Interactive Case for October-November 2003
You are a Texas hospital director. Because increased taxes for health
care proposed by the Governor did not pass, you asked an external advisory committee
to look at your current hospital expenditures and advise you how to manage your
resources differently. Otherwise, your hospital might go out of business. The
review committee recommended that you eliminate hospital departments that are
not making enough money and only offer hospital procedures to those who can
pay for them. The first department recommended for closure is the Emergency
Room, which loses $2 million a year and is the primary care site for 5000 patient
who cannot pay for regular medical care. What would you decide to do and why?
Dear Students:
Thank your for your thoughtful and interesting responses. We received
comments from 171 individuals representing 16 schools. Most of you opposed closing
the ER or thought that closing the ER should be the very last cost-saving measure
implemented. Following are comments about this case and your responses from
three professionals who are involved in biomedical ethics.
Commentator #1:
In today's difficult economy we are all faced with the challenge of "cutting
corners." As you saw in the scenario, even hospitals are being asked to
cut their costs. Many city and county hospitals in the United States provide
care for the poor. Often, these patients are seen in the Emergency Room even
if the patients’ problem is not an emergency. As many of you noted, closing
the ER would not only deny these patients access to care, but also might result
in deaths when people with true emergencies found the ER closed. Consequently,
most of you argued that the ER should remain open and that the hospital should
cut costs by downsizing. Others suggested raising money through charity or other
means such as bond initiatives and increased taxes. Many communities fight against
tax hikes not realizing what services will be impacted by their refusal, as
was the case in this scenario. Perhaps attempts to raise money should be more
focused as your comments suggest, for instance on taxes or bonds specifically
for the hospital system. Finally, some of you suggested that patients coming
to the ER for non-emergency care should be re-directed elsewhere. Many hospitals
around the country do so now as they try to lessen the burden on the ER. Overall,
I was impressed by the broad range of thoughtful solutions presented by your
responses as you attempted to deal with the exceedingly difficult problem of
allocating scarce resources. You consistently maintained compassion for those
in need, which is admirable, while still acknowledging that resources are limited.
Thank you for your insights.
Commentator #2:
As more than one student wrote, this is a true dilemma. On one hand: "It
really is almost morally wrong to close down the emergency room of a hospital,
as it is the place that gives the most needed care to patients in need.”
On the other, not closing down the ER could also be just as wrong: “Sadly,
it could mean that some of the people will die, but many more would lose their
lives if the whole hospital closed down." One of the problems for this
ER is the fact that it "is the primary care site for 5000 patients who
cannot pay for regular medical care." These 5000 patients are not coming
to the ER with life- or limb-threatening conditions, but rather with primary-care
complaints that should have been treated earlier (before they became acute)
in a lower-cost care setting. Perhaps the hospital should explore the possibility
of lower-cost primary care clinics conveniently located in the neighborhoods
where potential patients live and work. Even if the patients can't pay, the
hospital's losses can be slashed by providing the needed primary care in a lower
cost setting. Or, as a last resort, the hospital could impose a "pay-as-you-go"
rule for non-emergency care in its ER. Patients who are determined not to have
a true emergency condition can be treated for a fee in the ER or given a list
of alternative treatment centers. It's not an ideal solution, because some patients
will end up getting no care at all for a variety of different reasons but, as
almost all students seem to have recognized, saving the ER for true emergencies
should be one of the board's highest priorities.
Commentator #3:
Members of hospital boards of directors have a responsibility to maintain the
financial well-being of their institutions and to allocate scarce resources
in accordance with the hospital's mission. As many students pointed out, while
closing the emergency department may be financially beneficial for the hospital,
it may also run counter to the hospital's mission of providing health care to
the community, particularly if the hospital is a nonprofit or public one. One
approach to resolving this dilemma would be to review all hospital programs
and major expenditures in terms of their relevance to the hospital mission.
Those of less direct relevance could either be scaled back or increase their
charges, thereby helping to subsidize the emergency department. The hospital
might also seek outside funding to subsidize care for poor patients. This could
be done by assisting individuals who qualify for public benefits such as Medicaid
or CHIP (Children’s Health Insurance Program) to enroll in these programs.
Community and individual fund-raising to subsidize the emergency department
might also be attempted. Finally, the hospital board could lobby local and state
government for expansion of grants for health care for the poor.
Student Responses
11/30/03
Shutting down the imperative medical branch to a community would cause total chaos.
The ER may be a not a profitable area, but it is the most important area of the
hospital. If the ER closed where would people go when they had their next asthma
attack or tripped down the stairs and broke their leg? The hospital could gather
funds for the ER with fundraisers or asking for donations. Discontinuing the ER
would be my last resort trying to keep the hospital open.
FD
Wylie High School
11/30/03
First off I would not close the E.R. because although it would save me 2 million
a year, it would also mean that people in need of the E.R. might be sent to another
hospital and lose their lives because it’s too far away. I don’t believe
you can put a price on a person’s life. There are many people in need of
the E.R.’s services and just because they don’t have the money to
pay for it does not mean that they should suffer because of increased taxes. You
could cut back on another department or maybe find ways to be more resourceful.
Another thing you could do is start a fundraiser. You could have schools and stores
around the city participate. Even if you did close the E.R. I think it would cause
more harm than good because the E.R. is one of the main departments in a hospital,
without it people might stop going to that hospital altogether.
S.H.
Health Careers High School
11/30/03
I would not shut down the emergency room. It would not be fair to patients that
need immediate care. Some injuries are too severe and cannot wait for medical
attention. Also, other departments would end up with the would-be E.R. patients
and have to cancel or postpone their pre-set appointments. With all the extra
patients, the departments that were financially okay, might lose money because
clients decide to go to less busy hospitals. The E.R. should not be shut down.
Some patients are able to pay, but they would no longer have anywhere to go either.
To make up for the unpaid expenses or to help patients pay, the hospital should
try fund-raisers, appealing to donators, or cutting back on high-paid doctors'
checks or unused/ unnecessary purchases. They should not, however, only treat
patients that can pay as an alternative to shutting down.
C.C.
Wylie High School
11/30/03
Though the ER looses money, it is one of the most critical units in the hospital.
Deadly accidents happen, therefore taking out the Emergency Room would be costing
lives. For patients who cannot cover their medical costs, I advise a payment plan.
Paying in monthly installments for the services rendered. For those who could
not pay at all, they have the option to work in the hospital until they are out
of debt. Their work would be janitorial and paper-filing. This plan is worth a
try before any parts of the hospital are cut.
Wylie High School
11/30/03
If I were a Texas hospital director and were faced with this dilemma I would choose
to keep the emergency room in operation. Though the ER would lose two million
dollars per year, it could make the difference as to the survival of a patient
who has had serious trauma or is in some other life-threatening situation. If
all unnecessary hospital expenditures have to be cut in order to keep the emergency
room available for patient treatment then that is what will have to be done. And
though it is impractical, all patients will be treated, insured or not.
S.B.
Wylie High School
11/30/03
I would not close the ER at my hospital under these circumstances. I could not
reject 5000 patients who have real emergencies just to save $2 million. That means
each ER patient's life is only worth $400! I believe that each human life has
its own purpose, and you cannot put a price tag on it! I would like for the committee
to find other ways to cut down on expenses, like cutting or automating some of
the administrative services or lowering employee benefits or salaries. These ideas
would hopefully help the hospital recover the loss and stay in business.
H.E.
Wylie High School
11/30/03
I would keep the E.R. open because that is one of the most important parts of
the hospital, most of a hospital's activities branch out from that which happens
in the E.R. and it is what practically makes the hospital. Rather than gain money
by dropping the emergency room i would suggest the hospital shut down other, less
used areas or hold fundraisers to gain money. For if one does not have a place
to go to fix an emergency, that emergency then becomes a crisis.
T.A.
Wylie High School
11/30/03
I would not shut down the Emergancy Room for two reasons. First, the Emergency
Room provides care for emergancies. Without it many would get into worse shape
before they could get medical care. Also if a minor injury can be healed in the
emergancy room before it becomes serious, less work is required by other departments
to heal the person. I would most likely look for internal ways of lessening expenses
and then cut down on specialized departments.
11/30/03
i would do everything in my power to try to keep the ER open and running with
the required amount of staff. i would also try to cut down staff in other areas
as well as the ER, do as many fund raisers as possible and try to convince private
donators that we need their money to help with the thousands of patients who could
not otherwise afford medical care. if these did not work, i would then cut down
the staff or intake of patients from another department in the hospital like a
cancer center that is not in high demand. the ER is a much needed department of
any hospital in any area that is not worth shutting down unless there are many
other places to get medical care for the lower class or people who cannot pay
for regular medical care.
11/30/03
If I were the hospitals director and was told to close the emergency room because
budget wasn't approved; I would fight it in any way possible. Emergency rooms
are important because they save so many lives. Without one I feel we would just
loose to many people because they didn't get the immediate care they needed. There
are some alternatives, you could start a petition then maybe the governor would
reconsider the budget. Another solution would be to ask local businesses to sponsor
or donate money to the hospital specifically for the ER. If all else fails try
to momentarily close the ER until funding becomes more abundant.
L. L.
Wylie High School
11/30/03
As a hospital director I believe it is my duty to help all those that are in need.
I would definately not shut down the emergency
room. I would rather go into debt and be begging for money than shut down a room
that saves multiple lives everyday. As a
director I would try to continuallly raise money by having fund-raisers, bake
sales, or whatever it takes to keep the emergency
room. I believe that you cannot put a price tag on a life so therefore i couldn't
shut down the emergency room.
11/30/03
As the director of the hospital, I believe I would look into other departments
other than the E.R. The E.R. is where people can come in with any needs and get
fast help in serious cases. ( well, fast help in some hospitals) Maybe it would
be a little bit more reasonable to lay off some of the other departments such
as admitting or medical records. The E.R. is too valuable to close down in any
hospital.
T.L.T.
Wylie High School
11/30/03
If I were the hospital director, I would not close the emergency room. Even though
you don't have any money doesn't mean that you don't deserve medical care. As
the hospital director, I would do everything in my power to raise money to help
with the costs and cut down on as many expenditures as I could. I would downsize
the number of rooms in other areas of the hospital, as well as the number employees.
J.V.
Wylie High School
11/30/03
If I was a hospital director, I would be furious at the suggestion. How could
you possibly replace a person's life for the money. If something needs to be shut
down, they should go for another department.
M.S.
Wylie High School
11/29/03
What you have to relize is the choices and the consquences that go with your decision.
If you are the type that think that closing the ER branch is nessary and helpful
to the community in your perspective so be it. Yet I feel if I were a hospital
director, I would definitely not shut down the ER branch no matter how much it
costs.Peoples lives depend on the nearest ER, their critical conditions is no
waiting matter. Also,closing down the ER would result in a horrible situation
for anybody.
11/29/03
I don't believe that shutting down the ER would be a wise decision. Many people
depend on the emergency room since they can not afford other means of health care.
Just because people can't pay for the services given in an emergency, doesn't
mean that their life is worth losing. The hospital should find a more productive
way of earning money. There is no reason that innocent people should lose
their lives just because the hospital they went to needs money and can't give
them the help that they desperately need.
A.C.
Wylie High School
11/28/03
Obviously the ER is a very important contributor to patients, as are other hospital
departments. If I were a Texas hospital director I would first as the external
advisory committee to close only a portion of each department to help account
for some of the hospitals expenditures. This would most likely not account for
all of the expenditures, but the rest could be made up for by fund raisers. Healthcare
is an important cause and many people understand this, if you inform certain companies
they may support the cause and help out. This way, you would not have to close
the ER completely and your hospital would not go out of business.
N.N.
Wylie High School
11/28/03
I would choose not to close the emergency room, though it is costing us $2 million
a year, it is costing I am sure that there are areas of the hospital that can
be cut down to suffice for the operation of the emergency room. Since departments
need to be closed, perhaps some that offer facilities or operations that are not
used frequently could be shut down until a way of more income is provided.
J.M.H
Wylie High School.
11/27/03
If i was a hospital director i would not close my emergency room unless it was
completely necessary. If it got closed down many people in the area that needed
immediate attention would have to go to places further away, and that would cause
maany deaths. Also alot of people would be put out of jobs such as nurses, doctors,
and surgeons. Basically i think that there would be other places that you could
close down before you absolutely had to close down the ER.
O.S.B.
Burleson High School
11/27/03
If I were the Texas hospital director I would not shut down the Emergency Room.In
my opinion $2million is alot of money,I would not close the ER just because the
hospital is struggling with money problems.I think that this issue can be sorted
out over time, but the problem with people needing help right away and they can't
get it could be matter of life and death and that problem can not be solved.Image
if you got hit by a car and you were losing alot of blood rapidly and you went
to this hospital and could not give you help because they didn't have an ER and
if you go to another hospital you would die you would be very very very very angry.
So in conslusion I'm going to said that I beleive that the ER is the heart of
the hospital so, if they close the ER they might as well shut down the whole hospital.
CC
11/26/03
If i were a Texas hospital director, i would close the hospitals down. People
get hurt and need to go to the hospital. Everyday, humans get hurt either playing,
working, or even cooking. There is many reasons why the hospital shouldn't be
closed. I would make every effort to keep the Emergency Room open. Although the
Emergency Room loses $2 million dollars, it still helps 5000 people that are unable
to pay for regular medical care as well as the people who are able to pay for
their treatment. The public relies on the Emergency room when tragedies occur.
It would be immoral to make treatment available only to those who are able to
pay. On the other hand, there is reasons to close the hospital too. If a hospital
is in the business of treating emergency patients, other highly specialized areas
the hospital employs should be eliminated and have equipment shifted to another
focus or sold to raise capital. Otherwise, the hospital can focus on certain specialties
and close the emergency facilities and other common treatment facilities. If a
hospital can shift it's focus to another area and become
highly specialized in it, the hospital gains notoriety, donors, and publicity.
In conclusion, if i were to choose to close or keep the emergency room, i would
keep it. The reason for that is because people do get hurt every minute, and it's
better to save lives then to lose money.
P.M.
Fossil Ridge High School
11/26/03
I believe that it is tough decision one would have to face because Doctor's we
given a oath of some kind that says "hat they will administer the patient
no matter the cost and that all people a welcome for treatment" or something
like this, but on the other hand one would have to think about their family and
see if the could bring in enough money to sustain themselves. It is a tough
decision though, but I'd have to say that if the hospital closed down the ER for
the lose of money versus the cost of the hospital closing down it would be the
ER that would go. Although to solve this problem if everyone in the world just
would agree to Doctor's taking serious pay cuts and that the field of medicine
was not so expensive then the ER would not lose enough money to cripple the hospital
and the majority of the world would be able to afford going to the hospital. Cause
a heart transplant dose not need to cost 50,000. And the technology for its no
different than other aspects of life. You could probably study and medical book
like Leonardo De Vinci did and practice on some dead bodies. Keep a good heart
down at the butcher shop in the freezer and you would probably get the same results.
Bottom Line is that the world is greedy and the world will have to pay for it.
J.D.H.
Wylie High School
11/25/03
I will decide to keep the Emergency Room because I think that money is not important
as life of a person. Because as you’ve known, a person can make money easily
by doing their job, but if the Emergency Room doesn’t exist, there will
be a heavy loss of life everyday. And one of them can be our relative or
family member. And I think the patient can not pay their money because at this
time, there are many people that lost their job because the company can not pay
for them. And that is an acceptable reason for them not to pay money. And
the person whose life was saved will have a good attitude about the economic
and government, may be if after several year, they become a billionaire, they
will contribute their money to the Health Care field. I will fire the doctors
that really don’t cure disease for patient, the doctor that just pretend
to cure disease, but they just give useless drug to the patient to take their
money. I think that the best way to help the hospital out of the difficult circumstance.
TH.B.
Wylie High School
11/25/03
I would not close the Emergency Room if I were a Texas hospital director. Even
if we needed money, we're talking of lives
and it's not worth taking peoples lives away. If you have to close another department
then do it, but it just isn't worth it. Find
another way for money.
E.B.
Wylie High School
11/24/03
I would keep the ER open because people need healthcare. If the ER was closed
how would people be helped? Would they just have to suffer? The workers
of the hospital should want to help keep people alive and well. the hospital need
to make the patients aware of what is going on with them. I just think the ER
should be open to whomever needs it as long as they need it. instead of having
to be pushed away.
11/24/03
First of all, all departments of the hospital are essential to the functioning
of that hospital. Although some departments, require more expanse than others,
all have an important role within the hospital. If I was the director, and was
advised to close down the Emergency Room, I would be upset, because cleraly that
is where thousands of people are treated every single day, and without it many
people would have to go around looking for hospital, taking the chance to loose
thier lives. For this reason, I would ask the community's residents, as well as
other businesses to help raise money to keep the ER open. In additon to this,
fundraisers are great ways to raise money. And I'm sure once the society is aware
of the problem, they will be willing to help, because of the care provided to
them form the hospital. All in all ERs are the most busiest departments in any
hospital, and closing down one ER, will cause other hospitals to have to care
for thousands of more patients everyday, in additon to their regualr patients.
So I belive that instead of immediatly deciding to close down the emergency room,
I would try my best to rasie money with the suggestions that I previously listed.
B.B.
Wylie High School.
11/24/03
I think they should not close the ER becuase many people need the ER. many emergancies
happen and ther are so many other places you can close thats not the most important
section in the whole hospital. I feel that if the hospital should do anything
it should belaying people off. Another option is to just lower everyones salary.There
really no price youcan put on any persons life.A life is very precious.
Kayla Gifford
BHS
11/24/03
If I were the doctor that had to make the decision I would keep the ER. Without
it many people would die. The ways that I would try to get money would be to get
money donations from places and try to get little things that do not cost too
much donated from companies.
M.S.
Burleson high school
11/24/03
There is no way I would let the emergency rooms get closed. Despite the fact that
there are some losses in the funds for the hospital, people still need proper
emergency care. With out the ER open, all kinds of horrible accidents will not
get the proper kind of treatment. The lives of the citizens are far more important
than a financial problem. People's safety and care should always come before money.
S W F
Burleson High School
11/24/03
If I were the hospital director I would colse down the ER. The rason is becaue
there are always other hospitals around the
do have ER, so you are not the only hospital to have one . So it is not a "have
to have a ER to a considered a hospital" type
thing.
J.H.
Burleson High School
11/24/03
I would not close down the emergency room. I know that there is a large loss of
money, but you cannot afford even a small loss of life, but in this case it is
substantial. Plus in doing this, you will only be increasing the number of people
going to surrounding hospital's emergency room. Therefore, they will have to close
down, also. So in doing so you are not fixing your problem, but hurting the community
and the surrounding hospitals.
J A H
Burleson High School
11/24/03
I believe that they should not take out the emergency room. What if someone needs
it for a severe problem it could mean life or death. So I believe if I was the
doctor I would either leave the hospital or try my hardest to keep the emergency
room.
Burleson High School
11/24/03
My decision would be to do as the comitee says. No matter how much it would pain
me to do so, I would close the emergency room if i was instructed to. This is
so because a hospital with no emergency room is much better than no hospital at
all. If you were to keep the emergency room open, then there is a great chance
tht the entire hospital would close being able to provide care for no one. In
a perfect world, you would keep it all open but we dont live in a perfect world
so you do whatever it takes as long as you keep providing care.
11/24/03
I would keep the ER open because people need the healthcare provided. If the ER
was closed, where would the people
go? The employees of the ER should be willing to accept any solution if it would
prevent them from losing their jobs. The
hospital needs to make people aware of the crisis. They could raise funds another
way, such as private donors. Many people
probably are not even aware of the problem, and they would be willing to help
the hospital. Are indigent patients using the ER
instead of going to the doctor when their problem begins? A low-cost clinic could
possibly take some of the load off of the ER department and prevent problems before
they become serious enough for a trip to the ER. The ER should definitely remain
open as long as patients need it.
C.C.
Wylie High School
11/22/03
If i were the director i would not close the ER.Even if the ER didn't make money
i still wouldn't close it because it is more important to save peoples lives.
You can't just turn your back on someone who needs help. In an emergency it is
important to get help as soon as possible and if I closed the ER some people may
die before getting to the next one. I would find another way to save money like
pay cuts or downsizing the staff.
M.S.
Wylie High School
11/22/03
As a Texas hospital director, I know we can not afford to lose the ER unit of
the hospital. You can not put a price on saving someone's life. I would just have
to cut back on some paychecks and maybe lay off some people. Closing the ER would
not only affect people who cannot afford regular healthcare it would affect all
people who need emergency care. I would cut back on some other unnecessary expenses
and hopefully by following and proceeding with some other steps I can save the
hospital some money and we will not have to close down.
C.H.
Wylie High School
11/21/03
If I were a Texas hospital director, I would never get rid of the emergency room.
Like the paper said doctors care for 5000 patients who cannot pay for regular
medical care. If we hot rid of that, they would have nowhere to go. Before any
finial decisions we should talk to the bank. We could get a loan if we have to.
Also we can talk to the American Heart Association. I know they would pitch in
a little bit. Every bit counts. Also for donations we could hit the restaurants,
car washes, and stores. I understand that they are losing $2 million a year, but
think about who they are helping.
11/20/03
As the hospital director, I would make every effort to keep the Emergency Room
open. Although the Emergency Room loses $2 million dollars, it still helps 5000
people that are unable to pay for regular medical care as well as the people who
are able to pay for their treatment. The public relies on the Emergency room when
tragedies occur. It would be immoral to make treatment available only to those
who are able to pay. As the hospital director, I would look for other areas where
cuts could be made. Many small cuts in several departments might add up to large
savings. In addition to this, I would seek corporate sponsorships and/or fundraising
ideas. If the public were aware of the situation, a “Walk for the ER”
might be a fundraiser where the public could get involved in raising monies. Then
the people could come together as a community and not just as patients.
KE
Wylie High School
11/20/03
Because health care will always be needed everyday in society, it is ridiculous
and unnecessary to cut down on medical supplies, whatever reason it may be. Just
because the tax increase law did not pass doesn't mean that I would have to
sacrifice other people's lives to save my business. Yes, it's expensive to run
the hospital and each department. And yes, it will be hard to find $2 million
dollars a year to provide care for 5000 ER patients. But no, nothing will deter
me from giving the best care I can offer to the people in need. I entered this
career because I had passion to serve others, and serving others I will. It may
sound rabsurd and close to impossible, but I would atleast ask the community to
help out. Maybe individual donations. Maybe company donations. And yet, maybe
promotions that would spread the news, saving hospital departments. As a result,
more people will be exposed to the problem and would take action to maintain hospital
regulations. There are always ways around an obstacle, and I will find it soon.
J.N.
Wylie High School
11/20/03
As a doctor with minimum funding i would not close the E.R., because it would
leave people out with deadly injuries. If you
close the E.R. then your clients would have to find care somewhere that would
accept them. Although the E.R. losses money it is the most health providing center
of a hospital and it can give or take life when opened or closed.
j.c.
Wylie High School
11/20/03
This would be a very hard decision to make. However, in the best interests of
the people, for whom hospitals were created, I would not close down the emergency
room. I'm sure there are plenty of other centers in the hospital that are losing
money as well but aren't used by as many people. People rely on the emergency
room. It's extremely important to those who are critcally injured and need help
fast. If you closed it, you would have 5,000 people who would be in serious trouble.
You would have to question if you wanted to be responsible for that. I believe
that the best choice to make here would be to not close the emergency room and
instead look for an alternative.
H.R.
Wylie High School
11/19/03
I believe that shutting down certain areas of the hospital would do a lot more
hurt than help. The statement said that one of the first departments to be shut
down would be the Emergency Room area. That should stay open for peoples benefit.
Shutting the ER down would only cause problems. And, by not letting patients receive
care because they may not be as wealthy as someone else doesn't seem to be a very
smart solution either. There would be many people needing help who would not be
able to receive it.
R.T.
Burleson High School
11/19/03
To close the ER of an emergency room would be a huge disaster, no matter what
the cause is! The ER is a place where huge
numbers of lives are saved every day! To close this down would be disastrous because
it could end up being a cause of many
more deaths. They should go to the next department in line that loses a lot of
money in one year, but leave the ER alone. It is a vital part of the hospital
and of people's lives. People are worth more than money, and there's nothing that
can ever change that.
S.M.
Wylie High Shcool
11/19/03
If I were a hospital director I would not get rid of the ER.That is the whole
reason for health care because you don't know when someone will get hurt and someone
every minute is injured and needs repairs.It is your major source of health care.I
think you should just cut pay of the other health departments that aren't losing
that much money.You will always need an ER
because there is always someone getting hurt.Or you could raise the cost in some
of the other medical fields just balance it all out and figure out a way to make
more money.
B.D.M.
Burleson High School
11/19/03
If closing the ER was the only way to keep the hospital open then I would close
it. I would direct all patients in need of emergency assistance to another hospital
where they offered it. The ER is only a small part of the hospital so it would
be worth keeping the rest of the hospital open.
RK
Wylie High School
11/18/03
If I were the hospital director, it would take great convincing to get me to close
down the Emergency Room. If the Emergency Room is closed down who will take care
of the 5000 people who cannot afford regular health care and the people for whom
every second that passes puts them closer to death. I do not think it is fair
to these people to close the Emergency Room and what good does a hospital do if
it is not helping as many people as it possibly can. If I were the hospital director
I would look into saving money another way that does not influence so many people’s
lives directly.
A.B.C.
Wylie High School
11/18/03
I would keep the ER open for as long as could. When it became really serious then
I would shut down the ER. If I kept the ER open as long as I could another couple
of lives will be saved. If I kept the hospital open without the ER I would still
be helping people with their illnesses. Eventually I would end up closing the
ER for the preservation of the rest of the hospital.
F.P.G.
Wylie High School
11/18/03
This dilemma is one that takes serious amounts of thinking and debating about.
To close the ER would be telling many people that there is no longer ready help
for them if something bad happens to them. Many people don't understand how important
the ER is unless they've know someone who has had to be in there, and without
it, they would have lost them. To close something so important to people would
be deadly. If it is a monetary problem than there needs to be some sort of charity
event or fundraiser to raise the money. If the public knew what was going to happen,
they most definitely would voice their opinions and most likely help out. I would
keep the ER open as long as I could. Shutting down parts of the hospital, temporarily,
that are not used as often until the proper funds could be raised would also be
another option. The ER is one of the most critical parts of the hospital and it
would be killing many people to shut it down.
J. D. H.
Wylie High School
11/18/03
This is a very hard situation and it might cost us,but the Emergency Room in my
opinion, is one the most important rooms in
the hospital, so I believe it should stay open.There are patients that might not
be so fortunate like others and might not have
the money to pay the Hospital like they demand. Yes I do know it costs money to
treat with patients but we don't intentionally get diseases and we don't mean
for accidents to happen, so why should a person be rejected because of their income?
It just would not be fair for us to take the emergency room out. There are ways
to raise money for patients who cannot afford health insurance. We could set up
a department that would offer financial aid for those who qualify and a payment
plan to those who don't qualify. Another way to set up a charity department for
donations.
K.A.
Naaman Forest High School
11/18/03
IF I WERE THE DIRECTOR I WOULD'T CANCEL ANYTHING BECAUSE MANY PEOPLE NEED HELP
IN
MANY EMERGENCIES SO IF THE 2 MIL COULD SAVE 100 THOUSAND PEOPLE I THINK THE IT
SHOULD
NOT BE CANCELED MAYBE JUST DOWNSIZED IF NEEDED BUT EVERYONE HAS EXPERIENCED TOUGH
TIMES AND WHEN THEY NEED MEDICAL HELP THEY CAN COUNT ON AT LEAST ONE THING
THE EMERGENCY ROOM.
J.B.
11/18/03
I think that shutting down the emergency room should not even be an option.
Every citizen should have their rights to get hospital treatments in case of an
emergency. Hospitals need to set up programs for people who cannot afford treatments.
I don't think that anybody should get free treatment, but that people who cannot
afford treatment should go through some process of paying it back in some way.
BL
Wylie High School
11/17/03
Before closing the ER down I would look for other ways in which I could save money.
If that wasnt enough then I would close the ER. $2 million is a lot of money to
be losing and it would be beneficial to my hospital to close the ER instead of
having to close the hospital. ER is a good thing to have at a hospital but it
is not a must.
CL
Wylie High School
11/17/03
Well if I was the director of this hospital I would look at all the options available
before making my ethical over all decision. If we did not shut down the Emergency
Room it would eventually lose so much money that they would close it. But if they
shut it down now, many unhealthy patients would lose their lives or family members.They
could go to the nearby hospitals but there benefits to some patients might not
be the best that our hospital could have provided. There has to be another way
that the ER doesn't lose that much profit. U could take money away from other
jobs of the hospital that dont make enough either. But I would keep up with researching
other ways to help the hospital stay alive and keep the ER, before i make a final
decision.
B.R
Burleson High School
11/17/03
If I was the director of this hospital I would defienetly not shut down the Emergency
Room. I would pick another 1 or 2
wings of the hospital to shut down instead, if it was required. The Emergency
Room is the most important wing to the patients
in need of urgent treatment. If the hospitals intrest lies in the patients and
not it's bank account then the Emergency Room
would stay open, but if all it's conserned about is the amount off money it brings
in then the unethicial decision would be to
close the E.R.
Burleson High School
11/17/03
I would not close the emergency room down even if it loses $2 million a year.
That is where more than over 5,000 patients
who cannot afford to pay for medical care go. We could not possibly take their
only medical care away. I would have to
think of another department that wouldn't effect as much people. It isn't far
to take that away from them when its not their
fault they need the medical care.
KMJ
Burleson High School
11/17/03
No I wouldn't close the ER. Too many people go through there with life or death
emergencies and it is too important to let go. There are other solutions for better
using resources. If money is the problem, and the government doesn't want to help,
get the community involved. Have fundraisers and have the people that the hospital
serves raise the money to keep it running. If they realize that this is their
healthcare that needs funding they'll care and help out. Every part of the hospital
is completely necessary! We need that Emergency Room!
A.H.
Burleson High School
11/17/03
As the Texas hospital director, I would not close the Emergency room. Sometimes
people don't have enough money to pay for the bill, but however, money is not
worth risking someone's life over or causing a serious injury to get worse. There
are plenty of ways that money can be raised to help pay for the expensive costs
that may be involved to keep the Emergency Room up and running. For instance,
fundraisers and donations are always some ways in order to raise money. I would,
and
several people around the world im sure, would help participate in raising money
for these causes which will beneifit individuals who are in need of care, but
may not have the money to pay off the expenses at that time and place.
R.D.
Burleson High School
11/17/03
As the Texas hospital director, I would never get rid of the emergency room. This
is where some of the worst cases come and just because they don't have a lot of
money doesn't mean that they should be turned away from getting care. You could
offer them banks that could loan them money or try to find some way to get them
the money that they need to get help from the hospital. Also, they could look
to different foundations for help with whatever problem the in-patient is having.
Most of society does not have the money to pay for all these medical bills, that
doesn't mean that we should deprive them of help. Put yourself in one of those
patients positions, you walk into a hospital with a broken leg, and they can't
help you because you don't have enough money. How would you feel? There are plenty
of different ways to find money help for patients besides taking away the ER.
J.E.
Burleson High School
11/17/03
If I were the hospital director I would never close the ER down. People who have
urgent emergencies have no where else to go but to the ER. Even though it may
be losing alot of money, do something else to raise money. Like fundrasiers or
even pay cuts. Some workers may not like it, but it is just the choice you have
to make. The hospital would die if it didn't have an ER. The ER is like the heart
of the hospital. If you close it down where will all the blood go.
CC
11/17/03
As the hospital director, I would never in an instant shut the ER down. The ER
is the place where all of the action happens,
and where you get your patients. Without the ER, other departments of the hospital
would lose money as well. Without the
ER, there would be a lack of business, because if you don't have the ER, the the
ambulances would go to another hospital
nearby to get their business done.
A.S.
11/16/03
If I were a hospital director, the last thing that I would close would be the
emergency room. The ER is probably one of the most critically important places
in the hospital. When someone is severely injured, the first place they go is
the ER to get fast treatment. Though the other parts of the hospital are very
important also, the emergency room is most helpful. The hospital should set up
some sort of fundraising campaign, of private donors and corporate sponsors, to
help those who may not be able to afford the care needed. Just because someone
is not financially capable to afford care, does not mean that they should just
be sent out on the street to suffer. Unfortunately, people with the most money
are getting the best treatment. Everyone
should be treated equally no matter how much money they have.
AD
Wylie High School
11/16/03
closing the E.R. would be the worst thing that the hospital did, because if the
hospital closed the ER what would the patients that really needed it do? Say if
I had a broken leg and the emergency was closed how would I get care for my leg
at the moment that I needed it? Just because some people can't pay doesn't
mean that you have to close it.
H.S.
Burleson High School
11/15/03
As the director of a hospital I think the ER should not be removed from the hospitals
because hospitals are there to help people in need not to make bundles of money.
If the ER is shut down and someone has been shot or stabed, and is in critical
condition then how will they get help? The hospital can't just sit there and watch
them die because they don't have insurance or loads of money. Now maybe certain
thing should be cut off from the ER, but more life threatening things will be
treated. The other non life threatening things like ear infection, runny nose,
or sore throat should not be treated in the ER. Doctors should be worrying about
the amount of money they make, but the health of their patients. Now they should
still get paid of course because they work to keep people alive and healthy. So
as the director of a hospital even with the loses of money the ER should not be
shut down the hospital may save money, but they would not save as many lives and
thats what is important.
CM
Wylie High School
11/14/03
Closing the ER would be the thing to do if you wanted to cut back on the hospitals
expenses, but there are other alternatives
such as having less staff in the ER and other units that are not used frequently.
All of the areas of the hospital are important
because you never know who is going to walk through the doors and what condition
they are going to be in. However, when
doing so you are depriving many sick or injured individuals of the care that is
essential to stay alive. Many people depend on
the ER when doctors offices are closed and immediate care is urgent. So closing
the ER could cause some people their lives.
K.S.
11/14/03
I would not take take the emrgency room out because it would too highly effect
the community. The main responsibility of a healthcare provider is to care for
the patient. Taking out the ER would not be considered caring for the patient.
That is why I am not in agreement for taking out the emergency room.
W.P.
The Academy of Irving ISD
11/14/03
I would not shut down the ER not mater what. Thats mainly what a hospital is,
or made up of. When people think of going to
the hospital, they think of going to the ER for treatment ASAP. If the hospital
is in debt they need to find another way to fix it,
whether its laying off staff, or shuting down another department, but you dont
shut down the ER I would'nt think.
A.K.
11/14/03
As the director i would not close the ER, for many reason, for one the er is one
of the most important area of the hospital becasue he are having patient that
need medical fast and that why the hospital are for. if we close the ER and thier
are no t other hospital patient and kill from not geting medical so it would be
a wrong thing to close the ER. We can find other way
that we solve this problem, for ones we can gey donation for the commmunity so
that we could have found to keep they hospital in good economical place.
g.o
The Academy of ISD
11/14/03
I would not shut down the E.R. for the simple fact that it takes care of those
people that are sick and are in the need of help and cannot afford it. Shutting
down the E.R. would be a ethical and immoral matter and would effect the community
greatly. The first thing I would do is get the administration together and start
cutting the pays back just a little or I would make some of the department that
were not as busy smaller by cutting back some of the workers. I would also probably
go out into the community and see if I could get help from organizations or business.
j.s.
11/14/03
As a hospital director making such a critical decision like closing the ER would
have to be thought of very seriously. The ER
is a place where people with emergencies go to for help, I would not close the
ER because many people are in need of their
services. I would use other resources in order to still have the ER open for example,
cutting back on employee salary, maybe
cut back on some not so critical job positions and that money could be used to
help the ER department. Everyone should be
entitled to healthcare, they should not put restrictions on a person's health.
M.B.
The Academy of ISD
11/14/03
If I were the Directer of the Hospital I would not close the ER. Instead I would
cutback slaries of the staff and administration
of the hospital. It would be unfair to cutback salaries of the employees of the
Hospital yet administration keep their pay level
the same. I would also lay off extra staff that isnt needed or can be done without.
Closing the ER should only be a last resort
if nothing else can be done to save the hospital from bankruptcy. This hospital
could be the nearest source of emergency care
for some people and it would be sad to see someone die because they had to travel
an extra 15 minutes to a farther hospital
when they could recieve care there. The ER may loose money, but you cannot put
a price on saving human lives.
E.M.L.
The Academy of Irving ISD
11/14/03
i believe that when in a situation that is as complicated as this, you have to
keep in mind the greater good. shutting down the emergency room will only save
money, it will not do anything else for the hospital. however, keeping it up and
running for as long as possible and helping as many people as possibe will, in
the end, have a much better payoff. if i was in this situation, i would keep the
ER open as long as possible before other cuts have to be made. cuts in salary
could alleviate the financial problem, as well as layoffs, but no patient should
be turned away simple because they have no money. you job as a healthcare
provider is not to make money for your hospital, but to provide care to the people
who need it. you must keep
in mind the greater good.
m.s.
11/14/03
As the director of the hospital, i would never consider going to such extremes
of closing down the ER. Doing such a thing would only defeat the sole purpose
of the place. It should be our number one priority to save the lives of those
who are in desperate measures. How can we as people who chose to save lives as
our profession, one day decide not to due to the lack of payments for medical
care. So until we find an alternative way to cut down costs, we will most definitely
be running the ER daily.
h.y.
academy of irving isd
11/13/03
Although the emergency room loses $2 million a year, it really does care for many
people. Some of us maybe fortunate enough to pay for nice facilities and health
care, but there are other people that don't have the care financially and they
want some where to go when they need health care, too. You can always solve the
problem by closing a facility that is not in as much use that can get help else
where and then that would save some money as well. By closing the ER you not only
let down
many community members but also the people that work in that field of work. In
my opinion closing the ER would not be the best choice in this situation.
KKR
Wylie High School
11/13/03
A medical provider's best and most important task,is to take care of the patient.
Taking out the ER would not give the community the impression that the hospital
mostrly cares about the patient. If the hospital was to remove it, that would
give the community the impression of a hospital crazy for money and not for the
care and importance of the community. So if I was the one in charge, I would not
be removing the ER. That would be the last thing that I would remove. Its the
department that brings in the most people and the people who in most times are
in need of the most care.
L.R.
The Academy of Irving
11/13/03
No amount of money lost could convince me to close the emergency room. The ER
is one of the most critical elements of the Hospital. Countless individuals come
into the emergency room in need of immediate, and in many cases lifesaving, care.
Closing the ER is like sentencing those people to death. Even prisons don't put
people to death over money. Who here has
heard of a criminal being put to death over money? People like drug dealers and
gangsters kill over money. Do you wish to put the hospital in the same category
as those people? What about the Hippocratic Oath? It states: "I will follow
that system of regimen which, according to my ability and judgment, I consider
for the benefit of my patients..." not “I will follow that system of
regimen which, according to my ability and judgment, I consider for the benefit
of my patients IF THEY CAN AFFORD IT!" Don’t forget about the patients.
They are the important ones here right? Don’t just turn them into statistics
and dollar signs. Closing the doors of an Emergency Room is out of the question.SOMETHING
else can be done. We just have to try a little harder.
J.J.
Academy of Irving ISD
11/12/03
I would keep the ER open because no one deserves to be turned down from a major
emergency just because they don't have enough money to pay for it. If we did not
serve those who do not have enough money for care, we would have many more
deaths a day. I would have a feeling inside that I turned away people in dire
need of help, just because my business was failing. If I did not have enough money
to help in a life threatening situation and the hospital turned me down, I would
not be very happy with them and I would fear for my life. Everyone deserves the
rights of help in emergency situations. "All men are created equal."
J.Q.
Wylie High School
11/12/03
I think is a bad idea to close the ER. Because is were all the patients that had
accidents go there and sometimes they need
care withouth loosing time. They could close other department. ER is one of the
most important deparment in the hospital.
It might loose lots of money, but it also saves a lot of lives so is like paying
for peoples lives to save them.
FO
The Academy of IRving
11/12/03
If I was the director of the hospital, I would rather close the ER than the hospital.
Because the hospital is more important and not all the people are going to be
in the ER when they are sick. However, I would try to collect money and sell items
to help keep the ER open.
H.A
11/11/03
First of all I would like to say I am strongly opposed to closing the emergency
room. I don’t like that idea at all. That would be very bad for the people
who can’t afford the hospital procedures. But desperate times call for desperate
measures. Two million dollars is to much money lost on people who can’t
afford it. It hurts everybody in the long run not just a certain group.
Z.M.
Wylie High School
11/11/03
If I were a hospital director, I would definitely not shut down the ER branch
no matter how much it costs. If the hospital stopped providing services to the
people who could not afford them and therefore could not offer any financial benefits
to the hospital, then that action will bring a decline in the reputation of the
hospital in many ways. First of all, hospital does not only mean a profit organization,
numerous other values also represent the hospital such as the giving part of the
career that is employed in that place. Hospital has the responsibility to treat
all of the patients regardless of their status or there would be no purpose for
the existence of a hospital because the rich would be able to afford the identical
services at home. The first concern of a doctor should be to treat his or her
patients successfully, not how much he or she is going to be paid. Besides the
disturbance that this action of shutting down the ER will cause to the original
purpose of the hospital, it will also be an offense towards humanity which will
directly effect business of the hospital. The act of giving with out selfish reasons
symbolizes humanity and most all of the patients regardless of their status value
this. If the customers or patients feel the professionalism is compressing down
on the humanity of the hospital not many people are going to want to support and
enroll in that hospital where money and profits are valued more than the life
of a human being. I strongly suggest not closing the ER or services which are
offered to people who are unable to afford hospital services in a daily basis
because that action will cause more harm to the hospital than it will prove beneficial.
N.S.
Academy of Irving ISD
11/10/03
As a hospital director i would not close the ER. Even though the ER might lose
the most money but how can one put a price on saving a persons life. What has
to be done, it that i may have to start laying off people, or cutting back salaries.
What i would have to do personally is, also take a pay cut so that other will
see we must all must make sacrifies, and hopefully with those changes the hospital
will stay open.
B.N.Y.
Health Careers High School
11/10/03
Closing the ER is a very skeptical thing to do if closing it would be the only
option I still would not close it. Peoples lives
depend on the nearest ER, their critical conditions is no waiting matter. There
has to be other ways to keep the hospital open,
you shouldn’t even think of closing the backbone of a hospital. Even though
a lot of the people cant afford to pay everyone is
entitled to health care.
Lake Highlands Freshman Center
11/10/03
As a hospital director I would close the Emergency Room only as a last resort.
Because the emergency room is used by
more people in the community then any other department closing it would hurt the
hospital more then help it. If any department should close then it should be one
that is not used as often or by as many people. Maybe a department like an
ear, nose and throat department because there are special offices and sites around
town with that kind of medical attention. If
you look around the community there isnt really a building or facility devoted
only to ER. The hospital is pretty much the only
place for that. Closing the ER wouldn't allow people who need help to get it.
Closing it would also put many many doctors,
nurses, and surgeons out of a job. Closing the emergency room in my hospital would
not happen.
SMM
Wylie High School
11/9/03
If closing the ER was the only way to keep the hospital open, I would close the
ER. Patients needing emergency medical
attention would be brought to another hospital since it is not available at the
hospital in question. Keeping the ER open would
lose money that is needed to keep the hospital open, so other patients can access
it. Hospitals are still needed for things other
than emergencies, such as maternity and geriatrics. It would be unethical to deny
all people in the area healthcare. By keeping
the ER open, it would eventually shut the whole hospital down. In the long run,
it hurts everybody, not just a certain group.
R.C.
Wylie High School
11/9/03
If I had to make the choice I would certainly not close the ER. First of all it
is ethically wrong and immoral. All people
deserve healthcare no matter what the cost is. The ER is the most important department
of the hospital because it provides
immediate care to those who need it. Closing the ER would not only affect people
who cannot afford regular healthcare it
would affect all people who need emergency care! I would have to find another
way to cut costs like closing other
departments, increasing hospital efficiency or maybe even lowering the salaries
of overpaid supervisors and hospital
executives! To close the primary care site of five thousand people would simply
be horrendous.
J.H.
Jesuit College Preparatory School
11/8/03
I know my opinion is not very popular but I think that if I were a hospital director,
then I would have to close the
Emergency Room, that way I would not loose money so I could keep my hospital open,
because if my hospital were not
open then I could not help thousands maybe even millions of people that a usual
hospital saves a year. Plus, if the person
has a major injury or illness I would move them to ICU, and the rest could be
dealt with like a regular doctors office.
T.P.
Wylie High School
11/7/03
Although we are losing money I do not thing closing down hospitals is the answer.
Our job is to save lifes and closing down hospitals would do just the opposite.
We will have to find other ways to cut our loses down and to do that we will need
to explore every possible idea. I do not believe that we have earned the
right as people to decide who lives and who doesnt. By not treating the people
who are unable to pay for medical care we are putting lifes in danger. So in conclusion
we will keep all hospitals operating and emergency rooms until we can come up
with a better way of cutting costs.
L.J.
Crowley High School
11/7/03
First off If I was the director of the hospital I would never in my life shut
down the Emergency Room, yes it might not make
as much money from its patients but it is also one of the main functional areas
in the hospital. I recall coming into the ER and it
being packed full of people in need of medical assistance. Some of these people
were being rushed in by ambulances or by
people driving them there. Medical attention does not come cheep as we all know
but when its needed suddenly the
Emergency Room is where they go for assessment. To many people are dependent on
the ER of the hospital to shut it down,
there are too many incidents that involve people being rushed in the the Emergency
Room as well. Closing the Emergency
Room is just down right wrong to do becasue where would the people have to go
if they needed medical attention suddenly.
So this is why I think closing the Emergency Room should not be done.
N.K.
The Academy Of Irving IISD
11/7/03
I would chose to keep all offices open because it is important for people, and
especially poor people who can not afford
proper medical care, to be able to be treated. The ER room is an important place
where anyone can be treated for
immediate attention. I would allow anyone who needed healthcare, a place in my
hospital (assuming I have enough room)
because it is important for me and my staff. Our actions say who we are.People
would look at us reaching out to everyone
and see us as a better hospital. Eventually we would grow out of debt and be recognized
for what we did.
J. W. F.
Health Careers High School
11/6/03
If I was the director, I would not close down the ER because if someone needs
medical attention right away, then it would cause problems for them to get medical
attention somewhere else. Losing $2,000 a year is better then causing 5,000 to
find help somewhere else. Too many people count on the ER to close it down. Things
occur everyday and people get hurt, so if they close down the ER, they would have
no where to go. Closing it would be ethically wrong, at least that is what i think.
R.D.
Health Careers High School
11/6/03
Being the director of the hospital I would automatically think of my patients
and community before money. Although the emergency room is loosing vast amounts
of money it is a very important part of saving peoples lives. It is responsible
for treating people before an accident can get more serious or even lead to death.
The closing of this department would force people in the community to travel a
longer distance to receive medical treatment this could cause people to lose there
lives before they get there. Instead of closing the E.R. down I think fundraisers
and local charities could help play a part in earning money. Working out sensible
payment plans with people on ways they can absolutely afford. Even though it might
take a while for the money to get in money later is better than no money at all.
To wrap it up I’m basically saying that it is morally wrong to shut the
E.R. down.
C.F.
Mineral Wells High School
11/6/03
As the hospital director, you should immediately realize that the E.R. is one
of the most vital departments to any hospital. Many people use the E.R. as their
primary care center because they are unable to pay for medical care. Parkland
Hospital's E.R., for example, is a huge E.R. and provides a lot of the care to
the citizens of Dallas that need immediate medical attention. Closing the E.R.
and denying persons medical care for everyday illnesses would result in higher
costs to the hospital because people would then only seek medical attention when
their medical conditions are at their worst resulting in longer hospital stays
and more intensive medical care. Preventative medical care and early intervention
are the key to lower hospital costs. As the hospital director I would never personally
dream of closing the E.R. because of how important it is to people that can't
pay for medical care.
J.G.
Wylie High School
11/6/03
If I had to make a choice, I would not end the ER. The ER is a very important
part of the hospital. because it saves a lot of people from dying. Closing down
the ER will affect a lot of people. Nothing good will come out of closing down
the ER. I don’t know why anyone would want to close down the ER. I never
made many trips to the ER but I do know people who go there really need some help,
and if someone was to close down the ER it would destroy the source of aid for
many people.
D.H
J.J.Pearce high school
11/5/03
As the hospital director I would decide not to close the emergency room. The reason
why I chose this is because many people depend on that. In many cases it can be
a life or death situation. I don't feel that we should take away hospitalization
privileges from those less fortunate. By closing down the emergency room it will
effect many other parts of the hospital. And what if there was a terrible car
crash and over 15 people were injured and needed immediate care and it was past
hospital hours, what would they do? Bleed to death? That is why I would keep the
emergency room open. I think I would cut back from each section little by little
and still give everyone health privileges.
K.H
Crowley High School
11/5/03
As a hospital director, I would choose not to shut down the ER. The ER is where
lives are saved and saving a life is far more important than trying to save money.
The ER provides so much care for a lot of the patients. Instead of closing down
the ER I would look for other ways to save money like cutting back on superflous
materials. Closing down the ER would be the last step I would take in trying to
save money.
mlt
11/5/03
I think that we should try the medical health plan just like Canada. People could
have gone to the hospital and not worrying about how much they have to pay once
they are recovered. Even though it takes a long time to make this work, but, that
way, it's convience to everybody. We don't need important people or government
to stands out and speak for us. We are the ones who is paying for it. If we don't
like the situation or the fee now, we speak out! Without us, the people won't
have anything else to do. Health Plan should be cheap for god's sake. Paying 100
dollars a month is enough, even less. And once when you are sick, you can just
go to the hospital...and seek for help. I believe that's what doctors are for.
YC
Arlington High School.
11/5/03
Being the hospital director, I would definately choose to not close the ER. Although
it may lose alot of money, it does save alot of lives. I believe closing it would
only make the problem worse because those who normally come to the ER would go
to other hospitals who do have an ER and probably stay there as a preferred hospital.
I would instead try to figure other ways to make money. One other option would
be to consider shutting down other departments.
G.S
Arlington High School
11/5/03
First, if my hospital were in any danger of going out of business I would take
all precautions to diverge this impediment. I would proceed to close the hospital
Emergency Room. If the ER were unavailable, more serious cases would have to be
taken to another hospital since no ER medical would be available. If funding were
to rise again, the ER would open to those who have health care. Although this
act is not favorable to most opinions, they simply have not seen the hospital
director’s view clearly. Most people say they would keep the ER open, even
if it were to risk their hospital out of business. If the hospital loses money,
employees lose money, and with no employees means no hospital.
B. F.
Wylie High School
11/5/03
If this critical decision was placed in my hands, I would without a doubt choose
to leave the Emergency Room. My hospital would NEVER be centered around monetary
loss or gain. Isn't the point of a hospital to help people-not only those who
are financially stable but all those in need of medical assistance?
T. R.
Wylie High School
11/5/03
Being the hospital director, you should realize that the ER helps so many people
beyond comprehension. Closing down the ER could result in a situation where a
person becomes eternally ill or as bad as someone dying. If the hospital is running
out of money, you could become creative and come up with a charity event of some
sort to raise money, instead of closing down a place where so many people can
get help and possible cured from a sickness. Closing down the ER would result
in a terrifying situation, for anybody.
N.G.
Wylie High School
11/5/03
Money is a big issue these days, and millions of Americans don’t have insurance.
To close down the Emergency Room (ER), would be a big mistake because accidents
occur every day, and if you close down the ER these people would have no where
to go when they seek medical attention. The thought of closing the ER would be
morally and ethically wrong, but we are all humans, and the first thing we try
to do is look after ourselves. Two million dollars is a lot of money but should
not stand in the way of helping 5,000 patients. I would like to think that
if I were in charge of the hospital I would not close the ER, but before I answer
the question I would have to think about what is more important money, or the
lives of 5,000 people, and in the end would decide on not closing the ER.
E.G.
Health Careers High School
11/5/03
As the director, I would first find out any other departments they aren't making
enough money and see if they are expendable. But I would not get rid of the Emergency
Room. To many people need that. Besides what would happen to the people who cant
afford it, let them suffer ore even die on the street, I don't think so. I might
set a donation thing for people who cant afford it compleatly. have them pay what
they can.
B.H.
Wylie TX
11/5/03
The obvious answer is to seek a second opionion. That is personally what i would
do. Eventually, if it were certain that the entire hospital would have to shut
down if the Emergency Room was not closed, I believe I would come to the conlusion
that some is better than nothing and close it down. The patients not able to recieve
care at our facilities could be referred, and yes, I do believe that would lose
much business, but in the end, a hospital's goal is not in the least monetary,
it is to help as many people as possible and as well as the staff is possibly
able. I do not believe that the choice to close it down completely and merge with
another hospital would be the most advantageous because for those who need a hospital
for other reasons than the E.R. should not be forced to travel a further distance
when they could have had a more local, yet "E.R.less" hospital.
A.L.
Arlington High School
11/4/03
As the hospital director, I would ultimately decide at all cost not to close the
ER down. I believe without an emergency room, a hospital cannot function successfully.
The lack of a hospital ER would require patients with emergency needs to look
elsewhere for immediate care. The loss of revenue from these potential patients
would ultimately cause the hospital to shut down.
C.R.
Crowley High School
11/4/03
If I were the hospital director, I would not close the ER. I would suggest that
the hospital cutback only a little from every section, hopefully stooping the
loss of money a little. It would not be right to take from those 5,000 people
who could not afford regular health care. Cutting back a little from each section
respectively will hopefully still give everyone their health care, without totally
taking it away.
T.M.
Fossil Ridge Middle School
11/4/03
If I was the hospital director I would choose to keep the E.R. If the situation
got bad enough then I would shut down the next department recommended for closure.
The reason I would keep the E.R. department is because it is one of the biggest
and most important departments in the hospital. It contributes to the other departments
in the hospital because it helps them get business. The E.R. helps other departments
get business because some patients in the E.R. might have to go to one of the
other departments. So if you got rid of the E.R. some other departments could
loose business. The E.R. might loose a lot of money for the hospital, it could
decide if someone lives or dies if the E.R. is shut down, because if the E.R.
is shut down then the next hospital that has an E.R. might be a couple of miles
away and those couple of miles could decide if someone lives or dies.
TW
Arlington High School
11/4/03
If I was the hospital director I would decide to keep the E.R. because it is a
very important part of a hospital. I would go to the next department recommended
for closure and shut that department down. The main reason I would not shut the
Emergency Room in the hospital down is because if you think about it, more lives
could be at risk because if the E.R. is closed then that means that the next closest
E.R. could be miles away and those mile could depend on if someone died or lived.
Another reason that it would be a bad idea to close the E.R. is because it would
put many people out of jobs. Even though if you close another department it will
cause some workers to be released, there will not be as many released because
the E.R. staff is most likely to have the most employees because it is one of
the largest departments in a hospital. Another great reason why you should not
shut down the E.R. is because everybody has a right to health care no matter if
they can afford it or not. Even though you loose money with the E.R. if you shut
it down you could loose a lot of business in the other departments of the hospital
because they could be sent from the E.R. to another department in the hospital,
and without that some departments could loose business.
11/4/03
Anyone can see that this is a very bad situation, and would have to be dealt with
a very careful and steady hand. The situation really does back you up into a corner.
On one hand, you can close the E.R. and many immediate deaths would occur. In
the long run, however, this would allow you to keep other patients alive. But
on the other hand, you have the choice of keeping the E.R. open. This could make
your hospital finally go under if the situation is not treated correctly. My decision
for this challenging problem would be to keep the E.R. wing open as long as possible.
I would try to set up deals with fundraiser and charity organizations to help
set up methods to have money flowing into the hospital, as well as talk to other
hospitals nearby to help take some of our emergency patients, making sure they
will be properly sustained while in their care. When making this deal, I would
make sure the patients and their families knew that they were being transferred
to make sure all parties involved with the patient were up-to-date with the happenings
of their friends and family. If needed, I would continue to keep this deal open
until there would be a way to get more funding into the hospital to make us able
to stand on our own feet once again. While this problem is a very difficult
one for anyone to deal with, I cannot in good concience allow the emergency wing
of my hospital to be closed to all but the wealthy. The wing was designed for
people who severely need care, and I will not turn them over to the cold hands
of death for insignificant reasons like money.
M. B.
Wylie High School
11/3/03
If i was the board of the commitee, i would highly recommend that you find other
ways to cut back on expendures. The energancy is vital to the society and shouldnt
be cutback. Even if losing all that money you have saved many peoples lives, which
should be the greater reward. I realize that if you cant figure a place to cutback
on expendures that the hospital will be closed and with that many jobs are lost.
Then many people will also die with Then that creates a bigger problem. You could
cutback little by little in each section of the hospital. Cut back on sections
of the hospital that doesnt use everthing to the fullest and the patients that
need that care can go to another hospital that provides it. The hospitals can
work together in this process splitting up the sections for each hospital, thats
if they are near by. The ER provides many people and with that saves many lives
like i said before. This is probably the most important department in the whole
hospital. It provides more care quickly than other sections. You could also do
fundraisers like charities, grants, donations, volunteers. I am sure some people
are willing to take some time to save peoples lives. I believe that the last department
to go should be the ER. Its the most vital and where more of the action takes
place. I would take that risk of going out of business than cut the ER. Too many
peoples lives are saved. I am sure I am repeating myself but I feel like the ER
shouldnt be cut.
A.W.
Crowley High School
11/3/03
If i was the hospital director, I would not let the review committee close the
Emergency Room. It is true that hospitals are losing lots of money each year,
but many patients who couldn't afford to pay for their medical care might be really
sick and helping people is what hospitals are suppose to do; no matter if patients
are poor or not. I think that the committee should look somewhere else instead
of the Emergency Room.
A.C.
J.J. Pearce High School
11/3/03
Closing the emergency room would not be good for the community. The emergency
room is beneficial to more people than any other portion of the hospital. There
are other areas of the hospital that are not used by the majority of the community.
I think that it would be best to keep the emergency room and do away with something
else.
K.P.
11/3/03
Why would you close the Emergency room of a hospital. I would keep it open and
try to find other ways to deal with the budget problems. People depended on the
ER for EMERGENCIES that is why it is there, Being the son of a Doctor I have visited
the hospital, while my father makes rounds and I have seen that the ER is a very
busy place...hundreds of people, rich and poor come in everyday with problems,
plus the people who come by ambulance, need the help fast and can not wait hours.
Hospitals are there to help you when you are seriously sick or hurt. ALL HOSPITALS
lose money due to insurance, the money they need to cover for Malpractice, medicine,
and medical supplies. The ER would be the one with the least profit because it
does the most work and uses the most supplies. $2 million dollars is a lot of
money but what is more important Human life or a few extra bucks in your pocket
each month, I for one think it is life.
D.C.
J.J. Pearce High School
11/3/03
If I was the hospital director, I would strongly persuade the committee to look
somewhere else to make the cutbacks. The emergency room treats thousands of patients
that would be unable to receive care if it was not there. It is our duty to provide
care to these unfortunate people. The money this department is losing per year
is a substantial amount, but i think that the hospital can make up for it in other
ways. Local fundraisers or charities could alleviate some of these losses and
make it possible for the E.R. to stay open. I think it is the my job as well as
the committee's job to keep the E.R. open at all costs and
find another way to raise the money.
M.H.
J.J. Pearce High School
11/2/03
First of all, I am certain that closing the Emergency Room would be the worst
solution possible. While it might save the hospital money, the true purpose of
a hospital is to help the people that are in need of medical assistance, and because
so many people do come to the ER for help we must keep it available. I would much
rather eliminate hospital departments that do not make much money. Since they
do not make as much money it can be predicted that not as many people need those
treatments. So instead of having a department that is only in use half of the
time we should eliminate it and provide more money to other departments. The people
that do have the need for the eliminated department can find another hospital
near by in which they can receive their treatment. Although it may bring some
complication to these few individuals, the hospital would have more resources
available for the huge amount of patients that come to either the Emergency Room
or the other highly important departments.
CU
JJ Pearce High School
11/2/03
A hospital director has many obligations to not only the people, but the staff,
too. It really is almost morally wrong to close down the emergency room of a hospital,
as it is the place that gives the most needed care to patients in need. The 5000
people that are served depend on the service that emergency room gives. However,
not closing down the ER could also be just as wrong. After all other methods of
getting money have been exhausted (donations, grants, etc.), I would have to recommend
closing it down. Sadly, it could mean that some of the people will die, but many
more would lose their lives if the whole hospital closed down. Many of those 5000
could find other sources of help nearby. A hospital does not only give services
to ER patients; others need it to. Saving the lives of others outweighs the cost
of not closing down the ER. Even if saving lives other than ER patients were not
an issue, it would still be wrong to keep it. Many people would lose their jobs,
doctors, secretaries, janitors, etc., and that is even worse than closing it down.
Those jobless people could then trickle down into other lines of work and cause
the area to lose more jobs. This, in turn, would have a more disastrous effect
on the people. After all the consequences have been weighted, I am sure that most
people would agree with me that closing the emergency room down would be the best
decision. It would be the most productive and ethical choice.
C. M.
Wylie High School
11/2/03
This is a very tough decision to make. But I have concluded that we need to cut
back on many things. We will get rid of the emergency wing. If we keep it, all
that will happen is we will lose all our money in a year or so, and then nobody
will be able to get help. Hopefully, there will maybe be a center established
for those who dont have health insurance, where they can
go and recieve help.
S.N.
11/2/03
I think that even though the ER is losing money it should be the very last department
to close. Where are people who are in dire need of healthcare supposed to go if
they have an emergency? I would try to redo the budget and try to find another
source of money. I would try to cut costs in other areas and maybe shut down other
departments that can send their patients elsewhere. In my opinion, the ER is the
most important part of the hospital and is indispensable, and I would rather shut
down other departments and cut costs elsewhere. If shutting down other departments
or cutting costs isn't possible, then we have to ask ourselves whether it is better
to make money but send people who need help and are dying away or help people
and
loose money.
A.D.
JJ Pearce High School
11/1/03
I think that if your hospital is losing money and you had to close a department,
the emergency room would be the last place to close. The emergency room is the
place where patients tend to need immediate care to live. If I were the hospital
director, I would definitely not close the emergency room, but would find an alternate
solution to the problem. I would find some way to displace the 2 million dollars
lost in the emergency room and even close a department where the patients can
find care at another hospital close by. I would have to take the risk of going
out of business because I would not want to be the reason that thousands of people
died because they could not pay for emergency care. Just because a person cannot
pay for medical care does not mean they should not receive any.
R.G.
J.J. Pearce High School
11/1/03
If I had to make a choice I would not close the ER. The ER is a very important
part of the hospital that is probably the place where most people get aid from.
Closing down the ER will affect a lot of people. Not many goods things will come
out of closing down the ER. I don’t know why anyone would want to close
down the ER. I have not made many trips to the ER but I do know people who go
there monthly and weekly, and if someone was to close down the ER it would destroy
the source of aid for many people.
A.S.
Academy of Irving ISD
11/1/03
They should find something else to do. Everyone will get sick or hurt regardless
of how much money they have. And even people who can pay will need to use the
emergency room you can't help having medical emergencies.
C.J.
Wylie
11/1/03
To tell you the truth I would not close the Emergency room. There are many
reasons that come to mind but foremost is the amount of money people have now-a-days.
When the Economy is weak everyone expects to suffer a loss, even hosptials.
Insurance rates are so high that nearly 33 % of the people cant afford insurace
and on top of that doctors charge so much. A person needs the emergencey room
where he can go and by the a doctor goes in the feild to help out a person.
Money should not be a motive it is just a reward. So the emergency room no matter
how much loos it is accumulating should stay open and another plan to cover
losses was to ask the doctors to pitch in a little money to cover the cost and
every thing would be fine.
Z.K.
11/1/03
in order to avoid closing the hospital something would have to be done. closing
the emergency room is not the answer though to maybe people depend on that for
medical emergencies which happen all the time. not treating people who have no
way of ever paying for the treat ment seems like a good idea though.
10/31/03
I personally feel that no matter how poor a person is, his right to well being
and health care should not be restricted. If we take away the poor person's right
to health then soon we can take away the poor person's right to education. The
two are not far off; one represents mental well being and the other physical well
being. If we cannot provide proper care for all members of society then we are
not truly a democracy. Even if the hospital should go out of business, it is better
to die with nobility then to compromise one's ethical beliefs.
Z.G.
The Academy of Irving ISD
10/31/03
In this case, I would rather close down the emergency room down to keep the hospital
up, rather than keep it up. What you have to realize is that there are hundreds
of other hospitals that possibly may not have the same complications as this certain
hospital. 2 million dollars a year is a lot of money and of course that is not
measurable to the 5000 patients who will be let down with the closing. But the
fact of the matter is, with the whole hospital going down, many other patients
will be turned away in other departments and also, many of the patients currently
being treated in the hospital will have complications. You have to look at this
situation from abroad and consider ALL possible complications and make the decision
that will help the overall outlook of the hospital AND the patients. So if I was
the Texas hosptal director, i would definetly close the ER and try to keep the
hospital alive.
S.P.
Garland High School
10/31/03
I believe that the Hospital should do what it can or must to keep it in business.
If you take away the emergency room, it would only affect the people that need
the Emergency Room. On the other hand, if you don't get rid of the Emergency Room,
then the whole hospital will go out of business, and then it would be a big problem
for more than just the people in need of the Emergency Room. Patients would have
to be moved, Doctors would be out of a job, and there wouldn't be a hospital near
by the people in that neighborhood anymore. The Hospital can raise money quicker
and faster without an emergency room, so the removal could be temporary. There
also may be many active citizens in that community that may be willing to do a
fund raiser for the emergency room if they feel that the emergency room is necessary.
B.L.
Garland High Schoo
10/30/03
I think that it would not be wise to shut down the emergency department. This
is were lives are saved and also lost. 2 mill. is a lot of money but, I would
rather lose money then lives. The emergency room is for emergencies, and needing
immediate attention to your health but not having any money is an emergency to
me. The government needs to take a look at other departments to shut down before
you shut down the emergency room because other things can be prevented but emergencies
can not. You never know when an emergency is going to happen to you... Would you
want to be turned away from the hospital if you had no money but were dying??
J.I.
Garland High School
10/30/03
One must realize that a hospital is still a business. To survive a business must
make a profit or minimally break even, losses are not acceptable for a business’
survival. If the emergency room is losing the most money, then that, from a business
stand- point, is the most logical area to cut costs first. One must consider that
the Emergency Room’s availability is important to many people. Although
healthcare should be available to anyone in need, it is very expensive and must
be paid for. The money needs to come out of someplace other the non-existent
budget of the hospital. If no extra funds can be conjured up then it is reasonable
and logical to close the ER rather than go bankrupt rather than let the entire
hospital close.
R.M.
The Alexander School
10/30/03
I think that closing down the emergency room will be a bad mistake and choice
to make. I believe that it will be a bad decision because the emergency room is
where patients come to seek medical help and assistance. The medical room is also
where patients can come to get help with medical insurance or no medical insurance.
I personally, believe that saving a life is far more important than trying to
save money. I know that two million dollars is alot of money, but saving a life
is more important. So I hope that they make he right and best decision by not
closing down the emergency room.
S.S.
LHFC
10/30/03
After reviewing the information provided, as well as doing my own research, I
believe that closing emergency rooms may help our hospitals with their current
financial situation. Although hospitals help quite a few bit of people it is still
a business, not charity. Hospitals not only have to pay employees but they have
to be able to function as a hospital. I would rather be rerouted to a different
hospital than go to a closer hospital that is not properly equipped with equipment
to medically help me. Hospitals have to pay bills, salaries, by new beds when
necessary, bed linens, towels, cleaning equipment, and tons of other things. 2
million dollars may not seem like a lot of money for a huge hospital, but when
you think about what it takes to run a hospital 2 million dollars could come in
handy. California hospitals lost a total of $325 million dollars last year, because
of people not being able to afford Medicare. K. W. mentioned in his/her 10/23/03
post that maybe fundraisers could help with the money deficit, which seems nice
in theory, but in all actuality I cannot think of a fundraisers that will help
repay $325 million dollars. Unless it is a life or death situation people who
can afford treatment should be treated first. This method insures that hospital
knows who and who cannot afford treatment, and they recieve proper payment for
their services. It may seem wrong to treat only people who can afford treatment,
but it is also wrong to have to explain to employees that they are having to take
a pay cut because someone didn't have enough money to get treatment, but they
treated them anyway. Maybe we could find a solution if hospitals joined together
to form a bigger hospital, there would be more employees and supplies for both
hospitals. Or if information was given to people about when it is necessary to
come to an emergency room and when it is OK to go into a doctors office.
S.
The Alexander School
10/30/03
Like most things dealing with business in general, the desire to cut services
when revenues fall short remains the primary option. Sadly, this option is shortsighted
at best. If the emergency room or any other services were to be cut, it is hard
to envision a period in time when that section of the hospital could be reopened.
The immense expense incurred when reopening a dormant facility would likely be
counterproductive. The rehiring of doctors, purchasing of new equipment, etc.
actually costs more in the long run. A full audit of the hospital's functions
should first be immediately executed (no pun intended). All government programs
have immense amounts of waste and bureaucracy that could either be eliminated
to farmed out to private contractors to reduce costs. Though these cuts alone
would likely not fix the problem itself, it is a good start. Next, the focus of
the hospital itself should be determined. Children's Medical Center of Dallas
is undergoing a $150 million expansion due to its focus on certain highly-skilled
fields (separating twins conjoined at the head and others). If a hospital is in
the business of treating emergency patients, other highly specialized areas the
hospital employs should be eliminated and have equipment shifted to another focus
or sold to raise capital. Otherwise, the hospital can focus on certain specialties
and close the emergency facilities and other common treatment facilities. If a
hospital can shift it's focus to another area and become highly specialized in
it, the hospital gains notoriety, donors, and publicity. When tax money returns
(most likely soon, as exhibited by 7.2% Q3 GDP growth), the hospital can return
as a more efficient and focused business enterprise. Consequently, the hospital
gains more flexibility when it wants to reroute money to programs or expand. Next,
hospitals can follow an approach taken by major airlines when they experienced
financial trouble. Technologies and doctors can be shared between multiple facilities
to reduce costs and provide greater service at the same time. Areas of expertise
one hospital lacks in could be strengthened by a partnership with another hospital.
Finally, an effort should be made to lobby the state legislature to protect the
interests of the hospital and medicine itself. Emphasis placed on tort reform,
which would eliminate frivolous lawsuits aimed at putting doctors out of business,
helps lower the cost of medicine and care all around.
G.R.
Garland High School
10/30/03
The situation of the hospital is very unfortunate, but I feel that not all options
have been exercised. A simple tactic to create political pressure would be to
take the situation to the media. A simple news conference could greatly influence
public support and create political pressure on the state legislature. Also, closing
the ER is ludicrous and the hospital would become a large doctor’s office
of specialists. Through manipulation of profits in other areas of the hospital,
different branches of the hospital could compensate for the ER’s deficit.
Also, the ER should eliminate wasted care. Many patients rush to the hospital
but their doctor or a clinic could provide the same care at a lower burden on
medical resources. If these measures fail, it is the goal of the hospital director
to keep the hospital in business and provide the greatest good. While poorer citizens
may not be able to afford medical care, many charities will make up the difference
and at least a few patients can receive care.
D.J.
Garland High School
10/30/03
I believe that the only option is not to shut down the Emergency room or go under.
I think about the Scottish Right Hospital near my city. In front of the hospital
there is a place called the Ronald McDonald House. In this house parents are allowed
to stay for little to no cost depending on the given persons situation. As the
adminstrator of the hospital, I would begin to contact big companies and ask for
sponsorship in order to stay open. I may also ask for the companies to donate
items that I could put in a silent auction to gain money for the hospital. Big
Companies need to give so much money a year to charities in order to not have
to pay large taxes. In my search for sponsorship I would of course try the soft
drink companies first. I would offer them exclusive control over our vending machines.
I would make a public announcement asking for donations to the hospital so that
it may stay open and serve the people who truly need it. People will usually find
a way to give what they can't afford to charities that truly need it. There are
other options to consider than just shutting down the public means of health care.
I would do all that I could in order to prevent the E.R. from being shut down.
But if all my work proved to be in vain and the E.R. continues to lose too much
money, I would be forced to shut it down. Granted that many people may no longer
be able to get medical treatment, but what about those that can afford it or do
have insurance? They should not lose their health care because of the recession
in the economy. These people would need treatment and it would be better to be
able to treat few than none at all. A hospital is a business for medical care.
It must do what it can to stay open. So I would first attempt to raise money through
charity, but if that fails I would have no option but to shut down the emergency
room.
T.G.
Garland High Schoo
10/30/03
If anything, closing down the E.R is the last thing I would do. There's a reason
why it's called the Emergency Room, people come in cases where there's an emergency.
Not everyone that walks through those doors is poor. People could be dying, and
what if they can't make it to the next closest hospital? If anything, I would
go to the next section of the hospital that is the least used and cut that. Although
it still doesn't make any sense to cut out any part of a hospital; hospitals are
here to help people. If you cut any part out, it's like cutting out a body organ.
You need every part to be alive. If you have a stomach ache, you're not gonna
go cut out your stomach to get rid of the pain.
P.M
GHS
10/30/03
If i was the director of a Texas Hospital, i would do everything i could to
keep the emergency room open, however, we all know that with no money it is
impossible to keep a successful business (in this case an emergency room) running.
I would do everything in my power too keep it running, however, it is impossible
to come up with 2 million dollars selling chocolates (fund raisers). Perhaps
if you could reduce the superfluous materials in the rest of the hospital building
it may be feasible to build up a surplus of money that would cancel out the
extra expenditures that do not generate a revenue of money. If there is no way
to come up with enough money to fund the emergence room, you have no choice
but to eliminate it.
T.R.
10/30/03
Parts of the external advisory committee's plan works. Somewhere money must be
saved in order to keep the hospital open. The hospital's complete closing would
be more harmful than just the elimination of a few departments. Sure, by eliminating
emergency we bring harm to 5000 people, but how many use the hospital? Its the
principle of utility: if more people use the hospital total than those that just
use the emergency room, and by closing the emergency room you better provide for
the greater number who use the remainder of the hospital, you are morally obligated
to close the emergency room. Of course, if the emergency room helps more, then
you must keep the emergency room and eliminate other lesser used departments.
As to only offering service to those who pay... it may be necessary if there aren't
enough underused departments that can be closed to generate spare cash, but you
can always look at each individual case to deem who needs the free care most.
There is no clear yes or no answer (this is why its an ethics case), but a balance
can be acheived based on serving the greatest number possible with avaliable resources.
J.B.
Garland Highschool
10/30/03
First off, we must consider what is more valuable in this case: money or life?
I personally vouch for life over all else. Because the Emergency Room the section
being debated, I feel that there is even more reason to keep it up. This wing
of the hospital helps those patients who are in immediate need of medical attention,
and life is often at stake. As a doctor, you commit yourself to saving/preserving
life, not worry about making excessive money. As a hospital DIRECTOR, I would
be representing all doctors and nurses in the hostipal; on their behalf, I cannot
bring myself to fail the people who count on much needed health care. In fact,
many people cannot afford health care; would you close off ALL health services
to those who cannot pay for it? There is never a shortage the need for doctors
and nurses in this world. Even IF the hospital were to close, they can find jobs
somewhere else, and both professions pay well enough. Now consider the alternative:
you cut off the Emergency Room wing and MAINTAIN $2 million, not PROFIT. What
if the hospital continues losing revenue and ends up closing later anyways? One
human life is priceless; imagine losing five thousand. I firmly stand on keeping
the Emergency Room open to those in need, regardless of whether they can afford
it or not.
H.L.
Garland High School
10/30/03
Closing down E.R. should not be the primary consideration for closure because
it would harm many people who are in need. If spending $2 million to save the
lives of many people in emergent situation were waste, then closing down would
be a good idea. But lives of people are far more expensive and precious than $2
million, despite what the review committee might think. The previous student’s
response that “a general surgeon or M.D. could be the judge of those who
request ER room clearance” isn’t a good idea because that would slow
down ER (already slow enough) and thus make ER inefficient. In that sense, ER
would lose its purpose. Also, stopping cares for those who cannot afford would
defeat the purpose of hospitals: service. Hospitals should not be considered as
a “business” as said in the ethics topic because hospitals are non-profit
organizations. “Only [offering] hospital procedures to those who can pay
for them” is discrimination because that would preclude low class people
from getting health cares. Hospitals are needs, not wants, and therefore taking
away the needs of people would be unjust.
There are other alternatives other than closing down ER, such as working harder
to pass the bill or asking government for help. Instead of thinking about cutting
services, why not think about cutting some of those over-paid paychecks of doctors?
Why not put the “service attitude” into practice, not with mouths.
S.B.
Garland HS
10/30/03
I'm very disappointed to see that the majority of the people here aren't looking
at both sides of the issue. Of course, at first glance it looks like keeping the
emergency room open seems like the right choice, but there is another side to
this issue. By keeping the emergency room open, the hospital will continue to
lose money and will eventually have to close down. By a hospital closing down,
more lives will be lost because there is a lot of people that need help that is
not an emergency. I'm not saying that I would shut down the emergency room, but
I think that if there is no other option, then it would be in many peoples interest
to shut it down to save the other wings. 30 hospitals have been shut down since
1980 and many people with disease such as osteoporosis would have to travel a
lot further if they broke a bone. Women who are in labor, it is important to have
a hospital close by so that they can have a safe delivery. If a close hospital
shuts down, complications could happen from the extra time spent driving. Also
if a hospital shuts down, many people would be out of work. The state only gives
them 90 days notice before a place is shutdown. If only the emergency room was
closed, many of them could be transferred to another wing of the hospital. If
the whole point of a hospital is to save lives, we could save a lot more by keeping
a whole hospital, rather than just trying to keep the emergency room open for
a little while. I think that the idea of fundraising is a good idea in concept,
but I don't think that it would work in the long run. Insurance rate is very low
right now, 71 cents per 1 dollar, and the economy is horrible so its hard to get
money from anywhere. A possible solution is that the doctor would not make such
a profit, but based on the human nature of greed, I have a hard time believing
that that would happen. I like what BW had to say, and I agree with their idea
of trying to help the most people possible. Also I think that MR had a good idea
on looking at the bills and considering all of the options, and also recognizing
that because this is an ethical issue, there is no right or wrong. I was surprised
at what MT said, because they seemed to be more concerned about their career,
than all of the needy people. All of this is just my opinion, and I just want
everyone to look more closely at both sides of the issue.
LW
The Alexander School
10/30/03
If I was a hospital director faced with that decision, my choice would be not
to close the Emergency Room. I strongly believe that doctors should be doctors
because they care about people, not because of the money. There are many people
in this world that can’t afford the medical attention they need, and the
ER is the only hope they have. How could a human be willing to deny someone medical
care, and basically let them die eventually. I don’t believe that’s
right. Even if the hospital was going to close if the ER was not shut down, I
don’t think that would be a huge problem. First of all, if that is the only
hospital within a city, the city isn’t going to shut down the hospital.
Everyone needs medical care at sometime in their life. Citizens would know and
understand the importance of having that hospital and would help fight for its
survival. Whether the citizens donated money, or even helped the hospital set
up a fundraiser, the hospital would get its money. Also, if there were many hospitals
within that city and closing it wouldn’t be a problem, then all they doctors
currently working at the hospital that would be shut down, could find another
hospital to work at. There are always hospitals needing doctors.
S.T.
J.J Pearce H.S
10/29/03
Confronted with such a predicament, the hospital director has to realize his
or her motives for running this hospital. Although the ideal motive is philanthropic,
there is usually some hope of profit from running such a public service. I am
on the philanthropic side 100%, but I don't have a family to feed and support.
It is logical to get rid of the emergency room in light of its affiliation to
the retrogession of the hospital's expenditures, but then what is the difference
between the U.S. and underdeveloped countries? What is the purpose of having
a hospital that can't serve the most needy? The director really should just
find a way to get better profits from that department and take out one that
is a smaller commodity to the general public. A hospital in itself should represent
hospitality in a professional, business-like manner. There is always another
way (in most cases anyway), and in this case, I highly recommend the other way
because, otherwise, this hospital director is defeating the purpose of the hospital.
S.S.
Garland High School
10/29/03
In this scenario, the hospital director is placed in a difficult situation in
which the outcome of his decision will have a significant impact on the future
direction of the hospital. If the director chose to cut the emergency room division,
then the hospital woudl become less of a hospital and more of a private practice
and specialty center. Because specialists are so expensive and sought after typically
by those who can pay for them, then the latter type of medical establishment would
be more lucritive for the director. If I were to ever invest in or direct a hospital,
I would want it to be primarily and establishment for care giving and helping
the community as much as possible. This is why if I were the director, I would
instead opt to reduce the size and scope of the specialist's wings and maintain
the budget for the Emergency Room. The correct answer in this situation depends
entirely on the hospital director, where his/her priorities are, and how they
envision the future of their medical establishment. In my opinion, this problem
can be solved at the highest level by reducing the amount of government waste
and disciplining fiscal responsibility without increasing taxes. If there is less
money wasted through the other branches and departments of the government, then
there would be more money to spend on public needs.
L.G.
Garland High School
10/29/03
I think that closing and shutting down the emergency room will be a bad choice.
I feel that it will be a bad decision because, that part of the wing receives
alot of patients that can either afford the visit or cannot afford the visit.
I know that two million dollars is alot of money to lose, but I think that saving
lives is more important than money for any cost. I strongly believe that to save
a life or helping someone should not come at a price.
C.S.
10/29/03
I feel that if I was the director and I was faced with this decision, I would
definitely not close down the emergency room. If I was to close any area of the
hospital down, that area would be the very last. Yes, even though it does loose
a lot of money the emergency room, I believe is more important than a patient
being in a private room. In order to limit the amount of money the emergency room
losses, i would raise the prices of other procedures such as: receiving surgery,
being on life support, and patients which have minor injuries or irritations.
The patients that did come in and could not pay the whole price of what they have
received, i would allow them to pay at least five dollars; because something is
better than nothing. I would also make the patient pay before they are helped.
Even though it may seem unfair for others to pay more than some if you want to
be helped and treated then you just have to suck it up and pay the price.
S.Y.
Garland High School
10/29/03
I agree that money keeps hospitals going and that a part of the hosptital might
need to be shut down, but I don't think that the ER should be the one to go. While
the ER might be losing the most money, it probably helps the most people, which
is the main idea of the hospital anyway. As far as which departments of the hospital
to shut down, I think they are all important, but, if need be, get rid of the
ones that help the least people or that are the weakest at the hospital. Only
allowing people who can afford it to get treatment just is not right, but it might
have to be done. If it got to the point at which people could not be given treatment
without paying, then the hospital would have to turn people away. Without money,
the hospital does not work. In a world in which people are perfect, it wouldn't
be an issue. The richer people would give money to the hospital and the hospital
would have endless supplies and machines and money, but it is not a perfect world
and sometimes to get by, people have to do things like turn sick people away;
things they dont want to do. But they have to.
A.W.
10/29/03
I believe that it would be a bad choice to close down the emergency wing of the
hospital. Many people don't have very much money these days and they may not be
able to pay for the medical treatment they need. The emergency room would allow
them to get better with little or no money. Two million dollars is a lot of money
to lose, but I believe that losing the money is better than losing the lives.
The hospital could raise money to keep the emergency room running,too, so then
everyone can get the treatment they need.
L.J.
The Academy of Irving ISD
10/29/03
well hospitals are made to help people in any and every way ..... 2 mill is a
lot of money ....for a hospital... and 5000 people that didnt pay is a lot of
money ....Doctors are one of the main important jobs in the world without them
everyone would be sick or hurt or even without medications to help them get better.
So what ihave to say is that no matter what the problem is that the dotors have
to be there and help the pasintes out in any problem.....they have .. the hospital
has to treat people = even if u have insurance or dont....
C.L.
10/29/03
I dont think they should close down the ER, because most of the people who go
to the hospital today dont have enough money to pay. by closing down the ER there
won't be any place for those people to go. They will have to pay these high doctor
bills for private doctor that they can't afford.
K.G.
Academy of Irving ISD
10/28/03
If I were in charge of a major hospital whose emergency room was causing my hospital
to take a turn for the worse, I would never take away the emergency room. This
is a very simple reason why; either you help somone in desperate need , who may
not have all the money needed to pay off medical expenses, or you let that individual
die. Now it may just be me, but aren't hospitals supposed to save lives? To deny
a human being of their desperate medical needs is, in my mind, a greedy murder.
Greedy because it is helping you, and only you, make money at the cost of anothers
life. Either that hospital needs to realize that the emergency room may not make
them the most money, or they need to go out and purposely hurt people so that
their greedy selves can make some money off of their emergency room. I think that
my answer is clear enough, you have to keep the emergency room.
S.O .
10/28/03
2,000,000 dollars lost to 5000 patients a year that cannot pay for Medicare is
an atrocious sum. There is over 260,000,000 people in the U.S. alone, not including
illegal immigration everyday. Many of the ER department rooms are filled with
minor injuries such as headaches and the flu. These could be prevented at home,
without the additional hospital use. The ER room could be seriously downsized
if the public only knew of how to treat common problems appearing serious to the
normal eye. As a solution, a general surgeon or M.D. could be the judge of those
who request ER room clearance. If they are seriously injured, they are wheeled
to the ER. If the problem is not immediate or desperate, they may be held in a
nursing room under one hour surveillance of serious problems. This would reduce
the stress of the ER such as seeing other injured patients wheeled by, or hearing
the shouts and screams of victims/doctors/nurses in the room near yours. This
action could be considered drastic, but in the wake of losing a public service
such as a hospital, measures must be taken.
Dan
LHFC
10/28/03
I think that with so many businesses running low on money many are making the
unfortunate mistake by cutting out the most important parts. Hospitals are there
to help people and if one is so desperate for money that it is cutting out its
emergency room there is obviously a bigger problem than just money. Yes, emergency
rooms might be where the majority of a hospital loses it's money but it is also
where the majority of people in a hospital go to get help, which anyone should
have the opportunity to get whether they can afford it or not. If a hospital
really is losing such a large amount of money they should downsize on parts of
the hospital that are used the least.
BD
Lake Highlands Freshmen Center
10/28/03
While a hospital's main purpose is to help people, and not to make money, if faced
with bankruptcy, the owner has no other alternative than to close the E.R. By
closing it and retaining other services, he can still, at least, help some people.
The prompt stated that this was the first department recommended. That said, I
would look at the other departments that could be closed and determine which scenario
will enable the least amount of closure while still being able to help the most
people. The idea to not give hospital care to those who cannot afford, at first,
seems absurd, but on examination, seems reasonable, given the fact that, in a
capitalistic society, profits drive business. If this is the only way for the
hospital to stay in business without closing any departments, then so be it. If
the people insist the hospital stay open with no services closed, despite the
hospital losing money, then they should have to pay the price to cover these
costs. If this does not satisfy those who cannot afford basic healthcare, they
could lobby for an increase in government subsidies. The government should take
a close look at its waste programs and find things to eliminate in order to be
able to contribute more to the hospitals. A crack-down on welfare subsidies might
be a suggested start.
B.W.
Garland High School
10/28/03
Any citizen of the society in which we currently find ourselves would be shocked
to hear any proposal related to the closure of an Emergency Room. This in itself
is a valid reason not to follow through with any such plan. Any hospital intending
to close a security on which so many depend would no doubt meet with serious opposition
from the general public. The only advantage any hospital facility has over any
other is its location, and this is only truly a benefit in circumstances of dire
emergency. If the Emergency Room itself were unavailable, what can only realistically
be viewed as customers might take their business elsewhere, thereby possibly undermining
the productivity of the hospital more than the facility originally did. In addition
to the unethical nature of such a plan, it would have a high chance of being counterproductive.
JM
Wylie High School
10/28/03
This is a very hard decision to choose from. What it basically comes down to is
that do you want to help save the 5,000 lives, or do you want your business to
gain more income. We should all want to help people at all times. Many places
(for example The Red Cross and angel trees) help people that are not as fortunate
to gain things that they could not afford if it was not for other people who had
compassion to help. The Emergency Room though is a very necessity for a hospital.
What if you become sick too quickly to get an appointment, or you suddenly became
sick in the middle of the night? What would you do? You would probably go to the
Emer
