Canadian Healthcare- Bribe the Doctor

[KYTOP]

I found this article about Canadian Healthcare in the Montreal Newspaper very interesting. Now maybe I can understand people's concern about rationing healthcare and fear of the same thing happening here. I knew Canada limits the number of doctors and testing equipment like CT scanners but this was enlightening. Looks like if you got the bucks you can get the care there?

http://www.montrealgazette.com/health/Want+fast+care+Slip+some+cash/3892737/story.html

[JKane]

Looks like if you got the bucks you can get the care there?

Sounds exactly like here! Except that those without the bucks get a *much* better baseline there...

[TampaYankee]

This is really a terrible story or expose' if you will. It is not so much the doctors accepted bribes or the patients offered them, which is terrible too. Doctors could be cleaned up quickly by the medical licensing board. Just send some 'undercover patients' out to bribe doctors and strip the licenses from 15 - 20 and let everyone else know their next patient could be undercover. Routine monitoring to refresh the delicensing drama every now and then would keep most circumspect.

The big problem here is how to run a universal system offering medical service to all. Made the more difficult by hypocondriacs and those who dont like lines. Not everyone needs elective surgery by time for the Winter Party. There are serious cases that demand priority. However, establishing priority for the well-heeled is just as unjust as using bribes. The same is true for those with insurance versus those who cannot pay. You may not think so but it really is choosing those with resources over those who don't have resources. The only difference is whether the money is passed over the table or under the table. At the receiving end the money is the same color. It looks no different.

If we are going to sanctify 'buying access' then most of us will be screwed eventually. Most who can afford to buy find little or nothing wrong with the concept, I'm sure. However, health care costs are going up and up - dare I say almost exponentially. Attempts to curtail that future cost are met with denial of the facts and where they ultimately lead or with politics and stalemate or at best minor improvements around the edges.

As prices go up fewer and fewer will have insurance as business limits or discontinues coverage. Businesses dropping the perk are growing. Recognizing the spiraling growth in premiums, my company capped its contribution in the 90s. This is a kinder and gentler way of cutting the perk to eventual practical elimination.

As the prices rise, fewer of us can afford access. Hospitals will close down. Doctors will diminish as the opportunity for the big bucks shrinks.

Only the rich can afford to continually access a wasteful health care system that provides unlimited access, unlimited doctors, unlimited tests, the right to choose any treatment regardless of efficacy, immediate scheduling regardless of medical priority.

This is pretty much what those who have had access got. People cannot bury their heads in the sand and expect to have what we have known in the past. It just ain't sustainable.

Now insurance companies are limiting access through raising rates to undesirable groups, trumped up exclusions when they cannot invoke lifetime limitations or 'experimental treatment' for denial, or just arbitrarily dumping customers and small business. Why is that ok but it isn't ok for medical boards to establish recommended treatments based on proven efficacy? Why is it ok for insurance companies to exclude heroic medical treatments to extend life a few months at a cost of tens or hundreds of thousands of dollars but a Health Care System cannot deny the the same heroic treatments seeking a tempoary extension of life?

People can argue to obfuscate these points from this election to next election. However, taking a longer view down the road provides a very clear view where that road is going. As 'they' say, the current approach is not sustainable. Something has to be done to conserve a health care sytem that provides affordable access to everyone who needs it. That turns out to be everybody. How to do that in a world of finite resources and funds, hypocondriacs, imperfect physicians and patients, and politicians is the big challenge. If we do not get a handle on it now then in the future health care will be only for the rich. Ultimately. that will be bad for the rich too as medical R&D and pharmceutical R&D shrink due to a shrinking target base.

This Canada story highlights a problem of their system. I have alluded to some of the problems in our system. All pretty bad but small compared to the problem of doing nothing and travelling the road to health care oblivion. Burying our head in the sand will not make this go away.

[BiBottomBoy]

France manages to have universal healthcare without all this bullshit.

[RA1]

They just manage to have a lot of "other" bullshit, like unions complaining about, and all but closing down the country, retiring at 62? I only wish I could retire with a full pension at 62, but I am not willing to go to France to do so.

Best regards,

RA1

My real point is I perceive no country to have a complete answer to every social problem and they never will.

[Guest JamesWilson]

Sounds exactly like here! Except that those without the bucks get a *much* better baseline there...

Actually, I think the main difference is that here in Canada, we don't have to rely on for-profit healthcare insurers (e.g. HMOs) to get our medical coverage (either through our employers or through out-of-pocket payments). Yes, supplemental medical insurance policies are available (for needs like dental, optical, drugs, out-of-province travel, etc.), but every Canadian, from birth to death, employed or not, has pretty good comprehensive medical coverage. I'm not saying that it is perfect, but it seems to work for the vast majority.

Is it under pressure? Yes. Could it work better? Yes. Are we trying to make it better? Yes. Are forces in the business community trying to weaking universal public coverage so that they can introduce for-profit insurance and medical services? Yes.

But Canadians, for the most part, love their health coverage. I haven't seen any polls on the subject, but I bet that you wouldn't get many takers who would want to adopt the US model up here. And the politicians up here know that trying to do away with it would not only be political suicide for them individually, but would damage their respective political parties for years...

[Guest JamesWilson]

I found this article about Canadian Healthcare in the Montreal Newspaper very interesting. Now maybe I can understand people's concern about rationing healthcare and fear of the same thing happening here. I knew Canada limits the number of doctors and testing equipment like CT scanners but this was enlightening. Looks like if you got the bucks you can get the care there?

http://www.montrealgazette.com/health/Want+fast+care+Slip+some+cash/3892737/story.html

Ummm... don't you already ration healthcare based on ability to pay?

[RA1]

It depends upon what you mean by "health care". I don't believe anyone in the US is turned away from medical treatment because they have no money or no insurance. Some of this treatment is delivered in the emergency room when it should have been dealt with in another setting and this needs to be changed.

For my entire life time and likely before that there was a "saying" that the best medical care delivered in the USA was to the very wealthy and the very poor. The "middle class" suffered because they had to "pay" for their care without being wealthy. To some extent business sponsored health insurance ameliorated this "situation". Now, we are seeing changes in this approach.

I don't see any existent or proposed plans that "cure" the problem and I don't see that socialized Rx as practiced in Canada and elsewhere is a permanent solution either. I have personally seen Canadian medicine as practiced in Labrador to have been very helpful and efficatious to someone I know but curing a sore throat in the middle of nowhere is not the same as "modern medicine" being delivered in a timely manner to "everyone". I only wish it to be so.

Best regards,

RA1

[TampaYankee]

It depends upon what you mean by "health care". I don't believe anyone in the US is turned away from medical treatment because they have no money or no insurance. Some of this treatment is delivered in the emergency room when it should have been dealt with in another setting and this needs to be changed.

That is simply untrue. If you think this true then you are woefully ignorant of the American health care system.

My daughter is self-employed and uninsured. She has had a partially detached retina for a few years now. She has no insurance to seek treatment. This is not an emergency room malady. She lives with it as it slowly deteriorates more. She also suffers from chronic depression of the seasonally affective variety. Again, this is not an emergency room treatment issue unless and until she would become a danger to herself or others.

Emergency rooms are just for emergencies. Sometimes they treat nonemergency, cases if they can, out of compassion but if they do it is a one time treatment. There is no follow up, no continuing care for chronic illness. What about drugs? Emergency rooms do not dispense drugs except temp short-term if needed. Longer term prescriptions may be written but are not filled at the hospital pharamacy. A prescription without the money to fill it is just a piece of paper.

For my entire life time and likely before that there was a "saying" that the best medical care delivered in the USA was to the very wealthy and the very poor. The "middle class" suffered because they had to "pay" for their care without being wealthy. To some extent business sponsored health insurance ameliorated this "situation". Now, we are seeing changes in this approach.

Not everyone qualifies for coverage under Medicaid. It is usually mothers with children. That leaves a lot of other very poor without coverage, not to metion the milliions of working families who do not have coverage and cannot afford insurance or the resources to pay for signifiicant medical treatment that requires more than a doctor visit and an xray or two.

These myths based on half-truths make it easy for many of us to embrace the status quo. Unfortunately, reality is painted with millions of counterexamples.

[RA1]

I am sorry for your daughter's problems. I do not know where you live but here what I said is correct. I may be ignorant of a lot of things but I see with my own eyes what I have stated.

There is a treatment center just down the street from my office where mental problems are addressed at taxpayer's expense. No insurance or cash required.

I would LIKE to agree with you that emergency rooms are for emergencies but they are NOT. They are for everyday treatment of everyday medical problems, at least where I live.

Sorry to disagree.

Best regards,

RA1

[TampaYankee]

I am sorry for your daughter's problems. I do not know where you live but here what I said is correct. I may be ignorant of a lot of things but I see with my own eyes what I have stated.

There is a treatment center just down the street from my office where mental problems are addressed at taxpayer's expense. No insurance or cash required.

I would LIKE to agree with you that emergency rooms are for emergencies but they are NOT. They are for everyday treatment of everyday medical problems, at least where I live.

Sorry to disagree.

Best regards,

RA1

I salute your community. I wish every community shared the standards of your's, but believe me, your's is the exception not the standard according to my experience having lived in the South, MidAtlantic and Northeast, not NYC. It seems so for your emergency rooms too.

It would be great for women get pap smears every couple of years and ostomy patients getting regular check ups and if someone is diagnosed with cancer they can schedule surgery at the emergency room or a child with a heart defect. I assure you my daughter would make use of the ER for detatched retina surgery and depression drugs if they were handing them out.

I do salute your community. It far exceeds what many other communities provide. It gives insight into my perception of why you dont sense the urgency that I do.

[RA1]

I am not claiming any unusual situation or treatment in my community. It is only what I have personally observed and what seems to be common knowledge among my friends and acquaintences.

One seemingly obvious problem with what I have described, other than routine "pre-medical emergency services", is a possible logjam at an emergency ward which can lead to sometimes silly "triage" situations. One thing I mean is a better life style would likely benefit each of us which presumably would preclude some emergency treatment. I hope I am making sense here.

Best regards,

RA1

[MsGuy]

It gives insight into my perception of why you dont sense the urgency that I do.

TY, most insured folks have no idea of the difficulties the uninsured face in obtaining adequate medical care. And until they become aware just how close their own tax & employer subsidised insurance system is to collapse, they will continue to feel no sense of urgency to deal with the situation, especially if alternatives are presented as threating their own comfortable situation.

That's no reflection on them , it's just part of being human.* Problems that don't impact us personally just don't seem all that urgent. I readily admit the condition of the US health care system didn't seem all that urgent to me until I realized that I might actually live long enough to see it implode around me.

*Look at what's happening down in Haiti. Does either of us feel any real sense of urgency about this? Yeah, it's regretable but it's not really our problem, right?

[RA1]

MsGuy-

Have you personally seen folks turned away from medical care? I never have. I have seen multiitudes of uninsured cared for when they just showed up needing care. We only live a few miles apart but I do know a lot of folks from MS and AR and surrounding communities in TN come into MEM for "free" medical care and, they get it.

Again, I will readily admit we all need to take better care of ourselves to avoid needing "sudden" care of any kind or having routine care at the emergency ward but that is not only insurance or lack of it, it is education and a sea change in life style, something you and I will not see in our life times, sorry to say.

Best regards,

RA1

[TampaYankee]

MsGuy-

Have you personally seen folks turned away from medical care? I never have. I have seen multiitudes of uninsured cared for when they just showed up needing care. We only live a few miles apart but I do know a lot of folks from MS and AR and surrounding communities in TN come into MEM for "free" medical care and, they get it.

Please tell me where and when my daughter should show up to schedule eye retina surgery without being required to provide verifiable documentation of insurance coverage or a mulithousand dollar cash deposit and I will have her on a plane in two shakes. I would be most grateful.

[TampaYankee]

TY, most insured folks have no idea of the difficulties the uninsured face in obtaining adequate medical care. And until they become aware just how close their own tax & employer subsidised insurance system is to collapse, they will continue to feel no sense of urgency to deal with the situation, especially if alternatives are presented as threating their own comfortable situation.

That's no reflection on them , it's just part of being human.* Problems that don't impact us personally just don't seem all that urgent. I readily admit the condition of the US health care system didn't seem all that urgent to me until I realized that I might actually live long enough to see it implode around me.

*Look at what's happening down in Haiti. Does either of us feel any real sense of urgency about this? Yeah, it's regretable but it's not really our problem, right?

Sure, I understand that. What I don't understand is that they think they understand the problem without having a full picture of what is out there and dismiss the other sides out of hand. That smacks of the detachment that comes with the attitude 'that is not my problem'. That is why my new philosophy is to make it their problem by stopping the freeloading on the government via tax free status and their employer's handouts. Yeah, it will cost me too but that is the price for spreading awareness.

As for Haiti, it is sad but what you say it true, and I am not really surprised and sort of expected what has happened. At the time I called for a Marhall-Plan-like-program authorized by the the Haitian Government and the UN and then have them get out of the way while a UN sanctioned org structured and manned by NATO (mainly the US and France) and funded more widely was left unfettered to restore and rebuild Haiti. Instead we got the usual politics and corruption and management by committee. No suprise that people stand back and shake their heads.

[RA1]

Please tell me where and when my daughter should show up to schedule eye retina surgery without being required to provide verifiable documentation of insurance coverage or a mulithousand dollar cash deposit and I will have her on a plane in two shakes. I would be most grateful.

I have no wish to get into a argument on this point with you. As previously stated, I am sorry for your daughter's condition. I am neither a scheduler or advisor about individual medical treatment, however, I am sure that if your daughter were a local resident and showed up at one of our medical facilities with or without money or insurance, something would be done. There are several well known and excellent eye doctors in town.

Best regards,

RA1

[TampaYankee]

I have no wish to get into a argument on this point with you. As previously stated, I am sorry for your daughter's condition. I am neither a scheduler or advisor about individual medical treatment, however, I am sure that if your daughter were a local resident and showed up at one of our medical facilities with or without money or insurance, something would be done. There are several well known and excellent eye doctors in town.

Best regards,

RA1

I appreciate your sincere good wishes and don't doubt them in the least. However, they don't go very far in obtaining relief. That is not your fault but it is a shortcomimg of observers expressing beliefs that cannot be turned into actions.

[lookin]

There is a treatment center just down the street from my office where mental problems are addressed at taxpayer's expense. No insurance or cash required.

Wish I had one of those down the street from me. They'd get a lot of drop-in traffic just from us locals.

San Francisco has pretty good low-cost or no-cost health care too, and Healthy San Francisco is showing that on-going care is better and cheaper than emergency care.

I tried to check out Memphis's health care approach through Wikipedia, and so far found only this snippet:

Memphis is also home to the Memphis Medical Center, which is locally referred to as "The Med". In recent years, the hospital has experienced severe funding difficulties that nearly led to a reduction or elimination of emergency room services. In July, 2010, The Med received approximately $40.6 million in federal and local funding to keep the Elvis Presley Trauma Center operational.

Perhaps the free clinics in your area indicate that Memphis is also shifting its emphasis away from emergency care and toward preventive care.

As others have said, emergency room care, even if free and readily available, is often too little and sometimes too late. I think we all need affordable medical care that keeps us well and lets us avoid the emergency room whenever possible.

[Guest tomcal]

Caveat!: I don't know or have the answer to this question!

But, the thing I found interesting was During the Presidential election two years ago, both Canada and Brazil were referenced as countries with univeral healthcare and held up as examples. I grew up in Minnesota, not far from the Mayo clinic and we would often comment at the large number of cars in their parking lot with Canadian License plates and which still happens today even though they have to pay for the care there vs. free at home! As a frequent visitor to Brazil, I can tell you the difference between their free care and "paid" care is great! Many Drs., dentists have two offices, one for the regualar patients and one for the "paying" patients. It may be a case of the "grass looks greener.." As someone who has worked in the medical field for 25 years and as stated by a earlier poster, always being covered by a policy, I was not aware of the issues those w/o insurance face, but at the same time, how much healthcare is deliverable w/o bankrupting the country? Are kidney/liver transplants acceptable if someone is over 70/75/80..? Can we afford or who can afford to pay for all available options for all illeness for everyone without rationing it in someway based on age for example? when impants such as Hip and knee, now one of the most common procedures for those over 65 and one of the most sucessful in increasing quality of life, take 5+years and millions of dollars to bring to market and get FDA approval, why would companies continue R&D if they cannot realize a profit. These prices have come down considerably the last few years from the manufacturers but not from the insurance companies...where I believe alot of the "rehab" needs to take place.

The population continues to expand and the longevity continues to increase and new technologies continue to be invented, but I don't think the revenue to support the above can pay for UNiveral Healthcare w/o large tax increases. the biggest lie during the passage in congress is that the Healthcare bill would be revenue neutral! this has already to be wrong even before it's got off the ground. anyhow, just my 2 cents.

AS a side point and maybe to add to the discussion re:emergency rooms treatment, I was told that 70%+ of the births at UCI(univerity of California Irvine)hospital were to illegals. These people are not paying taxes to help support the system..maybe a reason to give them citizenshp..but that's a whole other hot topic!!! There was I believe a Higher % at USC, and UCLA Long Beach emergency room looks like Little Tijuana with families camped out for days there. It appears at times like we give better medical treatment to illegals than to our own citizens as they learn fast how to exploit the system, these costs are very straining on each Medical facilities finances and ER's are requried to treat anyone showing up. I don't think we can be everything to everyone in regards to medical care, unless there is some magical bullet to support it and I have no clue what that is!

[lookin]

As you say, the answers are important. For example, if Canadians were coming across the border for half - or even 20% - of their health care, that would suggest some pretty significant weaknesses in their system. But my understanding is that only a percent or two come to the U S. for health care and, even then, usually when they're here for something else, although the Mayo clinic may indeed be a magnet as it is for many around the world. So the answers are available, and they indicate that Canadians are pretty well satisfied with their health care system.

There was a program on TV a couple years ago that showed a hip-replacement patient who went to India for her operation. Not only did she have the option of a less invasive procedure that hadn't yet been approved by the FDA, she also paid about a third of the U. S. price, and recuperated for a few days at a luxury resort with some nice-looking Indian boys bringing her drinks poolside.

While it wouldn't be fair to ask our seniors to travel to India for hip replacements, it might be possible to bring parts of the Indian system here. We'd almost certainly have to give up our right to large malpractice awards for a start, and the FDA might have to find a way to streamline its approval process.

Of course, there are folks who don't want the FDA to change and others who support the idea of a large malpractice industry. Though that may be more about preserving wealth than about preserving health.

In my opinion, our country continues to struggle with universal health care not because we can't find the answers, but because many are not yet willing or able to hear them.

But I think the message will continue to get louder as the days go by.

[Guest zipperzone]

As you say, the answers are important. For example, if Canadians were coming across the border for half - or even 20% - of their health care, that would suggest some pretty significant weaknesses in their system. But my understanding is that only a percent or two come to the U S. for health care and, even then, usually when they're here for something else, although the Mayo clinic may indeed be a magnet as it is for many around the world. So the answers are available, and they indicate that Canadians are pretty well satisfied with their health care system.

I agree. As I have said before, I am basically satisfied with the health care I receive in Canada and you can't beat the price.

HOWEVER..... If I was to win "the big one" I would check myself into the Mayo Clinic and pay for a complete head to toe, inside-out checkup. I think they are the best in the world and could calm my hypochondriac nature. Unfortunately they are way beyond my financial means.

An acquaintance of mine went there with bladder cancer and had to have his bladder removed. The bill was 75 grand.

[TampaYankee]

As someone who has worked in the medical field for 25 years and as stated by a earlier poster, always being covered by a policy, I was not aware of the issues those w/o insurance face, but at the same time, how much healthcare is deliverable w/o bankrupting the country? Are kidney/liver transplants acceptable if someone is over 70/75/80..? Can we afford or who can afford to pay for all available options for all illeness for everyone without rationing it in someway based on age for example? when impants such as Hip and knee, now one of the most common procedures for those over 65 and one of the most sucessful in increasing quality of life, take 5+years and millions of dollars to bring to market and get FDA approval, why would companies continue R&D if they cannot realize a profit. These prices have come down considerably the last few years from the manufacturers but not from the insurance companies...where I believe alot of the "rehab" needs to take place.

The population continues to expand and the longevity continues to increase and new technologies continue to be invented, but I don't think the revenue to support the above can pay for UNiveral Healthcare w/o large tax increases. the biggest lie during the passage in congress is that the Healthcare bill would be revenue neutral! this has already to be wrong even before it's got off the ground. anyhow, just my 2 cents.

AS a side point and maybe to add to the discussion re:emergency rooms treatment, I was told that 70%+ of the births at UCI(univerity of California Irvine)hospital were to illegals. These people are not paying taxes to help support the system..maybe a reason to give them citizenshp..but that's a whole other hot topic!!! There was I believe a Higher % at USC, and UCLA Long Beach emergency room looks like Little Tijuana with families camped out for days there. It appears at times like we give better medical treatment to illegals than to our own citizens as they learn fast how to exploit the system, these costs are very straining on each Medical facilities finances and ER's are requried to treat anyone showing up. I don't think we can be everything to everyone in regards to medical care, unless there is some magical bullet to support it and I have no clue what that is!

Tomcal,

You make some accurate observations and raise some practical points. Definitely hard choices have to be made. Realistic benefit limits have to be formulated. Insurance companies already ration access based on cost and profit motives. Everybody cannot have everything but everybody should have access to standard health care and medical treatment. Extraordinary end-of-life treatment has to be reigned in. Our resources are finite and limits have to be established without pulling out politics to scare people in an attempt to maintain the status quo or political doctrine. If people desire extra benefits they should resort to private medigap policies as is done by many Medicare members. It keeps the present feature that those who can afford the very best coverage including extraordinaty end-of-life care will continue to have that option.

It will be costly whatever we do. I've argued that the present system is not sustainable in cost. I do not believe it is. As cost grows those who can maintain access will decrease. Businesses will drop it. I don't believe that the end of that road is an acceptable outcome.

You question if the country can afford quality health insurance for all. England, France, and Canada manage to afford it. Not sure what Germany and Japan do. Sure it is expensive it. It is very expensive here if you look at the numbers. We spend more per capita with worse health care stats nationwide. However, over there everyone has access and here many millions don't. What are they doing right that we are't? I think it is obvious by inspection.

I've also argued that the government has been in the business of picking winners and losers. The government subsidizes those with employer provided benefits by not taxing those benefits as earned income. It also allows business to deduct those payments too.

The goverment also provides for senior citizens through Medicare and selected indigent through Medicaid.

For those who cannot afford insurance or otherwise access it and who pay what they can out of pocket there is a capped tax write-off if one can itemize deductions and if health costs exceed the 7.5% income floor minimum expenses. The latter condition implies that they can afford some access. Most uninsured cannot afford that much or any access. The itemized deduction write off amount is miniscule by comparison to the empolyer benefit exclusions, in the large.

Uncle Sam definitely already has its thumb on the balance in this health care system. He subsidizes all the employer-insured, the aged and many indigent. That leaves between 30 million and 50 million working poor and uncovered indigent to fend for themselves and who many think don't deserve a government subsidized access to health care.

If nothing is done then that number will grow as insurance coverage increases and becomes more restrictive and businesses bail on that costly perk.

As for illegals, it is an expensive proposition as you point out. It already is as you observe. It needs to be dealt with in a financially manageable and responsible manner, now and in the future. It plagues the present system and any future system the same. That should not be an impediment to improving health care access in America.

I don't believe that any reasonable and informed person can deny that the present road the heath care system is on is NOT sustainable. Thus if my general prescription for reform is not the solution then what is the solution? Who will have access? How expensive will it be allowed to become? Will insurance companies be allowed to continue theft by deception when denying claims, or throwing small businesses and individuals off their roles? Who will pay when businesses opt out of employee coverage? Will the government still choose winners and losers through tax policy? How rational is that process for providing health care?

I think I have some broad ideas for answers. The devil is in the details. I'm sure my ideas far short of universal acceptance. Ok. What is the alternative? If that alternative doesn't involve susidized health care access for all then let's make sure that we don't subsidize anyone between 18 and 65.

I know this is a very difficult problem and an expensive one. Ignoring it wont make it any simpler or cheaper. Hanging a facade on it that only pretties up the pig but does not cure the ills that unfold along the present course is shortsighted head-in-the-sand thinking IMO and kicks the can down the road to more extreme problems and unnecessarily larger deficits.

I welcome any better ideas. If someone can make the insurance companies honest and responsbile, provide access to all, and make it affordable to all, keep it affordable for business support then I can sign on to that. I'm all ears and eyes with open mind.

[BiBottomBoy]

I'm not sure what the point of having a government is if it doesn't provide for the health and welfare of its citizens.

[RA1]

I tried to check out Memphis's health care approach through Wikipedia, and so far found only this snippet:

Memphis is also home to the Memphis Medical Center, which is locally referred to as "The Med". In recent years, the hospital has experienced severe funding difficulties that nearly led to a reduction or elimination of emergency room services. In July, 2010, The Med received approximately $40.6 million in federal and local funding to keep the Elvis Presley Trauma Center operational.

Perhaps the free clinics in your area indicate that Memphis is also shifting its emphasis away from emergency care and toward preventive care.

As others have said, emergency room care, even if free and readily available, is often too little and sometimes too late. I think we all need affordable medical care that keeps us well and lets us avoid the emergency room whenever possible.

lookin'-

One of the problems about funding of medical care in the MEM area is that people flock in from very nearby MS and AR but those states either don't pay or don't pay their share (a common complaint it seems among many taxpayers. However, the MED emergency room is still open. Unfortunately, it is widely thought of as an excellent place to go with trauma because they have "patched up" so many "Saturday night" woundings as well as car crash victims. A parallel to surgeons getting the "best" training during a war. I don't believe they ask for dollars or insurance when you are unconscious and bleeding.

Of course, I agree the best care is that which precludes going to any hospital or clinic because you are "healthy" until the day you die. However, the best from the government seems to be the threat of "get healthy or else, we won't treat you" or something to that effect.

Best regards,

RA1