ABC Nightline for Friday -- E.R.'s, healthcare of last resort?

[Bozita]

Nightline Daily E-Mail
October 24, 2003


TONIGHT'S SUBJECT: The final program in our week-long look at the national health care crisis. Tonight we look at emergency rooms, the country's health care safety net. E.R.'s are required by law to treat all patients, but as they find themselves overcrowded, overwhelmed and hemorrhaging money, some are saying a drastic change has to be made. Is the safety net about to break?

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Emergency rooms are pretty self descriptive. They are for emergencies. As anyone who has spent any time watching Dr. John Carter or Nurse Abby Lockhart on a rival network can tell you, emergency rooms are for traumas and life threatening conditions. E.R.'s are not health clinics. They do not treat complaints such as persistent coughs or minor skin rashes. Right?

Well, not surprisingly, truth is stranger than fiction. E.R.'s today have become the safety net for a health care system that leaves 43 million Americans without insurance. E.R.'s are seeing uninsured patients who have nowhere else to go. In fact, a recent study found that 55 percent of all emergency services go uncompensated. But E.R.'s are also being flooded by patients with insurance that is woefully inadequate. These patients are trying to make appointments with their primary care doctors but simply are not able to get in to see the doctor in a reasonable timeframe. Sick and desperate, they turn to the E.R.

The E.R. is the healthcare of last resort. Or is it?

Nightline producers Daniel Green and Brooke Runnette traveled to several emergency rooms and discovered that many E.R.'s are overwhelmed and overcrowded and losing money. In fact, for some E.R.'s, the crisis has become so acute that the hospitals are considering what was once unthinkable: turning patients away who cannot pay. In fact, that's what is happening in one of the E.R.'s we visit. If you don't have a true emergency, and you don't have insurance, or can't otherwise demonstrate your ability to pay the bill, you are going to be shown the door.

The crisis in emergency rooms in many ways illustrates the problem in the health care system overall. Financial decisions are competing with ethical decisions — and sick people are caught in the middle.

We hope you'll join us.

Sara Just and the Nightline Staff
Nightline Offices
Washington DC

[Bozita]

1. 35 minutes til airtime

[Doctor Panacea]

2. ER problems

I do not have to watch the Nightline program because, as a physician, I am all too familiar with the problem. The insurance companies, which are criminal by nature, have orchestrated a gradual erosion of health benefits for people with "insurance."

This, of course, does not even address the issue of the 45 million people without health "insurance."

It is time for everyone to have health coverage. Notice that I did not say "insurance," which is the wrong concept. The proper word should be "coverage." Insurance is a concept that is appropriate for something like your car or your house. Your car might not get wrecked, and your house almost certainly will not burn down. Houses and cars are insurable items; health is not. Health care is a right of everyone in a civilized society.

But in a society run by ChimpCo, big business will do everything it can to deny this basic right to the citizens of the nation.

[Spazito]

3. Well said!

It is coverage, it is what should be part of the infrastructure of a truely caring society.

[Padraig18]

4. Local Health Department applies a Band-Aid

I live in a rural area served by a small, 220-bed general hospital. The hospital essentially covers the area within a 50-mile radius and a population of approximately 150K. Any way...

So many people locally are without health insurance that our ER was becoming swamped with both non-emergency patients and patients who WERE emergencies (but would not likely have become so had they had access to primary care), that the bi-county medical society proposed to the local health departments that they operate free, bi-weekly clinics open to all and staffed by volunteer physicians on a rotating basis; the hospital provides instruments, supplies and medications. The aim was reducing the number of patients seen in the ER who were not or should not have become 'emergencies. The clinics opened last spring, and the results have been positive, for the most part; the number of non-emergency patients seen in our local ER has dropped appreciably, and the clinics are well-attended. Patients are seen by primary-care physicians and either treated or referred to appropriate specialists and sub-specialists who have volunteered to donate their services for free.

While this has certainly helped, it is nonetheless sad that so many remain without insurance coverage to pay for their hospitalizations, when needed, and scandalous that our governments would allow this issue to fester. Why should financially-strapped local communities have to cut-and-paste a 'Band-Aid' program together in order to fix a problem that is essentially not of their making?

[VolcanoJen]

5. We should all write letters to ABC News, thanking them...

... for taking a week-long look at the national health care crisis.

For better or worse, ABC News went wall-to-wall with health care coverage on their news programs this week, featuring full-length stories on Good Morning America, World News Tonight and Nightline every single day.

It's rare these days that we have the opportunity to thank a major media outlet for highlighting issues that are of importance to every American voter; ABC News definitely deserves our kudos for their work this week.

[JCMach1]

6. Time to stop applying capitalist principles to a non-capitalist

situation.

Modern American capitalism is about choice. People do not choose to get sick. They have virtually no control of the place and time of such an event.

It's time to throw the moneychangers out of medicine.

[Padraig18]

7. My own doctor says the system is 'irretrievably broken'

He supports Gov. Dean's plan as the 'most workable/implementable'.