How do citizens who cannot afford Health Care obtain treatment?

[Marilyn Monroe]

Since everyone gets emergency care regardless, let's assume urgent but non-emergency.

First, we make an appointment. Then, we show up 10 minutes early for the appointment. Then we see the doctor, cooperate with any proscribed tests, etc. If we get a prescription we make sure ask for the generic version.

A month later a bill shows up, and we call the hospital billing department to work out a payment plan, and add this new debt to our "Debt Snow-Ball" (http://www.daveramsey.com/new/baby-steps/).

$1000 a month is ridiculously expensive. She must have either high-risk pre-existing conditions, have had serious injuries/illnesses, and/or has one of those plans where she never has to pay for anything, be it a co-pay or an appliance.

Me and my husband pay $400 for 2 and what his insurance pays, which is around 70%, means ours is over $1,000 a month. We also have a $1500 deductible then we pay 90/10.

Some plans are much higher than ours. They run over $600 for a family, and that's not what the govt pays. They pay 70%, so you know that's way over $1,000. By the way ours is the federal govt plan, one of many to choose from, and they are not as good as private plans. These are the one's all those Congressman have. The so-called Cadillac Plans. The one's the auto-workers get are much better and the cost to the employee much lower. I'm sure the auto companies pay the bulk of the premiums. This is why when the auto-workers didn't have to take a paycut because Obama is in bed with the union, it's a travesty. Paycuts should have been of a primary importance. Everyone should have to sacrifice, not just the CEO.

 

[NoJingoLingo]

Me and my husband pay $400 for 2 and what his insurance pays, which is around 70%, means ours is over $1,000 a month. We also have a $1500 deductible then we pay 90/10.

Some plans are much higher than ours. They run over $600 for a family, and that's not what the govt pays. They pay 70%, so you know that's way over $1,000. By the way ours is the federal govt plan, one of many to choose from, and they are not as good as private plans. These are the one's all those Congressman have. The so-called Cadillac Plans. The one's the auto-workers get are much better and the cost to the employee much lower. I'm sure the auto companies pay the bulk of the premiums. This is why when the auto-workers didn't have to take a paycut because Obama is in bed with the union, it's a travesty. Paycuts should have been of a primary importance. Everyone should have to sacrifice, not just the CEO.

Autoworkers have been taking pay cuts and CEOs not so one time they don't take a cut and of course the disingenuous are right there to bash them. :roll:

 

[rivrrat]

Saying it repeatedly does not make it so. You indulge in wishful thinking.

Ditto.

When you're ready to have an adult discussion, let me know.

We are getting nowhere and won't. You have an intrinsic fear of government. I have an intrinsic fear of corporations who make life and death decisions based on profit margin. Canadians have had a system that I would find acceptable for decades and if you had a few conversations with a Canadian, they would tell you they are very happy with it.

I do not have an intrinsic fear of either. I have an intimate knowledge of how BOTH suck donkey balls. Which is why BOTH need to be removed from the healthcare decisions. I've worked for the government for years, I've also worked for an insurance company, I've also worked as an emergency medical provider. All of those experiences, along with extensive research, have led me to the position I have now: Government and insurance involvement in the healthcare industry have done nothing but get us to where we are now with outrageous costs. The healthcare 'reforms' that have been proposed only promise more of the same **** that's gotten us in the mess we're in now. More of the same is not going to fix the problems.

And I have had conversations with Canadians... ones that came to the US to get the care they wanted. However, finally Canadians do allow private practices to operate. Did you know that the people FLOCKED to the private practices when they opened? Can you imagine why?

(Side note: Toyoda (grandson of the founder) said preoccupation on profits caused them to act slowly in the matter of their deadly cars. I'm insurance companies are no different.)

You keep replying to me like I think insurance is the answer. It's not.

Again, it's not government provided healthcare, it's government provided payment. The fact that you refuse to acknowledge this simple fact exposes you as simply being perfidious.
Arguing that you can't have smaller government or less gov. involvement in your life if you have gov. provided PAYMENT is simply untrue and you have no basis of fact for your argument. Unless you'd like to provide evidence. Then I might be persuaded.

Yeah, cause Medicaid and Medicare have been such HUGE successes :roll:

Again, it's not government provided healthcare, it's government provided payment. The fact that you refuse to acknowledge this simple fact exposes you as simply being perfidious.

Oh please. There is no difference. When someone is getting treatment, they are treated differently if they're on government programs. Simple fact. Govt supplied, govt paid. There's no difference in application, only semantics.

Now, ER care is the most expensive way to handle getting care to all citizens. It's really not even healthcare it's Emergency Care. The fact that you choose to ignore this cost factor proves you're not interested in honest debate.

What am I ignoring? It's a HUGE cost factor. Which is why ERs should be able to turn away non-emergencies.

That's a childish premise. I've read what you call "detail everything" and it's difficult to believe that you don't see the inherent problems with your position. But when you're only focus is to argue your position instead of examine it, then one can not expect more. *shrug*

What inherent problems? I mean surely if they're so glaringly obvious, then you must be able to spell them out. Or are you only interested in coming in here making snide remarks?

I asked if you were compassionate for your fellow man or do you feel that if they can't afford insurance they go to the ER. You responded by asking what those two things have to do with each other and I answered. perhaps you still don't understand the answer.

One has nothing to do with the other.

ANSWER= if you are compassionate for your fellow man you don't want them to suffer to the point where they must rush to the ER. Wouldn't it be better to discover cancer BEFORE it sends you to the ER? After that it's probably no longer treatable and therefore terminal.

Yeah, they probably should go get checkups. What's that got to do with the price of rice in China?

I would say, not helping them get regular checkups, providing a low cost or subsidized route to see a Dr. when you begin feeling bad or notice a problem and hopefully solving that problem before it becomes life threatening and or infinitely more expensive is compassionate.

Yes, they should get regular checkups. $100/year. That's really not too much to ask.

Well, that's your cross to bear, I on the other hand still feel compassion for them.

No cross, dear. If you can help yourself, and choose not to, I don't feel sorry for you. And I sure as **** don't feel guilty for not feeling sorry for you.

It was an ancillary comment which why it was in parenthesis and not directed specifically at you. Although, your attitude does fall into the same category with them. Enjoy your company.

In this case, I'm glad I'm on the same side as other folks who are against big government

You didn't say "conservatives" you said "those of us against big government". I am against big government. :doh

:rofl

Right, I mean doing nothing or doing something more stupid than the current Bill, like leaving healthcare completely in the hands of the private sector.

Yes, I know... the evidence of the private sector without the involvement of insurance or big government providing excellent care at reduced rates and continually advancing technology is so lacking.

Oh wait.. no it's not lacking at all. It's staring everyone right in the face. One segment of healthcare has no government involvement via payments, no insurance involvement and yet has continually advancing technology at continually reduced costs. Imagine that :shock:

Well perhaps you won the lottery but normal people can't afford a second mortgage. :roll:

$100/month isn't a second mortgage. Hell, I've never had to pay any more than $25/month, because that's what I told them I WOULD pay. You get done what you need done, you make payments on it.

 

[Ethereal]

The problem with that is it doesn't work for truly catastrophic situations which require lengthy stays in ICUs and the hospital.

Most people will never need it, that's true. But if they use your plan and they end up in that minority of people who do end up needing it, they're completely and totally ****ed.

Since we can't predict the situations where it will be needed, insurance is the safety net just in case.

Essentially, people can roll the dice if they want. They'll probably be OK at the end of it all. But if they roll snake eyes, using your method they will definitely be ****ed.

It's too bad certain people take perfectly reasonable arguments such as this and blow them way out of proportion.

We start at, "Unforeseeable catastrophic injuries and illnesses should be the purview of society and government."

And end up with, "The Federal government has to reform the entire health care system NOW NOW NOW!!!

 

[Ethereal]

Which is why I'm in favor of a public option...

And I don't, so lobby your state government or move to Massachusetts. There's no need to force the entire country into a public option.

...with the use of a combination of vouchers which roll over yearly and private insurance for catastrophic coverage. The vouchers can be used for anything non-elective but includes vision and dental care. Vouchers cause you to be a penny-wise consumer.

I'm in favor of abolishing the Federal income tax and letting state governments provide social programs for themselves, like the Founders intended.

 

[Ethereal]

In 2007, the median annual household income was $50,233.00 according to the Census Bureau. How many of those could afford 13k in medical expenses?

All of them, assuming they lived within their means. But I guess that's asking too much...

 

[Ethereal]

When we were in China last time part of the adoption process required that our daughter get a full physical before leaving. We went to a clinic that offered every outpatient service imaginable, including even eye exams and hearing tests. You basically went in, got any vaccinations you needed, then saw a general practitioner for a physical (and it was extensive), you then got an eye exam, and then finished up with a hearing exam. It was basically like Walmart or Target for healthcare. A one stop shop for anything other than something requiring a hospital stay. It was better and more efficient preventative / routine care than I have ever received in the United States, and you paid for it out of pocket. It was not socialized, it was a privately owned for profit clinic.

The only reason why we don't have very many of those kinds of clinics here is that people just have to have their own doctor. Well, you know if all that preventative care was coming out of their own pocket rather than just paying a copay at their GP, and then another copay at the eye doctor, and then another copay at this specialist, and then another copay at that one, and on and on and on...... If they paid for that routine care out of pocket, something tells me that 90% of the people out there would not care so much about having all this choice they think they need, and would be a little more concerned about getting as much for their money as they could, and getting only the service they actually need. Moreover, the end result would probably be better care.

I wanted to become a radiologist, but I've reconsidered this and am thinking about becoming a general practitioner that services neglected demographics in the same manner you have outlined (like a Walmart for healthcare); I would also offer medical advocacy (in case I diagnosed them with something I couldn't handle) for a small fee. I think there is a huge market out there just waiting for doctors to interact with it.

 

[Ethereal]

It's not fair. That's why the Dems are trying (have been for 40 years) to reform it. However, Repubs don't , and never did, want any part of it.

The people who truly need health care/insurance are the ones who can't afford it. My family has been blessed with good health for most of our lives. However, we know many people who are not as lucky. Those who can't afford health insurance are forced to go without health care. In our country that is inexcusable. It is selfish. It should be fixed.

If Repukes family members (not immediate family) had a serious health problem and they could not afford insurance maybe those selfish bastards would change their tune. But, I doubt it.

How much money and time have you donated to helping these uninsured people?

 

[Ethereal]

Indeed and obviously I made a very poor argument for something I truly believe in. I believe that health care is an intrinsic human right and shouldn’t be denied someone because they can’t afford it. It’s not like asking that everyone drive a Ferrari. The healing of the sick and injured via the required medicine, doctors, and treatment is not a luxury by any stretch.

And while it is true no-one is denied care at ER’s, wasting hundreds of millions of dollars a year, people like my friend languish for months in terrible pain, un-treated because they don’t have the money for a procedure. ER’s don’t ultra sound kidney stones. ER’s don’t treat cancer patients. ER’s don’t provide insulin to people who can’t afford it. They handle whatever the emergent situation is and then release them.

Many of us would like to see a public health care system that re-allocates dollars from the most expensive form of care to a system that would meet needs before they become an emergency. We are paying for the poor or uninsured middle class already, whether that is admitted to or not.

It is hard for me to stomach that anyone would think there is an argument to be made to deny sick people care. Why is getting medical care when one is sick or injured considered a privilege? It baffles me. I’m lucky and I know it. I’ve had medical insurance all my adult life. I know, when I see the suffering of people like my friend, there but for the grace of circumstance, go I.

I plan on being a doctor one day. Do you think someone has the right to walk into my office and demand that I give them a rectal examination?

If health care is a right, how could I refuse them?

 

[Gina]

I plan on being a doctor one day. Do you think someone has the right to walk into my office and demand that I give them a rectal examination?

If health care is a right, how could I refuse them?

What the heck are you talking about?

 

[Ethereal]

What the heck are you talking about?

Don't be obtuse. You said health care is right, so what's to stop someone from walking into my office and demanding a rectal examination? Would I be violating their rights if I refused to do it?

I understand if you don't want to confront the logical inconsistencies of your position, but I'll point them out nonetheless.

 

[drz-400]

Don't be obtuse. You said health care is right, so what's to stop someone from walking into my office and demanding a rectal examination? Would I be violating their rights if I refused to do it?

I understand if you don't want to confront the logical inconsistencies of your position, but I'll point them out nonetheless.

Why would you refuse to treat them? Where is the liberty in refusing to provide someone their rectal exam?

Is it because you own it?

Why should someone not have the power and ability to recieve a rectal exam? From a moral and utilitarian perspective, it would make sense that everyone have the ability to recieve this if it is needed.

Why should we not have universal health care?

 

[FreshlyMinted]

Indeed and obviously I made a very poor argument for something I truly believe in. I believe that health care is an intrinsic human right and shouldn’t be denied someone because they can’t afford it. It’s not like asking that everyone drive a Ferrari. The healing of the sick and injured via the required medicine, doctors, and treatment is not a luxury by any stretch.

And while it is true no-one is denied care at ER’s, wasting hundreds of millions of dollars a year, people like my friend languish for months in terrible pain, un-treated because they don’t have the money for a procedure. ER’s don’t ultra sound kidney stones. ER’s don’t treat cancer patients. ER’s don’t provide insulin to people who can’t afford it. They handle whatever the emergent situation is and then release them.

Many of us would like to see a public health care system that re-allocates dollars from the most expensive form of care to a system that would meet needs before they become an emergency. We are paying for the poor or uninsured middle class already, whether that is admitted to or not.

It is hard for me to stomach that anyone would think there is an argument to be made to deny sick people care. Why is getting medical care when one is sick or injured considered a privilege? It baffles me. I’m lucky and I know it. I’ve had medical insurance all my adult life. I know, when I see the suffering of people like my friend, there but for the grace of circumstance, go I.

Why is getting medical care when one is sick or injured considered a privilege?

-Because doctors and other medical practitioners spend tens of thousands of dollars to go to medical school and get their license and they also have families to feed.
-Because much of the time, health problems are due to personal choices more than bad luck. Your friend with the kidney stones should have drunk more water and not had as much salt. Heart attack patients should have exercised more. Do you plan on mandating exercise and diet restrictions on everyone? Why not?
-Because supposing that there is a positive right just because there it supports a corresponding negative right in not feasible. Yes, people have a right to life, but it is not your duty to stop everything that you are doing right now to pay for people in Africa to have food to eat so that they don't starve to death. It's nice of you if you want to do that, but claiming that we have a moral duty to insure that no one dies or suffers regardless of personal cost is not a practical plan

 

[Cassandra]

Ditto.

When you're ready to have an adult discussion, let me know.

Not sure what you are referring to. So far, the only actual evidence you have presented is one very skewed opinion piece from the Cato Institute written during the Clinton years and which cherry picks the data. Amazingly, the author goes to great lengths to defend the pharmaceutical industry:

"Unfortunately, the proper diagnosis of our medical problems has been obscured by the demonizing of certain components of the medical industry. For example, the Clinton administration has at various times blamed the pharmaceutical industry, medical specialists, and health insurance companies for causing high prices and excessive medical expenditure".

Any self-respecting Libertarian would be horrified by the protectionism and lack of competition afforded this industry in particular and insurance companies as well. Kinda makes me wonder who was paying his salary.

$100/month isn't a second mortgage. Hell, I've never had to pay any more than $25/month, because that's what I told them I WOULD pay. You get done what you need done, you make payments on it.

So do you honestly think that any business can stay in operation granting people no-interest loans at whatever monthly payment the consumer decides they can afford to pay?!!!
Do you not see that hospitals would very quickly face bankruptcy if everyone chose your path?

 

[gopman]

So do you honestly think that any business can stay in operation granting people no-interest loans at whatever monthly payment the consumer decides they can afford to pay?!!!
Do you not see that hospitals would very quickly face bankruptcy if everyone chose your path?

Actually, most people just don't pay if they have a large procedure that their insurance doesn't cover. Hospitals would be thrilled if more people paid $25 a month. Actually to be more specific collection agencies would be thrilled. But if people tended to pay more they could sell the receivables to collection agencies for more money, so hospitals would be thrilled too.

 

[VanceMack]

Why would you refuse to treat them? Where is the liberty in refusing to provide someone their rectal exam?

Is it because you own it?

Why should someone not have the power and ability to recieve a rectal exam? From a moral and utilitarian perspective, it would make sense that everyone have the ability to recieve this if it is needed.

Why should we not have universal health care?

Why should we?

 

[Gina]

Don't be obtuse. You said health care is right, so what's to stop someone from walking into my office and demanding a rectal examination? Would I be violating their rights if I refused to do it?

I understand if you don't want to confront the logical inconsistencies of your position, but I'll point them out nonetheless.

Speaking of logical inconsistencies. Would you really expect someone to do that?

It's silly to use such an unserious scenario as a debating point.

 

[Cassandra]

Actually, most people just don't pay if they have a large procedure that their insurance doesn't cover. Hospitals would be thrilled if more people paid $25 a month. Actually to be more specific collection agencies would be thrilled. But if people tended to pay more they could sell the receivables to collection agencies for more money, so hospitals would be thrilled too.

If everyone did what Rivrrat is doing, how would hospitals stay in business?

 

[rivrrat]

So do you honestly think that any business can stay in operation granting people no-interest loans at whatever monthly payment the consumer decides they can afford to pay?!!!
Do you not see that hospitals would very quickly face bankruptcy if everyone chose your path?

Yes, actually. I'm sure they'd be thrilled if people made payments as opposed to not paying at all (which is what a lot of people do now). Let's see which makes better business sense: Try and force someone to make higher payments they can't afford and receive ZERO. Or! Let people pay what they can afford and receive something. Which do you think hospitals can and do choose?

So, no I don't see how or why they'd be forced into bankruptcy with ALL of their patients making monthly payments, instead of just SOME of them making payments and some of them not paying at all.

Not to mention the fact that providing the treatment is up to them. If it's bad business for them to provide certain treatments, that's their choice not to provide it. But once it's been provided, I'm sure they LOVE to receive some payments. I've never had an issue with making payments, they've always been damn willing to cooperate. Almost like... they wanted the money or something.

 

[Marilyn Monroe]

Autoworkers have been taking pay cuts and CEOs not so one time they don't take a cut and of course the disingenuous are right there to bash them. :roll:

Whatever paycuts they've been taking it hasn't been much.

Read this article.http://www.heritage.org/research/economy/wm2162.cfm The autoworkers make much more than the average US worker. Plus, the companies have to pay their retiree's huge packages. I see no way for them to have money left over to compete with.

There's no reason we have to have 3 auto manufacturers. If only one is able to be competitive then so be it.

 

[liblady]

Whatever paycuts they've been taking it hasn't been much.

Read this article.UAW Workers Actually Cost the Big Three Automakers $70 an Hour The autoworkers make much more than the average US worker. Plus, the companies have to pay their retiree's huge packages. I see no way for them to have money left over to compete with.

There's no reason we have to have 3 auto manufacturers. If only one is able to be competitive then so be it.

from personal knowledge, i can tell you that they've taken very large pay and benefit cuts.

and the union has taken over retireee health care, so the company is paying only their pensions, which were promised to them for 30 years of work.

 

[Cassandra]

Yes, actually. I'm sure they'd be thrilled if people made payments as opposed to not paying at all (which is what a lot of people do now). Let's see which makes better business sense: Try and force someone to make higher payments they can't afford and receive ZERO. Or! Let people pay what they can afford and receive something. Which do you think hospitals can and do choose?

So, no I don't see how or why they'd be forced into bankruptcy with ALL of their patients making monthly payments, instead of just SOME of them making payments and some of them not paying at all.

There is not a business on the planet the would remain viable providing no interest unsecured loans on the basis of ability to pay to all of their customers. Please explain how hospitals could do what no other business can do?

The only reason the system continues to function is because most people have insurance. Take that away and the entire system would collapse. Health care/insurance costs are significantly higher than they should be because of charity care and the number of people who pay a piddling monthly payment.

 

[Gina]

-Because doctors and other medical practitioners spend tens of thousands of dollars to go to medical school and get their license and they also have families to feed.
-Because much of the time, health problems are due to personal choices more than bad luck. Your friend with the kidney stones should have drunk more water and not had as much salt. Heart attack patients should have exercised more. Do you plan on mandating exercise and diet restrictions on everyone? Why not?
-Because supposing that there is a positive right just because there it supports a corresponding negative right in not feasible. Yes, people have a right to life, but it is not your duty to stop everything that you are doing right now to pay for people in Africa to have food to eat so that they don't starve to death. It's nice of you if you want to do that, but claiming that we have a moral duty to insure that no one dies or suffers regardless of personal cost is not a practical plan

I don't understand why the argument in the thread has shifted so as to suggest medical professionals will dispense their services for free. It doesn't stand up for an argument as to why you believe health care is a privilege reserved for the wealthy. We are not talking about giving everyone a Ferrari.

We are talking about lives. Treating the sick and injured and providing life saving medicines.

We already pay for the poor choices of those unable to pay for health care now, when they visit ER's without the ability to pay (not my friend though).

As to mandating exercise and diet restrictions, you point to an area that deserves some consideration. The obvious answer is no, we cannot mandate exercise and diet, it goes against our principles to infringe on personal choice. There is a segment of the population for which the cost will be greater because of their habits. I understand the resentment.

It's great that you have the answers as to my friend's development of kidney stones. Thanks.

That is exactly my argument, as a nation we have a moral duty to insure our fellow countrymen have access to health care. Doing the morally right thing is not always easy and in fact an be very difficult.

I'd prefer that the built in cost in my insurance premiums be redirected to national health care plan.

 

[rivrrat]

There is not a business on the planet the would remain viable providing no interest unsecured loans on the basis of ability to pay to all of their customers. Please explain how hospitals could do what no other business can do?

They do it now.

The only reason the system continues to function is because most people have insurance. Take that away and the entire system would collapse. Health care/insurance costs are significantly higher than they should be because of charity care and the number of people who pay a piddling monthly payment.

Healthcare costs are significantly higher than the should be due to government and insurance industry involvement, along with the masses of people (not the least of which being illegals) receiving non-emergency care in ERs that are required by law to treat them no matter what. (govt involvement, yet again) But, we've been over all of this before. And still yet you seem to think that more of the same bull**** is magically going to fix what it broke

 

[Mach]

That is exactly my argument, as a nation we have a moral duty to insure our fellow countrymen have access to health care. Doing the morally right thing is not always easy and in fact an be very difficult.

No, your duty is to take responsibility and do the following:

1. Plan your wants/needs and set goals to acheive them.
2. Set aside significant savings, at least 3-6 months worth of salary so that you can account for things you cannot predict individually.
3. Only start a family when you are sure you can afford it.
4. If you are struggling, you need to lower your living standard sufficient to accomodate your critical needs.
5. Even if you take a dead-end job, continue to find ways to train and better yourself, and look for opportunities to move up.
6. Educate yourself about personal finance.
7. Work insanely hard especially when young since you can more easily do so in terms of health, time, comittments, and because every dollar you make earlier, it compounds over time. We're talking about working 2 jobs, or serious overtime, for years, to get ahead.
8. Stop making excuses today.

It's this sort of thing that is ethical, and hard work. Making people who do all of that foot the bill for people too lazy? That's not ethical.

If you do the above, and then someone else doesn't feel like doing all of that hard work and sacrifice, you are then labeling us as immoral for not wanting to give them a free ride! Are you seeing how you have what is moral reversed?