bobdea Posted June 14, 2010 Report Share Posted June 14, 2010 Hey Bob, can I borrow this for another thread? ;) wasn't mine in the first place, have at it. Quote Link to comment Share on other sites More sharing options...
bobdea Posted June 14, 2010 Report Share Posted June 14, 2010 I'm out. okay dip**** you're using willywhit's name to further your cause? you know, I ride with the dude, right? his disagreements with BOL are different than yours I think but regardless I actually know him and consider the guy a friend.........but, me and tex don't have soul. what's your beef with Fin's thread? Have you been to keystone? It's funny, you whine constantly, now you're whining about others whining? WW used to give a lot of **** on this forum too..... but now that you're facebook friends you want to use his name to further your quest to be the biggest sally on this site? Quote Link to comment Share on other sites More sharing options...
skatha Posted June 14, 2010 Report Share Posted June 14, 2010 Manboobs! They may be bigger than mine! Quote Link to comment Share on other sites More sharing options...
Petrol Posted June 15, 2010 Report Share Posted June 15, 2010 and boredom and incredibly childish Quote Link to comment Share on other sites More sharing options...
bobdea Posted June 15, 2010 Report Share Posted June 15, 2010 and incredibly childish yeah, but, look what we're dealing with. Quote Link to comment Share on other sites More sharing options...
Jack M Posted June 15, 2010 Report Share Posted June 15, 2010 I'm in a middle of a 36 hour shift-24 at the ER and now a day job at a clinic in Conroe and last night was filled with my ER pet peeves....Like the 4 year old who's brought to the ER with intermittent stomach pain for a week at 4 am and who's laughing and playing with said mom... Like the 3 year old who's brought in because "mom can't control his fever with Tylenol". Of course it's one dropperful of the infant Tylenol drops that she gave him 1 time 12 hours ago...that child was brought in a 1 am... Like the 14 year old who snuck out of the house and got into a car wreck at 12 am....who was walking around the car and the scene and her parents refused EMS transport...but, once she starts getting into trouble, decides to tell everyone that the car was going 55 mph, and she was submerged for 5 minutes, and maybe she lost consciousness for a minute, and she wasn't wearing her selt belt and the car rolled over...did I mention she was ambulatory at the scene and showed up in the ER 3 hours after the accident? Or the drug seeker who shows up at 12 am with a 2 week history of a cough and, oh, BTW, can I refill her vicodin? Or the drug seeker with bad teeth who comes in with tooth pain at 2 am. Or the young lady who comes in for evaluation of a fever following an elective abortion and doesn't bother to mention she never got around to getting her antibiotic prescription filled and I find this out after I call the OB at 4 am. Antibiotic on Walmart $4 list, BTW See I just don't understand the concept that decent people owe these evolution escapees anything. You should be able to turn them away or have them arrested. Quote Link to comment Share on other sites More sharing options...
skatha Posted June 15, 2010 Report Share Posted June 15, 2010 See I just don't understand the concept that decent people owe these evolution escapees anything. You should be able to turn them away or have them arrested. EMTALA....The Emergency Medical Treatment and Active Labor Act I have to be able to document that a patient is medically stable. Also, the people with the huge sense of entitlement also have no problem complaining to administrators about how "rude" you may have been and, sometimes, it's not worth it! On the other hand, recently, we had a 23 year old kid diagnosed in the ER with Wolff-Parkinson-White syndrome, which is a cardiac condition that can cause a life threatening arrhythmia. He was told he needed to see a cardiologist ASAP or he could die. He didn't have insurance. He told his girlfriend that he could drop dead at any moment which is precisely what happened 2 weeks ago. Very sad. This is another pet peeve of mine.... Quote Link to comment Share on other sites More sharing options...
Jack M Posted June 15, 2010 Report Share Posted June 15, 2010 I understand it is the law, I just don't understand why. Quote Link to comment Share on other sites More sharing options...
skatha Posted June 15, 2010 Report Share Posted June 15, 2010 EMTALA grew from a circumstance where a woman with a high risk pregnancy was sent by ambulance, in labor, to UTMB, my medical school, without anyone knowing she was coming. Both mom and baby died en route. Family sued UTMB and the hospital in Victoria alleging malpractice and UTMB's defense was "No one told us she was coming". It was a very high profile instance of patient dumping. Of course, the woman did not have insurance or a regular doc. The feds stepped in and the rest is history... The original case happened in the late 70s...the law orginated in the mid-80s Quote Link to comment Share on other sites More sharing options...
bobdea Posted June 15, 2010 Report Share Posted June 15, 2010 I understand it is the law, I just don't understand why. because if it's not you end up with people getting refused treatment because they're not christian for example or whatever other institutional or personal bigotry may exist in a certain establishment. that or if the hospital is not sure you can pay they leave you on the curb until you can produce a insurance card and you die in the meantime. Quote Link to comment Share on other sites More sharing options...
zoom Posted June 15, 2010 Report Share Posted June 15, 2010 I understand it is the law, I just don't understand why. Hm. I can kind of see your point, but I think its a lot more complicated than a simple decision of "x" kind of person deserves care and "y" does not. Bob's onto one way of thinking about it. Below is a little more food for thought: When I was 22, and driving home after graduation, I rolled my Ford Explorer 2 1/2 times into the median of the interstate (car swerved into my lane, I swerved to avoid them, the right front wheel came off - stripped the axle nut completely out. Yes, I was wearing my seat belt.). I had all of my belongings and my mutt puppy with me, and I was wearing some pretty ratty clothes. I probably looked homeless, with a bloody rats nest of hair. I was unconscious to semi-conscious. A year or so later, my folks got a call from one of the first passers-by to stop at the scene, who was shocked that I wasn't dead. I was fortunate. Someone found my wallet, and I was just conscious enough to give my folks' phone number to someone (lucky, b/c I gave the wrong phone number for another contact). There are a lot of scenarios that could have led to me ending up in the ER, semi-conscious, looking homeless, with no ID, no contact info. What would you think if someone turned your wife or kid away in that state? Not to get too allegorical, here's what happened to my dog. Although the firemen and several people promised to take my dog to the vet, no one was willing to take the responsibility for the dog or payment for her. I could have paid, but I wasn't really in a state to figure out the logistics.... They just tossed her in the SUV and sent her with the wreckage. I was released later that day (weird, I know), and had the friend who picked me up take me to the junkyard. I found the 12 week old pup cornered under the truck by the (literal) junk yard dogs. Overall, the dog and I were lucky. I had a concussion, a lot of glass in my arm and some soft tissue damage to my neck, the pup broke her pelvis. The dog sits funny and my neck gets stiff sometimes, but we don't mind. Quote Link to comment Share on other sites More sharing options...
softbootsurfer Posted June 15, 2010 Report Share Posted June 15, 2010 I understand it is the law, I just don't understand why. Some People have Jobs were insurance is supplied en total or at a rate they can afford...a lot of folks have Jobs working for others were no insurance is offered and their pay rate does not allow enough funds to buy insurance... Being self employed, I have bought insurance for the last 35 years...now that I am 64 the rates are so high I have had to go to a deductible were basically I can not go to a doctor without paying out of pocket but still am paying for insurance for a catastrophic situation so as not to lose our home in case of accident or illness. I do not know if your employer pays for your insurance, but to classify all the people who can not afford insurance for their families as somehow Bums or Indigents that should be allowed to suffer is sick! Believe me, the rates you pay now in your thirties will triple when you get older :) Quote Link to comment Share on other sites More sharing options...
skatha Posted June 15, 2010 Report Share Posted June 15, 2010 And, hence, my pet peeve I worked for 3 years as a hospitalist for indigent patients for a hospital in Houston. My patients were contractors, day laborers, stay at home moms where the husband couldn't afford employer coverage for the family and, in TX, only kids and pregnant women are covered by Medicaid-but they all worked! Not many were illegal, either, but...when discussions came up for healthcare reform, all I heard was that uninsured people were illegal aliens or shiftless bums. Nothing is further from the truth! A college professor told me the story of going out to the shooting range with his friend, a shift worker with General Tire. Dr. Patton shot off his right index finger. The ER doc at Providence Hospital decided he didn't need his finger based on the appearance of his friend. Fortunately, Dr. Patton gave them the President of Baylor's home number and told them to call and get a flight arranged for Baylor at Dallas to get his finger re-attached. People like me shouldn't base treatment decisions on appearances, especially since, of all people, we understand the psychology of stereotyping! Quote Link to comment Share on other sites More sharing options...
Jack M Posted June 15, 2010 Report Share Posted June 15, 2010 I do not know if your employer pays for your insurance, but to classify all the people who can not afford insurance for their families as somehow Bums or Indigents that should be allowed to suffer is sick! Agreed, good thing I didn't say that. I don't understand why decent people should have to pay for the ER visits for the people like in skatha's post. That's different. Quote Link to comment Share on other sites More sharing options...
softbootsurfer Posted June 16, 2010 Report Share Posted June 16, 2010 Agreed, good thing I didn't say that.I don't understand why decent people should have to pay for the ER visits for the people like in skatha's post. That's different. I do not know any of the people in Skathas post...so I will not assume judgements on or about them... Who decides who is Decent and who is not Decent ? You ? Skatha ? the Decent Society ? There is no doubt that some are cheating the system, but who knows who they are? I understand the frustration, but what is the solution? 46,000,000 Americans as of 2009 were in this group of Non-Insured, which of course grows daily. Quote Link to comment Share on other sites More sharing options...
davekempmeister Posted June 16, 2010 Report Share Posted June 16, 2010 The law that you all are referencing is handled in an interesting way by well- heeled hospitals in the D.C. area. Dispatchers for Metro D.C. EMTs presumably have a list of all the ERs that they use in a revolving fashion to ensure parity in the way the homeless/undocumented etc are distributed. One hospital, rather than have those patients on display in their waiting room or triage, permanently stations an ambulance in proximity to the ER. The ambulance is dedicated solely for the purpose of transferring the patient from the City paramedic's ambulance to the hospital's own ambulance. ER doctors then attend to the patient in the ambulance, and once it's determined the patient is stable, arrangements are made at some other hospital and the patient is transferred. All charges incurred are paid in full by the hospital that originally rec'd the patient. To the best of my knowledge, the last part is what has kept this arrangement from becoming controversial. Quote Link to comment Share on other sites More sharing options...
bobdea Posted June 16, 2010 Report Share Posted June 16, 2010 I Who decides who is Decent and who is not Decent ? You ? Skatha ? the Decent Society ? There is no doubt that some are cheating the system, but who knows who they are? I understand the frustration, but what is the solution? 46,000,000 Americans as of 2009 were in this group of Non-Insured, which of course grows daily. word, pretty much how I see it. Quote Link to comment Share on other sites More sharing options...
jonbass Posted June 16, 2010 Report Share Posted June 16, 2010 When I was 22, and driving home after graduation, I rolled my Ford Explorer 2 1/2 times into the median of the interstate (car swerved into my lane, I swerved to avoid them, the right front wheel came off - stripped the axle nut completely out. Yes, I was wearing my seat belt.). I had all of my belongings and my mutt puppy with me, and I was wearing some pretty ratty clothes. I probably looked homeless, with a bloody rats nest of hair. I was unconscious to semi-conscious. A year or so later, my folks got a call from one of the first passers-by to stop at the scene, who was shocked that I wasn't dead. I was fortunate. Someone found my wallet, and I was just conscious enough to give my folks' phone number to someone (lucky, b/c I gave the wrong phone number for another contact). There are a lot of scenarios that could have led to me ending up in the ER, semi-conscious, looking homeless, with no ID, no contact info. What would you think if someone turned your wife or kid away in that state? Not to get too allegorical, here's what happened to my dog. Although the firemen and several people promised to take my dog to the vet, no one was willing to take the responsibility for the dog or payment for her. I could have paid, but I wasn't really in a state to figure out the logistics.... They just tossed her in the SUV and sent her with the wreckage. I was released later that day (weird, I know), and had the friend who picked me up take me to the junkyard. I found the 12 week old pup cornered under the truck by the (literal) junk yard dogs. Overall, the dog and I were lucky. I had a concussion, a lot of glass in my arm and some soft tissue damage to my neck, the pup broke her pelvis. The dog sits funny and my neck gets stiff sometimes, but we don't mind. That is an amazing story. i'm glad that you and your dog is all right. I couldn't imagine going through the accident and then finding I'd lost my dog too. Dogs are the good people in this world! Quote Link to comment Share on other sites More sharing options...
jonbass Posted June 16, 2010 Report Share Posted June 16, 2010 I do not know any of the people in Skathas post...so I will not assume judgements on or about them...Who decides who is Decent and who is not Decent ? You ? Skatha ? the Decent Society ? There is no doubt that some are cheating the system, but who knows who they are? I understand the frustration, but what is the solution? 46,000,000 Americans as of 2009 were in this group of Non-Insured, which of course grows daily. This is the crux of the problem. We have to take the good with the bad. Everyone's perspective on what is acceptable is different. A junkie still values their life but cannot overcome the addiction which causes them to be a burden and some people are too stupid or too lazy to use the health care system with discernment and restraint. My wife is a nurse and a very large percentage of the patients she see's are related to alcoholism and smoking. These are the major contributors. The next big contributors are sporting and ATV accidents, junkies and the elderly. Should we punish the elderly for being old? We have to assume that everyone is deserving of treatment or risk not helping someone in need. Many people would say that if you smoke you should lose your health care privileges. Those same people might not want this sentiment applied to people who drink alcohol as they enjoy the occasional beer and the occasional bender. Alcohol is in the least connected to so many costs in the health care system (health damage due to alcoholism, family violence, social violence, drunk driving etc.) but many people would fight to he death to protect their right to have "a beer". I'm not making a judgement whether any of these are right or wrong, just asking who decides which situations society should support? The beer drinkers or the tee-totalers? We love sports and they sometimes cause injuries. When people have to pay to have their injuries treated, some are unable to afford to participate in sports. This can end up leading to other health problems caused by a sedentary lifestyle. Where do we draw the line? Does their insurance policy state that if they have ever snowboarded their insurance is void? Insurance companies could also apply this to food. If you have ever eaten something with trans-fat in it, your policy is void? How about the elderly? Health insurance companies are already setting rates incredibly high for seniors, effectively punishing people for doing nothing but aging. I'm not willing to make those decisions for other people and I don't want anyone making those decisions for me especially insurance companies. Quote Link to comment Share on other sites More sharing options...
Jack M Posted June 16, 2010 Report Share Posted June 16, 2010 You're all talking about the concept of slippery slope. Well, it is up to a functioning society to draw the lines of what is acceptable and what is not. We do it already. And yeah, if we're going to socialize medicine, I think there should be serious consequences for smokers. There is no defending smoking. Quote Link to comment Share on other sites More sharing options...
Corey Posted June 16, 2010 Report Share Posted June 16, 2010 And yeah, if we're going to socialize medicine, I think there should be serious consequences for smokers. There is no defending smoking. Is there any defense for drinking? Or smoking pot? Or gambling? Or snowboarding through trees? None are necessary, all have a higher risk of death than doing nothing or exercising inside your home. For the record, I HATE smoking as I'm asthmatic. But when it comes to 'rights' all of the above are in the same boat - they're all different shades of grey. Quote Link to comment Share on other sites More sharing options...
kieran Posted June 16, 2010 Report Share Posted June 16, 2010 Is there any defense for drinking? Or smoking pot? Or gambling? Or snowboarding through trees? None are necessary, all have a higher risk of death than doing nothing or exercising inside your home.For the record, I HATE smoking as I'm asthmatic. But when it comes to 'rights' all of the above are in the same boat - they're all different shades of grey. it is arguable that smoking has detrimental effects to not only the smoker, but also those around them.beer burps aren't quite in the same league. or at least mine aren't. Quote Link to comment Share on other sites More sharing options...
Corey Posted June 16, 2010 Report Share Posted June 16, 2010 it is arguable that smoking has detrimental effects to not only the smoker, but also those around them.beer burps aren't quite in the same league. or at least mine aren't. What about the drunk guys that drive into things/people? Or the snowboarders that hit little kids? I've heard these arguments before from smokers defending their right to smoke. Some smokers are quite aware of the effects of second-hand smoke and are quite courteous to go outside/away from non-smokers. Quote Link to comment Share on other sites More sharing options...
two_ravens Posted June 16, 2010 Report Share Posted June 16, 2010 That is an amazing story. i'm glad that you and your dog is all right. I couldn't imagine going through the accident and then finding I'd lost my dog too. Dogs are the good people in this world! +1! Zoom, so glad you and your pup made it through all that - I can attest that the world would be a much poorer place without the two of you. :) Quote Link to comment Share on other sites More sharing options...
softbootsurfer Posted June 16, 2010 Report Share Posted June 16, 2010 You're all talking about the concept of slippery slope. Well, it is up to a functioning society to draw the lines of what is acceptable and what is not. We do it already. And yeah, if we're going to socialize medicine, I think there should be serious consequences for smokers. There is no defending smoking. I grew up in a tiny house with both parents smoking a couple packs a day...my brother, sister and I were all smoking by the time we were 14 years old...though we all quit years later we were addicted to and affected by being raised in a home filled with smoke. Smokers, Junkies, Obese people, softbooters all seem to be on your list Jack...The serious consequences you speak of are evident all around you in the signs of depression by people who are unable to break away from their addictions. You keep coming back to we need to draw the line somewhere and I am glad you are not the one who is in charge of that... Quote Link to comment Share on other sites More sharing options...
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