You see them all the time. The "frequent flier" you know who they are they are the ones that are non-compliant with almost every aspect of their lives; they are obese, they smoke, they dont take their meds, they "self medicate" with booze and drugs both Rx and illegals, they dont have any insurance, they dont work and havent in a long long time, yet there they are on your floor AGAIN for the ubiquitous "chest pain" which virtually guarantees you a room at least for a couple of nights. What are we to do with these people esp when the new health care reforms come into play in 2014? IMO I think that everyone that is going to be covered by this new plan should get 4 vouchers per year for a PCP visit ( which is about 4 more visits per year than I make for myself) and then they are cut off at the knees. Likewise with ED visits, treat the vast majority of em there and send em packing. They are a drain on the system and society as a whole, so why do we have to reward bad behavior with unlimited free medical care? I get tired of taking care of people that take no personal responsibility for their choices. Just yesterday we dc'd a guy at 14:00 and he was back in the ED, via squad mind you, at 15:15 with "chest pain". All because his apartment is too hot. Sorry not my problem and frankly I dont think we should be treating you AGAIN for the same so called problem ie iso's all neg, ekg normal. UA- negative, cbc and bmp- wnl, echo- no changes from the day before, cxr- no changes, and yet we admitted him. A complete scam of the system but there are no real safeguards in place to put a stop to this chit. Multiply this by the number of hosp  in this country and we, the TAXPAYER, are being bilked out of billions.  What can be done about it? I dont know but it fries my butt when people use the system and they arent responsible for any of the costs...... 

hahahaha