Suppose there were a stadium built with too few bathrooms (hard to imagine?). As the place became more popular, say 26% more people gathering there, 9% of the bathrooms disappeared and there were too few plumbers to keep them working. Suppose, too, that even though there are more people coming to the stadium, the number of seats had dropped 17%, so people used the toilets as a place to sit until a seat opened up. Most people don't go to a stadium to use the bathroom, but you'll have to admit, "when ya gotta go ya gotta go." It's an emergency.
That's the situation in US emergency departments. As described last year in an Institute of Medicine (IOM) report, it's even worse:
In a survey of 90 ERs across the country on a typical Monday evening, 73 percent reported that they were boarding two or more patients. Then there's the issue of "diversion"--the rerouting of ambulances as hospitals reach the saturation point. One study found that a half-million ambulances were diverted in 2003--an average of one per minute. "It's a system that's just hanging together, and it's on the verge of collapse," says Dr. Brent Eastman, chief medical officer at Scripps Health in San Diego, and an IOM committee member. "This is one of the most profound crises that American medicine has ever faced." (Arain Campo-Flores, Newsweek)
That's under normal conditions. Did I hear anyone say "pandemic"?
"You just keep chipping away at the stone and hope that at some point, someone will say, 'We've got to fix this'," says Dr. Frederick Blum, past president of the American College of Emergency Physicians. "We're not there yet, but we'll keep chipping away." Hopefully it won't take a catastrophic failure for others to realize the state of emergency the emergency health-care system is in.
But it's not getting fixed. The emergency medical services system is broken along with the medical care system in which it is embedded. It has become unbelievably expensive while delivering less care. It is estimated that 30% of the costs are taken up in administrative ploys to avoid paying for services. It needs an overhaul:
Some advocate a more ambitious agenda: universal health care coverage. "If we had that, we wouldn't be fooling around with all these complicated formulas all the time," says Richard Knapp of the American Association of Medical Colleges, which represents the nation's teaching hospitals.
The Bush/Republican alternative? More tax cuts for wealthy friends, so we have less to do more with. That makes sense. And you can always squat out in the backyard.
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I guess this one is a point of view Revere. It goes with the supposition that health care is a right, something God given. Its not. Not in the Constitution. Its a service and its provided by state and local governments. Each one of those rigs costs about 150,000 and then you have to man it. Each place in the US is different in how they provide that service. Response times in Idaho are different from those in Kokomo. I live in metro area and we actually killed one ex-mayor, two older men and one guy who had one of those concrete curtain walls that went over in a high wind and all in a day and under three hours.
The problem? There werent enough ambulances to go around that day. So this is a USGOVT problem? Only if you want the government in charge of everything. Thats the reason we have states here and not a single all encompassing federal hierarchy. Put in socialized medicine and you likely would see the South back out as they did in the 1860's.
A goodly part of the problem is that those same ambulances are doing wheelchair transports in many parts of the country because there is no other way to move them. Between police, fire and contract services there are 23 ambulances in this county of Shelby. Sounds like a lot? Not really when you consider that each call generally takes up about four hours. All of the people above died and the answer to the first three was over 45 minutes. One was a heart attack with the ex-mayor, the other two were a stroke and respiratory failure and all were pretty old. Would having another ten ambulances have made a difference? The last one was blunt force trauma and he was DOS. Crushed in fact. So no ambulance would have helped him. Enter the media.... Drum roll please. Not a word that these guys save one were way big old, previous heart and respiratory problems. The hyped up thing for today is......not enough ambulances!
So what got hyped? Lack of available pickup for a pre-existing condition on all three. They were all past 70 and in failing health except for the guy with the concrete on him. So do we capitalize for the inevitable or throw the wheelchair types off the ambulance? Its a local and State issue and be sure to write them and vote according to your wishes. Oh... and blame Bush for this one too.
So we can thank/blame the media for raising the taxes because now we have 5 new ambulances and three crews for each?...Response times now? Still 45 minutes depending on location. More available ambulances meant it was easier to get a wheel chair type downtown to pay their taxes. Yep, downtown with an ambulance so they could pay their taxes. Now this HAS to be a USGovernment problem and above all GWB's fault. So for a million bucks we got what-Still a 20-45 minute response in nearly all cases.
Media is really good at hyping this stuff up. One story was that there was a man having a stroke across the street from the fire station. Couldnt dispatch the ambulance because it was doing a coverage for the two adjacent districts. So the wife walked over to the fire station told the firemen what was happening. They grabbed a stretcher and went over and picked him up, put him in the back of that ambulance while they waited for another ambulance to transport. Its a service folks. Its poorly managed in most cases and very expensive to operate. It also is not something that the USGovernment wants to get involved in.
How you can correlate the usual Bush Bash with this one is beyond me. So lets see, GWB is responsible for poor ambulance services, tornados in Kansas, Hurricanes in MS, Hurricanes in LA, Bird Flu response and that there wont be enough ambulances or health care that likely wont work anyway in a pandemic. You are doctor living in a doctors world Revere. I respect that. But there are also major considerations when you try to socialize all of the medical care in the US and its all bad. The UK has had it for 60 years and people are arriving on our shores for ...medical care. Why is that?
Come on Revere. Do you really think that this stuff is going to go away when GWB is gone?
Tell you what, take two or three primaries in about 10 months and call me in the wee hours of Nov 7, 2008. You'll either feel better in the morning or you'll need an ambulance because another Republican went into the presidency. .
http://www.lse.ac.uk/collections/pressAndInformationOffice/newsAndEvent…
http://www.staff.ncl.ac.uk/peter.andras/ACDemDef.pdf
http://www.thescoop.org/archives/2006/03/31/nevada-rural-ems-response-t…
.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&li…
Randy: It's not a constitutional question of rights. It's a policy question which requires legislation. As for GWB, you know my views. I am curious about yours. Do you think he is responsible for anything?
You danged skippy he is responsible for a lot of the woes of the US but ambulance service isnt on the radar of the President of the US.
Hmm. I thought being prepared for terrorist attack was numero uno for George.
Personally if you arent, especially where you are I would be. Remember the blurb about taking your shoes off? Look what happened the next day.
Revere,
Who knows enough, to take care of this problem? Why aren't we doing something?
Patch: It's a problem with our health care delivery system. Current "reforms" are band-aids. We'll need universal health care to really have a chance of fixing it.
I personally dont want government intervening in my life any more than it is right now. I dont want a government first telling me that the money that I earned belongs to someone else. I dont want that same government taking money for a UHC plan that is failing across this planet. Everyone who has it is pretty much sick of it and it also has the same end effect and that is government in your life and in your pockets. For who and what? Not someone who can pay for it, its for someone who cant. It will end some serious gaps for sure, but at whose expense? Certainly not those that cant afford it. It becomes yet another entitlement that no one is entitled to. Show me entitlements in the Constitution or in the state Constitutions. It very likely would be found to be un-so just as the WPA was.
Well, Randy, that's why we vote. I, personally, don't want them to use any more money for the military. That's what's bankrupting us.
See you in November 08.