NYC homeless bums are costing you a fortune.
Ricky Alardo, a homeless alcoholic nicknamed Ricky Ricardo, swigs cheap vodka by day at his favorite corner in Washington Heights, then calls an ambulance to chauffeur him to the hospital for a free meal and a warm place to sleep, courtesy of taxpayers who fund his Medicaid benefits.
For a chronic caller like Alardo — who phones 911 four or five times a week — the annual medical bill can be as high as $300,000. Over 13 years, the length of time he has been abusing the emergency room, he has cost the medical system an estimated $3.9 million.
In Midtown, another bum, Robert, has faked emergencies to get food and shelter in ERs about 40 or 50 times in the past three years — and taxpayers pick up his tab, too.
Ricky and Robert are among the dozens of “frequent fliers” who clog the 911 system, tie up city ambulances, crowd emergency rooms and burn through Medicaid money.
An ambulance ride alone can run as much as $800, and an ER visit can cost, conservatively, $400 a pop, according to estimates from medical experts.
City officials don’t track frequent fliers or the costs associated with their transport and hospital care, but anecdotal numbers from ER and EMS workers suggest there are dozens throughout the city.
“We have a system that is extremely dysfunctional. We have no place to put these people,” an EMS medic said.
A paramedic working downtown said some frequent fliers think they’ll get faster treatment if they arrive at an ER by ambulance, rather than walk in.
“They know what to say to our call takers,” he said.
Or they’ll tell a bystander, “Oh, I have chest pains,” the medic said.
Alardo, 53, phones 911 so regularly, medics know which calls are likely his.
“When Ricky passes on, I’ll probably even go to his funeral,” said one medic who works in Washington Heights. “I’ve seen him almost every day for the last 13 years.”
An inebriated Alardo lauded the medics last week, saying they “treat me like a king.”
A few hours later, he called for an ambulance to pick him up on Bennett Avenue. He went into the hospital at about 4 p.m. and slept for hours.
His fellow frequent flier Robert said he has called 911 as many as 50 times since becoming homeless three years ago.
He said he would tell the 911 operator he had chest pains or was suicidal.
But, he confessed last week, “I’m not really suicidal.”
Robert, 40, said he was looking for a place to sleep, get a meal and get the medications he takes for depression.
He said he stopped his 911 habit after an ambulance driver “chewed him out.”
“I haven’t called an ambulance for about a month,” Robert said.
By law, EMS workers cannot refuse to treat or transport any patient. And ERs have to at least evaluate and stabilize homeless patients.
The drain on the city’s strapped medical system is huge. Medicaid reimbursements don’t come close to covering the costs of frequent-flier visits.
Medicaid pays just $175 for a basic ER visit and only $186 for the cost of an $800 advanced-care ambulance.
At a minimum, ERs give vitamins, showers, hot food and a bed to their homeless patients. But those who come in with underlying medical conditions require X-rays, cardiograms and medicines that can push the cost of an ER visit well above the average $400.
“They take space. They take nursing resources. They’re a drain on the staff’s energy level and emotions,” said Dr. Jeffrey Brenner, of Camden, NJ, who has studied the issue. “They’re costing the system in both direct and hidden ways.”
Brenner’s research found Medicaid paid $46 million for the top 1 percent of Camden’s frequent fliers, or 1,035 patients, during a five-year period.
A pilot program at Bellevue Hospital has cut ER visits by 67 percent among “high-cost” Medicaid patients by finding them their own doctors, housing and even cellphones to keep in touch with their doctors, according to a recent report by the United Hospital Fund.
But it will be hard to break the habit of vagrants who view the ER as their personal retreat.
“It’s not always easy to pick up these guys and take them in,” one medic said. “But our policy is: ‘You call, we haul.’ We have no other choice.”
(Source: NY Post)
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15 Responses
you’ve got to admit…..that is a pretty nifty trick for a drunkard to concoct!
In some cities, the EMS has ways of responding to an emergency call with less than an ambulance, and there are care options other than choose between leave the person on the street or take them to an ER. Instead of blaming the “homeless” person (who probably mentally ill, and probably not even truely homeless), blame the incompetent bureaucrats who are too lazy to address the situation (as if it is “their” tax money involved).
I do agree with the previous comments.
However, I must add that $400 for a simple plain ER visit is crazy, as is $800 for an ambulance ride. What is wrong with your country? How can you justify such prices?
In Europe these prices are MUCH lower.
I can only imagine the HUGE profits US hospitals are making.
Well, then again, they need something to be able to pay their physicians $50,000 a month…
This is an outrage. In the meantime, my family is having to sell the house that’s been in our family for seven generations because medicare wouldn’t cover my grandmother’s nursing home and hospice expenses. Every time she had a dr’s appt, they charged $350 for chair lift transportation, which caused her excruciating pain. If I had known how things were going to turn out, I would have thrown a fit and insisted they spring for the stretcher transport at $800 a pop, so at least she would have been more comfortable. Hindsight being 20/20 and all… *sigh*
#3- There aren’t all that many Mexicans in New York City. Most Hispanics in New York are native-born American citizens.
Blame the bureaucrats who could send a low-level EMT to drive the guy to a homeless shelter, but prefer to provide extra patronage to the EMS unionized crew, and the well-connected hospitals.
The homeless guy isn’t the problem – it’s the managers of the system.
in Israel MADA charges 400 Shekels to be transported to the ER if you were sick your insurance pays you back
#8 – as I asked… why 400 shekels vs $800 USD?
To #5(Daniel Breslaur): That $800 price tag helps cover the cost of a rolling intensive care unit with drugs and defibrillators, staffed by two skilled paramedics, that needs to be available for the real patient in need. It could be an accident victim, heart attack patient, someone with a diabetic emergency, a stroke etc… Each run, legitimate or not build on the costs of maintaining the ambulance service.
To #7 (akuperma)blame the lawyers who will bring a law suit in a heart beat (no pun) against the first ambulance service, paramedic or ER who accidentally misses one patient with a real medical problem and sends them to as shelter.The problem includes hispanics, latinos, blacks and and recent immigrants (legal and usually otherwise). I’ve had abusers of the system (headache for 3 days)say “but I’m paying for this… I’ve got medicaid.”
To #6: wait till Obamacare kicks in. All our elderly relatives will be allowed to die as the govt will be denying them care.
$800.00 is cheap. I worked in the Paramedic system. It can be a lot more. In Jersey I know a ride with the medics will start at about $1400.000. In Israel a Paramedic unit which includes 2 paramedics and a MD (yes and a MD) cost me 500 shekel. You are paying for all those that do not get paid and for the exec’s salaries. I know one exec that had a company car. Never worked more than 9-5. Full medical benefits, cell phone etc. and was being paid well over 300k a year. The poor EMT’s make nothing. How much will you pay a party planner yet people that save lives every day make $12-$14 an hour.
Back to the subject at hand. You really shouldn’t and can’t deny anyone medical care. With out going in details (for legal reasons) you never know when the person is really sick. I have had patients where they were faking it and other times where we suspected it but it was the real deal.
As others have said above we need to fix the underlying issue (for starters getting rid of some illegals)….
NYC homeless bums? Whose writing this stuff? Where are your Torah values? How about a tzelem Elokim?
No? Nothing?
Hey, Charliehall: Sorry Bro but you couldn’t be more wrong. Patients without insurance, withoutcitizenship, without legal resident status (because you’re not supposed to even casually ask them) are getting health care. When they present to an ED with a plausible chief complaint they get the same work up as anyone else (blood work, x-rays, EKGs, CAT scans, MRIs ETC…) If their problem is real they are admitted, operated on, stay in ICU, deliver their baby, again ETC…)And if they are not satified with the outcome, they can still have recourse.
Do you also think that our government that couldn’t make a lemonaid stand run efficiently is going to be able to run universal health care.
Our cancer survival rate is higher than for Canada and England. And why are people from all over the world including Jordan landing here, at JFK, and demanding to go right to the hospital for good old American health care?
By the way, where in our constitution are we given the RIGHT to health care?
To Charlie,
Mister lib dem lawyer (liar),
You know more than anyone that the law requires any necessary care, not just emergency care. Almost all care performed in a hospital is necessary. Why are you libs putting a spin on the truth -is it perhaps the fact that spiralling medical costs is due to the fact that we don’t have tort reform? The dems who created this problem are the ones who are going to fix it? You know that being a democrat is a new name for communism. The reason communism doesn’t work is because the people running the show were dictators. The lawyers and the politicians are the dictators. But if the US were a truly free capitalist society then people in the medical field would be allowed to live wealthy or at least have a nice living, just like you lawyers & politicians! But I believe in Hashem, that’s why I work in the medical field even though I have no money. One day there will be a day of reckoning and all the people who have caused people to die, not just the politicians, lawyers, insurance companies, but even the people in the medical field, will have to answer for it!
Dear Dr. Hall– I believe you were my Epi Professor, so I would humbly like to say that you should know more than anyone that you cannot make cause and effect statements based on other countries’ life expectancies and their having Universal Health coverage. There are far too many confounders. One way you might support your view is to show that these countries were behind the US in life-expectancy prior to Health care being universalized and then surpassed the US in life-expectancy without other reasonable explanations (such as diet in the US getting exponentially worse–which it is–and obesity increasing etc.). But of course the American diet and sedentary lifestyle is clearly such a risk factor for early mortality, not to mention the high rates of depression and dissolving family structure, that I imagine it would be virtually impossible to demonstrate that it is actually the universal health care of these other countries which is responsible for disparities in life expectancy unless there are parts of these countries which equally share these travesties. Also, while I haven’t researched the topic much, my understanding is that much of what drags down the USA’s life-expectancy number is that there is a higher infant mortality rate in the US, particularly amongst certain groups of people, and this rate is related more to individuals choosing not to get prenatal health care– often because of fear of parents or not knowing how to use their resources– as opposed to the health care not being available. While this too might be an argument for Universal Health Care, if those not receiving it are choosing this despite its availability, making health care universal shouldn’t help increase the US’s life-expectancy number. And while your point about screenings falsely making survival appear longer (a point well-made in class as well– I remember that one) is a good one, perhaps there are more important numbers to look at– such as survival time following a certain prognosis, percentage of patients offered treatments (i.e. chemotherapy) and their success… etc… (I imagine these have been done? Do you know of any results)? And, while there seems to be agreement on both sides that there is mismanagement of health care funds, I’m curious as to why your answer is to universalize the coverage (you said it’s “essential”) rather than finding less drastic ways to fix a problem– such as changing these policies or providing free clinics for the homeless and/or uninsured which must refer to the ER. Lastly, I don’t understand the belief that fees will go down without freeloaders– what about all those who currently don’t pursue minor (or even major) care because of the cost? I know personally, now that my son is on a great low-income insurance with no co-pay I’m much more eager to schedule all those “just in case” appointments than I used to be– multiply that by the entire country and it’s no surprise that other countries with universal health care complain of the waiting periods… I appreciate your time considering my amateurish and disorganized thoughts.
Charlihall: Drugs can be expensive for a combination of reasons. The costs of production research and development being the leading ones. Drug companies are entitled to recoup their R& D costs and their share holders are entitled to profit from their investment. The cost of restricting the use of lifesaving care can be prolonged morbidity and increased mortality. What makes us an advanced civilization is that we are developing greater tools for saving and preserving life (hopefully with greater quality too). This is happenning here. Not in any of the other countries you cited (except perhaps for the subclass of the very wealthy who can and do pay out of pocket for their care.
The over use of medical care and testing has been largely because of our letigenous society led by greedy lawyers (I mean no offense to the ethical lawyers out there reading this).
Restrain the lawyers (ie tort reform) eliminate the illegal aliens draining our resources, and place some responsibility on the shoulders of the the receipients of care to practice healthier living habits and we will have more afforgable medicine.
To Charlie,
Thank you, you just proved my point. You and your wife who work in the health system aren’t rich. So who is rich in this country? -the politicians and lawyers! We need reform. The politicians, lawyers, gov. officials should reform themselves. The health community should reform themselves. The gov. should not reform the health community. When you point 1 finger foward -3 are pointed back. Having our liberal gov. reform the health system is like having the fox guard the hen house!