[ShynneRN]

A few days ago at work (emergency department of a rural hosptial), a physician, some RNs, and I got into a discussion about Medicare and Medicaid. The night earlier, the physician was watching the national news talk about the democratic party wanting drug companies to lower medication prices. As the discussion progressed, we also debated whether or not Medicare and Medicaid (especially Medicaid in his opinion) should have out-of-pocket co-pays for ER visits, etc. Since alot of the patients that we see are actually non-trauma, Medicaid patients that choose the ER because they don't have a co-pay and Medicaid ends up covering the bill, this physician feels that enforcing a co-pay (and a higher co-pay for ER's than doctor's office visits) would free the nation's ERs for more serious traumas and reduce the workload and stress in many critical care situations.

What the pro and con opinions that you all have regarding this matter?

Here's an article about the 2007 democratic healthcare agenda:
http://www.medicalnewstoday.com/medi...p?newsid=60040

[cassioo]

some of us have had a similar discussion and I think the majority of my co-workers and docs think there should be some co-pay even $3-$5 per visit. Sure there are people that can't even pay that but there are plenty that can pay that small amount but it would maybe make them think twice about abusing the system... we had a girl (OB) the other day who the doctor told her to come to the office and he'd work her in after 3 but she didn't want to wait that long so she went to ER and they didn't get to her till after 5 so then she ended up spending the night c/o N&V and she had phenergan which is what the doc would have given her had she gone to the office. Most of the patients I see with a medical card can afford to smoke and they ask for "guest" trays for their boyfriends which are $8 each and want a private room (yes we still have semi privates) and privates are $25/night extra...those extra charges do get billed to them but if they don't pay they don't care if it gets turned over to collections where if I didn't pay my bill it would go to my credit rating. OK I agree with a co-pay.