America's Stunningly Overpriced Healthcare System In 2 Charts
http://www.businessinsider.com/healthcare-spending-as-a-share-of-gdp-2012-11It's no secret that the U.S. spends a crippling amount of money on healthcare.
Here's some global perspective from Credit Suisse.
First is healthcare spending as a share of GDP. It's not hard to find the U.S.
But this next chart is a bit more damning. It shows that the branded drugs Americans get are available for around half price across Europe.
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then why the hell are you in the ER?
Seriously, I see way too many people in our ER who have normal, everyday, over-the-counter ailments. Way too many drama queens.
I'm not saying that nobody who comes into our ER doesn't belong there. But I'm sorry to say the vast majority do not belong in an ER. 
say, spiking a high fever, then we can run tests at the ER that they can't run at the doctor's office, and get the results faster.
We had a patient recently with a post-op infection. The symptoms were such that they ran blood cultures. If the infection had gotten into the bloodstream, we'd be able to pick it up within hours and although it will take some time to identify the pathogen and sensitivity, at least we can let the doctors know they're looking at bacteremia or possible septicemia.
Luckily for me in this case, they only ordered one set of blood cultures and the nurse pulled all the specs off the IV setup. Lucky because I've had to draw very ill 6 year olds who were more stoic than this young adult, who, quite frankly, was a big, fat baby. Admittedly with no veins, but still, crying, begging, shaking, refusing, while his mommy sat there all upset at her poor widdle baby.
I was very, very nice, which I always am to patients, but inside I heaved a humongous sigh of relief when I got out of there scott free. 
but relieved I didn't have to actually try to draw him. He was crying and screaming "NO! NO!" when I gently probed his arm to look for a good vein. I had already let him know I wouldn't even try if I didn't find a really prominent, easy vein and promised I wouldn't make him a pin cushion. Good vein would mean a single quick try with smallest needle. No good vein, I wouldn't even try.
I can assure you that behind the scenes nobody would have had much sympathy for him. I have assisted with better behaved and more cooperative 2 year olds.
My empathy is vast with people who make the effort, but this kid was really acting more like a stuck baby than an adult having his arm gently probed for a possible vein.
I've drawn from 6 year olds who were seriously ill and very stoic after having to be drawn over and over. And I'll never forget the developmentally disabled little girl I assisted with. She was not an easy draw, but she kept her arm stock-still. Afterwards, her mother was in tears when she thanked me. So you can write what you want. Personally, meh. There are patients truly suffering who leave me in tears. Again, behind the scenes.
That said, there are other reasons you wouldn't want to be drawn in my hospital. One would be the pothead lab assistant who consistently mislabels tubes, when she doesn't leave them unlabeled somewhere. Another would be the alcoholic lead chemistry tech. Another would be the sexual harasser from the cleaning crew that a few lab assistants were encouraging, aiding and abetting by soliciting and providing him with personal information (about me). Except he finally got fired when another member of the cleaning crew alerted his manager to the fact that one night, in his determination to get my attention and set up a "date" he deliberately shoved me 4 times into my computer while I was sequentially attempt to run and result a pre-intubation critical arterial blood gas, a cord arterial and then venal blood gas for very sick neonate, a critically low potassium, and a critical post-intubation arterial blood gas. A fourth would be the porn addict they were protecting, except he became so brazen that they finally fired him. Not because ED specs were laying around un-resulted because he lost track of time while staring at female genitals on his computer screen, but because he had graduated to where he was doing it out in the open where any doctor or nurse running in from the ER might get an eyeful, which would cause trouble back at the lab chain headquarters.
And yes, I am getting out of the field. I have never worked in such an unprofessional environment as I am in at this hospital. And I've just been hired part time back to my old just in financial customer service. When I am one on one with a customer, I am able to deliver excellent customer service. I am very empathetic, but don't have a lot of tolerance for the occasional manipulators and cheaters, although I have my way of dealing with them so they 1. fail to get me to break rules for them and 2. are grateful or at least not angry by call's end. During my 1st (and last) tax season there, I won 2 quality awards and had 2 supervisor calls from customers raving about my service. Again, meh. 
I lost the love of my life to early onset alzheimers a couple years ago. Some doctors are great. Some, not so much. 
Seriously, sniffles and colds are best treated at home with bed rest and plenty of fluids. Second best with over the counter symptom relief if you need to work through it.
Flu shots are cheap and readily available.
And it's not automatically people without insurance. Most people here have some kind of coverage, including Mainecare if they're not insured.
You go to a hospital or to the doctor's office and you are exposing yourself to every bug everybody who has been in there is carrying, and exposing them to your bugs.
People in this country are waaaaaay too dependent on going to the doctor for every minor freakin' issue. They need to learn to take care of themselves with an appropriate diet, appropriate exercise and sufficient rest.
That also means using common sense and being aware of changes in your region's environment. We recently had a mother and son in with bloody stool. The doctor was testing for c-dif. Mother stopped by the lab to ask questions and while chatting, told us she'd been camping with her son and giving him survivalist training. I asked if they'd drunk from a stream as part of his "training." "Oh, yeah!" she nodded, smiling and enthusiastic. Lab partner and I looked at each other and blurted out "Giardia" in unison. 
It's now endemic here.
If they catch a cold, treat it at home. Doctor's offices are for treating things that aren't resolving at home, not running up bills for every headache, sniffly nose or 24 hour stomach bug.
Not to mention the rash of young, female syncope victims we had one night.
The ED treats each one as if it's a life threatening emergency because that's more revenue. It's also, ultimately, a huge cost on society.
that you know so much about the patients visiting my ER.
Because that's not what I see there.
I blamed people who should be in self-care.
I've never had a kidney stone, but from what I understand that's not some minor pain that will resolve with aspirin.
My point is that there is blame to go around. I see a *lot* of people who abuse our healthcare system. Sometimes we do actually get sick or injured people, like the post-op infection I mentioned above. But I see way too many people coming in with minor ailments that could and should be treated at home.
My understanding is that the hospital where I work always charges insurance companies more because they lose money on every Medicare patient and every charity patient. Plus the state owes them several millions dollars in back charges. We service a lot of Medicare patients and charity patients.
Now the state has responded by taking us off the "preferred vendor" list, so we're losing patients to the larger hospital an hour to our south that doesn't service a large Medicare community. The response has been to cut people at the bottom. Fewer people on the cleaning staff. They walked the experienced registration person out the door and replaced her with the semi-retired per diem who makes a million mistakes and a cheaper newby. And fight with the outsourced lab over every penny, so fewer people in the lab. My hours have been cut to the point where I started back at my old job last week and will hopefully transition to there full time and leave the shit hospital job for good.
I also blame certain doctors. There is one who automatically orders both a CRP and an ESR on his patients. They are different tests that measure essentially the same thing: nonspecific inflammation. There is no reason to order both tests, but he orders both anyway. That is enormously wasteful. Order the CRP and get a more specific result, sooner. Leave the ESR for outpatients that are having their arthritis monitored.
And there has been one doctor, and now there is another, who order a ridiculous number of blood cultures. Double sets of blood cultures on practically everyone who walks in the door. Again, wasteful. There are only rare circumstances when a blood infection should be suspected, and given the time it takes to get results, there is plenty of time to rule out systemic infection without going to that cost. But we see those doctors names on the roster and roll our eyes because we know we're going to be drawing a double set of blood freakin' cultures all night.
I've seen patients in ICU who were clearly within hours of death, with hands and arms black and vein-less as they're circulation shuts down. But we're still ordered to wake them up at 5am for routine chemistry so they can monitor everything to the bitter end. They belong in hospice, or at least allowed to die peacefully, without some poor, overtired, overworked tech sticking them over and over trying to find a functioning vein somewhere.
Our so-called healthcare system is, imho, sadistic. I've already decided I'd rather somebody just shot me then take me into *any* hospital that uses my lab chain. It's that bad.
The invisible hand wouldn't allow that.
