Comments on ReasonPharm: An aphorism in practice

To Stella and Burgess:There are a few "free standi...

2008-03-31T00:01:00.000-04:00

To Stella and Burgess:

There are a few "free standing ER's" that don't take Medicare/Medicaid patients and therefore aren't subject to EMTALA regulations.

The economics of these facilities is much more rational. Plus the service is good and the waiting times are very short, as one would expect from an industry freed of that sort of regulation.

Here's more information:
http://www.westandfirm.org/blog/2008/03/free-standing-ers.html
or http://tinyurl.com/2hn53d

I've complained about the prescription drug system...

2008-03-27T10:46:00.000-04:00

I've complained about the prescription drug system before, that's for sure. Why should I have to see a doctor every X amount of time to get drugs if I already know what's wrong with me? (And even if I don't know what's wrong, is it not my right to put what I please into my own body?)

I've read that getting an appointment with a dermatologist for a non-cosmetic reason is much harder than for cosmetic reasons, precisely because the free market is operating in the latter and not the former. I've only made one appointment with a dermatologist, but I did find that to be the case -- I had to wait three months to get my moles checked for cancer, but I suspect that if I'd wanted Botox, I could have gotten in much sooner.

I read this article as well and had a similar take...

2008-03-27T10:19:00.000-04:00

I read this article as well and had a similar take on it. I've been frustrated recently with the Primary Care situation; PCs seem to serve no function except as gatekeepers for referrals. Dermatologists can be just as useless: recently I needed a skin cream for a rash that's already been diagnosed. Last time I needed it, I had a friend who was in Greece at the time pick some up- since the cream is OTC in Europe and elsewhere, it cost $20 for more than a years supply. When that ran out, I found that I had to make an appointment with a dermatologist, sit in a waiting room for over an hour, just to have the pimple popper glance at my rash and give me a prescription. Of course, if I wanted a refill, I would have to come see her again so she could rack up another $100 bucks for writing me a prescription.

Yes Hillary, I definitely see now how it is the free market that's screwing up health care in the US..

Excellent question. Yes, EMTALA applies only to ho...

2008-03-25T08:20:00.000-04:00

Excellent question. Yes, EMTALA applies only to hospitals that receive government money from Medicare:

"EMTALA applies only to "participating hospitals" -- i.e., to hospitals which have entered into "provider agreements" under which they will accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program for services provided to beneficiaries of that program."

But, as the EMTALA website goes on to state: "In practical terms, this means that it applies to virtually all hospitals in the U.S., with the exception of the Shriners' Hospital for Crippled Children and many military hospitals. Its provisions apply to all patients, and not just to Medicare patients." As with scientific research, it is nearly impossible to run a hospital without taking government money; there are so many Medicare patients that one simply could not remain competitive with other hospitals that do.

Thank you for publishing this weblog. You have an ...

2008-03-25T07:45:00.000-04:00

Thank you for publishing this weblog. You have an explicit philosophical context while examining a particular industry. That can be a potent combination.

I have a question: Does EMTALA apply to all hospitals or only to a certain class of hospital, perhaps those that gain some benefit from being designated as "public" hospitals?

The reason I ask is because, as a layman, I notice that usually industries that are controlled are often subsidized as well, in some manner, directly or indirectly. But perhaps that is not the case here.