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consumedconvert
Guest
Thanks, nurse! I had no idea that was in the catechism
I think that, to a large extent, settles it…
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I think that, to a large extent, settles it…
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RachelsAlumni
Guest
Using up sick leave and vacation time means that she does not get paid her daily wage by her employer for the days she takes off past that point in that year cycle. It doesn’t mean that she no longer has a job or health insurance.
When she’s admitted to the hospital they will ask about Health Insurance, employment, SSN#, Driver’s license, etc. If she’s gainfully employed, which you said she is
Then she more than likely won’t qualify for assistance. The fact that she’s married to someone who earns more than the median salary will further disqualify her from aid. If she were unmarried, had no job and 3 kids then she would qualify for Aid to Dependent Families and they would pay all medical costs.
When being admitted to the hospital you can apply for Medicaid if you’re not already receiving it, then later submit W2’s and a whole lot more paperwork before actually receiving the aid.
I know this because while I was unemployed I fell and broke my leg. I didn’t want to go to the hospital because I didn’t have $$ or insurance, but I had no choice. Once I got there, the admitting clerk signed me up for Medicaid and they paid for everything. I did have to follow up (on crutches) and go down to the County Health & Human Services, fill out ooodles & ooodles of paperwork, and got on MediCal. Then they gave me a MediCal card.
I was glad to have gotten some of my tax $$ back in my time of need.
R
RachelsAlumni
Guest
Not exactly. If you own a home, a car, have a credit score and don’t qualify for aid then the Hospital and all the treating physicians will send you a bill. If you don’t pay that bill then your bills will be sent to collections, liens placed on your property, etc. etc.
It’s not a simple, anecdotal, matter of just choosing not to pay. You have to qualify for state aid, you have to apply within 30 days of hospital admission, and the hospital more than likely will assess upon admission whether you qualify for aid or not. If you don’t they will bill YOU.
I don’t think you can bankrupt out of medical bills either.
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RachelsAlumni
Guest
In my State/County there are County Medical Health Clinics that provide low cost/sliding scale (based on income) health care. These clinics are usually very crowded, but then again so are just about any HMO providers.
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rlg94086
Guest
Rrrrrrrright.Thanks, nurse! I had no idea that was in the catechism
Define “society.”
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rlg94086
Guest
Right…and when you can’t pay regardless of collections, liens, etc., the hospital still eats the cost.
Everything I’ve read is that the majority (over half) of bankruptcies are due to medical expenses, so I don’t think you are correct.
K
KathleenElsie
Guest
I don’t think of health care as a right. But there needs to be a middle ground for people that work for a living and are caught in the middle.
The people that have to pay for their own insurance have some choices but they pay highly for little coverage. The worker that shares the cost with his employer is charged what the company is rated so if there are a couple of people that have high bills all the employees pay higher costs sometimes up to 25% of their take home pay for a husband and wife.
I just know that there needs to be some way that the average worker, not just the government workers and big unions, to afford to eat and pay for medical care. Maybe someone smarter then I can figure it out. But I am not holding my breath as then I will need to go the the Dr and after paying my insurance there isn’t much left.
The people that have to pay for their own insurance have some choices but they pay highly for little coverage. The worker that shares the cost with his employer is charged what the company is rated so if there are a couple of people that have high bills all the employees pay higher costs sometimes up to 25% of their take home pay for a husband and wife.
I just know that there needs to be some way that the average worker, not just the government workers and big unions, to afford to eat and pay for medical care. Maybe someone smarter then I can figure it out. But I am not holding my breath as then I will need to go the the Dr and after paying my insurance there isn’t much left.
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neuro_nurse
Guest
I am not denying that Medicare fraud occurs, but “Google it” doesn’t work for me. Anyone can post what ever they want on the Internet. My sources are peer-reviewed medical journals.For what, medicare fraud?
Just for grins and giggles, google “Florida” + “medicare fraud.”
If people who don’t pay use the services – even if they “underutilize” them – then someone else has to pay for what services they do use, no?
And does that rule not hold for all – those who do not pay throw the costs onto someone else, right?
We are talking about proportions here. The costs associated with medical care of immigrants are small proportion of total healthcare expenditures in the U.S.: studies cited in previous post.
The vast majority of uninsured Americans cannot afford insurance:
Hoffman, C. B. (2007). Simple truths about America’s uninsured. American Journal of Nursing, 107(1), 40-43.
Most “frequent flyers” in emergency departments are insured:
Fuda, K. K., Immekus, R. (2006). Frequent users of Massachusetts emergency departments: a statewide analysis. Annals of Emergency Medicine. 48(1):9-16
Hunt, K. A., Weber, E. J., Showstack, J. A., Callaham, M. L. (2006). Characteristics of frequent users of emergency departments. Annals of Emergency Medicine. 48(1):1-8.
Hospitals have three obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA):
- Individuals requesting emergency care must receive a medical screening examination to determine whether an emergency medical condition (EMC) exists. Examination and treatment cannot be delayed to inquire about methods of payment or insurance coverage.
- The emergency room must treat an individual with an EMC until the condition is resolved or stabilized. If the hospital does not have the capability to treat the condition, the hospital must make an “appropriate” transfer of the patient to another hospital with such capability.
- Hospitals with specialized capabilities must accept such transfers.
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neuro_nurse
Guest
Did you forget about Bush’s bankruptcy bill in 2005? It made it much more difficult for people to declare bankrupcy - even for medical expenses.
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wifeandmomoftwo
Guest
“Medicare Scam Veterans Tell Panel How Easy It Was to Cheat,” Washington Times, November 3, 1995
.One estimate states that* fraud and abuse cost Medicare and Medicaid about $33 billion each year**. Worse, it’s ridiculously easy to cheat the federal government and taxpayers out of millions of Medicare and Medicaid dollars, according to three convicted felons appearing yesterday before a Senate panel*.
“Grand Jury: Florida Must Do More to Stop Medicaid Fraud,” American Medical News, September 23/30, 1996.
Ripping off the $6.7 billion Medicaid program in Florida is far too easy, reports a grand jury there after an eight-month investigation of the federal-state health program for the poor
“Fraud on the Rise: Those Who Get Caught Say It’s Just Too Easy,” USA Today, November 12, 1996.
*Home health care is now the nation’s fastest growing industry. But loose licensing and lax oversight have made it a magnet for thieves and scam artists, according to reports.
Some who work as caregivers abuse and steal from elderly and disabled patients.
Others set up fraudulent home care businesses.
Medicare and Medicaid will pay out an estimated $2.2 billion this year to these fraudulent “businesses” – with insurance companies losing millions more.
And it’s easy; in nine states, anyone can open a home health agency without any experience.
According to a General Accounting Office report, Medicare home health care benefit controls are “essentially non-existent.” the agency says that “few home health claims are subject to medical review and most claims are paid without question.”
The most common scams are billing for fictitious visits, billing for care that is unnecessary, over-billing or using low-skilled caregivers for work that is billed as skilled nursing care.
New York, Florida, Illinois, Texas and California are believed to have the most problems.
In Florida, a random audit of Medicare claims found that 26 percent of billings were bogus; at just one company, improper claims accounted for 75 percent of its $45 million in claims in 1993.
In New York, the owner of a home care company – one of the nation’s largest – was convicted of submitting more than $14 million in bogus billings to Medicare.
Among private insurers – who pay about 13 percent or more than $4 billion for home care services – industry officials say no one knows how much the industry has lost in the scams, but the amounts are growing very fast.*
“A New Brand of Crime Now Stirs the Feds: Health-Care Fraud,” Wall Street Journal, May 6, 1997
“Medicare Con Game Lurking Out of View,” Washington Times, June 26, 1997.
hhs.gov/medicarefraud/
During a three month period, this targeted criminal, civil and administrative effort against individuals and health care companies that fraudulently bill the Medicare program yielded 56 arrests and stopped companies who collectively billed more than $258 million to Medicare. It is the first step in a protracted effort to eliminate the potential for fraud.
.One estimate states that* fraud and abuse cost Medicare and Medicaid about $33 billion each year**. Worse, it’s ridiculously easy to cheat the federal government and taxpayers out of millions of Medicare and Medicaid dollars, according to three convicted felons appearing yesterday before a Senate panel*.
“Grand Jury: Florida Must Do More to Stop Medicaid Fraud,” American Medical News, September 23/30, 1996.
Ripping off the $6.7 billion Medicaid program in Florida is far too easy, reports a grand jury there after an eight-month investigation of the federal-state health program for the poor
“Fraud on the Rise: Those Who Get Caught Say It’s Just Too Easy,” USA Today, November 12, 1996.
*Home health care is now the nation’s fastest growing industry. But loose licensing and lax oversight have made it a magnet for thieves and scam artists, according to reports.
Some who work as caregivers abuse and steal from elderly and disabled patients.
Others set up fraudulent home care businesses.
Medicare and Medicaid will pay out an estimated $2.2 billion this year to these fraudulent “businesses” – with insurance companies losing millions more.
And it’s easy; in nine states, anyone can open a home health agency without any experience.
According to a General Accounting Office report, Medicare home health care benefit controls are “essentially non-existent.” the agency says that “few home health claims are subject to medical review and most claims are paid without question.”
The most common scams are billing for fictitious visits, billing for care that is unnecessary, over-billing or using low-skilled caregivers for work that is billed as skilled nursing care.
New York, Florida, Illinois, Texas and California are believed to have the most problems.
In Florida, a random audit of Medicare claims found that 26 percent of billings were bogus; at just one company, improper claims accounted for 75 percent of its $45 million in claims in 1993.
In New York, the owner of a home care company – one of the nation’s largest – was convicted of submitting more than $14 million in bogus billings to Medicare.
Among private insurers – who pay about 13 percent or more than $4 billion for home care services – industry officials say no one knows how much the industry has lost in the scams, but the amounts are growing very fast.*
“A New Brand of Crime Now Stirs the Feds: Health-Care Fraud,” Wall Street Journal, May 6, 1997
“Medicare Con Game Lurking Out of View,” Washington Times, June 26, 1997.
hhs.gov/medicarefraud/
During a three month period, this targeted criminal, civil and administrative effort against individuals and health care companies that fraudulently bill the Medicare program yielded 56 arrests and stopped companies who collectively billed more than $258 million to Medicare. It is the first step in a protracted effort to eliminate the potential for fraud.
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rlg94086
Guest
Bush was in Congress? I didn’t realize that.
IIRC, the changes are more restrictive by requiring means testing, so people with higher incomes would have to file Chapter 13 instead of Chapter 7. This is a good thing.
If you can show how it effects people of lower income with medical bills, please do.
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RachelsAlumni
Guest
:Hmmm:
With the The Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 bankruptcy isn’t the easy out it once may have been. This is why I’m uncertain as to how ‘feasible’ it is to just bankrupt out of medical bills anymore.
Basically you now have to prove that your income is below your State’s median income level or undergo a ‘means test’ (whatever that is). Bankruptcy attorneys must certify their clients’ financial statements to the court and will be held financially responsible if the statements are false. Due to this change, many bankruptcy attorneys may charge more for their services.
People who earn more than their state’s median income level no longer qualify for Chapter 7. Instead, they have to file under Chapter 13, which requires paying off some or all of their debt over a designated period of time.
No doubt Hospitals know the median income level for their state and if you’re earning below that level then they will want to get you on Medicaid to pay their bill rather than allow you to bankrupt out.
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rlg94086
Guest
GOOD!
The title of this thread is “should broke people receive health care?” Are you opposed to people over the median income level for their state going Chapter 13 instead of Chapter 7? If so, please explain why.
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cynic
Guest
The costs are jacked up because private hospitals ( their parent companies), insurance and drug companies are businesses who’s main objective is to generate profit and increase share price. That’s why the average to low income earner finds it difficult to afford insurance and needs medicaid. These companies compete at price points they set. If these services were provided closer to the actual cost of supply then there wouldn’t be such a problem.For what, medicare fraud?
Just for grins and giggles, google “Florida” + “medicare fraud.”
If people who don’t pay use the services – even if they “underutilize” them – then someone else has to pay for what services they do use, no?
And does that rule not hold for all – those who do not pay throw the costs onto someone else, right?
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RachelsAlumni
Guest
No. I was responding to someone earlier who said something along the lines of those who have other assets but choose not to pay for insurance so that the taxpayers will have to pay their medical costs. Then the topic got derailed about Bankruptcy and I had to explain my understanding of that.
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ribozyme
Guest
I made a joke about this in an earlier thread in back fence. Maybe free statins for all (or for those who need it)This is one of the fundamental problems I have regarding this issue. Everyone in the US has access to health care. There is no “systematic denial of health care” that I know of. Everyone has “access to healthcare.” The fact that it is too expensive is the real problem.
Vern’s suggestions would help somewhat, but I spoke to a doctor on a plane that explained to me that we can also reduce medical costs significantly just by implementing a few preventative measures that would seriously reduce heart disease, stroke, etc. Unfortunately, it has been many months since that conversations, so please don’t push for particulars.Anyway, that doctor is retired and putting all his efforts into lobbying government…both sides of the aisle.
J
jssaxon
Guest
How about if these folks cut back on eating transfat, start exercising, and lose weight?
The trouble with healthcare is that it’s not just simple nursing and the like. It’s complicated and extremely expensive. You have crazy things like a million dollars plus being spent on a premie, then how many million abortions done a year! What about all the expensive tortures done to patients in medical ICUs so they can die slowly. We all get to chip in for that bargain! It’s thousands a day! Yes, we all pitch in through our insurance premiums, hooray, socialized medicine!
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vern_humphrey
Guest
Actually, actual fraud costs billions – such as selling the same scooter over and over, or billing medicare for a prosthetic arm for a man who has two healthy arms (as I said, google “medicare fraud” + “florida” to read about it.)
Add that to people who can pay, but who choose not to, and throw the burden on the rest of us, and you begin to understand why medical costs are so high.
Throw in laws forbidding people to shop for health insurance across state borders (a violation of the Constitution, by the way) and preventing unaffiliated small businesses from banding together to bargain for health insurance for their employees, and you begin to see the outlines of the problem.
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whatevergirl
Guest
Being in the commercial insurance biz, I will say that we all take care of one another to a degree. Through taxes, and through paying a lot in coverage for private healthcare, if someone needed to go to the hospital, and didn’t have personal coverage through PPO/HMO, it would be covered. However, you might receive a bill. What I would elect is this…as it relates to reform with healthcare. There needs to be more price regulation across the board…from tort reform, to doctors not being able to price gauge, and the same for insurance companies. Also, if a person truly cannot afford coverage (lost his/her job, divorce, can’t find work, etc) there should be government programs to assist…for most prevenative care coverage, and emergency coverage. If the government would allocate some tax dollars to healthcare–especially with preventative care, we might see less sick people…we would see a more fair return for everyone. I don’t think we need to send anymore people to the moon–let’s reallocate some funds to healthcare in this country!
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vern_humphrey
Guest
There is no instance in history of “price regulation” producing more or better goods and services at a lower price.
And the programs to assist those who truly cannot pay are already there.
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