Reinventing care for poor means relying less on ER | StarTribune.com

Reinventing care for poor means relying less on ER | StarTribune.com
Minnesota politicians say they have a wonderful solution to the Governor's threat to stop the medical payment program for the poorest of the poor - GAMC. I love this quote from the article in the Trib.

"First, create a new system to provide comprehensive medical care for 32,000 adults, many of them homeless and chronically ill, add social work and psychological counseling, do it on a budget slashed from $219 million to $91 million -- and roll it out in 12 weeks.

Second, convince Samuel Matoke and other skeptical users of General Assistance Medical Care (GAMC) -- living on $203 a month and preoccupied with getting a meal and a bed -- that the best care starts in a low-cost medical clinic, not an expensive hospital emergency room.

"The emergency room, that's where you can go anytime," Matoke said last week during an interview at St. Stephen's shelter near downtown Minneapolis. "Maybe they don't like you too much, but they fix you up when you get really sick or you break your arm.""

A County hospital can't say no to this since a dime is better than nothing even if it means losing a dollar. But our system has such a history of driving the poor and sickest to ERs (which we all pay for in premiums, co-pays and taxes) that changing patient behavior will be very hard. And don't forget that often those arriving at the ER were taken there by others after hours.