Affordable Care Act (AKA Obamacare)

[GeddyWrox]

What's the difference between the government threatening to throw you in jail if you don't pay taxes and a hospital telling you that you have to die or live with debilitating injury because you can't afford treatment? edit: directed to Tim

When has a hospital ever done that? When you go to the ED you are guaranteed treatment.

Ignoring the fact that hospitals do indeed deny treatment to people not in emergencies, you get hit with a giant bill. You know, that you're required to pay. Like a tax.

People settle for incredibly lower amounts to pay. If they ever pay at all.

That assumes they know how to work the system, and even have the money to pay the lower amount. Most poor people don't know you can do that. Hell, I didn't even know you could do that. Most poor people are just going to see a bill for 50K and go "[expletive] that. BWAHAHAHAHAHA." and then throw it in the trash.

Right. Exactly.

So you agree the last thing you said is pointless?

What I am saying is that in the current system, people are not turned away for medical emergencies whether they can pay or not. They may receive a bill, but the hospital is lucky to see a fraction if any of the bill. Ipso facto you and I pay for it.

And the person with the health issue is bankrupted in the process.

[Tim]

If you're concerned about having fewer options and/or being able to keep your current physician, tell me why this won't work...

We expand medicare to cover all citizens. They get to select from PUBLIC providers. Maybe this list is limited, but everyone is guaranteed quality healthcare from SOMEWHERE.

Now, if you're rich and wish to buy extra PRIVATE insurance so you can continue to see your favorite provider, then more power to you.

Does this model sound familiar? I basically just described the public/private education system we have. Why won't this approach work in healthcare???

I would be concerned that providers won't accept medicare because reimbursements are poor, leaving those without the ability to purchase private insurance with very few options. That is already happening in Charleston, SC. Good luck finding a psychiatrist that accepts it except for the local mental health center. Wait to see a psychiatrist? 3 months.

And poor people have options now???

Very few. It is my opinion, and obviously differs from the board, that those options will worsen if government expands.

[Tim]

What's the difference between the government threatening to throw you in jail if you don't pay taxes and a hospital telling you that you have to die or live with debilitating injury because you can't afford treatment? edit: directed to Tim

When has a hospital ever done that? When you go to the ED you are guaranteed treatment.

Ignoring the fact that hospitals do indeed deny treatment to people not in emergencies, you get hit with a giant bill. You know, that you're required to pay. Like a tax.

People settle for incredibly lower amounts to pay. If they ever pay at all.

That assumes they know how to work the system, and even have the money to pay the lower amount. Most poor people don't know you can do that. Hell, I didn't even know you could do that. Most poor people are just going to see a bill for 50K and go "[expletive] that. BWAHAHAHAHAHA." and then throw it in the trash.

Right. Exactly.

So you agree the last thing you said is pointless?

What I am saying is that in the current system, people are not turned away for medical emergencies whether they can pay or not. They may receive a bill, but the hospital is lucky to see a fraction if any of the bill. Ipso facto you and I pay for it.

And the person with the health issue is bankrupted in the process.

I am not disagreeing that healthcare is way too expensive.

[GeddyWrox]

What's the difference between the government threatening to throw you in jail if you don't pay taxes and a hospital telling you that you have to die or live with debilitating injury because you can't afford treatment? edit: directed to Tim

When has a hospital ever done that? When you go to the ED you are guaranteed treatment.

Ignoring the fact that hospitals do indeed deny treatment to people not in emergencies, you get hit with a giant bill. You know, that you're required to pay. Like a tax.

People settle for incredibly lower amounts to pay. If they ever pay at all.

That assumes they know how to work the system, and even have the money to pay the lower amount. Most poor people don't know you can do that. Hell, I didn't even know you could do that. Most poor people are just going to see a bill for 50K and go "[expletive] that. BWAHAHAHAHAHA." and then throw it in the trash.

Right. Exactly.

So you agree the last thing you said is pointless?

What I am saying is that in the current system, people are not turned away for medical emergencies whether they can pay or not. They may receive a bill, but the hospital is lucky to see a fraction if any of the bill. Ipso facto you and I pay for it.

And the person with the health issue is bankrupted in the process.

I am not disagreeing that healthcare is way too expensive.

Then propose a better alternative.

[Tim]

What's the difference between the government threatening to throw you in jail if you don't pay taxes and a hospital telling you that you have to die or live with debilitating injury because you can't afford treatment? edit: directed to Tim

When has a hospital ever done that? When you go to the ED you are guaranteed treatment.

Ignoring the fact that hospitals do indeed deny treatment to people not in emergencies, you get hit with a giant bill. You know, that you're required to pay. Like a tax.

People settle for incredibly lower amounts to pay. If they ever pay at all.

That assumes they know how to work the system, and even have the money to pay the lower amount. Most poor people don't know you can do that. Hell, I didn't even know you could do that. Most poor people are just going to see a bill for 50K and go "[expletive] that. BWAHAHAHAHAHA." and then throw it in the trash.

Right. Exactly.

So you agree the last thing you said is pointless?

What I am saying is that in the current system, people are not turned away for medical emergencies whether they can pay or not. They may receive a bill, but the hospital is lucky to see a fraction if any of the bill. Ipso facto you and I pay for it.

And the person with the health issue is bankrupted in the process.

I am not disagreeing that healthcare is way too expensive.

Then propose a better alternative.

I am not knowledgeable enough to have the answer. It is my opinion that more government is not the answer. I realize I am complaining without a solution, but that is how I feel.

Here are my personal opinions. I have a hard time with my taxes paying for people to receive treatment for COPD when they decided to smoke cigarettes for 40 years. I have a hard time paying for other people to receive dialysis because their kidneys are shot, because instead of spending $4 a month on Lisinopril, they spent it on cocaine and worsening their hypertension.

Again, these are TAX dollars, not voluntary charity.

Please don't misunderstand where I am coming from. I have mentioned this before and do not say it to receive congratulations or pats on the back. My wife and I volunteer at a medical clinic in North Charleston. It receives absolutely no government funding. Zero. All drugs are free. All visits are free. We provide primary care, mental health care, and we have two therapists to provide counseling. In addition to the time we spend volunteering, we also give financially.

If I am taxed less then I will have more finances to give to this clinic. I think there is a place for voluntary charity. In my experience, it is efficient and provides good outcomes. My patients are invested because they know that I am doing this without any compensation.

When government is involved, we think that the poor are being taken care of. It is an after thought. When government gets out of the way, it allows for more clinics and better care. Again, MY OPINION.

I think we should also think about insurance. Why do we buy insurance? You don't buy car insurance to pay for oil changes. You buy car insurance for when you are in an accident and the immediate out of pocket costs would be too high. Somehow, some way, I think this mindset could be used in the medical field. Why should insurance be involved when I am going in for a yearly check up, some blood work, and the finger to the prostate? Insurance companies are a huge problem. One reason I like working in a prison system and as an ED psych consultant is because I don't have to deal with them. I just don't think further government interference is the answer.

[Arthur Dent]

I really have not heard anything proposed outside the ACA to single payer spectrum that would do anything to correct these problems.

Because such proposals don't exist. Skepticism of government is fine for what it's worth, but gets nowhere.

We're going to have to pay for people's bad health decisions one way or another whether through insurance premiums, taxes, or higher prices. Better to try and handle this rationally than to use personal indignity as an excuse to bury our heads in the sand.

Charity, while nice, is not up to a task of this magnitude, nor should it be, and there a no conceivable proposals that could change that.

Like it or not, the real choices available all involve various types of public regulations of health care financing.

[Diddy]

The thing I keep coming back to is the Postal Service. It is a great example of a business-like government entity that has very little corruption and is highly efficient. It just shows that it's not impossible for government to do something pretty efficiently. I have a small side business where I have to ship small things often. I can ship pretty much anywhere in the continental US for between $2.50 and $3.00. To ship the same thing via UPS would cost like ~$12. Granted, UPS guarantees delivery within 2 days. It's a nice option to have UPS if I need something urgent, but it's not a "need" since the $3 USPS option still gets it there within 3 to 5 days usually.

Health insurance truly is a "need". If rich people want some other more premium option for health care, I'm sure that would still be available one way or another.

Isn't the USPS hemorrhaging money?

[ghostrunner]

The USPS is a subsidized public service. I don't see why it should necessarily make money. It's lost and profited at varying times. How much money does the Department of Defense make? The EPA?

[33anda3rd]

It is my opinion that more government is not the answer.

It's my opinion that more free market is not the answer. The free market has controlled health care for a long time and it's a microcosm of society at large.

The 11 biggest pharma companies made $711 billion in 2013, and their 11 CEOs earned $1.57 billion that year. That's an average of something like $140 million per.

When the federal government's cost for a decade of Obamacare is $1.207 trillion (2016-2025) and the earnings for 11 pharma companies in just one year is enough to offset more than half that cost, what we've got is the kind of issue that got Sanders voters fired up. It is at the point where it is a How Dare They? issue.

[Diddy]

What's the difference between the government threatening to throw you in jail if you don't pay taxes and a hospital telling you that you have to die or live with debilitating injury because you can't afford treatment? edit: directed to Tim

When has a hospital ever done that? When you go to the ED you are guaranteed treatment.

Ignoring the fact that hospitals do indeed deny treatment to people not in emergencies, you get hit with a giant bill. You know, that you're required to pay. Like a tax.

People settle for incredibly lower amounts to pay. If they ever pay at all.

That assumes they know how to work the system, and even have the money to pay the lower amount. Most poor people don't know you can do that. Hell, I didn't even know you could do that. Most poor people are just going to see a bill for 50K and go "[expletive] that. BWAHAHAHAHAHA." and then throw it in the trash.

I guess it does assume literacy, but every medical bill I've seen in the past 6 years has a big bolded, highlighted, section where it discusses payment plans and financial assistance available if you are unable to pay your bill.