Comments on: Monday’s Town Hall Meeting in Newport Beach with John Campbell (R-CA 48th District) http://www.orangejuiceblog.com/2009/08/mondays-town-hall-meeting-in-newport-beach-with-john-campbell-r-ca-48th-district/?utm_source=rss&utm_medium=rss&utm_campaign=mondays-town-hall-meeting-in-newport-beach-with-john-campbell-r-ca-48th-district Orange County's top political blog Sun, 12 Feb 2012 20:09:27 +0000 hourly 1 http://wordpress.org/?v=3.1.3 By: Mark S. Wagner, MD http://www.orangejuiceblog.com/2009/08/mondays-town-hall-meeting-in-newport-beach-with-john-campbell-r-ca-48th-district/comment-page-1/#comment-105485 Mark S. Wagner, MD Mon, 31 Aug 2009 17:14:54 +0000 http://orangejuiceblog.com/?p=27971#comment-105485 I am a board certified emergency physician with 30 years of experience and have seen “America's Emergency Safety Net” gradually erode. I have personally suffered episodic ill health due to work stress and am forced at the age of 56 to consider retiring from my specialty. Many of my colleagues are burned out and want to leave the specialty of Emergency Medicine. Government has mandated we see all comers but is reducing our compensation disproportionately. Please help improve access to "real" emergency care and not increasingly overwhelm us more by your bureaucratic mismanagement. While an Emergency Medicine Resident at Harbor-UCLA in Los Angeles County in 1982 I treated an overdose patient that was inappropriately transferred from a neighboring hospital. This case became one of the sentinel cases in California that resulted in anti-dumping statutes that later led to passage of Federal EMTALA in 1986. I worked on a California/American College of Emergency Medicine Committee with Michael Jay Bresler, MD, FACEP, who is given credit for establishing several legislative amendments during his tenure on the Cal/ACEP Board. I therefore speak with some experience in helping to draft legislation to improve patient care outcomes when suffering emergencies. Lets for a moment agree to disagree… Having worked in an Urban ER for 7 years that serves primarily the indigent, I have seen that providing Managed-MediCal in no way guarantees access to care. Instead, it puts up more HMO barriers, and many frustrated patients have no alternative but to seek non-emergent and non-urgent advice at an Emergency Department. I am afraid that the currently proposed AAHCA of 2009 (“America’s Affordable Health Choices Act of 2009”) will guarantee coverage but does not guarantee timely access to care. Enrollees will be forced to stand in line at increasingly overcrowded ER’s. My plan would be to provide vouchers for the patients declared “stable” by triage standard and who could be safely directed to affiliate-licensed Urgent Care Clinics for timely rapid evaluation and care. The problem is, at present, this type of referral would violate EMTALA, and ER’s & Hospitals prefer the “bread and butter cases” waiting (for as long as takes) to fill in their “down-time”. According to HealthDay News, patients on Medicaid already have difficulty accessing health-care providers, according to a recent national online consumer survey by PricewaterhouseCoopers (PWC) Health Research Institute. Nearly a third of Medicaid patients reported waiting 30 days or more or an appointment with a doctor. What's more, many Americans still use the emergency room inappropriately. According to PWC's consumer survey, more than half of those who went to the emergency room in the last year did so for non-emergency reasons. http://news.yahoo.com/s/hsn/20090807/hl_hsn/expandinghealthcoveragemaynotimproveaccess Ten years ago and again last year, Harbor-UCLA ER (where I did my internship and residency) performed a study that showed that 10% of the LWBS (left without being seen) patients had significant morbidity and mortality within 24-72 hours of their initial attempted visit. My plan would be to have these potential LWBS patients directed to the clinics for a timely evaluation. The Canadian Plan is indeed an excellent plan for most patients. Problem is, doctors were guaranteed a significant salary increase by the government and they did indeed get it according to several Canadian friends I have spoken with. No such plan seems to be feasible in the United States where there are no longer available financial resources short of increasing taxation. Instead, the present plan seems to further guarantee reduced reimbursement to US physicians. This will not engender acceptance and may jeopardize real health care reform in the Unites States. I DO believe there should be a National Health Care Plan. I just do not agree that the present plan, as written, guarantees access to timely care… it is just false hope… Respectfully submitted, Mark S. Wagner, MD, FACEP PO Box 338 Dana Point, CA 92629 310-218-3892 mswagnermd@cox.net References: I am a board certified emergency physician with 30 years of experience and have seen “America’s Emergency Safety Net” gradually erode. I have personally suffered episodic ill health due to work stress and am forced at the age of 56 to consider retiring from my specialty. Many of my colleagues are burned out and want to leave the specialty of Emergency Medicine. Government has mandated we see all comers but is reducing our compensation disproportionately.
Please help improve access to “real” emergency care and not increasingly overwhelm us more by your bureaucratic mismanagement.
While an Emergency Medicine Resident at Harbor-UCLA in Los Angeles County in 1982 I treated an overdose patient that was inappropriately transferred from a neighboring hospital. This case became one of the sentinel cases in California that resulted in anti-dumping statutes that later led to passage of Federal EMTALA in 1986. I worked on a California/American College of Emergency Medicine Committee with Michael Jay Bresler, MD, FACEP, who is given credit for establishing several legislative amendments during his tenure on the Cal/ACEP Board.
I therefore speak with some experience in helping to draft legislation to improve patient care outcomes when suffering emergencies.
Lets for a moment agree to disagree…
Having worked in an Urban ER for 7 years that serves primarily the indigent, I have seen that providing Managed-MediCal in no way guarantees access to care. Instead, it puts up more HMO barriers, and many frustrated patients have no alternative but to seek non-emergent and non-urgent advice at an Emergency Department.
I am afraid that the currently proposed AAHCA of 2009 (“America’s Affordable Health Choices Act of 2009”) will guarantee coverage but does not guarantee timely access to care. Enrollees will be forced to stand in line at increasingly overcrowded ER’s.
My plan would be to provide vouchers for the patients declared “stable” by triage standard and who could be safely directed to affiliate-licensed Urgent Care Clinics for timely rapid evaluation and care.
The problem is, at present, this type of referral would violate EMTALA, and ER’s & Hospitals prefer the “bread and butter cases” waiting (for as long as takes) to fill in their “down-time”.
According to HealthDay News, patients on Medicaid already have difficulty accessing health-care providers, according to a recent national online consumer survey by PricewaterhouseCoopers (PWC) Health Research Institute. Nearly a third of Medicaid patients reported waiting 30 days or more or an appointment with a doctor. What’s
more, many Americans still use the emergency room inappropriately. According to PWC’s consumer survey, more than half of those who went to the emergency room in the last year did so for non-emergency reasons. http://news.yahoo.com/s/hsn/20090807/hl_hsn/expandinghealthcoveragemaynotimproveaccess
Ten years ago and again last year, Harbor-UCLA ER (where I did my internship and residency) performed a study that showed that 10% of the LWBS (left without being seen) patients had significant morbidity and mortality within 24-72 hours of their initial attempted visit.
My plan would be to have these potential LWBS patients directed to the clinics for a timely evaluation.
The Canadian Plan is indeed an excellent plan for most patients. Problem is, doctors were guaranteed a significant salary increase by the government and they did indeed get it according to several Canadian friends I have spoken with.
No such plan seems to be feasible in the United States where there are no longer available financial resources short of increasing taxation. Instead, the present plan seems to further guarantee reduced reimbursement to US physicians.
This will not engender acceptance and may jeopardize real health care reform in the Unites States.
I DO believe there should be a National Health Care Plan.
I just do not agree that the present plan, as written, guarantees access to timely care… it is just false hope…
Respectfully submitted,
Mark S. Wagner, MD, FACEP
PO Box 338
Dana Point, CA 92629
310-218-3892
mswagnermd@cox.net
References:

]]> By: Red Vixen http://www.orangejuiceblog.com/2009/08/mondays-town-hall-meeting-in-newport-beach-with-john-campbell-r-ca-48th-district/comment-page-1/#comment-105438 Red Vixen Mon, 31 Aug 2009 03:21:45 +0000 http://orangejuiceblog.com/?p=27971#comment-105438 Lou, Welcome to Orange Juice! We look forward to getting your event pictures. Please forward them to Art and myself. apedroza@earthlink.net rvixen@gmail.com I wish you much success tomorrow. Thanks for standing up for the community and getting attention drawn to the very important issue of health care reform. It is absolutely important to hold our elected representatives accountable for the decisions they will make on our collective behalf. Rv - - Lou,

Welcome to Orange Juice! We look forward to getting your event pictures. Please forward them to Art and myself.

apedroza@earthlink.net
rvixen@gmail.com

I wish you much success tomorrow. Thanks for standing up for the community and getting attention drawn to the very important issue of health care reform. It is absolutely important to hold our elected representatives accountable for the decisions they will make on our collective behalf.

Rv – -

]]> By: Lou Delgado http://www.orangejuiceblog.com/2009/08/mondays-town-hall-meeting-in-newport-beach-with-john-campbell-r-ca-48th-district/comment-page-1/#comment-105426 Lou Delgado Mon, 31 Aug 2009 01:52:17 +0000 http://orangejuiceblog.com/?p=27971#comment-105426 I'll be the photographer for the MARCH and organizers.... I'll send you the link to images on Monday evening. Best --LOU I’ll be the photographer for the MARCH and organizers…. I’ll send you the link to images on Monday evening.

Best –LOU

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