The story of 9 patients who have visited Austin, TX
emergency departments more almost 2700 times in the past 6
years at a cost of approximately $3 million is the latest
crisis in the media, with the tone of the same shock and
surprise as the AIG Bonus furor.

The issue of frequent fliers and drug abuse is hardly a
news story to most Emergency Departments, and it certainly
is a problem that needs addressing, but with the radical
responses from law-makers to other issues lately, healthcare
providers may not not appreciate the outcome.

A definite pattern seems to be developing politically that
could result in the death of medicine as we know it, rather
than reform.  The pattern is crisis, vilification, and
government take-over. Stories like this one can mean that
healthcare is the next major element of society that is in
the cross-hairs for the bail-out and seizure solution.

Before we get too excited about this waste of money on just
nine patients or blame the patients (albeit they are the
authors of their own illness), let's be honest.  The
problem here is that the Austin area (and many others) does
not have the readily available resources to properly treat
these patients outside the Emergency Department setting.

Some of my own clients have faced similar problems and
quickly figured out that it was much cheaper for them to
fund a local solution than to continue to lose money on ED
visits.

Before we do away with right to treatment or seize
hospitals, fire CEO's and limit doctor's pay to peanuts, or
ration healthcare, maybe some serious thought ought to be
given to local solutions. These may well be costly and
be painful, but they sure as heck will be better than
government take-over of our hospitals.

Tags: abusive patients, ED abuse, Emergency Department, EMTALA, healthcare, mental health cases, nationalization