Not if the hospital owns both the ER and the clinic. It's the same patients getting the same services, just two different doors and, in some cases, two different price tags.
Well, if one is charging $500 for a visit and the other is charging $50 .. but I don't think most ERs are abused in that way. I think in cities where you have a lot of homelessness, etc., is the problem -- the visits aren't being paid for at all in many instances.
In this regard, I think the health care initiative in Obama's stimulus plan that provides for "community health centers" could make a lot of sense. Although, I don't know the details of what they're doing.
But I cannot imagine that better health care wouldn't be available if every city had one or more such health centers that provided 24/7 care staffed by physicians and PAs and that dispenses medication onsite, predominantly generics, etc.
I would not find it problematic for the government to fund, for example, 250 such clinics across the country to care for the homeless/indigent -- as opposed to providing other free benefits. You could spend a couple billion a year and probably handle 10 million or more patient visits a year with drugs dispensed on the spot. That may well be a cost-effective model for government to provide care for those who cannot provide their own. For the severely ill, they at least get some care and can be diagnosed and perhaps placed into the county hospital system or whatever. I have no doubt it would provide a better outcome than a lot of these people now get and for a fraction of the cost. |
