Implications of Mass. Health Insurance Law

[TromboneAl]

The new law in Massachusetts which is about to be passed requires that everyone in the state have health insurance. If successful, news guys are predicting it could go nationwide.

What are the implications? Do insurance rates go down because everyone must have it? What else would change?

 

[MasterBlaster]

My questions is...

If it were to be implimented in California does that mean that the state must provide free health insurance to all those millions of Illegals.

I suspect the economics in California aren't like those in Mass.

 

[TromboneAl]

Just noticed that this is already (kind of*) under discussion

  Here.

*in among the boob and Walmart discussions.

 

[tryan]

If it were to be implimented in California does that mean that the state must provide free health insurance to all those millions of Illegals.

Health care is already free for the illegals (via the emergency room).

 

[justin]

Health care is already free for the illegals (via the emergency room).

Hey, don't be so discriminatory! It's free for anyone with no assets.

 

[astromeria]

When I lived in CA, I voted in favor of health care for illegals. Not because I'm a bleeding-heart liberal or especially wanted to spend my money on illegal immigrants, but because I catch respiratory infections easily and don't want to run into people with horrible diseases like untreatable TB or pneumonia.

 

[haha]

When I lived in CA, I voted in favor of health care for illegals. Not because I'm a bleeding-heart liberal or especially wanted to spend my money on illegal immigrants, but because I catch respiratory infections easily and don't want to run into people with horrible diseases like untreatable TB or pneumonia.

Really. A drug resistant TB infected cook in a taqueria can do you some real damage.

Ha

 

[Martha]

Health care is already free for the illegals (via the emergency room).

Hey, don't be so discriminatory! It's free for anyone with no assets.

Hospitals have obligations to stabilize emergencies before sending you away. You still owe them for the work. And you won't get your TB drugs, your biopsy, or your chemotherapy either.

Martha, the broken record. . . .

 

[free4now]

Really. A drug resistant TB infected cook in a taqueria can do you some real damage.

Ha

Back when I was working a couple of taquerias we used to go to for lunch got closed down by the CA health department. When they reopened, my thrill-seeking coworker would always drag us out to eat there on the first day they reopened.

Yet another way in which working can be hazardous to your health.

 

[Martha]

Walmart. Boobs. Canada. Illegals with TB. What will we think of next?

 

[Cool Dood]

Boobs again.

 

[justin]

Hospitals have obligations to stabilize emergencies before sending you away. You still owe them for the work. And you won't get your TB drugs, your biopsy, or your chemotherapy either.

Go to hospital in the north of town. Then south of town. Then east of town. Then west of town. Then in downtown. Oops, back to the north of town again. Rinse, repeat ad nauseum... It ain't gonna be Johns Hopkins, but you can get a lot of care for "free". I know, I know, they still owe for the care. But when you have no money, what is there to take? Agree to a $20/month payment plan in perpetuity? The hospital can sue the 84 year old lady to collect, but there's always bankruptcy protection.

 

[Martha]

Go to hospital in the north of town. Then south of town. Then east of town. Then west of town. Then in downtown. Oops, back to the north of town again. Rinse, repeat ad nauseum... It ain't gonna be Johns Hopkins, but you can get a lot of care for "free". I know, I know, they still owe for the care. But when you have no money, what is there to take? Agree to a $20/month payment plan in perpetuity? The hospital can sue the 84 year old lady to collect, but there's always bankruptcy protection.

And at each hospital she will get a prescription for pain pills, and a referal to an oncologist for her metastized breast cancer, and sent home.

Obligations of hospitals with emergency rooms to provide emergency care no matter your financial situation is a problem, not a solution.

 

[free4now]

Obligations of hospitals with emergency rooms to provide emergency care no matter your financial situation is a problem, not a solution.

Here here. If low income people really could get all the health care they needed from emergency rooms, the cost to the rest of us would be astronomical and would be a huge motivator to get us to universal coverage with non-emergency-room providers.

The reality is that the cost for 'written off' emergency room services is huge, but not huge enough to clearly motivate universal healthcare.

 

[sgeeeee]

Go to hospital in the north of town.  Then south of town.  Then east of town.  Then west of town.  Then in downtown.  Oops, back to the north of town again.  Rinse, repeat ad nauseum...  It ain't gonna be Johns Hopkins, but you can get a lot of care for "free".  I know, I know, they still owe for the care.  But when you have no money, what is there to take?  Agree to a $20/month payment plan in perpetuity?  The hospital can sue the 84 year old lady to collect, but there's always bankruptcy protection. 

Wow. I didn't realize it was that easy. Why do I pay for health insurance? Do you use this strategy, Justin?

 

[LEX]

If you really want to free medical care in the US make certain you provide frudulent ID at the intake a la the illegals.  Fake company or state photo-ID or similar surrogate official looking ID is the cost effective way to bug the hospital bill collection system and can be purchased for less than a c-note in any Mexican area of town.

Even the best collection lawyers and their PI's will give up on skip tracing a smart dead beat.  A few small steps will save thousands. It works for Mexicans with little or no education, and it can work for you silly, otherwise law abiding ER's!  Save your money and let the next guy and his taxes pay the bill, that is the true American way these days!

 

[kramer]

I live in California and you can generally get full medical care if you are poor.

There are several drug addicts in my family, and this is how they have always gotten care (I am sure this does not characterize most people on this program, though). For instance, my uncle got treatment for cancer about 10 years ago this way. There is an application procecdure.

Health insurance is available for children on a sliding scale from, I believe, $6 to $18 per month per child if your income is less than 3x poverty line or so (top eligibility was $48K earnings with 2 kids,I think, but my memory is fuzzy). But they get free care, anyway, through Medicaid, which gives them almost automatic enrollment.

My drug addict cousin also gets almost free housing (government pays ~90% of the rent of a private 2 bedroom apartment rental for her and her son) and a small stipend. Because of this help, she does not have to get a job, and has not had one for about 5 years now, and so she does not have to change her drug habits. Her personality is completely changed from what it used to be, and it is real sad.

And, unfortunately, my uncle who got the cancer treatment died about a year ago due to his drug addiction (meth).

Kramer

 

[sgeeeee]

I don't really know how many people (illegal aliens or otherwise) stiff hospitals and doctors on the outrageous medical bills in this country. But I have noticed some trends in the stories I hear. I notice that people who have experience in hospitals and medical care facilities seem to think that uninsured people get minimal, poor care. They often provide first hand tales and specific statistics. I also notice that people who think that health care is given easily to the uninsured tend to tell second or third hand stories -- like how they knew someone that their best friend's second cousin knew who got brain surgery for nothing. And they tend to use these anecdotal stories and extrapolate as the root cause for our expensive medical system.

 

[kramer]

In regards to anecdotes about treatment of insured vs. uninsured, white vs. minority, etc. A study of nearly 7000 folks who had recently gotten care was just published last month in the New England Journal of Medicine and found their treatment was almost equal, amazingly so. Although the general standard of care was low.

http://www.boston.com/yourlife/health/other/articles/2006/03/15/study_most_get_mediocre_health_care/

"It doesn't matter who you are. It doesn't matter whether you're rich or poor, white or black, insured or uninsured," said chief author Dr. Steven Asch, at the Rand Health research institute, in Santa Monica, Calif. "We all get equally mediocre care."

And you absolutely are right in that the price that folks without insurance are asked to pay hospitals is absolutely criminal. 60 minutes recently did a segment on this. It seems that some hospitals are being shamed into lowering some bills. Paying 3x, 5x, 10x or more for the same fees that insurance companies pay! It is unfair and symptomatic of something really wrong.

Kramer

 

[sgeeeee]

In regards to anecdotes about treatment of insured vs. uninsured, white vs. minority, etc.   A study of nearly 7000 folks who had recently gotten care was just published last month in the New England Journal of Medicine and found their treatment was almost equal . . .

The article was less conclusive than the title might indicate:

"Though we are improving, disparities in health care still exist," said Dr. Garth Graham, director of the U.S. Office of Minority Health.

Graham, who is black, pointed to other data showing enduring inequality in care, including a large federal study last year. He also said minorities go without treatment more often than whites, and such people are missed entirely by this survey.

 

[tryan]

Because of this help, she does not have to get a job, and has not had one for about 5 years now, and so she does not have to change her drug habits.

The dependency built on govenments "good deeds" is really shameful. After ~20 years in the rental business, I've seen this accross every government program: welfare (funding drug addiction), food stamps (peddled on the street for 50 cents on the dollar), SSI (the new welfare), section 8 housing (with the able bodied sleeping untill noon) ....

And now they want HEALTHCARE ... NO THANK YOU. I'ld rather pay my own way.

CAUTION: the insites above are first hand to me, second hand to you, and third hand to those you tell.

 

[Martha]

We also were in the rental business for a number of years. We rented to a number of people on SSI with section 8 vouches. They all had mental or physical disabilities. None with drug problems. Some had "sheltered workshop" type jobs. Even though we no longer own the properties, many of these tenants still call my husband their friend.

In March 1996, the Contract with America Advancement Act (PL 104-121) eliminated drug addiction and alcoholism (DA&A) as qualifying impairments for disability benefits under the Supplemental Security Income (SSI) program. As a result, on January 1, 1997, more than 166,000 SSI DA&A recipients lost their monthly income and health care (i.e., Medicaid) benefits. This population accounted for approximately 2.5% of all SSI recipients. In California, where nearly 30% of all DA&A beneficiaries resided, nearly 50,000 individuals were directly affected.
http://sswr.confex.com/sswr/2006/techprogram/P4275.HTM

Not that this was only 2.5% of SSI recipients.

My grandneice is on SSI--born without enough intestine and now waiting a liver and intestine transplant. My brother is on SSI--he is autistic.

 

[Martha]

I live in California and you can generally get full medical care if you are poor.

You are not eligible for MediCal based on income alone.


People in many different situations qualify for Medi-Cal. They are listed below.

You may automatically be eligible for Medi-Cal if you receive cash assistance under one of the following programs:

SSI/SSP (Supplemental Security Income/State Supplemental Program)
CalWORKs (California Work Opportunity and Responsibility to Kids). Previously called Aid to Families with Dependent Children (AFDC).
Refugee Assistance
Foster Care or Adoption Assistance Program.
Even if you don’t receive cash assistance, you may be eligible for Medi-Cal if you are one of the following:

65 or older
Blind
Disabled
Under 21
Pregnant
Diagnosed with breast or cervical cancer
In a skilled nursing or intermediate care facility.
Refugee status during a limited period of eligibility. Adult refugees may or may not be eligible depending upon how long they have been in the U.S.
Parent or caretaker relative of a child under 21 and
The child’s parent is deceased or doesn’t live with the child, or
The child’s parent is incapacitated, or
The child’s parent who is the primary wage earner is unemployed or underemployed.


http://www.dhs.ca.gov/mcs/medi-calhome/FAQs2.htm

 

[tryan]

In March 1996, the Contract with America Advancement Act (PL 104-121) eliminated drug addiction and alcoholism (DA&A) as qualifying impairments for disability benefits under the Supplemental Security Income (SSI) program.

The other great thing Clinton allowed was time limitations for collecting welfare. But what happened was everyone jumped to SSI - when welfare ran out - by claiming a mental disability. So we still have some work/regulation ahead of us (if we deem these programs necessary).

 

[justin]

Wow. I didn't realize it was that easy. Why do I pay for health insurance? Do you use this strategy, Justin?

You and I both have health insurance to protect our assets. If medical providers had no recourse to recover any money from me, I would go bare of course.