Welcome to sick season.
According to the CDC, New York City — along with New Jersey and at least 16 other states — is now experiencing “high” to “very high” levels of respiratory-illness activity as measured by the number of weekly visits to health-care providers and emergency rooms by people having symptoms of fever, cough, and sore throat.
The culprits are the usual suspects: this year’s strains of influenza, COVID, and RSV. And though flulike-illness levels have been above baseline nationally for several consecutive weeks, the CDC warns that we still haven’t hit the peak.
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As always, seniors remain the most at-risk demographic for severe outcomes from respiratory illnesses, which is why the low vaccination rates for that group remain troubling.
Beyond vaccination, for everyone, the best way to prevent the spread of respiratory illnesses like the flu and RSV is regular handwashing; avoiding touching your eyes, nose, and mouth; and staying home if you get sick. High-filtration face masks still work great, too, and not just for avoiding COVID.
Where do you propose people who don’t have insurance go for non-emergency healthcare?
Is that a serious question? I sincerely hope that people don’t think that is a thing to do.
Going to the ER is always going to be more expensive than going to a regular doctor, with insurance or without.
An urgent care clinic or general medical center is where you’re supposed to go for non-emergency care. If you can’t afford the doctor bills at those, then the local county health department should offer medical services at reduced cost for low-income people.
Urgent care and medical centers require insurance.
ERs do not.
So, again, where do people without insurance go for non-emergency healthcare? What the county health department should do is irrelevant. There should be universal healthcare in this country. There isn’t that and health departments aren’t offering any medical services at reduced cost.
The only option uninsured people have in much of the U.S. is the ER.
Man you really don’t know how the medical system works at all. Please stop giving out this wrong information to anyone.
Urgent care here requires insurance. There is no medical center here, so I can’t speak for those. The fact that there isn’t one here, however, suggests that they are not a good solution. The ER does not require insurance anywhere. Poor people here who have no insurance go to the ER. All the time. I’ve been in the ER three times this year so far (I do have insurance) and there are always people there who have no insurance who need to be seen for something medically that could have been taken care at the urgent care who won’t see them.
Furthermore, there should, in fact, be universal healthcare.
So what did I get wrong?
I have never heard of any medical practice that would not see patients without insurance. I have been to several of them with no insurance personally.
Here is a link that proves you are wrong:
https://www.cvs.com/minuteclinic/why-choose-us/walk-in-clinic-cost-no-insurance
EDIT: See also - https://www.healthcare.gov/community-health-centers/
Guess what also isn’t offered here? A walk-in clinic at CVS.
So I’m not sure how that proves me wrong.
Here’s another link for you, but you probably just want to argue by splitting hairs or something so good luck with your ER bills.
https://www.healthcare.gov/community-health-centers/
CVS’s link was simply an example, you should have several options in any city for a walk-in clinic if you look around. The community health center thing is nationwide and government funded.
Yeah… about those community health centers… https://www.bloomberg.com/news/articles/2023-04-12/as-millions-face-loss-of-medicaid-community-health-centers-strained
And, of course, you better hope you’re healthy enough to walk or take the bus to one if you can’t drive or have someone drive you. And you better hope work lets you off. Because being sick in America if you’re poor is very expensive for many reasons.
As someone who has spent a shit ton of time at many different medical facilities and, during that time, spent some of it completely poor, I can confidently assure you that you are the one who’s incorrect.
An emergency room can’t turn somebody away just because they can’t pay. Other facilities can and do. This results in people without health insurance going to the emergency department for every little need.
Ehhh he’s fairly spot on. When I didn’t have insurance I had to go to the ER or try to find a doc that would write a prescription “under the table” - which never went well. No urgent care would see me.
Now that I have insurance I’ve only been to the ER for a real emergency once.
Still going to the ER with insurance wiped out my savings though, so I don’t really see all that much difference.
Well it sounds like y’all are living in terrible places and you should move.
I live in one of the poorest parts of the USA, and have spent decades in poverty myself. During my terms in poverty I usually had no health insurance also, and I got all the medical care I needed by going to normal doctors, none of which ever turned me away for not having insurance.
So I have literally never encountered any medical facility that turns away patients for not having insurance. That would amount to a criminal action IMO and should be cause for a complaint to the state’s medical board should you encounter that again.
Theft is a crime.
You are admitting to being an entitled theif.
Please quote me “admitting to being an entitled thief.” This should be interesting.
wtf
There SHOULD be universal Healthcare, but there isn’t.
The answer is finding a private practice that will see you for cash, not theft, which is a crime.
You are not entitled to free healthcare.
yikes
Yikes what?
I am all for the US going single payer. We aren’t though.
So impoverished sick people who can’t afford to go to a private practice for cash should just die?
No, what isn’t getting through your thick skull?
You take on the medical debt. Like everyone else does.
And if you never pay it back… which poor people can’t afford to do… that’s not theft?
No.
Minimum/Good faith payments.
Carry the debt. Like everyone else.
Don’t be a criminal.
What is so hard to understand about this?
You cant afford a car. Do you go and steal a Lexus? No, you get a used PT Cruiser and you make the payments. Capitalism isn’t that hard to understand, if you live in America, you need to understand it until we get some Socialism installed, which I am for, but breaking the existing system and fucking over the rest of us is not the way.
Taking on 300 dollars in debt for a trip to a private practice is FAR better than taking on 3000 dollars in debt by going to an ER. And just skipping out on the bill you run out isn’t an option. That is theft.
If you go into debt with a car and can’t afford the payments, they take the car back.
What do you suggest happen if the person can’t afford to pay back their medical debts?
And I’m still waiting for you to quote me “admitting to being an entitled thief,” as you accused me of doing. Was that a lie?
Lmao this HAS to be a troll
I’m a nurse in a hospital. We absolutely do NOT consider uninsured people seeking healthcare to be theft.
Would we prefer that people have Medicaid and seek primary care services elsewhere? Of course. So one of the things we do when people come in is get them signed up. Should that be our responsibility? Of course not. But here we are.
To be clear, I am saying providing a false name or intending to fully skip out on the bill is theft.
I am arguing with people here who say the ER is the ONLY place you can go if you don’t have insurance. That is a lie. There are tons of places you can go, the ER is NOT your only option if you don’t have insurance.
I am arguing with people here who say if your uninsured and go to the ER you should provide a false name or fully ignore the bill you run up. That is theft. You take on your debt, you make at least good faith payments, or you file for bankruptcy, just like the rest of us.
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Um… a regular doctor?
Will still be cheaper than an ER…
Insurance doesnt give you access to the doctor. It reduces the cost for the going to the doctor…
Edit: ITT a bunch of uneducated and misinformed people argue with and downvote me for describing the current American Healthcare System because they dont like the current American Healthcare System, so they feel entitled to just go “nuh uh, I’m poor, the rules don’t apply to me. Imma just steal the most expensive healthcare.”
Can’t visit a regular doctor if you don’t have one already, and you won’t without insurance because they won’t be taking patients that don’t have insurance.
You can try those quick care places, but they tend to either require insurance or charge an arm and a leg just to be seen. They also tend to have limited hours.
The emergency room must see you for free at the point of service and will bill you later. That works for those that can’t afford to pay up front for care or have trouble being seen during work hours.
Your first paragraph is patently false.
The rest is “I’m a criminal. Let me steal medical services.”
You know where it is impossible to “steal medical services”? Any first world country with a single payer system.
Pretty shitty to blame people who cannot afford medical care because of our terrible system.
But you know where the people in this thread suggesting that poor people MUST abuse Emergency Rooms to steam medicine and services? America.
I agree, its a broken system. It should be universal single payer. It’s not though.
Medical debt sucks. You know what sucks more? Exhausted overworked doctors and nurses constantly being stolen because some people fancy themselves above the system.
Why are prices so out of control? Why does one trip to the hospital, with insurance or not, bankrupt someone? Because shit sucking leeches are perpetuating this complete lie that the only way to find medical care if you are poor is to rip off an Emergency Room.
You would rather people not get medical care if they can’t afford it than some companies lose some profits? The shit sucking leeches are the for profit insurers and their investors.
What a terrible person you are. Just fucking awful.
Not if you’re poor and uninsured.
In that case, you can go to an emergency room, be guaranteed treatment, and just give a fake name or ignore the eventual bill that will sink your credit rating that you don’t care about because you already aren’t particularly eligible for credit.
You can’t walk up to an HMO building without being enrolled in that HMO, but you can 100% find non-hmo practices and pay cash.
If you are saying you want to commit a crime and steal the services, then fuck you. And double fuck you for putting people’s lives at risk clogging up an actual ER because you want to dine and dash an emergency doctor to look at your sniffles.
Umm, I never suggested that I do this, or that anyone should do this. Calm down.
I’m saying that, regardless of what you or I think about it, emergency rooms are legally obligated to provide care for all people regardless of ability to pay, and people without insurance and in poverty know this.
You are still perpetuating a false and quite frankly disgusting way to look at it.
You are trying to frame it like there is a segment of the population that are forced to commit theft from Emergency Rooms. That is a patently false statement.
You responded to “Um… a regular doctor?” with “Not if you’re poor and uninsured.” and now you are back-peddling and saying “I never suggested that” instead of saying “you know what? you’re right. I shouldn’t have suggested that.”
Let’s see if I can add something to this conversation. I’m a fourth year medical student in the United States, who in a few short months will hopefully begin training to be an emergency medicine physician. You are absolutely correct, that the government subsidizes health insurance, and that in a decent number of cases, individuals without insurance or the means to pay for healthcare are eligible for Medicaid. You are also correct that the ideal use of the emergency room is to evaluate for medical emergencies, I say this as someone soon to be an emergency room doctor. Lastly, there are certainly physician groups which are capable of providing cash pay based care.
However, the process to apply for Medicaid can be quite complicated, particularly amongst those with low medical or even just general literacy levels. This disproportionately impacts individuals for whom English is a second language. As I said above, in a perfect world, the emergency department is only for true medical emergencies. However, patients as a whole are notoriously bad at knowing if their symptoms are from an actual emergency or not. Secondarily, in many communities, the emergency department is the only reliable access some individuals have to the health system due to difficult difficulties with transportation and scheduling. With regards to your last point, while there are certainly clinics that can provide cash based care, the majority of individuals who cannot afford insurance are also likely the patient who cannot afford a cash pay clinic.
The fact is also that a large number of uninsured patients will simply have their ER bills written off by the hospital, and/or social workers within the ED will help sign the patients up for Medicaid if they qualify so they become insured can then have the visit billed for, as opposed to the individuals giving fake names.
Unfortunately, the current state of the US Healthcare system is that for many disadvantaged populations, the ER is their primary care physician. This is not ideal, but I will not admonish my patients for doing what they can to seek care in a system that otherwise leaves them abandoned and uncared for
Well spoken, good points. I do take exception to:
and
You are going into emergency care. You are doing gods work. For your sanity, I think you have the best outlook to take on what you are about to take on. That said…
An ER is always going to cost orders of magnitude more than a private practice. When the hospital “writes off” bills, they aren’t waving a magic wand and making that expenditure of resources disappear. The hospital is making the call that collections activities cost money and will never see a return, so they roll the debt into pricing.
That is precisely why hospital care is so cripplingly expensive today.
Insurance or not, hospital care will bankrupt you. That is because poor uneducated people are misinformed and are exploiting the system, causing MASSIVE damage to the system as a whole.
Again, great compassionate mindset for when you are in the ER seeing the patients, but very damaging rhetoric to be preaching to the open internet.
I’m aware that those costs do not magically disappear and are absorbed into other billing/passed on to society. However that is not why healthcare is so ludicrously expensive in the United States. It is the substantial and unnecessary administrative costs, predominantly driven by for-profit insurance companies, for-profit hospital systems, and pharmacy benefits managers. The continued exploitation of the ill for shareholder benefit is a uniquely American take on health care, and coupled with our incredibly individualistic tendencies bring about a huge fraction of the poor health outcomes we have in comparison to other developed nations, despite spending generally more than double per person.
Some of this is certainly driven by system inefficiencies such as forcing people into a situation where they have to use the ER for primary care. Or where they cannot afford their blood pressure or cholesterol medicine, and instead of our society helping provide these very affordable interventions, we pass the buck. So when those individuals inevitably have a heart attack, we then pay many times more for care that they may not have needed had they simply gotten good preventative care.
I will happily stand up and bash the current US healthcare system. I despise its insistence that human lives and suffering are secondary to wealth-extraction. But as much as I hate it I can’t change it, and while I will advocate for policy to change things, for now all I can do is continue to provide care to the patients presenting as a symptom of an ill society.
I hope others can see that these patients presenting to the ER are simply doing the best they can to take care of themselves and their families, and that the real blame and consternation should be placed on the government, hospital, insurance, and pharmaceutical officials and lobbyists who continue to exploit their illness for profits.
They are actually looking at this reasonably and how it works in real life. The emergency department by law cannot turn a patient away because they can’t pay. Physicians’ offices can. This results in many people going to the ER for something that should go to urgent care or a regular primary care provider. But those locations will turn people away if they don’t have the right insurance.
Tell me you have no idea what health insurance is without telling me you have no idea what health insurance is.
A doctor will turn you away for not even attempting to pay your tab.
As long as you are making just good faith payments. 10-15 bucks a month, they will keep your tab open.
When you try to defraud the service provider (try and get clever and try and not pay for your service at all), yes. They will drop you.
That has nothing to do with insurance and has everything to do with you feeling entitled to free Healthcare.
Your argument is the equivelent to “I can’t afford food, so I shoplift from the most expensive luxury grocer in my area instead of finding my local food bank.”
It is just SO assinine.
You should be the one telling me how you don’t know how healthcare works in the US. They ask what insurance you have before they provide services.
I don’t know of many regular doctors who are willing to see people who are uninsured. Unlike hospitals, doctors expect to be paid back by everyone, even the poor.
Hospitals 100% expect to be paid too.
You can almost assuredly find a private practice doctor that will see you for a cash transaction, but you do need to pay for Healthcare services in America.
You shouldn’t put the lives of people experiencing true emergencies at risk because you want to commit a crime and dine and dash on an emergency doctor so he can look at your sniffles.
Medical debt is dischargeable by bankruptcy, but you can only get 1 of those every 8 years.