Bye, bye, ER
The sole ER in my little county (we have no hospital) just shut its doors, ostensibly because of concern that doctors had too little PPE gear. In fact, the medical staff desperately wanted to stay open and had made great strides finding PPE donations. So far we have zero reported cases in this county.
The ER has been operating in the red for the last year or so and has been taken over by its lender. The red ink results from the fact that the ER is freestanding and therefore ineligible for Medicare, in addition to which Blue Cross hates freestanding ERs and wouldn’t give them a PPO agreement on terms that would cover costs. The lender simply announced, without no warning, that it would shut its doors this morning and “furlough” staff for 45 days, helpfully adding that now they could pursue unemployment and other emergency benefits. I believe the peak for Texas is projected for May 15, i.e., about 45 days out.
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Why don't you issue an order for it to remain open? You're a government official now. Tie them up in court until at least past the peak date.
Because they know as well as we do that we have zero authority to do any such thing, and would simply ignore us. Texas Counties are an arm of the state and have extremely limited, enumerated powers, unlike cities, which are kind of like states: they presumptively have any powers not explicitly denied.
Now, whether the Governor could do it, I don't know. If he can, he's already being begged to do it.
The banks are actually running out of money.
Sorry to hear about your ER.
Believe it or not, Schumer saved ours in upstate NY town, from exactly predatory vampire capitalists in UoR HC. Sometimes a Senator is a Senator.
I'm actually RW, but Schumer stepped up.
ymarsakar is correct: The banks are running out of money since DEC.
They've been having liquidity issues related to basis points gambling.
The $4T QE/REPO was welcome - but then the FED killed the mortagage lenders hedges by buying $250B in MBS. This is sinking your Navy with your own Air Force level incompetence BTW. Add the mortgage and foreclosure moritoriums and you have banking in crisis. They've made it worse - far from liquidity the money from helicopters is acting as glue- and frozen the system.
I maintain the covid hyperbole was financially motivated, ruthlessness met opportunity for a $4T payday - but then it got out of control. There is a danger from COVID but the shutdown damage is worse - and not a projection.
The fact that you have zero legal authority is why I figured they’d win in court, bu I’ve never noticed it stopping a government from trying before. You must be uncommonly decent.
The lender posted a notice on the ER's website with a banner reading "Closed due to COVID-19," which made the medical director sputter with rage.
Well, on the plus side, the suddenly unemployed medical director has already opened a telemedicine practice. She won't be one of those half-asleep box-checking tele-doctors, either, but a real one. A silver lining of the emergency is that a lot of regulations that were strangling telemedicine have been swept away.
Why would they bother going to court? They'd just ignore us and keep the doors closed.
I think the Governor could at least requisition the two ventilators, but they'd just go to some hospital in Corpus, not much use to us.
I'm so sorry to hear this, Tex. I hope the lender's action are remembered after the crisis passes.
J.P. Morgan, not local, no exposure, I'm afraid.
bdoran said...
FYI, basis points are when Fed lowers interest rates by x percentage. So 50 = .5% afaik.
I am not a long time economic guru, but what I have heard is that the Asian gold stockpiles and Brexit, really did a number on these private banking cartels. Also for someone reason, the Federal Reserve controls the monetary policy of the United States... but they are not a federal branch of the government. They do not answer to the people or to Congress... or to President DJTrum. They are full of foreign, British, bankers.
What is up with that? Is that a good idea, America? Didn't America win the Revolutionary War... or was that a lie too.
In a catastrophic Event, don't American patriots think it is dangerous to have Britain making their economic policy? I mean what if the Fed decided to print a billion dollars a day to fix things here, to ensure the EU or Britain stayed afloat?
J.P. Morgan, not local, no exposure, I'm afraid.
Well, you know what Don Corleone believed: any man, however humble, could someday have the opportunity to harm the most powerful. A smart guy, the Don. :+)
I've know for a long time we'd lose this ER eventually, though I hoped it wouldn't be now. They were trying to offer an excellent service, without long waiting times. You can't do that and be cheap, too, especially if federal law mandates that you treat all comers and take your chances on payment later. A sentiment was building in my community that doctors who "balance bill" should be driven out of business. "Balance billing" means the ER sends a bill if your insurance company refuses to pay. The insurers like to play games with claiming that even obvious emergencies weren't really emergencies, or with setting "reasonable and customary" rates for cases they finally are forced to admit were real emergencies.
The R&C rate may or may not be enough to compensate a doctor in a crummy Corpus Christi ER with an iffy resume and iffier English, but the first-rate energetic board-certified docs at this ER were getting what's considered a premium. Blue Cross couldn't stand it. Medicare wouldn't cover the facility at all, because it hates freestanding ERs and won't pay them a dime unless they're 50 miles from the nearest hospital. We're about 48 miles in all directions. Because Medicare doesn't cover the ER, no public ambulance can deliver patients there.
But rather than grapple with these problems, a growing segment of the county's population felt that the real problem was "balance billing." Well, there are no more bills coming out of this ER. We can go to the cheaper one in Corpus Christi from now on. You know what they say: cheap, fast, and good--you can get at most 2 out of 3, and you may get only one if you're stubborn enough.
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