Friday, June 5, 2009

How Much?


In economics, the term ‘free’ is used to describe something that is available in nearly unlimited quantities with zero opportunity cost to society. (For the non-economics folks here, opportunity costs measures the value foregone as the result of deciding to produce one good over the other). Free in this sense does not mean that an individual (or group of individuals) can consume a good in unlimited quantities without deflecting a part of the cost to society as a whole. However, that’s exactly how a lot of folks are treating ER. In Canada, health care is ‘free’. That means that if an individual goes to a clinic or (for the purposes of this blog) the ER, they should be able to get a superfluous treatment that they deem necessary for themselves right? After all, it’s free, so what does it matter to the referring physician? And let’s say that the individual’s request was fulfilled and they went home happy with their productive visit, they have an exciting anecdote to share with their family and friends, right? Because in Canada, the discharge papers don’t include a bill. But here’s the thing –I think sending people with an itemized list of the expenses that they accumulate while visiting an ER versus the cost of visiting a family doctor might make the average person think twice before coming into an ER to seek treatment for non-urgent problems.* Maybe I’m being overly na├»ve here, but a population wide reminder of how much ER abuse costs the system (and raises taxes) can influence a shift in health care consumer behavior to make more socially conscious choices. Of course, this means that Canada really should start making it a little easier for foreign trained health care professionals to enter the Canadian system instead of letting them drive cabs (and other upstream interventions) but that’s another blog post entirely.

*Some stellar examples include, a cold sore, a cold, a well healing bruised hand, having TWO beers and feeling ‘wrong’, calling 911 for an ambulance and then talking on your cell phone the entire time while in the department, stubbing one’s foot against a parked car, bunions that suddenly got worse after wearing a new pair of shoes two sizes too small for the past several hours and on and on…

5 comments:

Haley Dawn said...

If only the people that used the ER in that manner could truly think in that way.. But CLEARLY they can't...

Tex said...

Interesting idea.
I mean, hell, ANYTIME you purchase services you get a receipt.
I wonder what people would say if they got one after an ED visit (regardless of insurance or 'free' care).

chuckr44 said...

I think the itemized printout should include the wording "You have been a drain on society in the amount of $..."

Rachael said...

um, don't hospitals already send itemized bills? The hospital sent an itemized bill a couple years ago after my husband's visit to the ER

Maha said...

I'm not sure about how billing is handled in the States, but patients in Canada usually don't get an itemized bill after an ER visit because the visit is covered by the provincial health plan. I know that orthopedic devices (ex: crutches, boots, canes) aren't covered and private inpatient rooms are handled by 3rd party insurance so patients do get billed for that.