Monday, January 20, 2014

D for Dangerous

I read this in the Atlantic Wire and went "wow really?"  Well no I didn't.  After spending the better part of the last few years pointing and laughing at the debacle called the Affordable Care Bill, which does nothing with regards to 2 out of the 3 parts of the name. Bill yes as we will see plenty of them.

And then I went to catch a bus today and saw a major accident that right now I still reel from shock.  A car racing lost control and crashed into a pole then into a cement wall crushing one vehicle and splitting the other car parked into two pieces.  Apparently both driver and passenger are alive but in critical condition,  I had to leave, too many memories and horrors of my own to remain and be the looky lou as one woman did at mine, not even bothering to call 91,  yet spoke to every Police Officer on the scene.  She saw nothing only heard the impact but waddled down to poke her nose into the accident and did NOTHING to save or help me.  I call her a Cunt but the man who did save my life, aggressively pushed for care and stood by and tried to talk to the Officers on the scene who also never laid eyes or hands on me, don't seem to recall this Gentle-man.  Funny he recalls them and me two years later.

I could not nor would rise up to either of those two, I had to leave.  I knew the song, both the lyrics and the tune to this one and had no desire to repeat it.

And I also knew the drill they would be taken to Harborview Hospital and if not dead by arrival they likely will be with the agents of death there.  Once evidence would be taken to make the lack of investigation easier, they will be placed in the dumpster or thrown out to families confused, frightened and intimidated by the goon squad staff of "social workers" employed by Harborview to cover up their incompetence and laziness.  Know that song too.

So read the article below and pray you never need help of any kind, you won't get it nor can get it. Few times you use the two conjunctives together - won't or can't - but I did today and I don't feel good about it nor should I but this is Seattle and we have other priorities to care about, human lives no, but the 12th man yes.  Sad. Grim.Pathetic.

America gets a barely-passing grade on overall emergency care, according to a report card issued the American College of Emergency Physicians (ACEP), which is pretty terrifying for those of us who live here and don't want to die in an emergency.
The overall score is a weighted average of the country's grades in five categories:
  • Access to Emergency Care (30% towards the total): D-
  • Quality & Patient Safety Environment (20% towards the total): C
  • Medical Liability Environment (20% towards the total): C - 
  • Public Health & Injury Prevention (15% towards the total): C 
  • Disaster Preparedness (15% towards the total): C - 
According to ACEP, the categories are "based on 136 objective measures that reflect the most current data available from reliable public sources." ACEP adds that these measures "represent factors vital to life-saving emergency care and meet the key criteria of relevance, reliability, validity, reproducibility, and consistency across all states," which means the U.S. scored a C at best on every meaningful aspect of life-saving emergency care. For context, the D+ score is actually lower than the C- the U.S. scored overall in 2009, the last time the report card was issued.

Though the news overall is somber, some states did see individual improvements. This year, Washington D.C. beat Massachusetts for the top spot overall, and Colorado and Ohio made it into the top ten for the first time. But a number of states also took an unprecedented plunge to the bottom fifth, including Alabama, Montana, Illinois, Alaska and Louisiana. At least those states aren't Wyoming, which got a flat-out F.

In addition to D.C. and Massachusetts, Maine, Nebraska, Colorado, Pennsylvania, Ohio, North Dakota, Utah and Maryland are among the top ten states in emergency care overall. But the gap between best and worst states has increased:
In 2014, the highest grade received is a B- and the lowest grade is an F. Comparatively, 2009 grades ranged from a B to a D-, reflecting a declining trend in overall state grades and contributing to the overall worsening national grade. While four states received grades falling in the range of a B in both Report Cards, the number of states with a C grade has dropped dramatically. That gap is accounted for by the increase in states receiving D’s.
CNN notes that more people are seeking emergency care while the supply of emergency care-givers has fallen:
The report also highlighted that there were 130 million emergency department visits, or 247 visits per minute, in 2010, and there were 37.9 million visits related to injury, according to the CDC's National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary. From 1995 to 2010, there was a 34% increase in emergency department visits, according to CDC's data. During this same time period, the supply of emergency departments went down by 11%. 
And that the number of people seeking care is only going to grow
The number of patients visiting emergency departments is likely to increase as baby boomers age and develop more medical problems. And the report projects that with the Affordable Care Act going into effect, millions of people who can't find physicians who accept their insurance, and who were added to Medicaid, will also seek emergency care. A recent study in Science suggested that Medicaid increases the use of emergency departments.
The ACEP authors have issued a number of recommendations designed to alleviate the situation, including protecting access to emergency care, supporting programs that focus on its importance, and allocating federal funds to disaster preparedness. Now the question is, is our government prepared to invest in change?

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