot of espresso and that’s overpriced now too

        here’s another thing folks. try black coffee. late in life I have given up the sugar, the fake sugar, and even cream. a good coffee stands on its own merits without dressing it up. kind of like taking expensive whiskey and then mixing it with coke. duh!

        1. here’s another crazy idea, one that i notice many american women find below their dignity. COOK AT HOME AND SAVE THOUSANDS EVERY YEAR

          often the people who eat out the most are exactly the ones who should learn to cook!

    3. they should file BK. i never understand why some people are so reluctant to do that.

      less a problem than medical debt is cc debt. it will strangle people with interest. how come nobody worries about usury? you never hear that word much anymore

      1. Kurtz, did you ever do bankruptcy? Was medical debt the reason for the majority of bankruptcies? Actually there were studies in the past based on the bankruptcy filings and the number of bankruptcies due to medical costs were in the low single digits.

        1. no not much BK, just tangential to lawsuits of various kinds

          cc debt is a killer for consumers. most people can’t expect to get 20% increases in income year after year, but most people are out there using the cc with that kind of interest, “betting on the come” as they say in craps. crazy but so common! and they loop in the young people who don’t know better

          and the eating out and starbucks nonsense. learn to cook at home!

  7. Obviously, I disagree that there are other benefits of the Affordable Care Act.

    I can tell you from personal experience that CA ER times are devastating, having recently waited over 5 hours to get my husband seen after a horse accident. Totally unintentional on the part of the draft. He was in terrible pain, and there was nothing to do but endure it. When he finally got in, they couldn’t give him any pain medicine until after they had cleaned the open fractures and worked on him. Due to the opioid epidemic, they have to take preventative measures against pill shopping. Because of junkies and a gummed up healthcare system, made worse by meddling politicians, innocent people suffer. I will say they had excellent WiFi.

    In any case, there are a few reasons why wait times are so long here in CA.

    1. Medical pays providers very little. That means it is difficult to find a good doctor, and patients often seek help in an ER. Medicaid, Medicare, and Obamacare individual policies also have low reimbursement rates. Doctors often limit how many Medicare patients they see, to spread out the reimbursement. Can’t get in to see a doctor, go to the ER. Since Obamacare individual policies represent a 30% pay cut to doctors and hospitals, it of course would no solve this problem.

    2. Broken mental health system. A psychiatric patient consumes more resources in the ER than many others. Centralized hospitals were emptied in the 1980s, to be replaced with community psychiatric wards. Those never materialized. Therefore, there are a lot of mad people on the streets, who end up in the ER. There are a few prominent cases of possibly criminally insane homeless people in the CA news diligently throwing up red flags, arrested dozens of times, threatening to rape women routinely, following them home…but apparently they can’t be committed until they actually harm someone. Sorry, future victims.

    3. Lack of hospital bed space. When there isn’t an open bed in the hospital, patients languish in the ER. The throughput clogs. Want more bed space? Then maybe now wasn’t the time to continue to cut hospital reimbursement.

    4. ERs lose money because many of their patients can’t or won’t pay. CA has an extremely high illegal alien population. They were not supposed o be covered by public health programs, but the state is now pushing to cover them. Illegal immigration has led to the closure of many ERs in border states. Public programs that cover the poor, Medicaid, Medical, Obamacare individual policies, have low reimbursement. So there is no incentive to build more money-losing ERs. They mostly serve low pays or no pays, along with a minority of solvent Americans whom they they overcharge to make up the difference. Should we switch to single payer, we will see more of the VA single payer nightmare – long wait times, salaried physicians working less hours. It’s not a solution.

    The following article discusses these problems, hopeful that the ACA would solve this crisis. However, since Obamacare individual policies represent a 30% pay cut to doctors and hospitals, it did not help. Once again, the government made promises it didn’t keep.

    https://www.dailynews.com/2014/10/02/southern-californians-endure-longer-waits-at-emergency-rooms-than-most-americans/

    1. Illegal immigration is one of the many strains on our benefits system and overall infrastructure. It’s not the only burden, but it is definitely one of the consequences of breaking immigration laws on a massive scale.

      If politician want to get serious, and actually improve access to health care and the prognosis of the poor in our own country, then we need to shut off the Niagra Falls of illegal immigration swarming over our border. It may no be PC, but it’s reality. You cannot keep dumping people into an overtaxed system and expect it to hold up well for those in the country, legally, whom it’s designed to support.

      https://www.beckershospitalreview.com/finance/10-states-with-the-most-illegal-immigrants-impact-on-healthcare-spending.html

      “According to The Center for Immigration Studies, the estimated cost of treating uninsured illegal immigrants is $4.3 billion a year, primarily at emergency rooms and free clinics. Some illegal immigrants even receive Medicaid benefits, despite the fact that they are not eligible to enroll in Medicaid plans, according to a Kaiser Health News report. Additionally, a 2007 report published by the Journal of the American Medical Association found that within a span of four years, about 99 percent of those who used emergency Medicaid were immigrants who entered the country illegally.”

      Here is an old LA Times article from the days when Democrats believed in supporting Americans and legal residents, whereas now they’ve been thrown under the bus in favor of illegal immigrants. Current Democrat voters are in the bag, and can be safely ignored, while they court prospective future voters in the illegal immigrant population, as well as their legal connections of family and friends.

      https://www.latimes.com/archives/la-xpm-2004-jun-20-na-hospital20-story.html

      “Besieged by illegal immigrants who jam its emergency room, then disappear without paying, tiny Copper Queen Community Hospital is growing desperate.

      The 13-bed private facility lost $800,000 caring for migrants last year and $500,000 the year before. At this rate, hospital administrator Jim Dickson predicts, he’ll shut down in three years, leaving the town of Bisbee without a hospital.

      “The more business I do, the more money I lose,” he said.

      It’s the same story at other border hospitals struggling to cope with record numbers of illegal immigrants sweeping through Arizona.”

      If illegal immigration shuts off, we can save states hundreds of millions of dollars in healthcare costs. Another reason why legal immigration is the only responsible way to go.

      1. The Center for Immigration Studies is probably not unbiased. It has been listed as an anti-immigrant hate group by the SPLC, as are its funders (plenty of documentation of this). So it’s “data” re: the contribution of immigrants to the loss of revenues to private/for-profit hospitals is suspect, I’m guessing. Regarding the cost, the potential hundreds of millions of dollars saved in healthcare costs (cite?) is a fraction of the over $10B contribution. Weirdly, until this last year, total immigration and apprehensions at the southern border have been on a dramatic decline. I don’t have data after 2016 (does anyone have good references?), but the total undocumented population dropped from a high of 12.5M in 2007 to 10.7M in 2016. With the increase in border apprehensions in the last year, this year (2019) will be the first year since 2008 that apprehensions have reached these levels (steadily dropping until 2017). What’s curious is that we were able to handle that level of apprehensions in 2008, with the staffing levels and infrastructure we had in 2008. It’d be interesting to see what happened with staffing and infrastructure in the intervening years as well as what changed in 2016 to trigger the increase.

        1. I agree that the Center for Immigration Studies is biased, in favor of legal immigration over illegal immigration. Most sources are biased one way or another, and it is difficult to find a truly unbiased source.

          However, I posted an article on the Left leaning LA Times, as well. You can find myriad sources, as the problem is well documented. Data, itself, is unbiased and pure.

          We should indeed look at staffing and infrastructure.

          There is no census of illegal aliens. Numbers given are always extrapolated estimates. Apprehensions are not a total number of illegal immigration. Border Patrol was on record complaining about all the times they were directed to ignore illegal immigrants. One of the reasons why I supported returning citizenship status to the census was it would provide better data. Of course, someone could always lie.

    2. Karen S.,
      The war on opiods jihadists have yet to explain how denying painkillers…..even non- opiod painkillers…..will stop the illegally importation and use of drugs like fentanyl and black tar heroin.
      But the fewer painkillers a physicains’ clinc or a hospital provides, some bean- counter in some regulatory agency can point to “progress”.

      1. Answer – it won’t stop drug smuggling. They had a recent bust where they found enough illegal fentanyl being smuggled across the border to kill every human being in Los Angeles.

        In order to prevent doctor shopping, there needs to be a functioning record system that is attached to each patient. This is other than the behemoth record system that only makes sense to insurance companies. That way, someone can’t go from doctor to doctor. There also needs to be a flag if a doctor is prescribing a thousand pills a month to someone who is not terminally ill.

        These opioids are highly addictive and neurotoxic, and they are being prescribed to patients who are not followed up with. They are not the safe panacea they were originally promised to be.

        I think it’s inhumane not to treat an injured person’s pain before working on the injury, but it’s standard practice now. It’s done nothing to stop the opioid epidemic, and instead renders hospitals on the level of “here, bite this stick” pain control from a hundred years ago.

        1. Wait. Please cite the Constitution wherein “ingestion of substances” is denied and precluded. Ingestion of substances was not illegal and not even unconstitutionally legislated against until the early 20th century. I think you may want to reconsider your grasp of American freedom. The American thesis is not Do What Karen S. Says, it is Freedom and Self-Reliance. Many Americans have gone overseas to pursue experimental treatments because some individuals decided they were dictators and denied them in America. Individuals are free and responsible for themselves. Caveat Emptor. Free individuals will make their own decisions freely. Government’s role is only security and infrastructure to facilitate the freedom of individuals. Additionally, government has no constitutional authority to regulate anything other than trade, exchange or “…commerce among the several States…,” Article 1, Section 8. The holier-than-thou pronouncements by the CDC and HHS regarding ingestion, smoking, vaping etc. are eminently unconstitutional and abuses of power. Who has taught Americans “dictatorship of the proletariat,” monarchy or any other totalitarian ruler? Oh yeah, the lazy, greedy, thug, striking teachers unions in public schools.

          1. George, I voice my opinion because it’s what I think of a matter, not because I believe I have any particular control. Strangely, my phone doesn’t ring with any President asking me what to do. Pity.

            In any case, there are arguments to be made for an against legalizing all street drugs.

            I am unsure if you are suggesting that all prescription drugs be made available over the counter, without any restrictions or guidance on prescribing them. Just in case that is your position, here are the problems against it.

            The FDA came about to prevent charlatans from harming people by lying and claiming their products were helpful. Individuals making a risk/benefit assessment on the products being touted at their doorstep would have no access to information on clinical trials, toxicity, or consumer complaints. It’s a bit difficult for caveat emptor to apply without information. Such trials also give information on the LD50 (the dose at which 50% of rats die), which is critical to poison control centers or those treating an overdose.

            Doctors are restricted on what they can prescribe, because they are supposed to do not harm.

            Should any easily addictive medication be available OTC? What about chemotherapy? Should people diagnosed with cancer be walking the aisle at the pharmacy, putting together their own cocktail without the benefit of any medical degree?

            The only way I think it would be possible to legalize street drugs is if they had to be labeled poison. Otherwise, they would fail any FDA trial. They carry no benefit and are literally neurotoxic. I don’t see how legalizing street drugs would allow the FDA to continue to exist. Properly labeled as poison, however, a libertarian view would be that people can consume whatever they wanted. I don’t think that society should have to pay for it, however.

            Pharmaceutical companies are in a pickle over granting access to gravely ill patients before the FDA trial is complete, or if the drug has not been approved for that off-label use. Terminally ill patients are the most fragile. Often their livers are already compromised, either by their illness or by the severity of the drug regimens they’ve already tried. Should they try a drug that has not yet been proven safe, or the dose perfected, through the FDA process, or for an off-label use, and it turns out to be deadly, then that drug’s reputation is thoroughly ruined. Perhaps it was never intended to be used that way, but everyone would hear about the deaths or injuries of those who tried it. The earning and therapeutic potential of the drug could be forever ruined. The reputation of the company could suffer, even if a release protected them from lawsuits.

            I am not sure what the answer is. I’ve known and lost too many people to cancer, and of course I would want everyone to have their best chance.

            I’m a bit on the fence about legalizing street drugs. I would like to see the FDA process streamlined. I tend to favor individual rights, especially over the autonomy of our own bodies, over government control.

        2. “I think it’s inhumane not to treat an injured person’s pain before working on the injury”

          What do HMO’s and ACO’s do? Both increased the power of the insurers who incentivize using the less expensive opiod over dealing with the problem.

          1. Allan, it’s apropos that you said that. An argument against insurance in general is that it has contributed to the high cost of health care, itself. No one could charge astronomical rates, if most of the population couldn’t pay it. However, it has also funded research and more costly treatment.

            On the other hand, I recently dealt with a very sick horse, as well as my injured husband. Two different horses involved. I pay my vet directly for all treatment and medications. There was no hesitation to immediately give her pain relief and sedation BEFORE a nasogastric tube. Well, one of those reasons is because a horse would not tolerate it, but there is also not a restriction on the animal’s pain relief. There is no insurance company limiting what it will cover.

            Vets have far less options to treat medical problems in animals, many of which are similar to what humans experience. However, there is less interference in care than there would be with an HMO.

            1. Karen, the best situation is where the individual buys his own insurance to meet his own perceived needs. When that happens we see high deducibles flourish, more transparency and more reliance on good care rather than expensive care. We also see prices fall and we would see pharmaceutical companies trying to produce drugs that have lower price tags. We saw this with MSA’s and then HSA’s. We see this in people that pay cash. What makes many new medications so much better than the old ones? Frequently the major difference is price and convenience.

        3. Karen,

          The govt used the proper procedure of changing the USC when the govt 1st passed the 18th amendment to ban alcohol & then passed the 21th amendment to repeal the ban on alcohol.

          It remains the case that the Federal govt has never passed another constitutional amendment to ban another substance, there by the Fed govt has no authority in that area….

          Many us do argue that point.

          But if a drug addict becomes a threat to the community there are plenty of laws to remove them off the streets.

          BTW: I liked reading some of your comments of the numerous troubles of the US’s/Repub/Dem healthcare system & it’s current collapse. Just like the failing tyrannical public schools & universities.

          The answer to our current Commie/Fascist type healthcare, ( VA, NA healthcare, ERISA, etc., ) is not more medical Tyranny by ther Fed & State Govt.

          The answer is more competition through our private free enterprise economic system in healthcare, education, etc..

          1. I agree that the free market can make customer-driven improvements. And thanks for the positive feedback.

      2. Tom, are you employed by a pharmaceutical?

        I asked you this question before when during the course of a debate you asserted that ‘no one in this country has died from legal drugs’ (or something along those lines). And here you are implying that the current crackdown on legal opioids is somehow the effort of ‘regulatory bean-counters’.

        Right now ultra-conservative Oklahoma is suing Johnson & Johnson with regards to the marketing of legal opioids. In bringing this suit Oklahoma joins a growing number of states seeking to hold the pharmaceuticals accountable for the seriously addictive nature of these drugs.

        Below is link by Bloomberg to a news video explaining Oklahoma’s lawsuit.

        1. Question Peter: when can we expect to see you set yourself on fire like this dude did in DC?
          Surely someone will come to your side and douse the flames

          Like this comment if you want to see Peter set himself on fire…

          1. V C, is it impolite to note that legal opioids are the subject of extensive litigation in even our most conservative states? Did I cross some kind of line in noting this trend?

            Or are you one of Turley’s psychotic Trumpers who thinks videos of people lighting themselves on fire is fine entertainment?

              1. If Trump is re- elected, he should consider additional mental health funding for the more extreme cases of TDS.

            1. It is not impolite, Peter; it is realistic.
              All states are going to jump on that potential pot of gold.
              The states are already collecting c. $250 Billion in there partnerships with the tobacco companies, and their profits may be exceeding the profits those companies themselves over the course of the “settlement”.
              And no, I don’t work for a tobacco company, either.
              Alcohol- related deaths probably exceed opiod deaths, but the states haven’t got around to seriously tapping that market…..yet

        2. No, I don’t work for a pharmecuetical company and I never have.
          And no, I never said that no one died from an overdose of a legally prescribed opiod.
          But if you want to image that I said that, if you need to believe that, go right ahead.

        3. of course they’re addictive. lawsuits are not going to solve the problem. but if they are legit let them go forward.

          pain is part of life. but acute pain needs treatment. we have been down this road before. it lead to a very bad place. some of these people will just blow their brains out if they cant get opiods. try and solve the addiction problems that come along with them in every generation, but do us all a favor and dont demonize the doctors.

          we are definitely headed into crusader mode on the opioids now. odd timing considering the legalization of medicinal marijuana.

      3. we went crazy against opioids in the late 80s and then cancer patients were blowing their brains out left and right. im old enough to remember.

        now maybe we’re coming back full circle eh? let the people smoke as much pot as they want but if you have acute pain get ready for the fifth degree

        pain specialist I know is constantly in fear of getting in trouble with the feds. he has hypes coming every day that he recognizes and turns away but it’s never enough for the crusaders who are always on the watch. sad!

    3. Karen…….what a nightmare story about your husband’s experience!
      I must plead “stupid” when it comes to healthcare…..I’m ignorant about the hows and whys of health insurance.
      In our little town we have no hospital, but several “Urgent care” ER ‘s that are open 8am to 8 pm.
      But we also have an ER that is a bonafide 24 hr emergency “room”.
      It is LOCALLY owned by Emergency Room physicians and staffed by professionally skilled workers.
      It is a dream! They do not take Medicare, however. But my husband and I love it. It’s clean, never crowded and state of the art.
      I swear if I could I would turn one of their rooms into a condo, buy it and live there….LOL
      I believe the full name of the franchise is Physicians Premiere ER.

  8. TURLEY THINKS WE HAVE NATIONAL HEALTH CARE

    The professor opens his column with this baffling question and answer: “Remember when national health care was going to finally clear our emergency rooms? It has not exactly worked out that way, particularly in California”.

    Unless I fell asleep several years, or slipped into The Twilight’s Zone, America never implemented “National Health Care”. ..So what is Professor Turley referring to..??

    Has Turley assumed the role of cynical Libertarian for the purposes of this column? Are we to assume Turley is talking about Obamacare when he says ‘National Health Care’? If so, that’s a stretch for even Libertarians.

    For 10 years Republicans have sabotaged Obamacare every which way possible. And Donald Trump has made it clear that he will completely disconnect what remains of Obamacare if given any chance.

    So what gave Turley the impression California has ‘National Health Care’? Did Turely hear that on Fox News..?? If so this illustrates what I’ve been saying for months: ‘Rightwing media has a dumbing-down effect’. And it appears that even law professors can become disoriented.

    My advice to Professor Turley: “Lay-off the Fox News”.

    1. there is a national medicare program, and a national medicaid program, and a national EMTALA law that prohibits turnaways from ERs. I thought he was talking about that. maybe I don’t get what you’re saying about Turley?

      I doubt he has much time to watch Fox unless he’s viewing his own clips or something someone suggested for an article

      1. Mr. Kurtz,
        We have a hybrid system;; of the c. $3.5 Trillion spent annually on health care in the U.S,’ at least half is government- funded.
        We have about 55 million people on MediCare and 70 million on MediCare (there is some overlap), plus the VA system, CHIPs program, etc. I think many of these programs were intended to be “stepping stones” to a universal single pay system, and both “Hillary care” and ObamaCare had a universal government- funded system in mind as the ultimate goal.

        1. Tom, are you stuck in the early 1960’s when Republicans fought Medicare? Should we cut all safety nets? Or should we incorporate them all under a single system?

          Personally I believe that a robust form of Obamacare is preferable to ‘Medicare For All’ or ‘Universal Healthcare’.

          But this argument that we already have ‘National Health Care’ is one I never heard until this morning. ..Is this a new trend in right-wing media; this claim that we have ‘National Health Care’..?

          I know conservatives like to keep changing language to bolster political talking points. But again, until this morning, I hadn’t heard this one.

          1. He understands better than you do. Why not try learning from him instead of producing hot air because they’re late with the day’s talking points?

            1. Tabby, what are you babbling about??

              You’re saying I’m ‘behind the times on semantics used by conservatives regarding American healthcare’? This ‘National Health Care’ reference is old and I’m just hearing it..??

          2. Peter,
            There is,, in fact, a hybrid system in the U S. with the government funding at least half of U.S. health care costs. We can’t go back to the early 1960s, in the era before health care costs exploded. The cost of living, the overall CPI, is up 600-700 % since the early 1960s, and per capital health care costs are up about 3000%.
            So the early 1960s had some benefits. The average hospital stay was about 8 days then. It is now 4.5 days, and a lot of that is driven by MediCare and other insurers’ formulas that you WILL leave the hospital in x numbers of days, period. That decisuon, back then, was primarily one that the doctor and the patient made.
            MediCare payroll taxes and deductibles have exploded since it was introduced over 50 years ago, and it is still heavily subsidized out of general revenues. Whether you’re looking at MediCare for All or some other universal government- funded health care system, there will be a need for far higher taxes to fund it ( or just put it “on the tab” with deficit” spending. It won’t be sold that why, but the proponents will count on the stupidity of enough American people to buy it.

            1. Tom fails to note that whether one favors “Medicare for All” or not, we are paying more by far than any other developed country, all of which also provide universal care. Not only are we reaching or exceeding our ability to pay such high rates, but we are not getting anything for it as our level of care does not yield better outcomes in general – we are good at some things and bad at others – nor do we receive more convenient care as our patient satisfaction rates are middle of the pack.

              This is not an either/or situation of the status quo or Medicare for all. The rest of the developed world pays on average about 60% of what we do and with a variety of systems from socialized government run – the UK – or private docs with private/public insurance partnerships – France and Germany. They all use the government to bargain/set prices to keep costs down.

              1. I’m aware of U.S. percapita health care costs relative to other countries, and my comment wasn’t about that.
                But since you brought it up the per capita and per service U.S. health care costs have exploded as government programs became a bigger a bigger part of our health care system.
                I’ve gone over this a couple of times before here, and there’s no way to review 40-50 years of government programs and health care inflation in a short comment.
                I will add that I watched a recent interview with Bernie where he said he’d cut prescription drug costs by 50%.
                You don’t need a universal health care program to cut costs that way.
                We could just past legislation tomorrow that forces all segments of the health care industry to cut the charges for the services and products by 50%.
                There’s no reason to stop the “cost cutting” with only one segment if the industry, and forget about the 80+%.
                There are publications that have run actual, realist numbers of what MediCare for all what really costs, but its advocates don’t want to talk about that.

                1. OK Tom. I am not an advocate for Medicare for all, but in fairness the real question for the cost part of the proposal is whether the increased taxes would equal or exceed the savings from not buying private insurance, or if your employer currently provides insurance, the increase in wages which would hopefully follow the elimination of that overhead. Private insurance is not cheap and as you know continues to become more expensive and with higher deductibles.

              2. Anon,
                “Tom fails to note that whether one favors “Medicare for All” or not, we are paying more by far than any other developed country, all of which also provide universal care”

                This is not solely a function of hospital costs or how the bills are paid (universally or not). It is primarily a function of the health of the people.

                As a country, we outpace European countries in the amount of processed food we consume. As a country, we fail to outpace European countries when it comes to regular exercise. No one walks to the post office hardly or the grocery store and bike accessibility is terrible. People generally don’t have an ‘evening constitutional’ anymore.

                Our lousy diet is a huge contributor to the terrible health of Americans and consequent high cost of healthcare. For example, having a low status of magnesium because of low dietary intake and poor absorption can result in insulin dysregulation, cardiovascular issues, osteoporosis, constipation, muscle spasms, etc etc. That’s just magnesium. Low vitamin D from being inside all the darn time? Cardiovascular issues, osteoporosis, sleep issues, skin issues.

                ‘Medicare for All’ fill not fix what people choose to put in their mouths, or not, or, what they choose to do with their time or not.

        2. Again, the revenue stream for ‘health care and social assistance’ is $2.56 tn, out of a gross output of $36 tn in 2018. About 19% of that stream flows to purveyors of long-term care rather than medical care per se.

          1. Gross output is usually measured in terms of GDP, which is much small than $36 Billion. Increased longevity/ nursing home costs are indeed factors in increased health care costs. But if you remember what health care services across the board cost 40-50 years ago, or look up what a night in the hospital or an office call costs then v. now, you’ll find that health care inflation has increased at about 3x the rate of the CPI.

        3. we have socialized medicine, socialized education, socialized employment, socialized unemployment and socialized food and nutrition programs, socialized arts, news media, broadcasters and more to list a few

          Defund Medicare, Medicaid, SSI benefits, SNAP, Unemployment Insurance, Social Security, and Veterans Administration Health and one of two things will happen: people will live responsibly or they will not. Their choice

          Either you are pro-choice or you are not. Simple

          1. Thanks for the Ayn Rand fantasy. Been an education. (Rand took her Social Security benefits, by the way).

    2. He is obviously talking about the national law – The Affordable Care Act. While it is not a healthcare provider per se, it regulated the entire insurance and health care industry. It promised it would solve these problems (see my article linked above) but failed to do so.

      Over and over again, the lie is proven to the rhetoric used to get this monstrosity passed. Now they want more power as a reward, in a single payer system. They have bungled the only single payer system we have in this country, the VA, in which our honored vets actually died waiting months for care, typical of a single payer system, and they lied about it. Should the result be severe consequences? Why, no! They want to be rewarded by putting everyone under such a system of care. And…there are a significant number of uninformed voters clamoring for their own demise in this manner.

      1. Karen, we don’t have ‘National Health Care’ period. And the Obamacare we have is heavily sabotaged. Only the most cynical could say we have anything even approaching National Health Care.

        And Karen if you have statistics to suggest that America’s healthcare system was better off ‘before’ Obamacare, I invite you to post those statistics here. But I don’t think any such stats exist.

        1. I have posted ad nauseous with statistics on how Obamacare hurt people. They are far worse off now. You may go look them up. I even used bullet points and links to original sources.

          I spent a significant amount of time putting together just a partial list, during which you were a contributing commenter on the blog.

          Don’t pretend you don’t know that Obamacare hurt people.

          1. Post them again Karen. I’ve read your stuff and like the bogus U-1 list you had, it was not in sync with reality or objective analysis of our system, or almost all about your personal situation. That is valid of course, but limited compared ti national numbers.

            1. Anon, you are newer than me to this site. I have never known Karen to post compelling statistics from credible mainstream sources. Anything Karen posts is likely to be from sources so obscure the reader is not completely sure who the source even is.

              1. Peter, the Washington Post is not a credible source of accurate statistics if politics is involved.

                1. Alan, one needn’t depend on only The Washington Post for credible statistics on our healthcare system. The Kaiser Foundation is probably the best source. But spoiler alert: Kaiser won’t tell you that our system was better off ‘before’ Obamacare. Those stats don’t exist.

                  1. Peter, you limit yourself too much. There are loads of studies and places where data can be obtained so that one can actually check up on what they think is true but isn’t. A little logic is also needed. The Kaiser Foundation is only one source but you exclude any source that isn’t certified as left wing.

                    What you need to look into is more raw data. DSS frequently brings up some of this raw data which you immediately consider to be false because it dosn’t conform to the conflated data you are used to.

                    You should have been reading what you call right wing economic forecasts on Obamacare. They predicted the failure of Obamacare and why. The failure is intrinsic to the bill and not due to sabotage.

                    Let me help you with healthcare. There is a triad: cost, quality and access. improvement on one side of the triad leads to a worsening in another. Obama was able to break the rule. He increased costs, decreased access and decreased quality for those that were on Obamacare and worked at jobs that paid more than the set figure.

                    1. Alan, my brother was a Senior VP at three major hospitals: one in Washington D C and two in Chicago.

                      My brother told me 20 years ago that the healthcare system was broken and every healthcare professional knew it. And my brother was only telling me what the mainstream media was reporting. By the 1990’s our healthcare system was faltering from too many uninsured patients. Hospitals were getting burned on a routine basis.

                      When the Great Recession hit in 2008, Medical Debt was the leading cause of Credit Card Defaults and Personal Bankruptcies. So anyone who tries to claim that the healthcare system was fine ‘before’ Obamacare is totally ignorant on the subject.

                    2. Peter, perhaps being a senior VP at major hospitals leaves him with a bit of telescopic vision. However, he was right. Our healthcare system has been broken, but part of the breakage was due to a government error made during WW2 and made permanent shortly after the war. Yes, hospitals were getting burned but they too are part of the problem. Do they post prices? No. Do they make sure that patients know the full costs? No. Did your brother discuss those things with you? Did he tell you all the nasties about what hospitals have done to help destroy the healthcare system?

                      I would like to see the proof about medical costs being a major cause of bankruptcy. About that time JAMA had a study done by Himmelstein which was garbage so if what you say is based on that study then you are wrong.

                    3. Medical Debt was the leading cause of Credit Card Defaults and Personal Bankruptcies.

                      It was nothing of the kind. The truth was that a certain % of people declaring bankruptcy had medical debts. That doesn’t mean their primary debt was medical or that the medical share had ’caused’ the bankruptcy.

                      For that particular subset, their mean medical debt was $18,000.

                    4. DSS, I assume when obtaining the $18,000 they used the actual debt owed at time of bankruptcy. Himmelstein’s study on medical debt called medical debt a major cause of bankruptcy if they had a bill of $1,000 (I think that was the amount) or over for that year. The news media and TV have used the terrible Himmelstein study results to push ideology as part of the news.

                    5. Alan, my brother was a Senior VP at three major hospitals: one in Washington D C and two in Chicago.

                      Does he do his own taxes every year?

                    6. This is Peter’s evidence:

                      “Two-thirds of people who file for bankruptcy cite medical issues as a key contributor to their financial downfall.”

                      That is a survey poll which gets the answer anyone desires. Since bankruptcy filings are carefully documented including dollar amounts one doesn’t or shouldn’t use a survey poll. They can use the actual data from the court houses which has been done demonstrating that your source is promoting garbage.

                      “A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work.”

                      Take note how they didn’t mention the name of the academic researchers or the study or where the study was published. This demonstrates this news media is being dishonest.

                      The above is what you consider proof. That is your problem. You take outright defieint reporting as proof even though it smacks of ideological reporting.

                    7. The Current P.H.,
                      I am not convinced that it is the healthcare system that is broken.

                      The Standard American Diet is broken.

                      Processed food has insufficient vitamins and minerals.
                      The predominance of most people’s diets is comprised of processed food.

                      What happens to people if their cells do not have sufficient vitamins and minerals to function optimally?

                      (Not to mention the depleting effects of stress, lousy sleep, impaired ability to clear toxic chemicals from the system, lack of exercise, etc.)

                  2. Peter,
                    The rate of uninsured Americans was actually fairly stable in the 1990s, and that relatively stable rate continued until the 2008-2009 recession.
                    The rate of hospital closures, especially rural hospitals, greatly increased after ObamaCare was enacted. Theoretically, at least, fewer uninsured patients should have improved hospitals revenues. It isn’t something I’ve looked into, but it may be that the lower rate of reimbursement from the flood of addition MediCaid patients put hospitals on weaker, rather than stronger, finanancial footing.

          2. So having health care insurance, regardless of the path followed to get that insurance, hurts people?

        2. “Obamacare we have is heavily sabotaged.”

          Obamacare wasn’t sabotaged. It could not survive as written and should never have been passed in that state.

          The words “National Health Care.” mean different things to different people so to call others cynical just means you don’t understand how those words can be used. We actually have national health care for many groups: Veterans have the VA; people over 65 have Medicare; the poor have Medicaid. We also have EMTALA for those that need hospitalization and of course tens of millions have insurance through their employers.There is also cash and charity.

          But today we have the ACA which is a bust.

    3. Here is an example of what happens in nations that are insured by their governments. There is a trade off. In this case involving Britain the trade of is in access. People aren’t getting cataract surgery (and a lot of other needed things but this article came up today). One might feel that an older person can live with impaired vision but one has to think deeper for older people have balance problems and therefore they might need that vision more than ever. If not they fall and break a hip. Things like that can cause death and death always saves the healthcare sector money.

      Investigation reveals doubling in NHS rationing of cataract surgery

      Laura Donnelly, Health Editor

      Patients are being forced to wait years for surgery to save or restore their sight
      NHS rationing of cataract operations has doubled in just two years, with patients increasingly denied cases until they are at risk of blindness, an investigation reveals.

      Charities warned of “shocking” restrictions, which are in defiance of national guidance.

      The figures from across the country show a sharp increase in the number of areas where the NHS is refusing to fund the operations until vision is badly compromised.

      It comes despite warnings from the National Institute of Health and Care Excellence that the NHS must not rely on sight tests to decide whether surgery is warranted.

      Experts say the rise of rationing is leaving vulnerable pensioners in misery and isolation, and increasing their risk of suffering falls.

      The research, published in the BMJ, found that in 2018/19, 22 per cent patients in England referred for cataract surgery were forced to go through tests to establish how poor their vision first. This is a rise from 6 per cent in 2016/17.

      And almost 2,900 cases were rejected – a rise from 1,301 refusals two years earlier.

      Eleanor Southwood, chairman of the Royal National Institute of Blind People (RNIB), said patients were being forced to wait years for surgery to save or restore their sight.

      She said: “Restrictions or delays to cataract surgery can severely impact people’s ability to lead independent lives, and prevent them from doing many of the things that everyone takes for granted such as driving or reading.

      “It’s shocking that access to this life-changing surgery is being unnecessarily restricted by so many clinical commissioning groups (CCGs) in England.

      “Denying people the cataract surgery they need is a false economy as people with cataracts can be at a greater risk of falls and isolation, resulting in costs to the public purse.”

      She urged CCGs to follow the Nice guidance, which was issued in October 2017.

      Mike Burdon, president of the Royal College of Opthalmologists, accused health officials of ignoring clear evidence that surgery is clinically and cost effective.

      He said: “Health economists spent 18 months reviewing the evidence for cataract surgery on both first eye and second eye, and they convincingly concluded that there was no justification to ration cataract surgery on the basis of acuity. “What is the point of Nice doing detailed evaluation if CCGs are just going to knowingly ignore that advice?

      Previous research has suggested that two thirds of areas have some restrictions on cataract surgery.

      Mr Burden said the situation was endangering pensioners, putting them at increased risk of falls, fractures and significant mobility loss.

      “I think is insulting to our elderly patients that this rationing is going on. It is unjustified,” he said.

      The figures show that the highest proportion of rejected cases came in Telford and Wreckin and Coastal West Sussex. Each rejected more than one in five patients seeking funding for an operation, because it was not routinely funded.

      Nicholas Wilson-Holt, a former member of the Nice guideline committee, said the “postcode lottery” across the country showed the guidelines were being ignored.

      He said: “The evidence clearly was that cataract surgery should not be rationed in this way. A lot of effort was put into producing the guidance, and it is a shame for patients that it is not being followed. It’s such an effective procedure and has the ability to change a patient’s quality of life.”

      Graham Jackson, co-chairman of NHS Clinical Commissioners, said, “Unfortunately the NHS does not have unlimited resources, and ensuring patients get the best possible care and outcomes against a backdrop of spiralling demands, competing priorities, and increasing financial pressures is one of the biggest issues CCGs face.”

      https://www.telegraph.co.uk/news/2019/05/29/investigation-reveals-doubling-nhs-rationing-cataract-surgery/

  9. What happened to the move to charge a fine for unecessary visits to First Responder or other neighborhood clinics or even going to the other waiting line in the hospital? d tThe ambulance service where I live makes the determination based on first response triage. Besides the incidence of a patient being left in a hallway for hours even overnight is far from limited to VA.

  10. . The question is what he have gotten from hundreds of billions of dollars in the most expensive health care system in the world.

    I saw a patient who demanded they be kept in the hospital because they would relapse if discharged into the community. A long time IV drug user the patient developed an abscess in their back shortly after being released from jail. They said they could not lift their left leg while sitting on the edge of the bed as I pressed down on it and offered minimal resistance. When I asked her/him to stand from the hospital bed to show me the affected part of their back better, they leapt up from the mattress without hesitating and the nurse practitioner who was rounding with me looked at me. The patient probably had a staph infection caused by dirty needles but though a biopsy of the mass in their back had been ordered, the young Caucasian patient said she/he could not tolerate the pain from the small incision to access the mass. The patie t demanded general anesthesia and an OR to do the biopsy. The patient has no insurance and is covered from head to toe with tattoos, signifying a high threshold for pain when it cones to skin etchings and incisions for drawing ink.

    Most of the patients I see in the hospital are very sick and suffer from uncontrolled diabetes, hypertension, heart disease, musculoskeletal pain, and other comorbid conditions. They are all related to lifestyle choices and poor compliance. Most are maxed out on prescription meds and not seeing improvement due to not taking their meds. Most are uninsured and unemployed but the hospital doesn’t pursue them for debt collection since socialized American medicine covers their bills. Instead the hospital uses bill collectors to pursue insured patients with remaining debts to offset the lost revenue. The government socialized health plans that cover patients drive up health costs.

    One patient demanded the hospital order the local retail pharmacy to deliver their meds to their house at the end of each month for refills instead of going to the pharmacy. The patient was more than capable to drive. Another demanded he / she be discharged from the hospital against medical advice but was shocked to learn that our hospital social worker would not provide hospital sponsored transportation or help make transportation arrangements. The patient was after-all leaving AMA. That meant we would not enable their AMA consequences. The patient most probably would die at home due to orthostatic hypertension.

    There are the grossly morbidly obese patients who are alcoholics who are admitted via emergent conditions due to hypoglycemia. Their liver is shot to hell. And there are the majority who present with “family dynamics” who expect us to serve as referees when their family members gather at the hospital and the drama erupts. Name calling, obscenities, unreasonable demands, entitlement attitudes….we try to calm them down since their fighting disrupts the other patients and hospital personnel. “Whats the problem, Doctor, are you a racist?”

    Mespo blames illegal immigrants but they largely avoid hospitals because they are pressed to work and support their families. Immigrants rarely seek medical care because they know it means not working if they seek medical attention.

    It is the ugly Americans, white, black, all shades therein, educated or uneducated, with ugly attitudes, ugly lifestyle choices, and demand white glove treatment even if they live like slugs at home. They think they will live forever because they can always go to the hospital. When the diagnosis and treatment are rendered, and it clashes with their “medical knowledge” from the internet, the response is usually the same: “The Doctor doesn’t know what he is doing”.

    yeah, that’s the problem.

    Most Americans deserve to be cut off from their medical care because they don’t want to lose weight, they don’t want to exercise, they don’t want to alter their lifestyle choices and they figure they are going to die some day so YOLO!

    They waive their Medicare, Medicaid, Blue Cross cards and expect physicians to jump at their slightest pain. Truth be told we wish they would die already just as their choices dictate. We have to stop enabling Americans and their unhealthy choices. Many other American exist who practice self-care and they should be the ones who receive the limited resources that exist in life. Entropy rules.

    (all patient information was altered to protect their identities)

    1. Your statement about illegals not using the emergency rooms is false.
      So what is your solution? Deny services to a patient you have just met and know nothing about based on your clearly prejudiced opinion?
      If you really are in the medical industry which I doubt, you sound burned out and too full of rage and hate to help anyone.

      1. Dawn,

        the solution to “illegals” healthcare needs is to outsource it to cheaper countries, like back to where they came from.

        As a matter of fact many Americans are actually outsourcing themselves for more affordable healthcare.

    2. There is overwhelming published evidence to dispute your claim that illegal aliens do not use hospitals or ERs, at least in border states, and instead it’s “ugly” Americans.

      Is it typical for a nurse to despise her patients? If you work with the public, you should actually care about the public, regardless of how frustrating the general public can behave. Hopefully, you do no harm.

      You are describing the general behavior of an addict lost to the throes of addiction. They feel terrible pain upon withdrawal, and can die. It is a self-inflicted problem, as is most obesity, toxic relationships, lost friendships, dishonesty. Self destruction is common among people in general. There is also a general feeling of entitlement and a lack of personal responsibility for a generation of people raised to believe that nothing is their fault, and to live life as hedonistically as possible. If it feels good, do it.

      These are the people whom you serve, and you are supposed to do so with compassion.

      I would love to see our society become more health conscious, less consumption/spending driven, and more responsible. It’s a culture, however, that is eroding.

    3. Anon Doc,
      Good post overall. I am sorry you are having such a tough time. I hope there are those rays of sunshine of people who are appreciative and thankful.

      I definitely have sympathy for your annoyance here:
      “Most of the patients I see in the hospital are very sick and suffer from uncontrolled diabetes, hypertension, heart disease, musculoskeletal pain, and other comorbid conditions. They are all related to lifestyle choices and poor compliance. Most are maxed out on prescription meds and not seeing improvement due to not taking their meds.”

      The meds would help to some degree, but the lousy lifestyle choices got them into trouble in the first place.

      “When the diagnosis and treatment are rendered, and it clashes with their “medical knowledge” from the internet, the response is usually the same: “The Doctor doesn’t know what he is doing”.”

      I am sure this is frustrating, but, at least they are trying to learn and trying to improve. They may be going about it poorly, but could it be redirected into a healthcare partnership rather than an antagonism?

      I was one of “those people” to an extent. My husband has marginal biotinidase deficiency (a pretty rare metabolic disorder). He got very sick following a tick bite and I tried to ask the doctors whether that particular metabolic issue could be playing a role in the lymphedema since biotin helps fat/protein metabolism. One doctor said ‘I don’t believe in that vitamin and mineral crap’ while the other doctor said ‘I haven’t heard of that. Could you tell me more?’

      Maybe I didn’t ask my question such that the first doctor could ‘hear’ what I was saying. As far as I could tell, the first doctor was an arrogant jerk. The second doctor was outstanding, though I was left still not knowing ‘an answer’ to my question since she wasn’t sure whether marginal biotinidase deficiency could exacerbate lymphedema, I felt like I could work with her and I felt she respected my desire to be an advocate for my husband.

      Maybe there is a way to kindly and thoughtfully ‘people manage’ those who want to read and learn and try to figure out what is ailing themselves or their loved one. At least they could be redirected towards better learning or better advocacy, whereas many of the others you deal with don’t want to know and don’t want to comply and don’t want to change. Pretty hard to inspire change in those folks, sadly.

    4. Anonymous,
      “Most Americans deserve to be cut off from their medical care because they don’t want to lose weight, they don’t want to exercise, they don’t want to alter their lifestyle choices and they figure they are going to die some day so YOLO!”

      Yet: “Many that live deserve death. And some that die deserve life. Can you give it to them? Then do not be too eager to deal out death in judgement.”

      ― J.R.R. Tolkien, The Fellowship of the Ring

      It is easier to mend a body than a soul. They are infuriating, but perhaps some of that resistance is not just a bundle of character flaws but a brokenness in the Self.

      Please do not become jaded. We need good docs and nurses.

      1. “Most Americans deserve to be cut off from their medical care because they don’t want to lose weight, they don’t want to exercise, they don’t want to…”

        I remember over 2 decades ago reading an article that said (paraphrasing) British hospital refusing to do cardiac surgery on people that still smoke.

        I can see an insurance company raising the price when a person intentionally raises the risk of disease and I think most people will have sympathy with that idea. However, if one paid into a system, should a government bureaucrat decide what is good and what is bad behavior? That type of power is abusive and corrupting. That is one reason one should not want that type of decision made by government especially when other modalities are available.

  11. What happened to Obamacare?
    Wasn’t that going to solve all the problems with the medical industry that ever existed?

    1. “Most Americans deserve to be cut off from their medical care”
      You sound like a budding Angel of Death.

      1. Dawn,
        It’s similar to the attitude that Basil Fawlty (John Cheese) had in the too- short British comedy seriers.
        He felt that running his small hotel would be so much easier without the guest.
        Just as the one claiming to be a doctor would prefer to practise medicine without the hassle of patients.

        1. I love Faulty Towers! Yet another pre-PC comedy where they even had an episode making fun of Nazis.

          I need to find it on DVD.

            1. Karen S.,
              I have all 12-14 episodes of Fawlty Towers I taped during a pledge drive. They’re stored away with about 100 other VHS tapes. I’ll have to dig them out someday ( and find my 1990 Sanyo VCR as well).
              In the meantime, I posted a short clip of Fawlty Towers. There are a lot of them you can find on the internet on YouTube, etc.
              I think there may even be an entire episode.

  12. The High deductibles for Obamacare Plans ate driving people to the ER

    “the services they can receive that aren’t subject to the deductible. These include an annual check-up, various preventative screenings and, depending on the plan, additional doctor visits and some medications. “

  13. Medical Monopoly Capitalism.
    Avoid doctors, clinics, hospitals. If you are on Medicare take your card and tell them that you will not spend any more money than Medicare will cover.
    We need a Revolution. Not one member of Congress will address the Medical Monopoly Capitalism problem. They all get money from the Monopoly.

  14. I got lasik eye surgery about a decade ago. I went in on a Friday to see if I would be a candidate for the procedure, they ran the tests, I scheduled the surgery later that day and I was seeing 20/15 on the weekend. This was all possible because it exists within the free market. It’s amazing how well a service works when they are fighting for your dollar.

  15. I don’t get sick & never seen an ER or doctor in 40 years. Here’s the diagnosis

    Burnout, characterized by emotional exhaustion as well as feeling cynical, ineffective or unaccomplished at work, is bad for both healthcare employees and employers.

    For doctors and hospitals, though, the ramifications can be especially dire. Doctors in the U.S. experience symptoms of burnout at almost twice the rate of other workers, often citing as contributors the long hours, a fear of being sued, and having to deal with growing bureaucracy, like filling out clunky and time-consuming electronic medical records. Burned-out doctors tend to make more medical errors, and their patients have worse outcomes and are less satisfied. Doctors also have higher rates of suicide than the general population, according to the American Foundation for Suicide Prevention.

    1. Aside from accidents and sudden onset ailments of some severity, people make use of the ER because they lack insurance or because the way in which they navigate daily life doesn’t incorporate making appointments, remembering them and keeping them. In my experience as a hospital apparatchik, this last is the modal reason. They’re given follow-up appointments, then skip them all.

        1. From the abstract: ” the uninsured use the ED substantially less than the Medicaid population. Second, while the uninsured do not use the ED more than the insured,”

          Medicaid is part of the insured population that is covered with other people’s money. Additionally the different categories have different types of urgency for care so I don’t know what the writers are trying to conclude. It doesn’t sound from the abstract that the article or study was well thought out.

          1. There’s nothing terribly mysterious there. The uninsured partake of medical services less than the insured, and the balance between ER care and ordinary outpatient care is tilted in favor of the ER.

            1. DSS, the question raised was included in the title: “The Uninsured Do Not Use The Emergency Department More—They Use Other Care Less”

              That and the abstract didn’t really say much of anything and my reply to it included: ” I don’t know what the writers are trying to conclude.”

              If things are so simple why don’t you tell us what of great importance did the authors conclude. Yes, they provided an indication of numbers that didn’t enlighten us.

              “The uninsured partake of medical services less than the insured” Does that tell us anything as to why? No. What does it add that is useful? Nothing. They included Medicaid in their discussion and Medicaid users are insured and have a very high rate of ER use.

              It is not “There’s nothing terribly mysterious there.” rather there didn’t seem to be anything tremendously useful there with regard, at least, to the arguments I have heard on this blog.

                1. “What the authors concluded is in the title.”

                  …And what meaning do you derive from the title?

                  How about this for a title: (healthy)’Kids from the ages of 6 to 18 attend public school more than those (the healthy) of all other ages combined.’ You don’t get much from this title either. Shall I place an article proving that in Health Affairs or another journal?

                  (I added the word healthy so you didnt go down a sidetrack and say Health Affairs has to do with the health care sector.)

                    1. DSS, Sometimes, believe it or not, your argument is faulty. Of course another can’t comprehend a faulty arguement but you surely should have been able to comprehend the response. Do you not know the difference between a trashy article and a good one?

                      Warning to all those desirous to to post results of medical articles. Some of the research is absolutely fantastic, but there are a limited number of good studies and a lot of journals that have to fill space between their covers. Additionally one always has to look at why an article was funded because a lot of articles are funded with the intention of proving a specific point. Conflating data together frequently is used to produce such desired results. When judging an article one should look at the methodology. If one uses a survey it should be immediately suspect if there is a better way of studying the subject. There are loads of things that have to be considered before one takes the title to heart, DSS, and draws a conclusion.

                      “There are three kinds of lies: lies, damned lies, and statistics.”___Unknown (attributed to Mark Twain, Benjamin Disraeli and others)

                    2. Allen, the argument is that of the authors of the study, and their point is perfectly clear. Just read the abstract. It’s not obscure.

                    3. Obscurity is not the problem lack of value is. Their statement can be clear even thought what they say is pointless. I’ll ask the same question again: ” Do you not know the difference between a trashy article and a good one?” and I’ll ask another question that preceded that question “…And what meaning do you derive from the title?” and another question asked: “If things are so simple why don’t you tell us what of great importance did the authors conclude. Yes, they provided an indication of numbers that didn’t enlighten us.” and another: “The uninsured partake of medical services less than the insured” Does that tell us anything as to why? No. What does it add that is useful? Nothing.”

                      DSS, you continuously say the same things while never responding to the questions. Why?

          2. Allan,
            “Medicaid is part of the insured population that is covered with other people’s money.”

            I wouldn’t count Medicaid as just another kind of insurance. The unfortunate demographic difference between those with employer-provided insurance and those on Medicaid renders an important distinction. They do need to be looked at separately, especially when the abstract indicates that those with employer-provided insurance use the ER less than those on Medicaid. Why do those on Medicaid use the ER more than other ‘insured’ people?

            “Additionally the different categories have different types of urgency for care so I don’t know what the writers are trying to conclude.”

            I am not sure what you mean here. The abstract states that the uninsured and the employer-provided insured use the ER at about the same rates and for about the same circumstances, though the uninsured use other medical care far less than the employer-provided insured do. That, to me, sounds like the urgency is about the same.

            It is those on Medicaid who use ERs the most, it seems.

            1. Prairie, the variables were great in number yet they drew a conclusion. Because there were so many variables not taken into account (based on the abstract) the article seemed to be irrelevant and a puff piece. If Medicaid is counted in the insured population then the ER rate goes up. If it is counted in the uninsured population their ER rate goes up. I agree with your statement: “I wouldn’t count Medicaid as just another kind of insurance.” which demonstrates a fault of the study where apparently there existed a lot more variables that were unaccounted for.

  16. Excuse me Professor, but exactly where in the United States do we have National Healthcare? This article is attempting to blame the problem on a non-existent thing. The reason these people are waiting over five hours in ER’s is because they have no health care program and no other choice for treatment. NOT having national healthcare is the cause of this problem. Oh, and I’m still curious. Do you ever long for the days when you were a respected and honored expert on the law or was getting rid of those feelings of regret all part of selling out to trump?

      1. He’d be correct. Congress has the power to tax only for “…general Welfare…,” deliberately omitting and, thereby, excluding any power to tax for individual Welfare. Understanding that “general” means all, Medicare is individual welfare and is not used by all people in similar amounts or frequency. Young people often don’t use any Medicare at all, while older people use Medicare constantly. Healthcare, clothing and food consumption are always based on individual needs whereas “…general Welfare…” consists of commodities and services such as water, trash pick-up, electricity, sewer, post office, roads, etc. As “…general Welfare…,” China used to have communist state uniforms that all citizens wore in similar amounts and frequency constituting “…general Welfare.”

        Of note, Article 1, Section 8 also severely restricts and limits regulation by government to trade, exchange or “…commerce among the several States…”, deliberately omitting and, thereby, excluding all other regulation, simply to preclude bias or favor by one state over another.
        _______________________________

        Article 1, Section 8

        The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

        To borrow money on the credit of the United States;

        To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

    1. The US Federal government is directly or indirectly involved in most of the medical care in the US. There has not been a free market in health care since WW2.

      1. Unless you’re willing to go full Ayn Rand, a market system for the provision of medical care isn’t feasible. Market mechanisms within a state-supervised system are feasible, but not a market system like you’d have for home appliances.

        1. DSS, I leave Ayn Rand to the Randian’s though her major points are valid. You seem to be arguing points as if everything said by others was black and white while your own arguments are gray and even littered with color.

          Your argument: “a market system for the provision of medical care isn’t feasible.” Why not?

          But then you hedge a bit rather than carefullly defining what you are saying: “like you’d have for home appliances.”

          Is the home appliance sector the only sector of our economy that is using a market system? All sectors have a variety of interference by government, even the household appliance sector. You are very careful with your words and definitions when dealing with concepts presented by others so before travelling futher into a futile argument why don’t you define your terms with words instead of comparisons?

          1. DSS, I leave Ayn Rand to the Randian’s though her major points are valid.

            Rand can be both good and original. Never at the same time.

            Is the home appliance sector the only sector of our economy that is using a market system?

            No, it’s just the example I came up with on the fly. Substitute any consumer good or fee-for-service enterprise you care to.

            Your argument: “a market system for the provision of medical care isn’t feasible.” Why not?

            1. Because the services are given to unpredictable spikes in propensity to consume.

            2. Because the value of the service is opaque to the end user, who relies on counsel from one segment of providers.

            3. Because the consequences of abstention from consumption are severe in a way they aren’t for any other good or service.

            A partial solution to these problems is the development of risk-pooling services and the development of a philanthropic sector. The solutions are only partial, and the former incorporates challenges of its own.

            1. “rand can be both good and original. never at the same time”

              funny, i have seen that sort of phrase attributed to samuel johson

              i also seem to recall it was either Pope Benedict, or maybe Hillaire Belloc? who said something like that about what Mohammed brought forth in Islam

            2. “Rand can be both good and original. Never at the same time.”

              DSS, it’s dangerous to say ‘never’ and also doesn’t add anything to the discussion.

              “1. Because the services are given to unpredictable spikes in propensity to consume.”

              That is why insurance exists.

              “2. Because the value of the service is opaque to the end user, who relies on counsel from one segment of providers.”

              That is why one of the first things on everyone’s list is transparency. Market places incentivize transparency.

              “3. Because the consequences of abstention from consumption are severe in a way they aren’t for any other good or service.”

              Without being exact on the old numbers, 90% don’t need a doctor. Of the remaining 10%, 5% can’t do much of anything about their condition.

              Abstention from food will kill a person.

              “A partial solution to these problems is the development of risk-pooling services”

              One of those solutions is insurance. There is no solution that doesn’t develop cracks and unintended consequences.

              1. Without being exact on the old numbers, 90% don’t need a doctor. Of the remaining 10%, 5% can’t do much of anything about their condition.

                That’s the nut of your argument. And it’s an ass-pull.

                1. DSS that is one argument and not only that but that argument is useful in finding solutions to the problem. Do you have better numbers. Those used to be numbers commonly used just to provide a bit of perspective, something it appears you might need. How many times before the age of 50 did you see a doctor? What percent could have gotten better on their own? You can list the diseases like bronchitis, a non illness etc. How many times did you go for a heart attack?

                  I don’t like those numbers but do you think abstention from an annual physical kills people?

                  What about all the other answers like what insurance is useful for or marketplaces incentivizing transparency. What about the differences between other sectors of the economy from each other. You want to make it seem that healthcare is different from other sectors of the economy but that can be said for transportation, banking, etc. You are trying not to deal with discussion that is sitting there in front of your face.

                  1. he’s obnoxious as usual but i think i agreed with what he said, if I understood it correctly

                    there is an aspect to public health which is shared karma: disease

                    if people can’t get well, then they get sicker. if it’s an infectious disease, then we can catch it.

                    hungry people can just starve quietly and not immediately drag others down with their private condition. but people who have diseases cough them out onto us and then we get sick too

                    even degenerative diseases that are not infectious like diabetes have drastic social costs that can be imposed upon us

                    so there is a strong compelling interest in getting sick peoples’ conditions handled whether the market mechanisms are there working well or not

                    i am not a benevolent person but I am interested in maintaining good conditions of public health. mostly because i walk around every day in that public and it can bite me hard if it all falls down. selfishly, i am wiling to tolerate some publically funded health services to help secure my own life.

                    ayn rand would have an explantion about how I am “irrational” because of so and so, and my selfishness was not being properly applied according to some “principles” or whatever but she is dead and I am yet alive so mostly i am interested in continuing to live not winning approval from Rabbi Peacough and the Rand coven. a clique with which I was very familiar at one time in my life and now happily long estranged!

                    i heard that she took medicare and ss when she was old too, for what that’s worth

                    1. Kurtz, exactly what in my answer is obnoxious? But, at least you agreed with what I said. I guess that means that you don’t like people that question what you say. That is the problem with these pesky lists. People can always ask you the hard questions which I guess you find irritating.

              1. The book, “On Pain”, was that about the pain one gets when they read a federalist post or a how to book by federalist dealing with how to be a pain. Thanks in advance Kurtz.

                1. ha ha

                  it’s a book by a german writer ernst junger who wrote the famous World war one memoir, “Storm of Steel”

                  https://en.wikipedia.org/wiki/Ernst_J%C3%BCnger

                  his writings after world war II are well regarded. he is considered to have been a conservative and not a nazi . he was not however, a liberal.

                  reading his works, i found they spoke to me

                  I am not sure why but I have found some german writers of the last century compelling, most of all, hermann hesse, martin heidegger, ernst junger, and carl schmitt.

    1. The problem is that common provision is possible when there are goods and services produced which can be passed around. Global common provision is not the least bit feasible. The left in this country and in Europe has settled on provisions for gatecrashers, in part because they can employ the gatecrashers in their vote farm and the gatecrashers are the people they can use to dilute the influence of people they despise. (That would be the non-exotic wage-earner element and the non-exotic common-and-garden bourgeoisie).

      There’s a path to improving the standard of living among Hondurans, but it involves generating the conditions for people in Honduras to produce more goods and services – in Honduras. It does not involve recruiting Hondurans to colonize Southern California.

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