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mothballed 2 days ago

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cogman10 2 days ago | parent | next [-]

> And the actually sick people who have something they can get sued for are terrified to go because now they have to subsidize all the bad actors and they get gutted to do so

Or maybe they are dealing with hospital staff being openly hostile to them and calling them "hood rats" and claiming they are just there with STDs and the flu?

> they have to subsidize all the bad actors

You're right, we are all subsidizing the health insurance and private medical industry.

The problem you describe "People go to the ER because they are uninsured while working" isn't a problem with people being lazy terrible people, it's a problem with the entire US healthcare which binds insurance and healthcare to employment.

You want to make the whole thing cheaper and more efficient? Then nationalize health insurance either by expanding medicare or medicaid to everyone (I prefer medicare). Then you won't see these "hood rats" using the ER for more minor medical issues because they can simply afford to go to a clinic instead.

mothballed 2 days ago | parent [-]

[flagged]

cogman10 2 days ago | parent | next [-]

> Why are you so hostile in tone to the truth?

Because it's not truth and because my family has been personally affected by this attitude.

My wife went in several months to an urgent care with blood in her urine. They ran cultures that kept coming back negative. Didn't matter, antibiotics and she was told she needed to wash more thoroughly while being offered a doctor's note to get out of work each time.

Eventually, they decided "hey, you are coming in here a lot, go to the ER and check to see if it's something else". So we did. Even there, she was treated as a "hood rat" (want to guess her skin color). They did a CT anyways and kidney cancer. We had her kidney removed as it was too big to salvage and unfortunately it ended up metastasizing to her liver.

So, sorry of I'm hostile to someone "speaking truth" about "hood rats".

mothballed 2 days ago | parent [-]

You just contrived your sob story to falsely fit a narrative I didn't portray. Cancer isn't considered an STD and it's not the flu, and your wife was victimized by the very people I'm describing that wasted ER resources.

cogman10 2 days ago | parent [-]

Yeah, no way you can face that your terrible attitude has almost certainly hurt people like my wife. That's never your fault is it.

The story isn't contrived or a sob story. We are in the middle of immuno and chemo therapies.

You asked why I'm hostile, that's why and it's the truth.

mothballed 2 days ago | parent [-]

You called me a liar, how's it feal?

>Yeah, no way you can face that your terrible attitude has almost certainly hurt people like my wife

Lol, go work in an ER then and put your money where your mouth is. Show everyone how you're better. Pretty soon you'll know the truth too. No one is angry about someone with a fucking doctor referral showing up to the ER and then being found to have cancer using resources for that and it's "contrived" to try and fit that into the bucket I portrayed.

cogman10 2 days ago | parent [-]

> You called me a liar

No, I didn't you snowflake.

I said what you said isn't the truth, that doesn't make you a liar. People say false things all the time without lying. You can deeply hold incorrect beliefs, that doesn't make you a liar.

But it's telling that that little pushback has your feelings hurt.

mothballed 2 days ago | parent [-]

I don't know what to say, your wife was victimized by the very people I describe, and the main takeaway is we will attack the messenger for saying it in a way they didn't like. I'm advocating to improve things for people like your wife, but we don't like to hear "hoodrat" or something like that we'd rather not hear it because we have this magical belief that people will get worse health care if some people are accurately called hoodrats.

Maybe I didn't say things in a politically correct way, hopefully someone will come along and package it in a very delicate way for gentle sensibilities that won't be so triggering.

cogman10 2 days ago | parent | next [-]

> your wife was victimized by the very people I describe

No, she wasn't. The people you describe didn't dismiss her symptoms or assume her motives for coming in.

Perhaps the medical staff became more predisposed to make those assumptions after interacting with black people just looking for a doctor's note. But, it's entirely on them for judging someone solely on their appearance.

Here's the truth about cognitive bias and racism, you ignore the misses and focus on the hits. I completely believe you that you dealt with "hoodrats" who came in just wanting a note to get off work. Have you considered that you prejudged people as not needing help because of those interactions? Did that change the way you interacted or did you continue to divide people into hoodrats and deserving?

The problem is that "hoodrat" behavior isn't confined to black people, plenty of white people also use the ER to get a doctor's note. The commonality is poverty.

The problem is you've misidentified the problem as being caused by "hoodrats". People using the ER for general care or even to just get off work isn't them being bad people. It's understandable behavior in a nation without good working rights or healthcare.

And, for the record, not everyone has treated my wife like this. But enough have. It still comes up. Because, as I'm sure your aware, chemo and immuno therapy can have mild appearing symptoms that are ultimately serious. That means that we do sometimes need to go to the ER because of excessive diarrhea on a weekend when oncology is closed. We do still have to deal with dismissive medical staff that first treat her openly hostile and then change their tune when "I have cancer and am on chemo and immuno, my doctor has told me to come in" come out.

That's not my wife being "victimized" by hoodrats. It's people with racist biases that never take the time to question if they are prejudging people unjustly.

mothballed 2 days ago | parent [-]

When people come in for treatment, they're able to provide a chief complaint. This is usually the first thing you tell the lady at the desk or whoever approaches you.

What you're asking medical care professional to do is dismiss their chief complaint, and assume their motive isn't exactly what they stated. If someone comes in and states "I need a doctors note for flu" or "I slept with someone with chlamydia" then the medical care professional will assume that is their motive for coming in. You act as if it's made up.

What's ironic here is what you're advocating is for doctors to do the exact opposite of what you want. You should be thankful that they don't just assume their motives are what they state and the actual situation, because that's how they catch stuff like cancer.

And yes it is often found that something other than the chief complaint is the underlying cause.

>t's people with racist biases

Lol sounds like you might be the racist. I never mentioned anyone's race. Any race or nationality can be a hoodrat[], but for some reason you jumped straight to you're wife's skin color (and seemingly presumed from that she is a hoodrat, lmao).

Whatever it is you think I've done, I can at least say one thing. I've at least never shamelessly used my wife's medical condition as bait for debates on the internet as a trump card to garner enough sympathy to look over what you've said blatantly doesn't fit the criteria of misuse supplied.

[] https://www.urbandictionary.com/define.php?term=Hood+rat

KittenInABox 2 days ago | parent | prev [-]

Dude, you're the one who used your subjective negative experiences and made them so broad as to encompass a woman with cancer. Someone might've given you a bad experience but you're the one who took that and decided to broaden the category as everyone who uses an emergency room. This reads like maybe you had a traumatized experience and are acting extremely traumatized about it (like if a man punched me in the face and I declared all men to be face-punchers. My nose is broken but not all men broke it.).

mothballed 2 days ago | parent [-]

They didn't encompass a woman with cancer, they encompassed the people that degraded her care. A commenter literally used his cancer-ridden wife as bait to support his false argument, which I find to be way more abhorrent than whatever it is you think I said. Y'all are using the whole cancer excuse, which isn't the flu nor considered an STD, because you know anyone with cancer automatically wins the argument because how can you argue against a spouse of a metastatic cancer patient.

It's the debate equivalent of bringing a bunch of little kids in casts from a school shooting to a gun control debate. If the kid speaks up, it doesn't matter what you say, if you discount their opinion you lose, all you can do is nod and say thank you for sharing your experience.

Welp, we're on the internet here, and I have no "face" to lose. So I'm willing to get banned from HN or face unpopular opinion if it means telling the realities of the situation and not having my opinion shouted down "because of my wife with cancer" trump card. I'm not willing to just nod, I don't give a fuck if he extends the story to 3 kids with leukemia and his arthritic dog.

KittenInABox 2 days ago | parent [-]

Bro now you're assuming a guy is baiting you when, as far as I can see, he was just protesting his wife being in the category of what you called "hood rats". You're the one that extrapolated your bad experience to all patients in the ER, btw, not the "hood rats" you were forced to deal with. This is such an emotional overreaction I think you probably went through some shit and can't see how damaged you've become as a result. You can't even see a man who loves his genuinely suffering wife as anything more than a cheap shot to win an argument. I'm sorry for what it's worth.

mothballed 2 days ago | parent [-]

The commenter insinuated his wife was a hoodrat because she was black, which was some blatantly racist nonsense. He's the one that insinuated she meets the criteria of a hoodrat, I don't at all agree with his categorization based on facts presented. Amazingly he even shits on the people that even found her cancer, so you can see even if you do the full work up (the very thing he implies those who believe there's a "hood rat" wouldn't do despite paradoxically accusing of the people doing it as thinking of her as a hoodrat) and catch cancer you're damned.

The cancer discovered post a referral by a doctor to go to the ER doesn't even remotely fit under the criteria I listed.

The only reason why what he said carries any weight as a rebuttal is because he's carrying an intensely sad story that has clouded both of your minds with emotion to the point it's being used as a trump card.

vel0city 2 days ago | parent | prev [-]

> when it is heard the real reasons why ER is broken from people that worked there

You're confusing the symptom and the reason.

The symptom is the ERs are flooded with non-emergency care.

The reason is because they have nowhere else to go.

The solution is to give them somewhere else to go, i.e. give them actual primary care doctors and regular clinics instead of having their only option be going to ERs.

And FWIW, I personally don't like dehumanizing language, comparing people trying to get help to vermin.

mothballed 2 days ago | parent [-]

You're confusing the symptom and the reason.

The symptom is that emergent cases are getting worse care.

The reason is that non-emergent cases go to the ER even when it is known apriori the case is non-emergent.

The solution is to disincentive non-emergent cases from going to the ER when it is known apriori they are non-emergent.

How you actually accomplish that could be violence (use IRS men with guns to fund PCPs by taking away money from someone else they could have used on necessities as we currently do in social security), it could be charity (monetary or labor donations for medical services), or it could be finding ways to make people pay for abusing the ER system, or it could be deregulating health care so it's cheaper. There are lots of ways to implement the solution but your comment presents a false premise it's the only choice.

vel0city 2 days ago | parent [-]

Your reason here is the exact same as mine. Non-emergency cases go to the ER because they have nowhere else to go to deal with their needs.

Your symptom is mostly just a rephrasing of my same symptom. ERs are flooded and have worse outcomes overall because of the crowding of non-emergency cases.

So no, I don't think I'm confusing anything.

And in the end, sure. I only gave one potential solution to "give them somewhere else to go", but in the end the solution is still to have them go somewhere else regardless of how we accomplish that. I personally think providing "free" primary care is one of the better ones. Seems like the charity route isn't working out well enough. You're not going to get people with nearly no money to "pay for abusing the ER system" unless you're talking about jailing people (rats according to you) just trying to access the only point of healthcare they have access to. While you might make some healthcare a bit cheaper with deregulation you'll probably still have crowds of people unable to afford it and you might also end up with a lot of other worse outcomes depending on the regulations you cut. Looking around the globe, it seems like funding primary care for all usually leads to the best outcome for society overall and would do a ton to reduce the reason we both agree leads to bad outcomes in ERs.

We're already paying for their primary care, we're just paying for it in the least efficient manner. Its not really new money we'll have to find. Far cheaper for them to just stroll into a regular clinic and get these services than have them use up precious and expensive ER resources.

gdbsjjdn 2 days ago | parent | prev | next [-]

Huh, so if the people going to emergency for the flu had primary care doctors they wouldn't have to go to emergency? That's almost like an argument for public non-emergency clinics and universal health insurance so people can get treatment in an appropriate setting.

mothballed 2 days ago | parent [-]

Might work. But it just goes to show, no one wants to hear the actual reasons why ER are broken, because the tone you use indicates you don't like the truth you're hearing.

palmotea 2 days ago | parent | prev | next [-]

> End result is a gazillion hood rats showing up to the emergency room with an "STD" or the flu "muh 20 hour a week job that provides no health insurance needs a doctors note" and meanwhile the dying guy has to deal with the drain those people impose on resources, not all of which can be mitigated away by triage.

The solution to that problem is to give those people real healthcare, not kicking them onto the street because they had the temerity to try to access healthcare in the one place that can't turn them away.

hiddencost 2 days ago | parent | prev [-]

Hoodrats?

mothballed 2 days ago | parent [-]

Source: worked ~1 year in an inner city ER alongside a doctor seeing every case. Yes it was the hoodrats abusing the system.

habinero 2 days ago | parent [-]

Working all of one year before you got fired doesn't make you an expert, sorry. It's probably best you moved on from healthcare, you don't seem suited for it with your attitude.

mothballed 2 days ago | parent [-]

Unfortunately my attitude is the only one that will actually help you fix things because I'm bringing you a sober view of what the situation is. And people much "better suited for it" who worked in inner city ER generally had even less rosy thoughts than I did, if you want to defer to "experts" it's hilarious you would think this is unusual takeaway and that my opinion wasn't formed in large part by the experts thinking the very same thing (which of course they are never going to tell to the patients, you're probably not going to hear it unless you actually work in an ER and are close and comfortable enough with doctors for them to risk themselves to tell you what they really think as it's totally unacceptable to say it publicly).

habinero 2 days ago | parent [-]

Sure, buddy. "Everyone thinks this way, they just don't say it" has been the rallying cry of people with bad minority opinions forever.

mothballed 2 days ago | parent [-]

Nah I was just doing as you asked and deferred to the "experts" that outlasted me. Hilariously you indict your own argument and only reveal in it the very fallacies you would damn. And I'm well aware I'm unsuited for healthcare in the USA, because the policies are dominated by people with either a 5 year old's ideological view of reality or with the worst perverse industry interests to do regulatory capture in the USA, having worked in it I've realized it is the most disingenuous violent rent-seeking enterprise in existence here and very little of that has to do with the actual health care providers.

If you want instruction on why people are reluctant to point out the situation publicly, notice people (in a sister thread) start screaming bloody murder about "racism" and "because of my wife with cancer you lose" and it becomes obvious why no one is going to publicly give anything but the most gentle and populist message if they actually work in healthcare with their license on the line. Very few people are going to get fired, possibly have their license revoked, have a bunch of frivolous racism cases all to do the favor of having people understand why ERs are broken but then refuse to believe any of it.

habinero 2 days ago | parent [-]

I saw the thread. Nobody was "screaming bloody murder" lol, you were firmly (and correctly) taken to task for your opinions towards other human beings that you voluntarily shared in a public forum. I agreed with what they said and I thought it was more than fair. If you can't handle it, don't share.

mothballed 2 days ago | parent [-]

Clearly I'm one of the few that's willing to "handle it." You should be thanking me, because few that have been there will take the heat to tell you the truth.

habinero a day ago | parent [-]

My ex worked in healthcare for years, I heard about life in the trenches plenty lol. Sorry bud, the problem is you. I wouldn't share this again, you do not come off as the good guy here.

a day ago | parent [-]
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