Originally Posted By skinnerbox For those of you following the Texas Ebola story... ... would anyone care to place a bet that the patient's first trip to the hospital last week wasn't exactly as being reported in the news? I'm betting that the ER intake nurse *did* tell the attending physician that the patient was recently arrived from West Africa, but that the hospital administration decided to push him out the front door because he didn't have health insurance. I'm betting that the hospital is going to hang this incident on the nurse's head and blame her for not communicating the full story regarding the patient's travels in order to cover up the truth regarding a standard practice of most hospitals when dealing with uninsured patients: get them out the door as quickly as possible. Which brings me to the main point of my post: Why would anyone with half a brain actually argue in FAVOR of keeping citizens and non-citizens alike out of healthcare facilities, given this incident? Why would anyone want immigrants or tourists who are ill to just "tough it out and weather the storm" instead of treating their illnesses? This is precisely why you never make that argument. Ever. Single payer solves this problem. Everyone in the country, even tourists, gets healthcare when they need it. Then you don't have to worry about situations like this one in Texas simply because the person suffering with a deadly disease doesn't have health insurance coverage!
Originally Posted By RoadTrip Can't agree with that at all. You would end up with a massive number of 'tourists' coming here from third-world countries to get treatment they could not get or afford to pay for at home. Single payer, yes. Coverage for ANYONE who happens to be in the country at the moment? No way. Even Britain charges for NHS treatment of visitors. You've really gone over the edge this time!!
Originally Posted By skinnerbox Just because Britain does it doesn't make it ethical or morally correct. What if someone who truly can't afford to pay our outrageous healthcare costs decides to forgo the ER trip, and ends up infecting dozens of locals as a result? How can anyone seriously argue in favor of this? Second, you're not going to be able to close the door to everyone who wants to come here. Impossible. And having single payer isn't going to make our country more tempting, either, given the higher standard of living we currently have without it. People don't migrate for healthcare. They migrate for everything else. Besides, the vast majority of the other first world nations already have nationalized healthcare. So why would any of those citizens leave their country to come here if we had it? It would be for other reasons. Lastly, in dealing with diseases like Ebola with long incubation periods, how the heck are you going to catch infected individuals when they disembark here? Short answer: you won't. Healthcare is a right, not a privilege. Give everyone Medicare and stop making healthcare a massive profit center. Then future outbreaks of deadly diseases like the latest flavor of enterovirus making the rounds (cousin to polio, btw) won't end up being as deadly. Pay-to-play is stupid dumbarse model for healthcare. Period.
Originally Posted By ecdc >>You would end up with a massive number of 'tourists' coming here from third-world countries to get treatment they could not get or afford to pay for at home.<< The data says otherwise; this is pretty much a myth concocted in the '90s to combat Clinton Care. Which isn't to say I'm on board with single payer for just anyone who shows up. I'm not well enough informed (I kinda suspect that's the case for everyone else here) to know how feasible that is, what it would look like, etc. Overhauling the nation's healthcare system is complicated, and it defies easy answers, as Obamacare has taught us. But yeah, there's little risk of third-world people who can't afford shoes or running water hopping on a plane to the U.S.
Originally Posted By ecdc I'd add, regardless of what specific concerns we might have over any kind of national healthcare program, the thrust of the OP is spot on. The broader problem is when healthcare is a for-profit industry. The Ebola outbreak is a prime example of why healthcare shouldn't be for profit. There are public health considerations about how it might spread, how we might contain it, etc. History and precedent are clear: relying on for-profit companies to do the right thing and take care of the public over their bottom line is a disastrous idea.
Originally Posted By Dabob2 They do if they realize there's a problem. If they're notified before the guy leaves the hospital. If the first question a hospital asks is "how will you be paying?" and certain answers result in a "let's just get rid of this guy" response, then it's possible that you get...well, pretty much what we got in this case.
Originally Posted By ecdc I'm sure they do (again, I'm not well informed on this stuff, and I probably should be), but we then have the problem of public and private institutions trying to coordinate. When it's one hospital in Dallas, that's probably not a big deal. But what happens if someday it's 200 hospitals around the country, run by two dozen different private, for-profit companies? Don't get me wrong: there's plenty of legitimate concerns about how we go about healthcare reform and instituting single payer. But for me the bottom line remains: for-profit healthcare is a terrible idea. As I read the OP's claim that the hospital may have turned the man infected w/ Ebola away, it doesn't sound far fetched to me. Maybe that's not what happened, but we live in a country where we all know it could happen, and that's kinda troubling with infectious diseases.
Originally Posted By skinnerbox So... the Dallas hospital changed its story earlier this week about why the Ebola patient was released after his first visit to the ER, claiming that a glitch in the software kept the attending physician from seeing the intake nurse's complete set of notes. But now, that story is being discarded in favor of the ever-popular "we don't know what happened" excuse: <a target="blank" rel="nofollow" href="http://www.huffingtonpost.com/2014/10/04/hospital-send-ebola-patient-home_n_5931780.html">http://www.huffingtonpost.com/...780.html</a> <> Texas Health Presbyterian Hospital Dallas, which is currently treating patient Thomas Eric Duncan for the Ebola virus, has revised the explanation it offered earlier this week as to why it had initially released Duncan after his first visit to the hospital on Sept. 25. Duncan later had to be brought back to the hospital by ambulance on Sept. 28. In a statement released Thursday, the hospital said that Duncan had told a nurse that he had traveled to Africa within the last four weeks, and that the nurse followed protocols by entering that information into the hospital's electronic health records system. According to the hospital's statement, the lapse was due to "a flaw in the way the physician and nursing portions of our electronic health records (EHR) interacted in this specific case. In our electronic health records, there are separate physician and nursing workflows." The statement went on to say that, "As designed, the travel history would not automatically appear in the physician's standard workflow." However, in a "clarification" released on Friday, the hospital said that there was in fact "no flaw" in the interactions between the physician and nursing portions of the record systems. The hospital's reversal on its previous statement leaves the public with no clear explanation for why Duncan was initially released on Sept. 25. The hospital's full statement can be seen here: "We would like to clarify a point made in the statement released earlier in the week. As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow. There was no flaw in the EHR in the way the physician and nursing portions interacted related to this event." Texas Health Presbyterian did not immediately respond to a request for further information Saturday. UPDATE: 12:55 -- During a press conference Saturday, city and U.S. health officials said they did not have any additional information regarding the hospital's latest statement. Centers for Disease Control and Prevention Director Tom Frieden said that the broader issue is the need to ensure that careful travel histories are taken for all potential patients, and that such information is shared across health care teams. <> I'm in agreement with most of the HuffPost commenters since this story first broke, that the patient was released because he wasn't American and had no health insurance. The hospital administrators didn't give a rat's arse that he probably had Ebola given his symptoms and where he traveled from. All they saw were lots and lots of dollar signs in profit floating out the window had they taken the right course of action and isolated him for observation and treatment. I hope to high heaven that this hospital loses its license and that the administrators who made this decision are stripped of their medical licenses and barred from practicing in this country ever again. And for those who are interested in how local city and county officials badly bungled the linen containment and isolation of the family he was visiting, watch Rachel Maddow's show from yesterday (10/03/14): <a target="blank" rel="nofollow" href="http://www.msnbc.com/rachel-maddow-show">http://www.msnbc.com/rachel-maddow-show</a>
Originally Posted By RoadTrip << I'm in agreement with most of the HuffPost commenters since this story first broke, that the patient was released because he wasn't American and had no health insurance. The hospital administrators didn't give a rat's arse that he probably had Ebola given his symptoms and where he traveled from. All they saw were lots and lots of dollar signs in profit floating out the window had they taken the right course of action and isolated him for observation and treatment.>> You are like the right-wingers... you always see some type of conspiracy behind everything. Sending him home because of anticipated expense would make no sense. The hospital would have known if he actually had it he and the expense would be back and now they would have bad publicity on top of it. I think it was just run of the mill incompetence. Doctors and hospitals make mistakes all the time. I imagine this is especially true in Texas... the whole state suffers from piss-poor healthcare.
Originally Posted By KongKongFuey Forget the obomo care single paying thing. This guy should have never been allowed in here to start unless he was cleared by a US health official. Homeland knew he was in Liberia so he should have been quarantined until checked out. And stop blaming the hospital so much...they are not the villain. The Ebola man KNEW he had contact with Ebola pregnant girl and lied his way into the USA. HE IS THE bad guy.
Originally Posted By KongKongFuey Homeland blew it, the hospital blew it and this guy was a Richard head for bringing us a virus worse than cholera .
Originally Posted By skinnerbox RT, you should really do your homework before popping off like that: <a target="blank" rel="nofollow" href="http://publichealth.gwu.edu/content/critically-ill-uninsured-americans-still-risk-being-turned-away-hospitals-despite-law">http://publichealth.gwu.edu/co...pite-law</a> <a target="blank" rel="nofollow" href="http://www.medicalnewstoday.com/articles/248854.php">http://www.medicalnewstoday.co...8854.php</a> <a target="blank" rel="nofollow" href="http://www.kaiserhealthnews.org/stories/2012/february/19/hospitals-demand-payment-upfront-from-er-patients.aspx">http://www.kaiserhealthnews.or...nts.aspx</a> <a target="blank" rel="nofollow" href="http://www.huffingtonpost.com/jeffrey-feldman/do-doctors-in-america-tur_b_478267.html">http://www.huffingtonpost.com/...267.html</a> The practice of turning away patients without the means to pay for services rendered still goes on today. And since the patient in question was a non-American without insurance, the hospital had no means whatsoever of suing him for non-payment once he returned to his country. Therefore, there was no financial incentive to help him. And you can forget all that crap about bad PR. Hospitals have been holding patients captive for decades, given how few of them operate compared to the size of the population serving them, and the fact that not all insurance plans participate with all hospitals. Having insurance is no guarantee that the facility nearest your home is going to treat you when you need them. There are well-documented cases about preventable deaths (and the subsequent lawsuits) of unstable critical patients who were transferred from non-participating hospitals to network hospitals tens of miles away because the insurance provider refused to cover the non-discounted charges being incurred by the critical patient. You'd think there would be a law in place to prevent this garbage but none exists. Private for-profit hospitals do this crap all the time. So turning away a foreigner with insufficient funds to cover emergency care is completely expected, given how these medical arsehats have operated for the past several decades.
Originally Posted By skinnerbox The patient did not know the woman died from Ebola. He thought she died from complications related to her pregnancy because she kept complaining of stomach pain. Also, the patient did not have a fever when he left the country. He didn't have symptoms when he flew to Texas to see his relatives, and he didn't have those symptoms for several days before his first visit to the ER. But the hospital is totally to blame for releasing him from the ER given that he told them he had been in West Africa within the past four weeks. The patient is not to blame. He didn't know the pregnant woman he helped had Ebola. The Liberian authorities at the airport are not to blame. They check all passengers twice with IR thermometers before anyone is allowed to board the plane and this patient did not have a fever. Therefore, it was impossible to ascertain that he was infected at that point. But the hospital is clearly to blame for releasing an ER visitor out the door who specifically told the medical staff that he was recently arrived from Liberia. Those are the facts. But I guess in your "blame the victim" world of conservative perfection, facts don't matter.
Originally Posted By KongKongFuey Are you ever going to blame the a hole who lied his way in or are you still going to do the flaming knee jerk thing you always do. Also, what incentive would an entry level or low level staff member at a hospital care about ability to pay? They get there 20 to 60k per year regardless of who shows up at the desk. Wow you are a conspiracy theorist or worse.
Originally Posted By KongKongFuey The Ebola dude LIED!!! Get it through your thick skull. He lied on the declaration exit forms of Liberia. Liberia wants to charge him with crime if the a hole lives
Originally Posted By RoadTrip skinner... I don't doubt patient dumping occurs. But I seriously doubt it was a factor in this instance. Ebola is bound to make headlines, and no hospital would want to be known as the hospital that released someone with Ebola into the public, thereby exposing others to a deadly disease. Turn them away if they will slip between the cracks and never be heard from again? That I believe. But not with Ebola.
Originally Posted By Dabob2 "Forget the obomo care single paying thing. " That sentence right there reveals that you don't have any clue what Obamacare is. It is, unfortunately, nothing like single-payer.
Originally Posted By KongKongFuey I forgot to put a ..comma or slash mark between the two so sue me. Yes I know they are different. Does not everyone on world events? I guess punctuation Guatemalan death squad are in full force here.
Originally Posted By Dabob2 If you know they are two different things, then it was simply irrelevant to mention it.
