--- The Fool <[EMAIL PROTECTED]> wrote:
>
http://story.news.yahoo.com/news?tmpl=story2&cid=68&ncid=68&e=9&u=/nyt/200
>
30117/ts_nyt/states_can_limit_emergency_access_in_medicaid_cases
> 
> States Can Limit Emergency Access in Medicaid Cases
> Fri Jan 17, 9:01 AM ET  Add to My Yahoo! 
>  
<snippage> 
> States say they are facing the worst fiscal crisis
> in more than 50 years
> and are desperately looking for ways to control
> health costs. Many have
> cut benefits or restricted eligibility in an effort
> to hold down Medicaid
> costs, which rose 13 percent in the last fiscal
> year, the biggest increase in a decade... 
> 
> "Three emergency visits a year for an adult may
> sound like a small
> number, but it's really not," Mr. Bearden said today
> in an interview.
> "I'm 60 years old, and I've been to an emergency
> room once in my life.
> The E.R. is very expensive, and people in this state
> use it
> inappropriately. They go in for a stubbed toe." 
> 
> Louisiana used to have a three-visit limit, Mr.
> Bearden said, but, at the
> insistence of federal Medicaid officials, the state
> ended the restriction
> for people in managed care a couple of years ago. 

I can vouch for inappropriate use (my personal
favorite was the elderly lady who "hadn't had a good
physical in about a year"), but if they don't consider
chronic underlying disease as a factor, they'll have
diabetics and asthmatics dying in the streets.

While good primary care should be able to greatly
reduce need for ER visits in many (perhaps even most)
cases, there are, frex, brittle diabetics who -
despite best medical care and best patient
participation in their own health - will require
emergent care.  Ditto for severe asthmatics, severe
heart failure patients, etc.

The country is going to have to face the dilemma of
limited resources-endless demand WRT healthcare.

Debbi

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