A friend of mine told me that his mother called him the other day and told him that she wasn’t feeling well, had a 100.2 fever and was going to the emergency room. He asked, “what kind of symptoms are you having, mom?” She said she was just feeling kind of under the weather and had this fever. He said,”don’t go to the emergency room. Wait until Monday and go see your doctor or go to one of the AM/PM clinics.”
What was it about the emergency room that made this son caution his mother about a visit there? He was afraid that it would cost a fortune. Why did the mother want to go there (by the way, she did go to the emergency room)? The real question is,”why not?” Her out-of-pocket exposure is virtually zero so it is human nature to match the demand with the perceived price.
This is the nature of entitlement. Something perceived as “free” makes folks demand things they don’t even need. Ever been to a store that had some items for 80% off? Ever thought, “I’ve got to get me one of those…I don’t need it but boy if I ever did I’ll sure be glad I got it now.”
“I was feeling ok but just thought I’d come in for a check-up all the same.” ”Why did you come in to see me?” ”Because Medicare will pay for so many visits a year.” Physicians see this type of behavior all the time. I think things would be very different if people had to pay for their own care themselves. I think there would be fewer emergency room visits if people had to pay for this service themselves. I think that without major changes that make individuals more responsible for their health/actions this bankrupting behavior will continue and worsen.
Phil Gramm, the former senator from Texas once said,” ..our safety net has become a hammock.” This, as the above illustration shows, has proven true.
G. Keith Smith, M.D.
