The Stockholm Network's weekly bulletin for March 18 is not yet online, but it came into my e-mail with a fascinating bit of news from Eire:
A new report in the Republic of Ireland by the Health Service Executive
(HSE) has revealed that the amount of patients attending accident and emergency
(A&E) departments has decreased by almost 5%, in the wake of increased
governmental charges for the service.
The 2009 Irish budget, presented by finance minister Brian Lenihan,
revealed that charges for A&E services would rise from €66 to €100, if the
patient has not been referred by their GP, or if they do not hold a medical
card.
The revised tariff came into force on 1st January and there are fears
that the HSE’s findings, which saw 4.5% less people attend A&E in January
2009 than in January 2008, could highlight that the new charges are frightening
people off being treated.
However, the report also claimed that “The drop in attendances was
mainly in the lower triage categories, which would explain why the lower numbers
did not result in a reduced number of admissions to hospital”.
Meanwhile, here in the Excited States of America, the government
outlaws the use of financial incentives to motivate patients to go to
doctors, or convenient clinics, or urgent-care clinics, as appropriate, instead
of going to ERs. Which, despite what you've read in the papers are
"free"
if you want them to be free, courtesy of EMTALA,
which commands all hospitals with ERs to "stabilize" anyone who presents there,
without charge.
When it comes to incentives to manage overuse of the ER, at least one single-payer country has it figured out better than the U.S. does!
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