9 Patients Made Over 2,600 Hospital Visits

CBS Evening News: How A Few Homeless Patients Monopolized Emergency Care Resources, And How To Fix It

(CBS)  At one of the busiest emergency rooms in Texas, simply keeping up with the daily flood of new patients is challenge enough. But at University Medical Center Brackenridge and several other ERs in the Austin area, it's a handful of familiar faces that have taken up massive amounts of time and medical resources, reports CBS News correspondent Don Teague.

Nine people visited Austin's ERs more than 2,600 times in six years, according to a report from the nonprofit Integrated Care Collaboration, a group of health care providers for low-income and uninsured patients in Central Texas. One of those people went to city emergency rooms 145 times last year alone. All told, the cost for treating the nine people was more than $3 million.

For reasons of medical privacy, CBS News can't name the nine patients. But three of them are homeless, seven have been diagnosed with mental problems, and eight are drug users.

And doctors think that the problem is much bigger than Texas.

"Every ER doctor anywhere in the country can tell you who their top 10 list is," said Dr. Christopher Ziebell of University Medical Center.

Overusers are part of the reason trips by Americans to the emergency room rose 30 percent in 10 years - from 93 million per year in 1997 to 121 million ER visits annually in 2007.

In the Austin cases, the overusing patients usually complained of chest pains, at times running up diagnostic bills of $20,000 in a single visit, and forcing other patients to wait.

"It really detracts from what we're able to do with those individuals who are really needing more acute care," said Dr. Stan Rice of University Medical Center.

And since the overusers can't pay for their care, emergency care costs more for all of us.

"If we're talking about $3 million among nine people in Austin, Texas, then we're talking about hundreds of millions of dollars across the nation," Ziebell said.

The report's authors say the key to solving the problem is technology: Identifying those who abuse the ER system, saving time, money and resources for the patients who truly need care.

[hetup-2009]

It is the illegals the hospitals hire for cheap. Massive profits.

Most of the heavy users of ER are single moms with 8 or more children in tow

[shockolit]

Geesh, every time we have had to go to the emergency room there were no illegals there. Where are you all seeing all these illegals? How about all the jobs companies have sent overseas because these other countries have socialized medicine, and it saves the expense of providing health coverage?

[incog-nito]

The utter idiocy of those who want to get rid of Medicare is beyond comprehension. They support the current employer-based system which, by its very nature, does not insure retirees or people who are out of work. They actively support a system that considers their retired parents or grandparents a "high risk" group. They expect older people to go without health coverage at a time when they need more of it, and when their income is fixed and limited. They seem to have no problem with the virtual certainty that these older people will become destitute the first time a major illness hits, or worse, to die because the health care simply isn't there.

[jd2408]

And no one blinks at the fact that it's possible to run up such a bill on chest pains in a single visit? Let's put things into perspective here! We can complain about the 'users' of the system, but they are few and far between compared to those (read: the rest of us) who get stiffed by the unjustifiable and inhumane cost of care in the USA. Puh-leeze. Bring the costs down to reasonable (meaning insurance companies, manufacturers and doctors do away with their gazillion percent profits) and then tell me about the users. Until then, I really don't care. Posted by tmonta67 at 11:38 PM : Apr 4, 2009

========================================================================

Amen, this is so true. The nursing home did not have an opening for my neighbors 87 year old husband and they had to keep him in a hospital care center for a short time. The hospital doctor called in ( 9 ) specialists to come in. Everything from a foot doctor, brain specialist, cardiologist, you name it. I think he was there for one month when he was transferred to a nursing home and died the first week he was there. My neighbor told me she could not understand what they were doing and they did not share information with her. They took her life savings except for $3000 dollars they said she could keep. I hope President Obama can take an honest look at this health care system that seems to be more like big business.

[incog-nito]

Posted by YouCantBSirius at 10:01 AM : Apr 5, 2009

You idiots don't get it. Medicare is NECESSARY because your heroes the private insurers will NEVER write an affordably policy for older people. Without Medicare MOST retirees on fixed incomes will not have any health care coverage from the current employer-based system, because they're not working, get it? And they're the ones needing health care the most. Are you saying that when older people get sick they should be left to die? Are you that stupid?

[runningralph]

In the 1930's, the US taxpayers started giving away money. In the 1950's there was a huge class of takers. Also there is a huge class of businesses whose sole product is squeezing money out of taxpayer giveaways. All these give away recipients and businesses created to take advantage of them are nonproductive people taking from productive people. The only way to increase wealth is through mining, agriculture, and manufacturing. If the government keeps taking from producers there will be no reason for producers to produce. The government's job is to is to keep taxpayers safe and try to create more taxpayers and productive citizens. Giveaway programs have the opposite effect.

[tmonta67]

"complained of chest pains, at times running up diagnostic bills of $20,000 in a single visit"

And no one blinks at the fact that it's possible to run up such a bill on chest pains in a single visit? Let's put things into perspective here! We can complain about the 'users' of the system, but they are few and far between compared to those (read: the rest of us) who get stiffed by the unjustifiable and inhumane cost of care in the USA. Puh-leeze. Bring the costs down to reasonable (meaning insurance companies, manufacturers and doctors do away with their gazillion percent profits) and then tell me about the users. Until then, I really don't care. I'm almost tempted to say 'good for them', as unreasonable as that is!

[element51]

Phxfire.......Trying to reason with these Obama haters on here is an exercise in futility. No matter how much factual information you provide they will still blame Obama. Ask them why, when they had the chance, did they refuse to require that the government be able to negoiate prices with big pharma the way the VA does. Could it be because big pharma showers them with money to get re-elected? The Obama haters will blame Obama. And universal health care will NOT solve all the problems but it will certainly help a lot of people. I believe that most Americans want to work and take care of themselves but the system is stacked against them. There used to be regulations in place to control the health care industry......until Ronald Raygun removed those regulations. We need to put some regulations back in place before it's to late. But the haters will cry, "socialism" and the politicians will do what big pharma tells them to do. It's going to be very difficult to get any meaningful legislation passed when all the republican party can do is scream no, no, no!

[Phxfire]

1. Its not an 'Obama' caused problem, so back that truck up. Universal care is about providing health care when its needed, it has nothing to do with rewarding abuse of the system. If you want to point political fingers, how about the madness in Medicare and the Veterans? Something the conservatives in the Administration and Congress chose to ignore for 8 years, too much invested by many of the same people we should have expected and received reform from...(they and their lobbyist friends).
2. Drug treatment programs are largely volunary. You can provide the information and assistance, but they have to agree to participate.
3. The biggest abusers aren't illegal immigrants. Its the US citizens who aren't covered by insurance, aren't paying taxes and use the ER as a clinic for non-emergencies. These are facts, not hysterical and bigoted opinions.

[incog-nito]

I am really glad that they finally looked into this. I work in the field and constantly see these "freguent flyers" who are doing nothing more but milking a system that does not keep track of their abuse, and they are not all mentally ill, most are just looking for the best drugs. Now Mr. Obama how do you intend to fix this in your universal coverage?

Posted by workingmom3 at 4:17 PM : Apr 3, 2009

Universal Health Care is not a panacea that solves everything. It's intended to provide affordable health care to all Americans, especially those who currently cannot afford it for reasons such as unemployment, age, pre-existing conditions, etc. This is an issue that affects most Americans, even those who currently have insurance. All it takes is a lay-off or simply changing jobs, and a family can find itself without coverage (employers can make you wait 90 days before giving you coverage).

Saying that universal health care should solve everything, and then deriding it because it cannot, is not exactly a constructive way to tackle the problem.

[panamasandy]

If the patients were "drug seeking" wouldn't it have been cheaper and more effective to refer them to drug treatment?

[workingmom3]

I am really glad that they finally looked into this. I work in the field and constantly see these "freguent flyers" who are doing nothing more but milking a system that does not keep track of their abuse, and they are not all mentally ill, most are just looking for the best drugs. Now Mr. Obama how do you intend to fix this in your universal coverage?

[mollydtt]

You never want to go to an ER. Even if you are close to death, the wait time alone will kill you. I have had to take my daughter to the ER twice over the past 18 years, and I felt extremely lucky to only have to wait a couple of hours each time.
Someone said that the state pays for the health costs incurred by illegal aliens. Actually, it is the hospital district (county or city) that covers the cost.

[bobnjersey]

[In the Austin cases, the overusing patients usually complained of chest pains, at times running up diagnostic bills of $20,000 in a single visit, and forcing other patients to wait. ]

gee ... i've complained about chest pains and they give me a chest xray ... which costs $75. what are they doing that costs $20k?

[brianlevin]

has there been any investigation of the cost to hospital Emergency Rooms for the behavior health patient in need of a psychiatric evaluation? My professional experience has shown that patients need to be "medically cleared" before they can be psychiatrically evaluated. I have heard of situations when patients have spent entire weekends in an ER bed waiting for the psychiatrist to return to the hospital Monday morning. This must be a huge expense to the hospital, not to mention the unfortunate and unnecessary ordeal for the patient and their family. Has this ever been examined? signed, [e-mail]

[czechtraveler]

Federal law requires hospitals to treat patients no matter their ability to pay........my hospital wrote off over 35 million dollars in unpaid bills last year......in our ER we see the same GOMER's over and over........some get discharged and go out in the parking lot and call 911 to return........yes we see many who do have serious chronic illness and they use the ER because it is an easy avenue for their healthcare even though they can go downtown to a clinic.......i'm in favor of socialized healthcare and hope Obama makes it happen.........everyone in America already has healthcare.....it's called the local Emergency Room

[sockeye35]

Omnibus,
I think you have missed my point which is that of the overstated hard costs reported by this particular hospital. The hospital is reporting its unpayed cost for these visits as $1153 per visit. What I, a paying customer, would have to pay for service is obviously not going to be the same as the hospital's costs because they have to make a profit.

[incog-nito]

Our family has dual medical insurance coverage. Our son sliced his hand on a Friday night. Had to go to the ER. Exam, numbing shot, 3 stitches. Total time with a healthcare provider (a PA, not an MD) was less than 20 minutes. The bill? 1648.00. That must be to make up for the millions of illegal immigrants who use the ER and never pay the bill...

Posted by kirstinharr at 5:28 AM : Apr 3, 2009

Wrong. It's the insurance company ripping you off. The state pays for illegals' health care. Don't get too confused now.

[element51]

It mentions in the article that a large number of these people were mental cases. I remember back in the 80's when the great Ronald Raygun decided that we were spending to much money on mental hospitals so he shut them all down and many of them returned to the streets. It was a great way to deal with the "problem."
I am on Medicare and not long ago I began to suffer severe chest pains. Normally I go to the VA clinic but it was Saturday and they were closed. I was in severe distress so my wife took me to a urgent care clinic. They put me in a room and a nurse came in and took my blood pressure then a doctor came in and asked me how I was feeling. The pain had eased and I told him this and he left. They came in and told me I could go. I gave them my medicare card and they took the information and I left thinking this would be covered by medicare. About a week later I got a bill from the clinic for 585 dollars. When I called they told me to pay or it would be turned over for collection. So I paid and now I'm afraid to seek treatment should something happen. I still don't understand it. I thought I was covered but I guess I was wrong.

[icjunior97]

There is a long list of things wrong with our health care system. My Mom has worked in the field for over 35yrs. The stories I hear are beyond crazy. The amount of illegal people using our system is through the roof no doubt. But she had a lady, who worked, but her insurance hadnt kicked in yet. She had a stomach pain, so they want to check to make sure her apenix was not infected. A simple blood test would check her white cell, a sure sign if it is, cost 25 dollars. No the doctor made her have a Xray cost $2000. Come on now.