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Subscribe to RSSUp to half of the people who are treated at hospital emergency departments and trauma centers are under the influence of alcohol, experts say. That may be a sobering statistic, yet a recent study found that emergency departments can capitalize on this “teachable moment” to discourage problem drinking in the future.
But laws in more than half the states permit insurers to deny payment for medical services related to alcohol or drug use and that can derail hospitals’ best intentions, experts say. Faced with the prospect of not getting paid for care, some emergency department personnel may sidestep the problem by simply not testing patients’ blood or urine for alcohol.
In the study, published online in the Annals of Emergency Medicine in March, nearly 600 emergency department patients who were identified as hazardous or harmful drinkers (defined for men as drinking more than 14 drinks per week or more than four on any single occasion, and for women as more than seven weekly drinks or three on any one occasion) took part in a seven-minute interview. During the interview, an emergency department staff member discussed the link between a patient’s injuries and alcohol, as well as guidelines for low-risk drinking, and encouraged the patient to discuss what was stopping him from drinking less and to set a drinking goal.
Compared with those who received standard care, patients who took part in the sessions reduced their average number of weekly drinks significantly as well as their episodes of binge drinking and drinking and driving over the next 12 months.
“In the emergency department on a weekend, all the cases may be drug or alcohol related, and yet we don’t do” screening and intervention, says Gail D’Onofrio, the study’s lead author who is chair of emergency medicine at Yale University School of Medicine. “Our goal is to normalize this in the emergency department.”
Although some of the nearly 4,000 emergency departments screen patients for drug or alcohol use, it’s not required. Level 1 and 2 trauma centers, however, which are typically equipped to handle emergency patients suffering from serious injuries sustained, for example, in major car accidents, must screen for problem drinkers. Level 1 trauma centers must also be able to provide counseling.
Such screening and counseling can be effective, says Larry Gentilello, a trauma surgeon who has published studies on injury prevention and substance abuse.
“Most of the people who are injured don’t need to go into treatment,” he says. “They aren’t alcoholics or alcohol dependent. That’s why one counseling session can help them by talking about the risks of drinking.”
The extent to which so-called alcohol-exclusion laws deter emergency medical personnel from screening and counseling patients for alcohol or drugs is unknown.
The laws have a long history. Since 1947, more than 40 states have passed measures allowing health plans to refuse to pay for care if the patient’s injuries occurred while he was under the influence of alcohol or, in some states, drugs, say experts. As people came to understand alcohol addiction and the possibility of treatment, however, it became clear that the laws were counterproductive. In 2001, the National Association of Insurance Commissioners recommended against them.
Since then, at least 15 states have repealed or amended their laws and now prohibit exclusions of coverage for drinking or drugs, according to data from the National Institute on Alcohol Abuse and Alcoholism. Maryland and the District of Columbia are among them; Virginia’s law remains in place.
Regardless of state law, self-insured companies that pay their employees’ health care costs directly can refuse to cover employees for alcohol-related claims.
The laws have ensnared both problem and occasional drinkers.
Gentilello describes the case of a Seattle woman who was celebrating her 25th wedding anniversary and had a few glasses of champagne at dinner with her family. It was a rainy night and she was dressed up and wearing high heels. As she and her husband tried to hail a cab, she tripped on a curb, fell and broke her ankle. In the emergency department, her chart noted that she had a few drinks. Her insurer refused to pay. Washington subsequently adopted a prohibition on alcohol-related claims exclusions in 2004.
It’s unclear how frequently insurers continue to apply such laws to avoid paying claims. Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade organization, says the group doesn’t know what member practice is. Cynthia Michener, a spokeswoman for Aetna, says that “to our knowledge” the company doesn’t apply such exclusions. Other insurers, including UnitedHealthcare and Humana, didn’t provide information about their practices.
But a professor who has written about such laws says there are indications that health plans continue to use them to deny payment.
“There are tons of these cases,” says Sara Rosenbaum, a professor of health law and policy at George Washington University’s School of Public Health and Health Services. “The only evidence we have suggests that these cases go on.”
“There’s no reason to think that insurers, eager to hold down costs, wouldn’t continue” to deny payment based on such exclusions, she adds.
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In my younger day, if you were drunk the police would take you home, now you go to the hospital.
And then in front of a judge.
This is ridiculous. So if I have family over for dinner and we are all cooking in the kitchen with a bottle of wine being passed around and a knife slips off the counter slashing a foot, insurance won't cover stitching it up? Again..... this is ridiculous.
Blake- I agree, this is a bit much. What if someone has a few drinks, takes a cab home, but the cab is involved in an accident? That person has made responsible choices, and shouldn't be denied insurance coverage because they were injured after drinking, through no fault of their own. I'm sure this rule was made with drunk drivers, bingers, and those that take crazy risks in mind, but from what I read it's way too broad of a definition.
There's always going to be various ploys by all, including med insurance, to now save money and/or bilk people out of money. 4 drinks at one occasion, or however put, is now considered problem drinking? How many gather with friends, go to the bar, and have less than 4 drinks? 3 for women? Discrimination? I can see more than a 12 pack when something occurs, but come on.... this is just plain silly.
So, I suppose if one's 30 lbs. or more overweight insurance won't cover their claims, as it may be attributed to the weight. Actually, by their standards, 15 lbs. is more in order.
ModerationInAllThings: First, let me say, I agree with you - it's silly to not cover these accidents. Second, I would like to say, it's not discrimination (4 drinks for men and 3 for women) - it's based on science. The average man can process more alcohol than the average woman due to variations in weight and how effective the alcohol dehydrogenase enzyme is (basically, the larger the person, the more of this enzyme they have, the more alcohol they can tolerate).
I had a dog for 2 years that I knew had occasional problems with snapping, but was working with him; medically as well. He did one day bite me, extensively... I was scalped to some degree and had over 250 stitches on my head and forehead, just one grab (big Dane..... not his fault and loved him dearly, just for the record).
I had been drinking that day, it was Saturday.... I just went to kiss him goodbye as I always do before leaving. So under this BS, I'd be denied treatment? Drinking had naught to do with what happened, yet under proposed guidelines I'd be screwed? What's most frightening is that this seems to be something left open to interpretation, to discretion and thus personalities not only of the medical professional but also between care giver and patient. Rapport may become part of treatment and should never be. If a patient is known or a friend of a care giver, especially in smaller communities, will they be given a free pass even though they're known to drink or use drugs? The list can go on and on of just how fraught with problems the idea of this is....
Are you sure you didn't mistake a mountain lion for your dog...?
Summer, I would say that to some extent that data is outdated; men and women have, nowadays, little in weight difference given that as a society we're overall overweight (maybe have seen more large women vs. large men, actually... especially in the hospital setting). Having been out of college for over 20 years now, I can attest that in my partying days then girls drank as much as us guys, so tolerances have likely equated which has more to do with any than amylases for breaking down alcohol, especially when discussing 4 vs. 3 drinks. There's always some variables, but most are genetic now moreso than gender specific per drugs and alcohol.
Not trying to be disagreeative with you, Summer; I just think some stats and ways of thinking are out of date especially pertaining to genders and overall obesity problems. Tolerance has more to do with this than much else, and science seems to ignore these changes in social drinking in favor of leaning towards insurance lobbies and $$. But, we do agree that it's wrong and that's what matters. It is wrong.
That's not a word.
@ Summer - I think that typically, people process one drink (1 beer with 4% alcohol content) per hour. So if a person drinks 3 beers within an hour, sure, that can be too much depending on the person's weight. But on an afternoon bar-b-que with friends and family, a person might drink several beers and never become "drunk."
Alcohol is good for you in moderation, and a couple glasses of wine with dinner relieves stress. So a woman who drinks wine with dinner is now considered an alcoholic because she has more than 7 drinks per week? Are we for real? No wonder we're all crazy and taking anti-depressants! Relax people!!! Geez!!!
This mandate is BOGUS!!!
ModerationInAllThings: Actually, it's not out to date information. There are more factors than size differences in men and women that account for the difference, but it really has to do with with body fat percentage - women, in general, have higher body fat percentages which means we have (in general), less total body water. Alcohol distributes to the total body water over time, women have less total body water, which means they have a higher concentration of alcohol with lower doses of alcohol - which overwhelms the alcohol dehydrogenase. Alcohol dehydrogenase is necessary for metabolism of alcohol - so, metabolism of alcohol in women is slower, leading to a longer and higher level of intoxication when the same amount of alcohol is consumed between men and women. Thus, a woman will have the same level of intoxication with lower levels of alcohol consumption than a man. Furthermore, women, in general, simply make less alcohol dehydrogenase to begin with - so, that contributes to it.
There is a secondary mechanism of alcohol metabolism that kicks in when someone has expended their alcohol dehydrogenase - that's the MEOS system. It typically only kicks in in alcoholics and certain people of Asian descent that have a genetic deficiency of alcohol dehydrogenase. It's why people who consume alcohol either chronically or in certain Asians, appear red. It produces a different metabolite causing a flushing.
This actually is the biochemical basis of tolerance of alcohol - and why women, in general, are less tolerant to alcohol than men, in general. Yes, there are individuals that will go against the "general" population. But, it's just the way most people are.
Regardless - you're right, denying claims just because alcohol was involved is wrong.
@Chris; HAH! You're not the first to think that, especially those that saw me for the months following, but no... he was a Great Dane, old school size at that. Ironically (this most find amusing) we used to play 'hat of Dan'; whenever I'd wear a hat in the cold and what not, he always pulled it off and ran around with it, or would sit there and wait for me to put it back on only to take it again. One of our favorite games. Still love him, but had to put him down; children at home.
That would've been something, though; denying me treatment because I'd been drinking per insurance coverage. Quite costly, as you could imagine, and not like other things I'd super glued at home vs. going in to hospital... really no choice on that one. So.... I'd take on thousands of dollars of debt or go home and see if I got a fatal infection or not if this practice were in place; about 1/5th of my skull was showing. And, as an aside... it took over 2 hours for them to get someone in that could suture properly, so the plastic surgeon had to cut off the dead meat they couldn't save per letting me sit there that long WITHOUT pain meds or antibiotic IV, which he ordered as soon as he arrived. That should've been a no brainer; dog bit, scalped, .... need antibiotics and pain meds per IV. But, no... 4 doctors prior in and out and none did diddly.
Makes good sense to me. Same thing goes with many auto insurers. If you have an accident and are not wearing your seat belt, some have taken the stance they will not cover the accident.
It's a sad day when foreign criminals can get medical care but American citizens and taxpayers can be refused because they had a drink.
Summer; I remember college courses citing differences, but we do agree that this is not only ridiculous, but 3 vs. 4 drinks I find to be not only not worth scientific effort but a discriminatory way in for denial of treatment. 1 more beer for a woman, and coverage denied. Now, in the ER environment, having worked in hospitals for 6 years I've seen my share of self inflicted moronic activity the result of which being attributed to drugs or alcohol and it was more than obvious the patient was wasted. So, perhaps this isn't black and white as much isn't, but this seems more a way of paying for health care change that can't be paid for. It could also be another angle, but I don't really see this as being a viable change; worthy of letting the public know of it's considerations but doubtfull as to being enacted.
I'd hope....
Adrienne Picard I think all those are estimates and averages, with fatty meats and cheese to eat while drinking, I surely can process much more than that, as in your "barbecue" scenario :)
These rules are getting crazy. My wife was working for a builder. she had to go and meet the owner of the house to check out a problem.
The owners dog came out and bit my wife.
Then the company sent my wife to the hospital for a drug test.
After much complaining to the company they finally got the owner to have the dog tested for rabies!
What a crazy world!
Agreed. There are several problems with this sort of idea: 1) People do moronic things all the time. Sometimes they hurt themselves doing these moronic things. However, they are still people and if they need emergency treatment to prevent loss of life or serious illness, they need the medical treatment. Perhaps they'll learn a lesson and not repeat their moronic behavior. But, if we deny them treatment or if payment from an insurance company is denied over this, we run into problems. If they survive their injury/illness, but we bankrupt them in the process, they can become depressed - which increases the risk of alcohol use as a self-medication and can cause them a lot more other problems. 2) I think it could be difficult to enforce. For example - my friends and I go out occasionally (not very often, medical school really interrupts your social life), but when we do, we are all of legal age and always have a designated driver or take a cab. Say we get in a car accident - will the passengers that were drinking, but not driving have claims denied? 3) This could, potentially, have a negative effect on patient care. The article mentions that some hospitals will forgo doing drug/alcohol screenings (if there is no proof the person was intoxicated by lab reports, then the insurance claim has a higher chance of being paid). This means that if the person is intoxicated with certain things, they may not receive necessary treatments to better care for them - which means that their care is less than optimal.
This is a bad idea all the way around.
Shaking my head. I can see both sides of the story here... However, can't their be some compromise here? In my opinion, if I was below the blood alcohol content for drunk driving, my insurance company should pay the medical bills in an accident.
Guess what America... We get to use our tax dollars to pay for what the insurance companies won't cover on this one.
Moderation - I'm curious. You needed over 250 stitches from a dog bite. The dog has known issues and attacks and chews (a single "snap" wouldn't scalp you even if it was a hybrid gator-dane) and it wasn't the dog's fault? How is living in a world of denial working out for you?
This Idea that you can pay thousands of dollars to a company for so called health insurance and then go do something that is totally legal (drinking alcohol) and not having insurance if you get hurt is about the most assinine thing I have ever heard. Those of you that drink should deduct that time from your monthly insuance bill. Since when did insurance companies become social judges and juries? I guess if your speeding or do something else like run a stop sign you won't have auto insurance during that time next? Are these companies going to tell us next because you didn't climb the ladder correctly and you fell your not covered? I really think OWS is not doing enough or we need more people to stand up to people you pay. We could all do what Romney says and fire the people that work for you!
How dare people take any responsibility for themselves! Seldom will the hospital check for alcohol levels if you've only had a couple of drinks. Why would they? If you come in toasted and cut your foot off with a chainsaw because you were drunk and thought you could juggle them, then they might. I have NO problem in insurance not paying because someone was drunk and did something stupid, but not just because you had a glass of wine (but again why would the hospital check etoh levels for no reason?). You'd be amazed at how many people come into the ER for hangovers and our tax dollars pay for it. Auto insurance companies have been doing this for years, so it's nothing new.
On the other side: Just think as mandatory insurance becomes the law the insurance companies will find more and more reasons to cover less and less. Soon you'll be mandated to pay $1000/month and the only thing they'll cover is birth control, mammograms, and well care check ups because those things are required by law. The law has tons of pages but the specifics are vague, so tons of loopholes.
Mike, So where do you draw the line with responsibility and risk? Sure, drinking increases risk but so do a lot of other activities. Should we not cover sports injuries? After all, it's a risk they willing took. Should we not cover automobile injuries (driving is dangerous?) I could go on and on.
Do you think they put a clause in the "rules" that members of the House and Senate are exempt?
It is my understanding that in the US, if you arrive at the ER in serious condition they HAVE to treat you until you're stable, regardless of insurance or ability to pay. Once you're stable they can discharge you and refuse further treatment. The law may even extend to non-life threatening conditions, not sure about that.
This is why we are already paying for the care of a lot of people who don't have insurance to begin with - because the law requires it but never provided a way for public hospitals to get their money back except through higher bills for everyone else.
As for the alcohol thing - you bet your bippy the Insurance companies are still enforcing this. They don't let go of a penny the don't have to. Unless you're drunk this is a complete dodge and should be stopped.
ER's are treating, insurance is NOT paying, that's the story!
While mandatory insurance may become law it does not require one to purchase it. It provides "opt out" options by paying the "penalty" and the government will cover your premium through the penalties you pay. This is actually the better method since the government does condone stupidity and will cover you and will also under-charge for that coverage - bassed on past government performance. As such I will realize a nice increase to my take home pay even after I pay for the "free" government medical coverage.
Pregnancy is avoidable. Why should insurance companies be expected to pay for pregnancies when aspirin is so readily available? You want children? Pay for them yourselves. :-/
Obesity is avoidable. Why should insurance companies be expected to pay for illnesses associated with over-weight people? We should, all, be eating lettuce and grass-clippings. :-/
Inhaled carcinogens are avoidable. Why should insurance companies be expected to pay for illnesses/deaths associated with tobacco, work-related hazardous conditions, and smog? Stop that "pleasure" in life, insist that your corporation/business issue "hazmat" suits and face masks, and move away from congested, fouled-air areas. :-/
Traffic accidents are avoidable. Why should insurance companies be expected to pay for driving accidents? Stop driving. Don your pedestrian helmet (complete with face mask), your elbow pads, your knee pads, and shin-guards and walk to and from work/shopping. :-/
Sports injuries are avoidable. Why should insurance companies be expected to pay for broken bones, concussions, and other injuries associated with sports? Just do what I do; sit on the front porch and watch the grass grow. :-/
DIY accidents are avoidable. Why should insurance companies be expected to pay for these "accidents"? Broken bones and other injuries from falling off of decks/patios, ladders, stairs, step-stools, ... ad nauseum are commonplace. Stay away from heights! Do not conduct any DIY projects in and around your home. :-/
See where I'm going with this? Stop living! Just pay your "dues" to insurance companies. They own you and have over-whelming influence on your lives.
The issue with insurance companies is this. Most are insured through employers so people really don't get to pick and choose their insurance company. This means that there is no competition and they are a monopoly, so they can do and cover what they want. They've been screwing over doctors for years with no payments for various bs reasons. This is nothing new. They've also excluded many things for years!
As far as the insurance reforms go. Yes you can opt out but in a few years the cost of opting out will be through the roof. It will be the higher of the flat payment or an increasing percentage of your salary. That means it will be mandatory and you have no choice, so if it's not legally mandated they won't have to cover it! Sadly, until it gets painful enough that people get tired of it do not expect it to change. The executives of insurance companies are significantly made up of former politicians (both democrats and republicans) so don't look for political help anytime soon.
Your only option is to take personal responsibility for your health and pray you don't need to use your insurance that the government will require you to purchase. Perhaps one day we'll get patient care reform and the candy store will be taken from the insurance companies. But don't expect it too soon as they have deeper pockets than any of us individually and Washington is ALL about money!
Just another way for the medical industry to deny people health care.... Well the way I see it, Alcohol is a legal substance in the United States. If someone gets hurt while drinking, (Partying, falling down, etc.) then they should be legally treated in the Hospital just like anyone else who gets hurt. What are they going to say next to someone..."Oh you fell huh? Well maybe I smell Alcohol on your breath." lol
Did you misread the article, or are you being disingenuous on purpose? The people are treated at the ER, but because of the alchohol or drugs involved, insurance companies in some states are not paying. It's a question of who's paying, not who's getting treated. It's a violation of federal law for an ER to refuse to treat a person who comes through the door.
kg - The point was not whether the patient was treated but the insurance was not paying because of consumption of alcohol - a legal act. Yet the insurance will pay for the results of a car crash that resulted from speeding - an illegal act.
And if you actually read the article - you would find that hospitals are indicating that they will not check for alcohol if they start being stiffed by the insurance companies. Hospital administrators are not stupid - they will not do things that cost them money.
That's the way it should be all you Sauceheads take note stop drinking yourself silly and being obnoxious and stupid and maybe somebody will help you. Now lets compare numbers here who has the most ER visits Alcohol consumers and the victims of some dumbazz that's been drinking. Alcohol is nothing but trouble in too many ways to describe. But hey everybody it's legal so it's got to be OK. What a bunck of ignorant F@*KS.
You still don't get it. There are many of us who drink in moderation and safely. Some of us may then have accidents or medical situations unrelated to alcohol.
Then no payment from insurance for those who are obese, have diabetes and need insulin. Stop freaking eating.
No payment for cardiac bypass surgery or stents for anyone who has a BMI over the ideal or has had a hamburger in the past year.
No ranknfile, this is not how it should be.
If you are such Moderation drinkers switch to Non-Alcohol beer. Won't because you drink to get High admit it.
Im sure they will test to see if you are over the legal limit. Funny how some people automatically go straight to the extreme on issues which leaves no room for discussion. If you are legally drunk beyond the legal limit then I do not see an issue with this.
If you have auto-accicent injuries and were driving a sports car or a motorcycle you should also be denied because hey, you asked for it. Right?
*moot.
There is nothing more pretentious than a sanctimonious teetotaler.
LOL...True...except maybe an abstinent birth control opposer!
How about no coverage for NRA members who accidentally shoot themselves?
I'm with you sam adams, as long as they also deny coverage for pregnancies of birth control opponents.
And the award for most retarded post on the internet today goes to ... RANKNFILE!!!!!
1. You don't get high from drinking.
2. How is it any of your business if somebody has a drink or two to get a buzz? It's not your business, and it's legal so STFU.
3. Alcohol is only a problem if you abuse it. The conversation here is not about abusing alcohol. So everything you said is null.
4. Learn to read, learn to comprehend context, learn to spell, learn to not judge, learn that your opinion is not always right, learn how to gain knowledge beyond your bubble, and most of all learn how to not make a fool of yourself on the internet.
5. Finally, just for good measure, you sir are an IDIOT. Have a good day and enjoy your life of mediocrity.
Norm those words were spoken so eloquently just like an ANGRY ALCOHOLIC Your Morgue Slab Awaits.
@pjam - some auto insurers already do deny auto accident claims if they find out you were not wearing a seat belt.
Keep big insurance companies from getting between you and your doctor!
This article is about ER doctors treating patients who are under the influence of drugs or alcohol and insurance companies who don't want to pay for it. My doctor is not an ER doctor. Is yours? In no way does this article say my insurance company is coming between me and my doctor.
Some states don't allow the exclusion and insurance companies have to pay. It seems to me like a bit of a grey area. Take life insurance, for example. If you commit suicide, your life insurance company is not going to pay a dime to your surviving spouse or estate. And that makes sense, right? But when it comes to alcohol or drugs, a person could have an accident that has nothing to do with the impairment caused by the substances, so it wouldn't seem fair for an insurance company to not pay in that case. The problem then is that there's no clear way to define when an insurance company will pay and when it won't because it will be too arbitrary. And when there's no clear policy in place, insurance companies find ways to not pay. So, even though impairment is self-inflicted, I still think that insurance should pay in order to protect the people who might be injured when such injury has nothing to do with the impairment.
Is suicide a good example to use for analogies? After all, most people are successful at committing suicide so there is a known and anticipated result while insurance is to cover unexpected/unanticipated results. Therefore, insurance companies specifically exclude purposeful acts such as suicide, owner-induced arson, etc.
good, its about time; People have to be responsible for themselves. Why should our insurance rates go up because of drunks?
Johnnyboy
They are going to go up anyway. Hospitals are not allowed to refuse emergency treatment. If the insurance company denies payment and the patient cant or refuses to pay the cost is shifted or it comes out of patient care. one way or the other you will pay.
Drunks today, but tomorrow they might decide not to cover you because you took pain medication or because you ran the red light and therefore it was your fault that you weren't paying attention. It can be anything. If you are paying for insurance, you should be covered period, even when you did something stupid. It's like saying you won't cover a woman's rape kit or medical after she was attached simply because she had a few drinks.
johnny - "Why should our insurance rates go up because of drunks?"
I'd much rather pay for drunk citizens than foreign criminals any day. Remove the burden of 15 million illegals and drunks can easily be handled.
why should my costs go up b/c people smoke or are obese? Smoking and obesity are preventable. All you people who are about to jump my a$$ about obesity being preventable, I'm sorry, but in 99% of cases it IS!!! I enjoy my wine, but I don't smoke, I work out 5 times a week, I have low cholesterol, and low blood pressure, yet my costs are skyrocketing because of smokers and fatty mcfattersons.
Well then there wouldn't be much use for most of the medical industry. But when for instance will we determine whether a person's lung cancer is self-inflicted or environmental or occupational, posthumously? Let's stay off that slippery slope and just eliminate the profit taking middlemen and have universal health care or at least a system like Japan lower cost better outcomes.
Hey, what about joggers who are slowly damaging their ankle and knee joints?
What about athletes who get injured while playing? A football player with a concussion? Basketball player with a broken something?
What about drivers? Driving in an inherently dangerous activity, even when you are following all the rules.
Should we stop paying for these people whenever they engage in the above activities?
How about the drug user overdoses, will we still treat them in the ERs? A person can die from alcohol poisoning just as the addict from a drug overdose. What's good for one group is good for the other.
ER's treat everyone, its insurance companies paying the bill that we are talking about. But to answer your question, Doing drugs is NOT illegal, having them in your possession is. So, if it is not illegal to do drugs, then insurance companies should cover the treatment, whether it be overdose, or accident.
we are becoming more and more "dictated to". The freedom in America has been lost to corporate money and politics. There is coming a day when we will rise up against each other again and fight for our freedom back.
Screw this, I am going to the medical surplus store and buy my own IV Drip so the next time I blow a .43 I'll hook myself up at home. Your not getting my business any more!!
Don't you all know that the insurance companies know what is best for you? Now go to work, pay your premiums, go home and wait till you can go back to work to pay more premiums. Don't eat fatty foods, drink alcohol, smoke, or do anything risky with your life otherwise you'll cut into the insurance companies profits.
Argh
Nor will they cover people that think they are pirates
Oh, awesome. Yet another way for insurance companies to not give us what we pay for.
So if I have two beers with dinner at a restaurant, take a cab home, and it gets in an accident, you don't have to pay regardless of the tens of thousands of dollars in premiums I've paid over the years.
Guess what? F--k you. I'm going to cancel my health insurance and just not pay any medical bills I incur.
Pretty sure the cab's insurance would have to pay in that instance.
These dam law makers are just too much. They all drink but they expect us to be perfect which does not exist. Again big business trying to run our lives. Insurance is for accidents if not what good is it.
I don't see cops or law makers not drinking they support the liquor industry more than us. They want all of us to go broke and only have the rich have anything. We may have to have a revolution to bring down the rich and crooked law enforcement and law makers. Just not right and it never stops with what they want to take away from us.
I guess this makes me for the national insurance plan Obama put in place.
Being a nurse in a metropolitan, academic hospital trauma ICU, I can tell you that in a large percentage of trauma, alcohol and drug use is a factor. As I was reading this article I thought maybe the health insurers, who are NOT my favorite people, should impose a surcharge on patients who are injured as a result of their alcohol or drug use as determined by their blood serum/urine testing while in the emergency department. These are standard tests in a trauma work-up so no one would be looking for information which isn't relevant to the event. This surcharge is similar to what the auto insurers, also NOT my favorite people, do when you have an accident. It might make some people realize the connection between their bad behavior and their injuries, not only to themselves but to others, not to mention the societal cost. When the penalty comes out of one's pocket, people tend pay more attention to their behaviors.
That's all well and good, but they're not differentiating between someone who's had a couple of beers and got bitten by a spider, and someone who drank a case and wrapped his car around a telephone pole. They need to make the definition for denying coverage much, much more specific. Otherwise, they're just laying the groundwork to deny as many claims as possible, which is a really sh-tty way to do business. Not that I expect any better from them.
Respectfully to you Diane, the true Alcoholic would not be phased by a surcharge. Hopefully, they have a Big Book of AA around there where you can read the forward called the "Doctors Opinion". That is reality with what you are dealing with. Thank you for your service.
This seems like a good alternative but what about extending it to obesity, smokers, ect.. This would open a whole can of worms most politicans would not want to open.
The law should just stay out of this entirely. If I want to drink, I just purchase a plan that doesn't have an exclusion. If I don't drink, I purchase a plan that does. The insurance companies should be able to tailor plans based on what people want to buy, not what the government thinks they should cover. The only thing the government should do is make sure the companies clearly state what is and is not covered, and punish those companies who fraudulently deny coverage.
As for drinking... I say and do stupid things quite enough when I'm sober, so I never had a desire to drink alcohol.
You should try it. Makes food taste better for some reason.
Oh, yeah? What about if you're sober but speeding in your car and you get yourself into an accident and need medical attention? Or someone is drunk, a fight breaks out, and non-participants who are drunk but get hurt need medical attention?
Sezyou, that's what the courts are for: they assign responsibility and blame.
People were worried about the government "rationing" their care. But the way i see it, the current system does just fine rationing it on its own, by pricing it out of reach for those without insurance, and then the insurance companies deciding what you can and can't have covered.
So you think health insurance companies charging 1500 dollars for a premium simply because someone suffered permanent damage through no fault of their own is just hunky dory?
Morlack,
I think that was the point brian was trying to make.
Morlack, health care is already rationed. Unfortunately, most people don't see it that way. Universal health care would allow everyone in the country access to health care. The US is the only industrialized country in the world without universal health care.
Seems like something's wrong with us.
Just because others countries have universal health care doesn't mean it is the best.
deb-colorado
Really? How about Great care for ALL!
True universal care will never become a reality in the US because as soon as you start talking about limiting what care a person can receive people start complaining that it's not fair. On one side if you won't cover a 95 yr old person getting a triple bypass you support death panels or the other side insists that not covering abortions is anti-women. So the far left and far right will never agree to something in the middle and they run the political parties.
That aside, right now we actually do have a form of universal care. If someone is willing to go to the free clinics or med schools they can often get care for almost nothing. They may have to wait hours or visit a larger city but it is there.
The real argument should be about making sure every gets affordable emergency medical and basic wellness care. That could be done by flattening out the current insurance system, which has monopolies within each state. 30-60% of every healthcare dollar goes to something besides healthcare when 50+ yrs ago it was only ~ 10%. That is the real problem, the system is top heavy. Even limiting insurance companies to 20% doesn't help, as we still have another 20-40% in overhead from businesses handling insurance to cost of billing to hospital administration to medication development.
Another case FOR Universal Health Coverage!
So many people actually require probably more than one er visit before they grow a brain? Pitiful and stupid.
“There’s no reason to think that insurers, eager to hold down costs, wouldn’t continue” to deny payment based on such exclusions, she adds. They dont do it to "hold down costs"! They do it in order to get 100% of premiums for free to enrich themselves!
My brother in law is a BUM who drinks up to 3 weeks straight with no food ( no kidding ) at least every 2 months, yes he is a complete loser and we have to drag him to the hospital or he would drink himself to death. He denies that he has a problem and this is always the last time (until next time). I am probably venting but why should he be covered when he is doing this to himself over and over again, of course he has no coverage so you and I pay for his care whether we like it or not. This is not casual drinking this is extreme and I am talking filth and nastiness that most of you have never seen before, I have no sympathy for him anymore and people like him make it bad for casual drinkers who get cut or slip and fall or something.
Why don't you just let him die so the rest of us can stop paying for him? Seriously.
Also, please describe this "filth and nastiness that most of us have never seen". I like to hear about how sh-tty other people's lives are.
Can't do that Chris, I'm married to his sister. He will eventually die one way or the other.
You most certainly can. My future brother-in-law is a similar drunk (literally wakes up and waits at the front door of the package store until it opens to get his first fifth of the day), and he's banned from our house permanently. She cut him out of her life. You can only try to help someone out so much before you just have to let them go.
Chris you say your future brother in law and then say she cut him out of her life? I hope she doesn't marry this bum, as for my brother in law I don't care JACK about him but like I said I'm married to his sister and every month or so she has to scrape him off his soiled bed and pack him off to an emergency room for FREE TREATMENT. This post is about hospitals cutting off treatment for alcohol related issues, he has milked the system for years and yes he should be denied and sent to rehab. He needs treatment not another couple of days drying out at taxpayers expense only to be right back there a month later.
What? No. I meant my girlfriend's brother, not my sister's husband.
Good luck Chris, you will be going through the same thing that I have to deal with on a 30-45 day basis until he decides (if ever) to grow up.
The whole point of the medical industry is to provide medical care. Denying coverage is not about managing costs, just about maximizing profits. When coverage is denied, and the problem not dealt with properly, it is only likely to get worse and require more medical care later. In the end, this just drives up the cost of health care.
this is depressing... just another ploy for control. More rules and laws to control and reap the working peoples pockets. work , pay, work pay , no play!! watch your behaviors! its only a matter of time before they control everyones behaviors , wont matter if you dont drink , use drugs, over eat it, will be everyone soon enough.
If they want to do that, which is not a bad idea.
Lets do the same for smokers, drug users and other abusive habits that cause people to run to the emergency rooms. I gotta think we would see a reduction in hospital, medical and in turn insurance rates.
Also, how about athletes, drivers and children. All of these people have a higher tendency to go to ER's as well.
If we are going to have a socialistic health care system, where dregs are provided subsidized insurance...we should refuse treatment if they use illegal drugs. And limit coverage to the basics- set a broken leg, hand out aspirin...but any real insurance should require purchase of a higher quality or coverage.
Wow, the media reports that we NEED to do this. Then, they will look forward to the day they can report about the "discrimination" taking place as ER doctors "refuse" to care for the "needy". The Democratic controlled media is a joke. They say they are like Edward R. Murrow but report like they are the Nat'l Enquirer.
What a joke. They offer no proof that Obama is truly a citizen, other than they say so. Yet, they questioned former candidate McCain's citizenship, because he was born in Germany. Never mind he was born to TWO US citizens on a US base (sovereign US soil). You liberals will accuse me of "being one of those". Sure, one of those who refuse to accept the US media propaganda. Yes, that is me.
The USA my dad and brothers fought for is no longer. The liberals who refused to serve are making this a rotten nest of garbage based on their fairy dreams of everything being everything to everybody. Sure. Like all their ideas, it is long on dream and short on reality.
if you don't like THIS america feel free to leave it. mccain's citizen ship came into question only to show the idiocy of your quest to see obama's birth certificate. your views on who served don't bother to mention the children of the rich who were nestled into hiding places when their turns to serve came. funny that the USA that you yourself didn't fight for is what you mention and then proceed to how liberals refused to serve. does that make you a liberal?
sincerely, son of a liberal vet.
Rwing, your denial isn't America's problem. Your foolish insistence that President Barack Obama's original birth certificate be released was at last granted, to no avail. If we could travel back in time and film him emerging newborn from the body of his mother in Hawaii, you people would doubt the evidence of your eyes.
There's a black man in the White House. He's doing a good job turning the economy around in spite of getting no help from the GOP. He'll probably get re-elected for another term. Learn to cope.
McCain was born in Panama, not Germany. My, you are misguided. Get your news from Fox, do you?
LOL....
Well, studies DO show, Faux viewers are the least educated!
Another instance of corporations abusing their customers. Will the insurance companies pay for substance abuse counseling? If not, they are denying their clients coverage both for acute care and for long-term wellness. ERs cannot refuse treatment, and ERs are closing everyday because their hospitals aren't getting paid for service rendered. Also, chemically-impaired patients are not all alike. A single intervention may work for somebody who got drunk&stupid once, but will only waste the staff's time when the patient is a chronic alcoholic whose luck finally ran out.
Most do not.