Should broke people receive health care?

[neuro_nurse]

I think we all agree that Medicare fraud occurs, but this is from the Medicare website:

The vast majority of physicians, providers, and suppliers who serve people with Medicare are committed to providing high quality care to their patients and to billing the program only for the payments they have earned.

However, there are *a few *individuals who are intent on abusing or defrauding Medicare, cheating the program (and in some cases the people with Medicare who are liable for co-payments) out of millions of dollars annually. (emphasis mine)

That’s millions – not billions.

I think we all agree that there are people who abuse the ‘safety net’ provided by our society – in whatever form that takes.

I have yet to see anyone produce empirical evidence that the people who abuse the system are anything other than a minority of the population that utilizes the healthcare systems in the U.S.

I hope we all agree that there is a substantial proportion of the population of the U.S. who are in need of healthcare but can’t afford it. I have yet to see anyone produce any empirical evidence that the people who need healthcare and cannot afford it are anything but the majority of those who utilize the safety net provided by our society.

Let me distill this down to two points:

1. Abuse occurs, but abusers are a minority of people who use the system.
2. There are people who need healthcare but can’t afford it and they are the majority of the people who use the system appropriately.

I have provided references to empirical evidence that substantiates the points I have just made.

Can we justify denying healthcare to people who can’t afford it based on the abuses perpetrated by a minority of the population who use the system – especially when there seems to be a lack of empirical evidence that the abusers are anything other than a minority of the population who use the healthcare system?

 

[rlg94086]

Hi all,

I found these links to the Facts About Health Care from the National Coalition on Healthcare:
nchc.org/facts/coverage.shtml
nchc.org/facts/cost.shtml

Also, here is a link to a speech by one of the Coalition’s members. I’ve excerpted the Coalition recommendations: nchc.org/materials/speeches/2005-2007/06_07_2007.pdf

**
II. A Path Forward: Specifications for Reform
Our Coalition has developed a set of answers to that question. After more than a year of study and deliberations, we issued a major report that reflects a consensus among our members. It is the most ambitious and comprehensive health care reform proposal in the national debate today.

Our more detailed report is included in your information packets. For now, I just want to summarize our recommendations, which fall into five categories.

First, our members call for coverage of all Americans within two to three years after the passage of legislation. We recommend that Congress specify a core benefit package, which is outlined in the report. Employers would be able to provide, and individuals would be able to purchase, supplemental coverage beyond the core package.

The Coalition identifies a range of options for insuring all
Americans, including:
**• **Employer mandates (supplemented with individual mandates as necessary);
**• **Expansion of existing public programs that cover subsets of the uninsured;
**• **Creation of new programs targeted at subsets of the uninsured, or
**• Establishment of a universal publicly financed program.

To assure that everyone gets coverage, participation must be
mandatory, and subsidies must be provided for those who are less
affluent.

Second, the Coalition proposes measures to assure much more effective cost management. Our members believe that over time, the health care system must be made far more efficient by providing more and better information for patients, providers, and purchasers; improving the quality and outcomes of care; and building a national information technology infrastructure for health care.

But we also believe that the urgent need for cost relief requires short-term constraints, even as these other measures are being aggressively implemented. These constraints would include rates for reimbursing providers for care encompassed by the core benefit package and, only after those rates take effect, limits on increases in insurance premiums for the core benefit package.

Third, our members propose a major national effort to improve the quality and safety of health care. This effort would include the accelerated development of an information technology infrastructure for health care and national practice guidelines.

Fourth, our members call for steps to make the financing of health care more equitable, including the reduction over time of inequitable cost-shifting across categories of insurance programs
and payers. Our report identifies mechanisms that could be used to fund the upfront program costs of reform. Lastly, the Coalition recommends steps to simplify the administration of health care – which would save money and help to reduce the burdens, and the frustrations, of providers and patients.

 

[jmcrae]

By not having to pay, of course!

In the US, you can go to any emergency room, and they can’t turn you away. If you can’t (or won’t) pay, the hospital has to eat the cost – which means, of course, they pass it on to the paying patients, raising their bills.

They would receive a bill, and then lose their credit rating if they didn’t pay it within a certain time frame, though, right? Meaning that they would lose anything that they are paying for with credit, such as their home or any cars that they are driving, plus the ability to use any lines of credit or credit cards that they may have had. And if the hospital decides to collect, then they would lose anything of value that was previously paid for, too, such as wedding rings, heirloom jewelery, furniture, art, musical instruments, and so on.

So, I doubt that anyone other than someone who didn’t have anything to lose to begin with, would go the route of simply not paying the bill. (For example, someone like yourself who seems to have a lot of nice stuff, would probably not choose to lose it all over a medical bill, if you happened to come down with an illness that your insurance doesn’t cover - you’d work out some way to pay it off over time, or you’d use your savings, or something, rather than lose your beautiful home and your vehicles.)

 

[ElizabethPH]

I don’t know that that’s the case. I don’t think I’ve ever said that myself, but I’m sure other people who say that aren’t always the ones who broke it.

We’ll never go back to the time when the doctor came to your house when you were sick and you paid him in chicken soup because you didn’t have any money.

Medical care, prescriptions and insurance are all so expensive that I can’t imagine how some people manage. I have a job with very good medical benefits, and I still pay over $200 for prescriptions…diabetes. I can’t imagine how I could do this without the insurance. Some of the stuff I take would be $284 a month. COBRA for one person is possible but a family? You’re not working and somehow have to find $1700 a month for COBRA. The equipment the hospitals have costs a fortune, the education the doctors get costs a fortune, the medicine costs a fortune, the tests cost a fortune, and everybody in the industry has to make a living and pay for his insurance too.

The worst part to me is that the “working poor” don’t get insurance from their jobs and sure can’t pay for it themselves. When one little sore throat costs $120 for the doctor and $25 for a prescription, what does the guy who makes $8 an hour do?

So what’s the solution? Anybody got an idea?

They don’t go to the doctor. At least I didn’t and don’t. And either did my children. I was thankful they never had any major illness. Now I am able to afford health insurance. But only catastrophic. they don’t cover an existing health problem that I have; after applying with several major insurances none of them covers this existing health problem. I’ve never been able to afford health care even now. I am just happy that if something catastrophic happens to me I’m covered 100%. I don’t know. I’ve always been the sort that if I can’t afford it I don’t get it…and that goes for health care as well. My husband on medicare and blue/cross after being ill and in the hospital; died…he had 500k in medical bills. I was assured he was well covered. After it was all said and done I had to pay some of that after all. And it wasn’t free…my husband paid for his B/C and medicare premiums

 

[jmcrae]

There is no instance in history of “price regulation” producing more or better goods and services at a lower price.

Health care is not a “good” or a “service.” It’s not like there’s any sort of competitive market in the health care industry that would naturally help to keep prices down. When people need health care, they don’t have the ability to “shop around” for a hospital that can serve them for less money than the one that the ambulance is rushing them towards.

And the programs to assist those who truly cannot pay are already there.

Then why are we always seeing Americans in the Prayer Forum asking for financial help as well as healing, whenever they run into medical problems?

These obviously aren’t the desperately poor, since they have jobs and at least a somewhat middle class lifestyle, given that they can post on CAF, but somehow they are not able to get appropriate insurance coverage, and they don’t have the level of savings or credit to be able to look after their medical bills without losing their homes. etc.

 

[vern_humphrey]

They would receive a bill, and then lose their credit rating if they didn’t pay it within a certain time frame, though, right? Meaning that they would lose anything that they are paying for with credit, such as their home or any cars that they are driving, plus the ability to use any lines of credit or credit cards that they may have had. And if the hospital decides to collect, then they would lose anything of value that was previously paid for, too, such as wedding rings, heirloom jewelery, furniture, art, musical instruments, and so on.

You’re painting an odd picture – you’re assuming that the people who don’t pay actually can pay, but simply won’t.

The title of the thread is “Should broke people receive health care?” People who are actually broke are, as the lawyers say, “Judgement proof.” They have no assets that a court or bill collecter can attach.

But if people can pay, they should.

So, I doubt that anyone other than someone who didn’t have anything to lose to begin with, would go the route of simply not paying the bill.

And how would it be wrong for a person who can pay to work out an agreement with the provider and pay some or all of his bills?

(For example, someone like yourself who seems to have a lot of nice stuff, would probably not choose to lose it all over a medical bill, if you happened to come down with an illness that your insurance doesn’t cover - you’d work out some way to pay it off over time, or you’d use your savings, or something, rather than lose your beautiful home and your vehicles.)

A person like myself would pay because it’s the right thing to do.

 

[daeve]

They don’t go to the doctor. At least I didn’t and don’t. And either did my children. I was thankful they never had any major illness. Now I am able to afford health insurance. But only catastrophic. they don’t cover an existing health problem that I have; after applying with several major insurances none of them covers this existing health problem. I’ve never been able to afford health care even now. I am just happy that if something catastrophic happens to me I’m covered 100%. I don’t know. I’ve always been the sort that if I can’t afford it I don’t get it…and that goes for health care as well. My husband on medicare and blue/cross after being ill and in the hospital; died…he had 500k in medical bills. I was assured he was well covered. After it was all said and done I had to pay some of that after all. And it wasn’t free…my husband paid for his B/C and medicare premiums

It’s fine if you don’t go to the doctor, but your kids need check-ups and vaccinations. A sick kids needs to go to the doctor.

And people do get sick. Your catastrophic will cover some expenses of cancer, but don’t get diabetes! It won’t pay for that. WITH my insurance, I spend over $200 EACH MONTH on prescriptions. Someone without insurance cannot just do without…this isn’t a vacation or cable TV. If they’re not truly disabled, but can’t work at a job that includes benefits, what do they do? I used to adminster Long Term and Short Term Disability, and there were people who didn’t qualify, but also could not work. What do they do?

 

[vern_humphrey]

Health care is not a “good” or a “service.”

Yes, it is. Hospitals and doctors are not exempt from the laws of economics.

It’s not like there’s any sort of competitive market in the health care industry that would naturally help to keep prices down.

Which is why we need true Medical Savings Accounts, where people save money for health care before taxes and roll any savings over into their IRAs. Under such a system, people would be encouraged to bargain for healthcare and not to over-consume.

When people need health care, they don’t have the ability to “shop around” for a hospital that can serve them for less money than the one that the ambulance is rushing them towards.

That’s absolutely false. The vast majority of health care issues develop slowly and there is plenty of time for bargaining. There is nothing that prevents me from contacting several doctors to see what they charge for an annunal checkup, for example.

If I find I need surgery – such as my wife’s knee replacement – the time between diagnosis is adequate for searching for the best price.

Consider pregnancy – a woman has plenty of time to shop for an obsteretition.

Then why are we always seeing Americans in the Prayer Forum asking for financial help as well as healing, whenever they run into medical problems?

And frankly, I am a firm supporter of charity. But it must come from the individual, through his own will, not be extorted from him by force or the threat of force.

These obviously aren’t the desperately poor, since they have jobs and at least a somewhat middle class lifestyle, given that they can post on CAF, but somehow they are not able to get appropriate insurance coverage, and they don’t have the level of savings or credit to be able to look after their medical bills without losing their homes. etc.

And do you claim this is a randomly-selected cross section of the population?

Most of us would be more comfortable if someone would help us pay our bills, or deal with special situations. But if we all rely on someone else to pay the bills, who is left to actually pay?

 

[neuro_nurse]

Yes, it is. Hospitals and doctors are not exempt from the laws of economics.

As someone who has worked in the U.S. healthcare industry for over 15 years, I concur with your statements: healthcare IS a service industry, hospital absolutely compete for business – take a look at the billboards in your city – and people DO shop for healthcare – you’d be foolish not to!

rlg94086,

Thank you for those excellent links. They are a concise source of data I have seen in other places.

 

[HannahLisa]

Broke people should receive health care. Health care is much more than an industry; we’re talking about people’s LIVES here. You can’t let someone die just because they can’t afford the health care.

Also, about Medicaid: Jobs are not as easy to get as people think they are. My father, through no fault of his own, has been unemployed and searching for work for long periods of time in the past. When he does have a job, medical insurance is expensive and will not necessarily cover all of us. Plus not all of his jobs provide health insurance as a benefit. My siblings and I have been on Medicaid, and now we are covered by a children’s health insurance provided through the state. We do pay for it, but it is an extremely cheap. Thankfully we have never had to use it, but in case we do need to it’s there.

 

[vern_humphrey]

As someone who has worked in the U.S. healthcare industry for over 15 years, I concur with your statements: healthcare IS a service industry, hospital absolutely compete for business – take a look at the billboards in your city – and people DO shop for healthcare – you’d be foolish not to!

And attempts to fix prices, or otherwise force the medical providers to operate without regard to profit will be counter-productive.

Instead, we should seek ways to make both medical care and insurance more competitive – like some of the things I mentioned earlier.

 

[rlg94086]

Broke people should receive health care. Health care is much more than an industry; we’re talking about people’s LIVES here. You can’t let someone die just because they can’t afford the health care.

Also, about Medicaid: Jobs are not as easy to get as people think they are. My father, through no fault of his own, has been unemployed and searching for work for long periods of time in the past. When he does have a job, medical insurance is expensive and will not necessarily cover all of us. Plus not all of his jobs provide health insurance as a benefit. My siblings and I have been on Medicaid, and now we are covered by a children’s health insurance provided through the state. We do pay for it, but it is an extremely cheap. Thankfully we have never had to use it, but in case we do need to it’s there.

That’s one place I definitely think we need to fix. There should be some sort of insurance coverage included with unemployment. It could be set up in a similar fashion - the worker pays unemployment insurance for both some pay and health insurance in the event of job loss.

I was laid off for a 6 month period. We ended up having to sell our home because the unemployment wasn’t enough to cover our mortgage (and we didn’t have enough savings…save, save, save!), but what really scared me was not having insurance for 6 months. Thankfully, my kids were major accident free during that period.

 

[jmcrae]

You’re painting an odd picture – you’re assuming that the people who don’t pay actually can pay, but simply won’t.

I thought that was who you were referring to. (Didn’t you say that there are already programs in place for the truly destitute?)

But if people can pay, they should.

Of course!

And how would it be wrong for a person who can pay to work out an agreement with the provider and pay some or all of his bills?

Well, hopefully no Christian would ever take on a debt, if he had the means to pay right away.

A person like myself would pay because it’s the right thing to do.

Getting to keep your house is a nice incentive, though, I’m sure.

 

[vern_humphrey]

Getting to keep your house is a nice incentive, though, I’m sure.

It’s usually possible to negotiate a repayment schedule that will allow you to keep your house.

Now, there are people who are in over their heads – like the guy in the commercial who talks about his big house and other expensive possessions and asks, “How do I do it? I’m in debt up to my eyeballs!” Which is why a prudent person would save, and not use debt to finance his lifestyle.

I had a kid working for me once – he had just got his master’s degree – and he was getting married. His parents owned a home with a basement apartment, and offered to allow the newly-weds to stay there, rent free. He and his fiancee, however were determined to go out and buy a house.

I asked him, “How do you and your fiancee get along with your parents?”

He replied, “We love them!”

So I said, “Do this – go shopping for a house. Find out what the monthly payments would be on the house you want. But don’t buy it – stay in your parent’s basement apartment, and put that much money into a savings acount each month. If you do that for a year, you’ll be able to afford a hefty dow-payment which will reduce your mortgage payments when you do buy.”

“If you it for two years, you can invest the rest in good mutual funds, and have enough to put your kids through college.”

 

[whatevergirl]

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.

That is an interesting thing to ponder though. The theory many have is…lower the prices or regulate them, so everyone can pay…why doesn’t it work???

 

[vern_humphrey]

That is an interesting thing to ponder though. The theory many have is…lower the prices or regulate them, so everyone can pay…why doesn’t it work???

Because it destroys the profit motive, drives suppliers out of the market, and encourages those who remain to cut corners and provide less value.

And in order to enforce those price caps, you have to hire an army of bureaucrats – who eat up much of the money that ought to go for healthcare and make the problem even worse.

Go to the Canadian border and notice how many Canadian doctors are working on the US side. Go to Canada and note how many hospitals and clinics are seriously understaffed.

We have had Canadian posters on these forums railing at us for “poaching” their doctors, and demanding we penalize Canadian doctors who come to the US to practice.

Socialism in action.

 

[jmcrae]

We have had Canadian posters on these forums railing at us for “poaching” their doctors, and demanding we penalize Canadian doctors who come to the US to practice.

You have? I haven’t noticed.

 

[vern_humphrey]

You have? I haven’t noticed.

You should be more alert.

 

[jmcrae]

You should be more alert.

I happen to prefer the Canadian system. It has its flaws, for sure, but at least everyone who needs care, gets care, without having to panic and wonder how they will pay for it.

I am looking at the minimum Cobra payments, and thinking it’s a lucky thing I don’t live in the States, because I tend to be accident prone. Last January, I took a blow to the head when I fell down in a parking lot, and had to get an MRI scan to see what the damage was.

The Cobra payments listed in this thread are more than my take-home pay each month, and I’m sure I would not have been able to pay for an MRI scan all by myself. I had to pay for the ambulance, and that was bad enough!! (It took me two months to raise the cash for that.)

So, in my case, anyway, HURRAY FOR SOCIALISM!! I’m alive today, because of it!

 

[whatevergirl]

Yes, it is. Hospitals and doctors are not exempt from the laws of economics.

Which is why we need true Medical Savings Accounts, where people save money for health care before taxes and roll any savings over into their IRAs. Under such a system, people would be encouraged to bargain for healthcare and not to over-consume.

That’s absolutely false. The vast majority of health care issues develop slowly and there is plenty of time for bargaining. There is nothing that prevents me from contacting several doctors to see what they charge for an annunal checkup, for example.

If I find I need surgery – such as my wife’s knee replacement – the time between diagnosis is adequate for searching for the best price.

Consider pregnancy – a woman has plenty of time to shop for an obsteretition.

And frankly, I am a firm supporter of charity. But it must come from the individual, through his own will, not be extorted from him by force or the threat of force.

And do you claim this is a randomly-selected cross section of the population?

Most of us would be more comfortable if someone would help us pay our bills, or deal with special situations. But if we all rely on someone else to pay the bills, who is left to actually pay?

Medical savings accounts? I could afford it…maybe a lot of people on here could afford it…but the thread title is about broke people. I work in the insurance biz…it costs companies millions to supply health coverage for their employees…millions in premiums each year, depending of course on the size. Med Spending funds actually were created by insurance companies, as a product to sell, whereby companies that are smaller, can still offer ‘something’ to their employees. (But large global enterprises have adopted them too–hey why should we pay all that premium? )It won’t help the Walmart 40 hour employee, I’m afraid. Not that this person defines broke, but they probably cannot afford health care as we know it. I am not against medical savings accounts…my employer offers them and some people love them–but they won’t help people who are broke. I might read through the thread so I understand the definition of broke, to make sure I’m on the same page.