Health system is abused

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A recent visit to the emergency room of one of our local hospitals brought to light a situation that I was not aware of.

I had fallen in my driveway and sustained a cut on my forehead that required attention, and as a result made a hurried trip to the nearest hospital. I was greeted as soon as I arrived by a very pleasant nurse who quickly ushered me to an examining room. I was given a quick look to determine the extent of my injury.

I was then transported to radiology for a computed tomography scan, then back for further care. A very young and competent ER doctor advised that stitches would be required, and he would be back shortly. “Shortly” turned out to be an hour and 45 minutes.

When he returned, he was very apologetic and said that he had been delayed because of three ambulances that had shown up, each with a patient complaining of various ailments. Since they had come by ambulance, he had to give them priority in spite of the fact that their complaints were specious.

He said little more, but here is what I learned by observation and other sources. Medicaid patients will often call an ambulance for transportation as they know that (1) they will be tended to ahead of patients who make their way to the hospital on their own, and (2) the ride will be free to them.

In the case of the above-mentioned patients, it is doubtful that there was anything wrong with them, and they were making an effort to get a prescription for a narcotic. I don’t imagine that they were successful in their attempts, but I am sure in many cases they are. Even if they don’t, they have tied up the ER staff who have legitimate patients who need care. There I sat, a paying patient, waiting in line behind people who were abusing the system at my expense.

We often wonder why Medicare/Medicaid costs are out of control. This is one example why. The system is being abused by those who are making no contribution to it.

Carleton Duvall

Augusta

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Techfan
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Techfan 01/20/12 - 06:03 am
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Don't forget Rick Scott (R).

Don't forget Rick Scott (R). $1.7 BILLION is fines for Medicare fraud. Nice of the Tea Party to reward him with the governorship of Fl.

carcraft
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carcraft 01/20/12 - 06:40 am
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Not only are

Not only are medicare/medicade costs out of control but Obama via Obama care has cut 500 billion form medicare, it is only going to get worse as states have to poney up cash to cover the short fall!

Techfan
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Techfan 01/20/12 - 08:03 am
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Once again, the right wing,

Once again, the right wing, "If you tell a lie often enough, people will start to believe it". "Obama care has cut 500 billion form medicare"
http://www.politifact.com/oregon/statements/2011/nov/14/rob-cornilles/an...
http://www.factcheck.org/2010/10/health-care-spin-again/

mendema
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mendema 01/20/12 - 08:29 am
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I fully agree with the

I fully agree with the thoughts on Medicaid fraud, but there is also fraud in the Medicare system. My mother recently received, free of cost, an electric wheelchair. No one ever came to assess her need or whether it would fit her living space. All it took was her doctor writing a prescription. It was totally inappropriate and has never been used. When she tried to return it, of course, she was ignored.l I have thought that perhaps the doctor is getting kickbacks from the wheelchair supplier. I could go on about other things, but I think that we need to see just where the fraud is coming from. I contacted Medicare about this but did not receive a response. Until they treat Medicare and Medicaid patients the same as those with private insurance this fraud will continue.

justthefacts
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justthefacts 01/20/12 - 08:51 am
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carcraft, please get it

carcraft, please get it right. President Obama did not cut $500B, as Techfan's link points out, he just reduced the amount to be budgeted by $500B. Now let's discuss the definition of "is".

blackindependent
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blackindependent 01/20/12 - 09:09 am
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techfan: Your statement

techfan: Your statement reminds me of another saying... "You can fool some of the people all of the time and all of the people sometime and some people will fall for anything all of the time"

justthefacts: Obama "cut" $500B from Medicare so that he could use the money to help pay for OBAMACARE. Bottom line, seniors are still paying so that kids can stay on their parents health plan til age 26.

jic
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jic 01/20/12 - 10:01 am
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Let's also not forget that
Unpublished

Let's also not forget that "medicare fraud" is not perpetrated by Medicare. It is victimized by fraud. Why do we scapegoat medicare when it is the victim? Second, stop "lumping" medicare and medicaid. They are two different beasts. We are in fact "entitled" to medicare because we worked and payed into it all our lives. Medicaid is a state run program for the poor. Some state programs are better than others. In some states, medical groups will not even accept medicaid patients because of their reputation for being abused and for non-payment of services. So the truly sick flood emergency rooms. Since there is no state-funded mechanism for sick-call clinics, emergency rooms in CA have started implementing their own separate sick-call areas so genuine ER traffic is not disrupted. Again, some states recognize the problem and just deal with it. Others politicize it and do nothing and everyone suffers.

TParty
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TParty 01/20/12 - 10:45 am
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My favorite part of this

My favorite part of this story was how since the letter writer had to wait almost two hours, their only conclusion was that everyone who received treatment before them was only faking it and trying to score pills.

Chillen
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Chillen 01/20/12 - 10:53 am
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You ain't seen nothin' yet.

You ain't seen nothin' yet. Wait until 40 million more people are added to the healthcare roster because of obamacare. Emergency rooms will have lines about 2 miles long. And good luck getting an appointment with your family practitioner. He'll be dealing with welfare mom's 15 kids instead or you with your private insurance that costs you $750 per month.

The entitlement mentality in this nation must end. Medicare needs serious revisions and limits. Medicaid needs to be eliminated - other than to provide someone 3-6 months of lifetime emergency benefits.

We cannot afford to keep this up. The model is unsustainable. Just ask Europe.

Bizkit
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Bizkit 01/20/12 - 11:57 am
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Remember when Obama and Biden

Remember when Obama and Biden were running for office they both campaigned against requiring adults to buy insurance. Then he changed his mind. I have to agree with Physics that always the Dems talk about cutting proposed spending not any real deficit cuts (it is all about them spending your money). Just deception like with the unemployment statistics. Like all the media portrays anyone who thinks Obama is a socialist is a moron, when in his book he talks about all the socialist influences and admits as much. Geez.

soldout
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soldout 01/20/12 - 12:41 pm
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The root of the problem is

The root of the problem is greed and sin at all levels and it will destroy the medical system as we know it in a matter of time. If you passed 4th grade math you know it can't continue. If you went to Sunday School for over two years you understand the problem and the solution. After all is said and done more will be said than done.

You will always be able to get the medical care or anything else you need if you are willing to pay the price. We still have enough freedom left that if there is a need; it will be met.

willie7
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willie7 01/20/12 - 01:28 pm
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Thank you Techfan for the
Unpublished

Thank you Techfan for the Rick Scott post.

Bruno
780
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Bruno 01/20/12 - 01:47 pm
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According to Wikipedia

According to Wikipedia Columbia/HCA was fined 600+million. Civil lawsuits cost the company more than 2 billion but given the nature of civil lawsuit awards you can't really tell if the cost was just or not.
To the article, I would have to concur. I was a Paramedic for a few years and saw the ambulance and ER service being used for what should have been routine visits to the patients primary care physician. While doing my ER rotation I had a patient in triage complain that people were being let in ahead of him. I looked at his chart and he was complaining of an ingrown toenail. He was at the emergency room for an ingrown toenail!!
There were many instances where the patients used the ambulance, for all intents and purposes, as a taxi service to the hospital. At the time I was riding the average cost of the trip was just over $600, if you just laid on the stretcher and we didn't do anything or use any supplies. As I was working for a private ambulance company they were more than happy to bill medicaid for it.

bjphysics
36
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bjphysics 01/20/12 - 02:19 pm
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I’m sorry Carleton Duvall

I’m sorry Carleton Duvall fell and had to seek medical care but grateful he wrote this letter; he is by far, one of the most honest people I have ever met online and I take him at his word because he is a gentleman’s gentleman. Get well soon Carleton and don’t be falling down because we all need your wisdom and balance, so balance yourself for us and the greater good.

Carleton Duvall
6305
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Carleton Duvall 01/20/12 - 04:06 pm
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Thank you bjphysics, What a

Thank you bjphysics, What a nice thing for you to say. The only problem is that you have put a lot of pressure on me to live up to your words. I will try, I promise.

harley_52
23959
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harley_52 01/20/12 - 04:23 pm
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Ditto to the words of bj.

Ditto to the words of bj. Glad to have you back on board.

Cdr4500
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Cdr4500 01/20/12 - 05:10 pm
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Oh my...what a RIDICULOUS
Unpublished

Oh my...what a RIDICULOUS conclusion.

While, I have no doubt whatsoever that abuses like this go on and that's why Insurance Reform (i.e. Healthcare Reform) ticked me off. Using an ambulance wouldn't be a big deal if the service didn't charge $300 - $500. And though other abuses in the system need to be dealt with AGAIN, it wouldn't be such a big deal if the cost of health care itself wasn't so ridiculous. We COULD afford to cover more people if an aspirin didn't cost $200. In one fell swoop Mr. O bailed out big insurance AND protected health care providers from charging fairly for their services. It's not the cost of insurance, dummy, it's the cost of health care that makes health care and insurance unaffordable for Americans.

skeptic griggsy
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skeptic griggsy 01/20/12 - 05:37 pm
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The Affordable Care Act is
Unpublished

The Affordable Care Act is reducing the federal budget and those of Americans! We can better it.
People can abuse any government service,so don't blame the Act for abuse. CBR-4500, the external costs like those aspirins are the reason for the budget being out of control,other than voodoo economics.
Medicare for All would lower costs by ridding the middle man from his cost factors.
Again, stop from using the word socialism without defining it! Social democracies are mixed economies,despite the Randroids, are ever increasing the wealth of all. A = A , so that they do not eqate to state socialism.
Fellow cognoscenti, thanks!

Willow Bailey
20603
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Willow Bailey 01/20/12 - 06:14 pm
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Carleton, glad you are on the

Carleton, glad you are on the mend. Your comments are always a treat for me.

shrimp for breakfast
5460
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shrimp for breakfast 01/20/12 - 06:32 pm
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I can see it now, "Honey can

I can see it now,
"Honey can I go play golf today?"
"Carleton you mussa bumped yo head or sumpin!"
Glad you're ok my friend!

Carleton Duvall
6305
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Carleton Duvall 01/20/12 - 06:43 pm
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Thanks, Willow Bailey. My

Thanks, Willow Bailey. My letter was not intended to about me but about abuses that I encountered while visiting the ER for repairs. And thank you shrimp. I appreciate your concern. And a thanks to you ,Harley. It is good to have friends.

Cdr4500
20
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Cdr4500 01/20/12 - 07:28 pm
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Mr. Duvall you're making a
Unpublished

Mr. Duvall you're making a lot of assumptions here, IMHO. You don't know for a fact about the medical coverage of any one those who came by ambulance. You don't know for a fact they all came just to acquire narcotics. Hospital gossip doesn't equal a fact. And if your medical providers were, in fact, giving you what amounts to privileged(Ever heard of patient's privelege?) info then please report them because that is illegal. By the way do you know what they say about assumptions Mr. Duvall?

Carleton Duvall
6305
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Carleton Duvall 01/20/12 - 07:39 pm
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This is an opinion

This is an opinion page,cdr4500. I have the same right to express an opinion as you do. My opinion was made based on observations that I made along with general facts that i received from other sources. You can either believe them or dismiss them. Your choice.Other people that have made comments have confidence in me. I am sure that you have noticed that.

bilgerat
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bilgerat 01/20/12 - 07:57 pm
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This letter is right on

This letter is right on target. Years ago I was a EMT in Aiken County and then a paramedic in Richland County and the abuse of the system by freeloaders who did not have a medical emergency was tremendously frustrating. Our welfare state has brought about a sick attitude that some people feel they are entitled to "free" services paid for by everyone else. The EMS service and Medicaid should charge for these ambulance rides if they are indeed non-emergencies. Otherwise they will continue to be a unsustainable burden to taxpayers and other patients who are charged inflated rates to make up for all the "free" services that were given away.

JRC2024
9284
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JRC2024 01/21/12 - 12:05 am
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Carlton, you are right about

Carlton, you are right about your observations. I knew several people who I went to school with that had drug problems and would go to the emergency room with trumped up illness to try and get the drugs they needed. They would call an ambulance most of the time. Feb 1 my wifes and my medical insurance rate increases to $1081.00 per month with a $1000.00 ded. If we have to go to the emergency room we should get better treatment than those that pay nothing. By the way, we pay the entire premium each month. Those that pay nothing and contribute nothing should not be allowed to increase my costs and all others who pay.

skeptic griggsy
39
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skeptic griggsy 01/21/12 - 01:55 am
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Improve the Affordable Care
Unpublished

Improve the Affordable Care Act!
Report all scams!
Obama has decreased taxes!

specsta
6592
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specsta 01/21/12 - 01:56 am
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JRC2024 - thank the Holy God

JRC2024 - thank the Holy God in heaven that you have $1081 a month to pay a medical insurance premium. Many, many folks don't even make that much a month in total income.

skeptic griggsy
39
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skeptic griggsy 01/21/12 - 11:04 am
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specsta, indeed! Please
Unpublished

specsta, indeed! Please respond to my comments!

justthefacts
22681
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justthefacts 01/21/12 - 11:15 am
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"thank the Holy God".

"thank the Holy God". JRC2024 success in life is probably due more to hard work and good decision making rather than God.

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