Illness as the primary cause of bankruptcies...

[SteveL]

Most governments in the world are struggling with this problem. All are faced with aging populations who need more care, greater availability of more expensive medical technology, the drug industry, rising expectations of better health by people, and increased life spans.
In the US, these problems are made worse by a system that pays the persons who deliver the service on a piece rate. This would be similar to paying a carpenter by the nail.
Where I live in Wa. State, if you move here and are 65 you can't get a doctor, because Medicare reimbursements are so low.
The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

[maddythebeagle]

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The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

I think this is a very good point and I also believe there is a lot of cost shifting. I noticed that a lot of local working class arent paying medical bills and notice several small claims court actions (as if that will get payments). Seems like everybody's bills should be the same.

[Martha]

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Originally Posted by SteveL The bankruptcy issue has not been helped by hospitals who charge the poor much higher rates than they charge the insurance companies. There are several law suits now underway on this issue. Hospitals will lose, and this obscene cost shifting to the poor will end. The rest of us will have to pay more.....

I think one of the arguments in these suits is that many hospitals were created as charitable organizations and to charge the highest rates to the unisured poor conflicts with their mission.

Some hospitals have said that they were essentially forced to charge the highest rates to the unisured because all discounts work off of these rates. Another rationale of hospital is that they had to charge market rates to the uninsured or they would get into trouble on medicare and medicaid reimbursement. Some months ago HHS issued a letter that lower charges could be made to the indigent without jeopardizing medicare and medicaid reimbursement. Of course, this won't help if you are not indigent and are simply soaked for big charges because you are unisured.

Socialized medicine, pay as you go, fee for service, HMO, PPO: all are different ways of rationing health care. You can ration by long waits, by high costs, by hassling the individual until he goes away, by using "gate-keepers" with a financial incentive to keep costs down.

I personally think that some minimum level of health care should be a right in this country. If you want above the minimum level, you can pay for it. Evidently, I'm in the minority.

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Originally Posted by astromeria I personally don't think our system could be much worse.

[justin]

If I could pay medical care providers at their insurance negotiated rates, I wouldn't care to have insurance except maybe a $10,000 deductible policy or something.

[sgeeeee]

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Originally Posted by tozz Socialized medicine, pay as you go, fee for service, HMO, PPO:* all are different ways of rationing health care.* You can ration by long waits, by high costs, by hassling the individual until he goes away, by using "gate-keepers" with a financial incentive to keep costs down.* I personally think that some minimum level of health care should be a right in this country.* If you want above the minimum level, you can pay for it.* Evidently, I'm in the minority.

I agree with this completely. Unfortunately, discussion of providing any minimal health care as a basic right seems to be like discussing the existance of god.

[greg]

Quote:

Originally Posted by tozz Socialized medicine, pay as you go, fee for service, HMO, PPO: all are different ways of rationing health care. You can ration by long waits, by high costs, by hassling the individual until he goes away, by using "gate-keepers" with a financial incentive to keep costs down.

One of my big problems with the current system and where it's heading with the new program being implemented this fall-winter is that everybody that is sick or injured shouldn't be faced with all kinds of hassles, requirements, and pre-requirements. Old people shouldn't have to have support from five less feeble family members to wade thru the gate, especially when they need to be focusing on getting the person back up and running. Sometimes I think all the distractions and anger at the healthcare system can further compound the complexity of the health decisions. It may even extend the course of an illness. IMO.

--Greg

[maddythebeagle]

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If I could pay medical care providers at their insurance negotiated rates, I wouldn't care to have insurance except maybe a $10,000 deductible policy or something.

I think that is what a lot of people have on this board (somewhere in the 5k dollar deduct.). I would actually like a ppo (my current one through work doesnt require a referral) and you just look up in a book if your specialist is covered. I would like to have a medical savings account that rolled over year-to-year also with it.