Judge rules Obamacare unconstitutional, endangering coverage for 20 million

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I worked with a woman facing bankruptcy over the costs of the birth and hospitalization of her preemie son.
 
F_Marturana said:
I worked with a woman facing bankruptcy over the costs of the birth and hospitalization of her preemie son.
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Yep. Both of my daughters were premature.

Now, I’ve been fortunate, and thanks to my parents, who provided for me and my education, and God, my family has really good insurance and the resources to deal with the situation, it all turned out okay.

But I can’t imagine how a family with less could have managed that situation without facing financial destruction.
 
Which is why we need universal coverage that includes much more cost containment. Every other industrialized country has done it and at less cost than us.
 
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In 2000, Trump wrote a book called The America We Deserve , in which he praised universal healthcare systems:
“We must have universal healthcare…I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses…

Doctors might be paid less than they are now, as is the case in Canada, but they would be able to treat more patients because of the reduction in their paperwork…

The Canadian plan also helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. If the program were in place in Massachusetts in 1999 it would have reduced administrative costs by $2.5 million. We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.”………….end quote……….
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So, who knows. Steel today, concrete yesterday, anyway the wind blows. Anything is possible.
 
Most of the time, medical providers will work out discounts, write-offs and payment plans rather than push somebody into bankruptcy. If it’s Ch. 7, the providers get nothing. Something is almost always preferred to nothing. While it varies from state to state, even Ch 7 isn’t a total “wipeout”. There are exemptions for home, vehicles, household goods, retirement plans.

Now, Inisfallen tells us with his station in life he has insurance and other resources so he doesn’t have to even think about bankruptcy. That’s good for him. Someone else might have a bigger squeeze than Inisfallen. Some might have a smaller one. Some will do a workout to avoid Ch 7. Some will take Ch 13. Some few will actually do Ch 7, but usually only if they have a lot of other unsecured debts that won’t accept a “settlement”. Sometimes people who could do settlements don’t because they don’t want to pay at all.

But among all of the people, almost none will actually be denied care.

So the real question when it comes to national healthcare is by what method the more fortunate members of the middle class are going to pay the medical providers for the ones who can’t pay it but don’t have Medicaid. Obamacare shifts the cost from one part of the middle class to another part of the middle class. That was also the case before Obamacare, just by a different method. Some people got settlements with the providers or filed bankruptcy, and those like Inisfallen who are more fortunate paid it through their charges and health insurance premiums.

Why do I talk about the middle class? Because there aren’t all that many truly rich people and since the costs and insurance for the rich are not significantly more than that of a member of the middle class, all of this is really just a question of the method by which the cost of the lower middle class gets paid by the middle middle and upper middle class.

More to the point, do those who can’t afford to pay for their own insurance but don’t qualify for Medicaid, get a free ride at the expense of the rest of the middle class or do they have to “cost share” with the rest of the middle class by liquidating down to the bankruptcy exemptions?
 
I read an interesting story the other day, highlighting the reasons healthcare is more expensive in the US.

How they handle malpractice was one of the key points. In France you are required to use a Govt mediator and the lawyers can only bill for their hours, not get a percentage.
 
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That deals with regulations, and the reality is that up until 2016 the medical inflation rate was lowered, plus scrap insurance policies that often defrauded people either had to meet the ACA standards or go out of business. Around 20 million Americans purchased insurance through the ACA, and now it is far more popular than Trump’s wall.
 
Ridgerunner said:
So the real question when it comes to national healthcare is by what method the more fortunate members of the middle class are going to pay the medical providers for the ones who can’t pay it but don’t have Medicaid.
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And isn’t that basically true of any legislation that mandates funding? If Trump were to get “the Wall”, would I be exempt from paying because I believe it’s an idiotic idea? Did I have to pay some of the costs of us going into Vietnam even though I strongly believed the “war” was immoral? Yes, I did.

That’s how a representative democracy works.
 
Doesn’t mean it’s wise, though.

There’s a “bottom” to expenditures for the wall, whatever one thinks about it, because there are only so many miles and after a point, additional height serves no purpose. With healthcare, there isn’t, because healthcare is significantly discretionary.

The Vietnam example is closer because there was a great deal of it that was discretionary.
 
Ridgerunner said:
With healthcare, there isn’t, because healthcare is significantly discretionary.
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To me, basic healthcare coverage should not be “discretionary”, and I do believe it should be flexible enough to be at least somewhat adjustable to individual family needs. However, in order to do that, we must strip away the for-profit delivery system that is terribly expensive and spotty in coverage. To not do that will continue to make this problem worse, thus further leading to higher medical costs without even having universal coverage.

I’m confident that it will eventually be done because more and more people are fed up shelling out money to filthy rich investors. It’s just a matter of time. If not, we “suck”.
 
Ridgerunner said:
But among all of the people, almost none will actually be denied care.
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Many will be denied many kinds of care.

If, for example, one needs physical therapy to manage an old injury, and presents oneself to a doctor and a physical therapist, without insurance or cash, it’s not going to happen.

Nobody will be denied emergency care (to the point of stablization), although they are quite likely to receive a crippling bill.
 
It would be better to try not to let ideology about rich people blind one to the reality. Insurance companies manage all government healthcare programs except VA, and will probably continue to do so no matter what kind of program this country adopts. it’s a very big and complex system and hard to duplicate.

Occupationally, I have read thousands of medical records in my time, and a very great deal of treatment is discretionary.
 
Metis1 said:
That’s how a representative democracy works.
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Exactly. But I did think about it. If this wall was done as some are suggesting health care should be done for the poor, it would only be about $30 a person for each of the President’s supporters.
 
The doctor part will happen. The PT part might not. How many dire and non-covered needs for PT are there?
But even with the PT unless the patient announces up front that he can’t/won’t pay, he’ll receive at least some treatment.

I take it, though, that you would ensure top of the line care to everyone and have the middle class pay for it, but not require “cost sharing” by the patient?
 
Ridgerunner said:
It would be better to try not to let ideology about rich people blind one to the reality. Insurance companies manage all government healthcare programs except VA, and will probably continue to do so no matter what kind of program this country adopts. it’s a very big and complex system and hard to duplicate.

Occupationally, I have read thousands of medical records in my time, and a very great deal of treatment is discretionary.
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I am finished with ever responding to you because the above is so utterly irresponsible and dishonest as to accuse me as such naivete as I have been dealing with studying healthcare programs internationally for over five decades now.

Sorry but I’ve had it with this nonsense and frequent misportrayal of where I stand and why. It is so utterly disgusting that you have me taking positions without having the common decency to maybe ask me where I was coming from or why.

I will no longer respond to your posts.
 
Ridgerunner said:
But even with the PT unless the patient announces up front that he can’t/won’t pay, he’ll receive at least some treatment.
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Well, I suppose it’s true that if the patient conceals his inability to pay, he’ll get some treatment, and then he can skip out on the bill.

I don’t think that’s a workable health insurance plan.
 
No. Not very workable. But I suspect there are a number of providers who would provide payment plans. I didn’t say it was an easy row to hoe. I still think it comes down to whether people are to be expected to share the cost of their own care even if it’s difficult, or expect someone else to pay it all for them.

I think many who espouse “universal healthcare” have that expectation. But someone always pays. And that payment system costs money. I remember a doctor once telling me a good part of the reason healthcare is so expensive is the effort people put into it to ensure that someone else pays for their care.

Lot of truth to that.
 
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