Hits & Misses – 2009/6/12

Harvard's Mobile Clinic keeps people away from ERs. The van saves roughly $36 for every $1 invested.

Plant-Based, Low-Carb Diet May Actually Work. Picture candlelight, soft music and rabbit food.

Comments (8)

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  1. Bruce says:

    ER factoid for Canada is interesting. Do you realize that the most oft repeated argument for national health insurance is that it will relieve people of the necessity of going to the emergency room for their health care?

    Apparently this hasn’t happened in Canada after (50?) years. It hasn’t happened in Massachusetts either.

  2. Tom H. says:

    This is why the idea of universal care in Canada is a myth. Formally, everyone is insured. In practice, there is a huge access problem — as great or greater than in the United States.

  3. Ron Greiner says:

    I think the government option is a hoax. The Democrats want the so-called “Gateways” and all their mandates to purchase insurance.

    The cheapest plan (HMO) from Blue Cross Mass. Connector (Gateway) is $18,924 per year for a 55-year-old family. A Blue Cross non-HMO costs $34,116 per year.

    Sen. Grassley wants community rating too. Iowa is the cheapest state in America now. With community rating premiums will soar everywhere. We need to replace all of the politicians from both parties.

    I’m on 8 radio station in Mississippi 4 PM (CST). Listen in online if you have the time.


  4. Bart says:

    ER: I’ve been wondering for a long time whether the cost of non-urgent ER visits is overstated. How much of this is simple accounting fiction? If the ER is already open and staffed 24/7, and non-urgent cases are handled at lowest priority, then aren’t they just using surplus capacity? To handle these cases in a separate urgent-care clinic would require billing to recoup the clinic’s fixed costs. I don’t see how this could be any cheaper.

    I wonder if non-urgent patients are being used to conceal the true costs of running an ER, or at least some ERs.

  5. Bart says:

    Re-wording my last sentence: I wonder if non-urgent patients are being used to conceal the true costs of caring for emergency patients?

  6. Devon Herrick says:

    That may be true because the grad student won a “myth busters” award for his research showing non-urgent, primary care patients were not much of a burden on Canadian ERs. His research found “patients in urgent need of acute-care, admitting beds, extended stay, specialists and other high demand care needs actually have a greater impact on overcrowding.”

  7. John Goodman says:

    Bart: Good point about the accounting. Let’s say half the patients are there for nonemergency conditions and the marginal cost of treating them is as low as it is in a walk-in clinic or a community health center.

    The problem is: For every two emergency rooms that are open, we could have sufficed with one if only emgency patients showed. So no matter how you do the accounting, we are keeping very expensive equipment and specialist’s services unnecssarily on hand at one of them because the ERs are being used for primary care.

  8. Bart says:

    John- Why would you need two emergency rooms instead of one larger one, presumably with more waiting area and primary care personnel but the normal complement of specialists and special equipment?

    Other than that, I suppose it would depend on the usage patterns, e.g. I could see how a busy big-city ER could have a steady stream of heart attacks and gunshot victims, so that there really is no idle capacity between emergencies. But some of the private hospital ERs I’ve seen seem to stay rather quiet most of the time, in an otherwise busy facility.

    There my impression has been that marginal cost for non-emergencies is basically just some space in the waiting room and stalls for admitted patients, plus whatever basic equipment is duplicated in each of the stalls.

    I guess most of my experience has been at the latter. I try to stay out of county hospital ERs, so my experiences may not be typical.