I have a suggestion for all of those federal workers who are concerned about a government shutdown, who are concerned that they won’t be paid if a budget compromise isn’t reached. To all those who already have better insurance and better benefits than most in the private sector; for all those whose jobs pay more than equivalent private sector jobs for the same activities. Do what hospitals do. ‘Go to your jobs, and do the necessary work anyway.’
It is ironic, but hardly surprising, that the government suddenly so concerned with being unfunded continually demands unfunded work from hospitals and medical providers. Or at best, expects underfunded work.
I ask you, friends and colleagues in the world of medicine, how many physicians see patients at the markedly reduced Medicare rate, the criminally reduced Medicaid rate or the tyrannical EMTALA rate of zero!
How many physicians, in attempting to do the right thing, find their care denied by Medicare on technicalities, or suddenly find themselves targeted for fraud for misunderstanding the complexities of the already inappropriately low compensation the government pays them?
Untold numbers of hospital administrators struggle to keep their facilities afloat because they are mandated, by virtue of accepting Medicare, to see all comers. They provide care for every abusive, abusing, non-compliant, non-paying individual who passes through their doors. Day after day, these administrators, and the physicians who work in their facilities, conduct their ‘business’ in an unfunded environment.
Not only so, but they conduct it in an environment of high litigation risk (which the government refuses to mitigate), and they conduct it under the ever watchful eye of a federal government licking its hungry lips in the endless search for violated rules, missed guidelines, and perceived inadequate ‘performance,’ all with an eye to either litigation against, sanction of, or refusal of payment to those hospitals and providers actually caring for the sick and dying.
As a consequence of this unfunded environment, some hospitals close, many physicians are leaving hospital care in droves, nurses are being laid off, nursing coverage is being cut, patient care is ultimately compromised and the federal expectations and rules grow ever more onorous. But we keep going back, and doing the best we can, day after day, year after year.
Unfunded government? If all of those agencies are really that important, really that critical to the well-being of our citizens, they’ll do the right thing regardless. Like we do.
Well, you definitely have a point. But many of those unpaid workers are in the military and are facing a month with no pay. Most of them don’t have savings because they don’t make enough money. And they are worried about how they are going to buy food and diapers. And they are being ordered to work and they don’t have a choice to just walk off the battle field.
RKM
12 years ago
emmy, I agree with you that it is bad, I think the fact the president and the legislatures get their checks and nice opt out of Obamacare health care plans without a pause during this is even worse. Why did our legislatures in Washington forget this when they were feeding at the trough for this foreseeable contingency ? I did see on NBC tonight when they listed things that would continue to be operate regardless of funds they included Emergency Rooms in the list and hospitals. Thanks again Washington.
I feel your frustration RKM. And while I’m glad that Emergency Rooms will continue to function, we are reminded by Dr. Leap that the edict that emergency rooms are open to people who cannot pay is an unfunded edict. Hospitals don’t get paid for this, and for that reason I understand Dr. Leaps angst. I have just heard that congress has just passed a plan to fund the government and am glad that I won’t have to be sending aid to my son and his family, as he is one of those soldiers who would be unpaid. The greatest problem… Read more »
Rudolph, I understand your point. EMTALA, in its inception, made sense. But I don’t know the entire history of everyone seeing patients at that time. Can we assume that there was widespread abuse of the poor? I doubt it. The fact that legislation was enacted to counter problems doesn’t mean that everyone was neglectful or lacking in compassion. Just like unions made sense when workers were in physical peril and financially abused. Now, EMTALA has had unintended consequences just as unions have become sacred cash cows, and notorious special interest groups. As for specialists in big hospitals, well, my sense… Read more »
I’m new to your blog and am enjoying it. I worked as a nurse for 20 years, 10 at omc. My husband was critically ill. when he got weaned off the ventilator he asked me quit work so we could spend time togetheer. I paid for COBRA, but it ran out before medicare could kick in. We were both recently in the hospital with pneumonia. He has medicare. I have no insurance. I was in for 3 days and got a bill for $12,000. I applied for assistance, but because I HAD over $500 in my checking account, I was… Read more »
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Well, you definitely have a point. But many of those unpaid workers are in the military and are facing a month with no pay. Most of them don’t have savings because they don’t make enough money. And they are worried about how they are going to buy food and diapers. And they are being ordered to work and they don’t have a choice to just walk off the battle field.
emmy, I agree with you that it is bad, I think the fact the president and the legislatures get their checks and nice opt out of Obamacare health care plans without a pause during this is even worse. Why did our legislatures in Washington forget this when they were feeding at the trough for this foreseeable contingency ? I did see on NBC tonight when they listed things that would continue to be operate regardless of funds they included Emergency Rooms in the list and hospitals. Thanks again Washington.
I feel your frustration RKM. And while I’m glad that Emergency Rooms will continue to function, we are reminded by Dr. Leap that the edict that emergency rooms are open to people who cannot pay is an unfunded edict. Hospitals don’t get paid for this, and for that reason I understand Dr. Leaps angst. I have just heard that congress has just passed a plan to fund the government and am glad that I won’t have to be sending aid to my son and his family, as he is one of those soldiers who would be unpaid. The greatest problem… Read more »
Rudolph, I understand your point. EMTALA, in its inception, made sense. But I don’t know the entire history of everyone seeing patients at that time. Can we assume that there was widespread abuse of the poor? I doubt it. The fact that legislation was enacted to counter problems doesn’t mean that everyone was neglectful or lacking in compassion. Just like unions made sense when workers were in physical peril and financially abused. Now, EMTALA has had unintended consequences just as unions have become sacred cash cows, and notorious special interest groups. As for specialists in big hospitals, well, my sense… Read more »
I’m new to your blog and am enjoying it. I worked as a nurse for 20 years, 10 at omc. My husband was critically ill. when he got weaned off the ventilator he asked me quit work so we could spend time togetheer. I paid for COBRA, but it ran out before medicare could kick in. We were both recently in the hospital with pneumonia. He has medicare. I have no insurance. I was in for 3 days and got a bill for $12,000. I applied for assistance, but because I HAD over $500 in my checking account, I was… Read more »
p.s. my husband’s bill was $58,000 for 8 days, 3 in critical care.