For Georgia and America to rescue their failing rural emergency rooms, state and federal legislators, hospital administrators, emergency medicine physicians, nurses, ancillary medical staff, patients, and the public at large must first come to terms with several simple and unavoidable truths:
1) Rural ERs are being abused by non-payers, drug-seekers, those looking for a work excuse or a free pregnancy test, and those who have no idea what the true purpose of an ER is.
2) Those in a position to do something about these problems aren’t doing anything meaningful about these problems.
3) Hospitals – even those listed as not-for-profit – are businesses, not charity organizations, and any hospital that is operated as a charity rather than a business will eventually fail (well, except maybe St. Jude’s).
4) Emergency physicians who refill maintenance medications including narcotics are partially to blame.
5) Malpractice lawyers aren’t to blame but social security and disability lawyers who encourage clients to visit emergency rooms to enhance their chances of a successful claim are partially to blame.
6) Most important, health care is not a right, rather, it is a personal responsibility.
For those who disagree, I invite you to pull a 24-hour shift with me in a rural ER to see for yourself. Unlike deluded Hollywood celebrities and disgruntled second-string NFL players grasping for their last 15 minutes of fame, my comments are based not upon something I heard at a party or read in Salon Magazine but, rather, on real-life, day-to-day (and night-to-night for that matter) experiences during the thousands of hours I’ve spent working as an emergency physician in several of Georgia’s rural ERs during the last nearly 20 years.
Working in a rural ER has an upside – saving a life, easing someone’s pain, making a sick child feel better. But there is a dark side, too, and only those who work in emergency medicine fully understand what I mean. There are those in society who want something for nothing, who demand much from the system but offer little or nothing in return, who believe the world owes them a living, and who accept no personal responsibility for their actions…and these people, it seems, frequent rural ERs in droves. The problem, at least from a policy standpoint, is that due to the insular and private nature of medicine in general, and emergency medicine in particular, the general public has little or no awareness of the abuse – if they did, they’d be outraged. To put the situation into financial perspective, every time you write that check to pay your exorbitant medical insurance premium, just know that you are paying for your own coverage and that of 8 or 10 other people you don’t even know.
To be sure, the problem is multi-factorial, as the above list attests. However, the most fundamental issue leading to the financial failure of rural ERs and hospitals is the leftist notion that health care is a right. For decades, beginning with President Roosevelt’s pre-World War II implementation of John Maynard Keynes hair-brained economic theories to the post-World War II influx of European socialists, those on the Left have attempted to indoctrinate Americans into believing all personal needs could be, and should be, met by the government. That led eventually to President Johnson’s colossal failure known as the “Great Society” program and recently culminated in President Obama’s $20 trillion dollar national debt attributable mostly to the massive expansion of Medicaid and the food stamp program.
In fact, people have no more of a right to demand that someone else provide them with medical coverage than they have a right to fill a buggy with merchandise at Wal-Mart and walk out without paying or to demand their next door neighbor mow their lawn for them while sitting on their front porch drinking sweet tea. Until this segment of society finally comes to understand that health care isn’t a right but is an individual responsibility, rural ERs will continue to be abused and, as a result, will continue to fail.