Healthcare reform article

[haha]

Discussions with the administrators who are trying to keep the hospitals open and and the Obstetricians that are delivering these babies. I know that it is hard to understand. And certainly painful to accept. And I sincerely wish that the numbers that we are seeing were not true.
There is this old saying that if you are going to tell the truth you better have one foot in the stirrups. I suppose this certainly applies to this situation.

This is one thing people overlook when they say, "Well, national health schemes work in Europe". It takes a long time to fully corrupt a socially homogeneous, well functioning, cohesive society.

Few would likely apply these adjectives to today's USA. As long as some favored groups benefit and the costs can be offloaded onto the taxpayer we will have no effective or rational immigration control, or control over what goodies get handed out. People with little firsthand experience usually are acting with their emotions, driven by manipulative propaganda from the control groups which are benefitting.

Ha

 

[Brat]

I wonder how many young women would get pregnant out of wedlock if health care services were available to them before conception?

There are some cultural groups in the US where out of wedlock pregnancy in the young is common. This is a public health issue IMHO. We should be doing more, all kinds of more from just say no to contraceptives, to preventing these conceptions. However, good prenatal care is an investment in the health of the child and mother. Obstructions and mid-wives do not get rich, this is not an area of health care I would target.

 

[Leonidas]

There are some cultural groups in the US where out of wedlock pregnancy in the young is common... this is not an area of health care I would target.

But we're talking about people from outside the U.S. coming here to have their illegitimate children in the U.S. so they can claim government benefits using their U.S. born children as the qualifier. The numbers and costs are so huge that it creates a health care crisis in places like Texas and California. The Federal Government, run by politicians seeking Hispanic votes, rushes billions in extra aid in order to prop up things like Medicaid.

We've always had illegal aliens here, but their impact on health care (and other public services) didn't start becoming a problem until the mid-1980's.

Bordered by factories and docks, the Magnolia Park neighborhood has long been a beacon for generations of Mexican immigrants seeking sturdy homes and steady wages. Over time, most found jobs, assimilated and moved on to a better life.

But that is much less the case nowadays. The neighborhood is as much a place to stay poor as it is to start poor. Upward mobility among the 14 million people of Mexican descent in the United States -- the nation's fastest-growing major ethnic group -- is faltering, and on Magnolia Park's shady streets the signs of trouble are everywhere: high-school dropouts, teen-age mothers, families doubled and tripled up in bungalows, and day-laborers who gather at street corners hoping to sell their services.

Mexicans Come to Work, but Find Dead Ends - The New York Times

State and local governments are finding themselves faced with unprecedented demand from illegal aliens, and not only is the Federal Government not helping very much, in some instances it's making it worse.

"Texas is the case study for system implosion," says neurosurgeon Guy Clifton, founder of the Houston-area group Save Our ERs.

The problems here, as elsewhere, are many. Small employers are dropping health coverage. Federal and state subsidies don't make up the difference. Illegal immigrants represent 21% of the county's public caseload, even though they represent only about 6% of the area's population.

What does a health crisis look like? See Houston - USATODAY.com

We are not treating an existing problem, we are creating a newer and bigger problem.

Michael Antonovich of the Los Angeles County Board of Supervisors states that two-thirds of the births in Los Angeles county hospitals are to illegal aliens. Additionally, Mr. Antonovich notes that these children now account for 30 percent of all AFDC (Aid to Families with Dependent Children) cases in Los Angeles County.

Center for Immigration Studies

Rising numbers of undocumented immigrants from Mexico and Central America are streaming into Texas to give birth, straining hospitals and costing taxpayers hundreds of millions of dollars, health officials say.

Also feeling the strain is Starr County, an already poor South Texas county that has the region's only taxpayer-supported hospital district.

Immigrants "want a U.S.-born baby" and know that emergency room staffers don't collect any money up front, said Dr. Mario Rodriguez, an obstetrician in Starr County.

"The word is out: Come to Starr County and get delivered for free. Why pay $1,000 in Mexico when you can get it for free?" Rodriguez said.

''When we are separated only by the distance of the river, it's easy to do," Starr County hospital administrator Thalia Muñoz said. "It's gotten worse, and it's because the economy in Mexico is not good and because we provide all these benefits."

''Our little snapshot is duplicated in all the municipalities between here and California," said Tony Falcon, a Rio Grande City physician who was appointed to the U.S.-Mexico Border Health Commission in April. ''What you see here is what is happening in Brownsville, McAllen, El Paso and San Diego."

He operates a private family clinic and delivers babies at the Starr County hospital. About a third of his deliveries are what he calls "walk-ins" — mothers in labor showing up at the ER.

''Obviously, it has a huge impact on patient health and the kind of health care that's provided," Falcon said. "You don't get the kind of prenatal care you should get."

Starr County Memorial Hospital had $3.6 million in uncollected medical bills in 2005, up from $1.5 million in 2002. The total when fiscal 2006 ends on Sept. 30 is expected to hit $3.9 million, chief financial officer Rafael Olivarez said. Unpaid bills for the past five years will reach nearly $13 million, he said.

To make up for the shortfall, Starr County's hospital district is proposing a 25 percent tax hike.

Already, the U.S. government is pitching in, setting aside $1 billion in Medicaid funds to pay for emergency care received by undocumented migrants over the next four years.

But Olivarez said getting the reimbursements isn't easy. Federal officials ''told us at a meeting they would pay us about 20 cents on the dollar," he said. "But it's better than nothing."

Houston Chronicle Article reprinted here (emphasis added): Did You See This ? More illegal immigrants are pouring into Texas to give birth? - Yahoo! Answers

I think Sevo's point was that, especially in health care, our politicians are just trying to buy votes with our tax dollars. The results, either unintentionally or stupidly, can be disastrous. Local taxpayers are paying the price and health care is suffering.

Illegal immigrant mothers deliberately wait until they are about to give birth because they know the hospital has to accept them in the E.R. at that point.

 

[lets-retire]

That sucks. But at least the silver lining here is that you have 60 days to elect COBRA, and its coverage is retroactive. That means that many people who expect a less than 60 day "gap" in coverage not only qualify as "continuing coverage" for the purposes of pre-existing conditions under HIPAA (I believe that requires a gap of less than 63 days), but also that you may be able to save money by not signing up for COBRA. And if a multi-kilobuck emergency medical expense hits in the interim, go back and retroactively sign up for COBRA and eat the premiums going back to your last coverage date -- and it will be retroactively covered.

Your response, seems to indicate I didn't clearly state what happened. This occurrence was a few years ago. After receiving the hospital bill, we paid for the COBRA and had the insurance pay the ER bill. Nothing was out of pocket, except my little injuries. I could have had the insurance pay for those also, but figured it wasn't worth my time or energy to fight for the small amount of money I'd receive back.

 

[ziggy29]

Your response, seems to indicate I didn't clearly state what happened. This occurrence was a few years ago. After receiving the hospital bill, we paid for the COBRA and had the insurance pay the ER bill. Nothing was out of pocket, except my little injuries.

No, I understood you. Some people seem to think I have a way of reiterating agreement by sounding like I'm disagreeing. My point was that the silver lining is that you were still able to retroactively sign up for COBRA even if you didn't elect it initially.

 

[Nords]

But we're talking about people from outside the U.S. coming here to have their illegitimate children in the U.S. so they can claim government benefits using their U.S. born children as the qualifier.

It's not just the illegitimi. Pregnant South Korean women travel to Hawaii to give birth to a little American citizen. Perfectly legal.

Birth tourism in Asia

 

[Leonidas]

It's not just the illegitimi. Pregnant South Korean women travel to Hawaii to give birth to a little American citizen. Perfectly legal.

Birth tourism in Asia

I'm absolutely cool with that, as is the guvmint, 'cause we aren't paying for it:

The Immigration and Naturalization Service says the birth tours are not illegal as long as the women have enough money to pay their medical bills...Kim estimates the trip will cost at least $20,000, much of it in medical bills that would be covered by her health insurance if she stayed at home. It would be even higher if she didn't have a grandmother in Los Angeles with whom she can stay...Kim is not bashful about having money and what it can do for her."If they could afford it, all my friends would go to the United States to have their babies," Kim said.

She's not a financial burden, she's here on a valid visa, and she's hiking her butt back home when she's done and her visa expires.

I guess if I were a less-than-wealthy South Korean I might be a little unhappy about the draft dodging intent of some of the mommies-to-be.

And since the baby is a boy, I thought it would be a big gift for him not to be burdened with military service.

But then again maybe not. Note that the article is from 2002. This from the U.S. Department of State:

The Government of the Republic of Korea does not recognize dual citizenship. Men must choose a single nationality by March 31 of the year they turn 18 years old, and women by the age of 21. If men do not select a nationality by that date, the Korean government will consider them to have chosen Korean nationality, and they will be obligated to serve duty in the Korean military...Under a law that went into effect on May 26, 2005, Korean men who have dual citizenship may be required to serve in the military before they can give up their Korean citizenship...A male who was born in the U.S., and whose name is on the Korean Family Relations Certificate, and whose Korean citizen parents lived only temporarily outside Korea, may not renounce his Korean citizenship until he completes his service in the Korean military.

Darn, $20,000 wasted.

WWW.BirthinUSA.Com is defunct.

I guess young private Kim will be reporting for duty with all the other little privates in 11 years or so.

 

[lets-retire]

No, I understood you. Some people seem to think I have a way of reiterating agreement by sounding like I'm disagreeing. My point was that the silver lining is that you were still able to retroactively sign up for COBRA even if you didn't elect it initially.

Got it.

 

[Independent]

The idea that every one needs any kind of insurance other than for catastrophic illness is mass insanity.

I can agree with this. OTOH, I think that everyone does "need" catastrophic insurance. That's why I'd have the taxpayers fund universal catastrophic insurance, but have the gov't get out of the non-castastrophic issues.

Unfortunately, I think you'd still be dealing with the gov't for a significant number of patients - depends on what your practice looks like.

 

[FinanceDude]

I can agree with this. OTOH, I think that everyone does "need" catastrophic insurance. That's why I'd have the taxpayers fund universal catastrophic insurance, but have the gov't get out of the non-castastrophic issues.

Unfortunately, I think you'd still be dealing with the gov't for a significant number of patients - depends on what your practice looks like.

That might cut down on the amount of head colds the average ER sees on a given day.......

 

[lets-retire]

I can agree with this. OTOH, I think that everyone does "need" catastrophic insurance. That's why I'd have the taxpayers fund universal catastrophic insurance, but have the gov't get out of the non-catastrophic issues.

Unfortunately, I think you'd still be dealing with the gov't for a significant number of patients - depends on what your practice looks like.

Of all ideas for government health care, catastrophic health insurance is the one area I could accept. I don't think it would be as good as what we currently have, but if the government's involvement can be limited to only that I can find it acceptable, though undesirable. The expected efficiencies from preventative care would not be materialize.

Has anybody seen the article where hospitals, are giving up 155 billion in future Medicare/caid payments to pay for the new health care. So in order to pay for government health care the government is going to cut payments for government health care that is already spending more than it is taking in. Interesting idea take money from an agency that has no money to fund a program that needs money.

 

[Brat]

I couldn't figure that out either. There is cost shifting today from the no/low pay care to insured. What is there to give up??

Maybe we wrap the medicare patients into the new health insurance program. Perhaps that is what they have in mind.

 

[lets-retire]

Maybe we wrap the medicare patients into the new health insurance program. Perhaps that is what they have in mind.

That would make a lot more sense than what I read.

 

[Sevo]

Lets Retire. My heart, and I really mean this, goes out to every one caught up in this insane system we are in. The hard working tax paying citizens are the ones caught up and literally terrorized by the government mandated system that we have. I will not bore you with my trials and tribulations of trying to keep my family insured.

Societies are complex. What we are dealing with now is the consequences of forty year of our socialist experiment that was started with the great society. Unfortunately I don't think that in reality there is much hope. If you look at the average family unit here in South Texas and you can argue about the numbers but it is irrefutable that we are talking about more than 50%. Since we live in a Democracy any greater than 50% voting block controls every politician that runs for office. This family is usually not an illegal alien but rather an at least officially unwed mother who's family is multi-generational American. They have been told all their lives and truly believe that free health care is their right. The father of these children knows that it is his right to have as many children as he wants to , with as many women as will allow him to,and that it is the responsibility of the rich tax payers ( that means every one on this board)to provide the best care that is possible free of charge. As voters they have no choice but to vote to keep it that way.

There is a way out that is simple but would be very difficult and probably impossible from a political stand point and that is to unwind the federal involvement in health care altogether. It has taken us more that 40 years to get to this crisis situation and it would take a long time to unwind it and that would include a lot of education. But for right now we are going to get socialized medicine with every one involved being micro managed by our centralized government. The ultimate cost is going to be astronomical. hey a trillion here a trillion there and soon you're talking about real money. Hopefully for the first few years as long we are able to keep borrowing money from the Chinese to pay for all of this is is going to work out okay.

My biggest concern for every one who has worked and saved for retirement and hopes to retire or continue in their retirement is that when the bill for all of this comes fully due there is going to no other option than to start heavily taxing / seizing retirement funds. I can not imagine any voter who is scrambling to make ends meet who gets any government subsidy taken away going to think that it is fair to have a bunch of relatively young retired rich people sitting around with as much as a quarter of a million dollars in a retirement fund when they need that money right now to feed clothe and get free health care for their children and them selves. The fact is that if the federal largess starts getting cut back your retirement money and mine is only one voting cycle away from being public property.

Now there may be in a few years some improvement because as history shows even in the old Communist systems ( I had a friend who lived in Poland who's parents were both doctors) you will wind up with a two tier system even if it is illegal. There will be the public system where you have rationing and no privacy.....ie universal electronic medical records and a private pay as you go system. The system run below the government radar by market forces is usually very well run and will be relatively inexpensive. Hopefully that system will be available if you have a little money.


Thanks for letting me vent by disturbing a few internet electrons. Really there is nothing that we can do now.Hang on and lets see what Washington hands out to us.

 

[FinanceDude]

It's amess, that's for sure.......

 

[eridanus]

There is a way out that is simple but would be very difficult and probably impossible from a political stand point and that is to unwind the federal involvement in health care altogether. It has taken us more that 40 years to get to this crisis situation and it would take a long time to unwind it and that would include a lot of education. But for right now we are going to get socialized medicine with every one involved being micro managed by our centralized government. The ultimate cost is going to be astronomical.

The cost is already astronomical and grows faster than inflation. It's unsustainable as is, without any "socialized" medicine. Of course, you should realize, the Canadian and British system pay less than we do and achieve equivalent results (that's what you mean by "socialized" medicine?).

I'm not sure what you mean by "unwinding" current federal involvement. Are you talking doctor boards? Medicare? Medicaid? Regulation of prescriptions? ER mandate to treat patients? COBRA? Group policies?

 

[Sevo]

The cost is already astronomical and grows faster than inflation. It's unsustainable as is, without any "socialized" medicine. Of course, you should realize, the Canadian and British system pay less than we do and achieve equivalent results (that's what you mean by "socialized" medicine?).

I'm not sure what you mean by "unwinding" current federal involvement. Are you talking doctor boards? Medicare? Medicaid? Regulation of prescriptions? ER mandate to treat patients? COBRA? Group policies?

By unwinding I meant all of the above and no longer having the Federal Government being involved in health care. In fact there is nothing in the Constitution that gives the Federal Government the power to mandate health care to or for any one. I understand that we have been educated to believe that we can't take care of ourselves with out Parenting from the Federal Government. That some how we are helpless. Because of that it is almost impossible for us to even think about the concept of not being "managed" in almost all we do by the feds.

It is very very important to remember that societies are very complex. We keep being told that England and Canada have such wonderful medical systems but that is not the entire story. Taken as a whole I don't see a mass exodus of people going from the US to either of those countries even though we all are free to leave the US any time we want. We also know that there are lots of Countries that have Universal health care. Cuba , Vietnam, Mexico, Russia China, etc In fact Hawaii has Universal health care. Now a great deal of that is paid for by tax payers through out the other 49 states through Federal largess ( you and I pay for that part). On the other the system in Hawaii is so expensive that it makes it almost impossible for business to operate there. State income tax is very high etc. We are all free to move there at any time that solves any problems with health care with out voting to put the rest of the nation under that same sytem.

Letting the Federal government take over health care in a nation that has over 300 million people ( no one knows really how many) many are here illegally, many have a LOT more loyalty to their home country and religion than they do to the US and most of whom do not pay any federal income tax is going to cause frightening unintended consequences.

My opinion is that giving your money to the ruling elite in Washington and expecting them to provide the health care you want and need is just as smart as giving a bunch of teen age boys a case of whiskey a kilo of cocaine and then giving them your Porsche and expecting them to successfully drive it from New York to California. Good Luck to us all

 

[eridanus]

Taken as a whole I don't see a mass exodus of people going from the US to either of those countries even though we all are free to leave the US any time we want. We also know that there are lots of Countries that have Universal health care. Cuba , Vietnam, Mexico, Russia China, etc In fact Hawaii has Universal health care.

Hawaii doesn't have universal health care.

It's impossible for there to be a "mass exodus" of US citizens emigrating to other industrialized countries. You can't just emigrate to the UK or Sweden. It's also odd to advocate moving to another country so that the US can continue its current, inefficient, health care system.

 

[modhatter]

This is a true story. I once had a live in housekeeper from Venezuela. She had five children back in Venezuela living with her family. The father of the children would not marry her. He eventually came to US illegally and looked her up, and got her pregnant again while she was working for me. So now I had a housekeeper without a home and a baby. Then when the child was about 1 yr. old, she got pregnant again and had another baby. (both times by the way going to the hospital to have baby with no insurance)

Then her citizenship came through and her five children were allowed to come to the US. . As soon as her US citizenship came through, the father of her now seven children married her (thus gaining citizenship himself)
It was at this point of course, I had to say NO WAY Jose. So she left with her new husband and did the most sensible thing and got pregnant again. It was a few months after that that her husband left her. (now with eight children)

This may sound crazy, but I know it is happening all the time. There does not seem to be very much personal thought and responsibility in having children by some people. What has this done to the cost of our health insurance? What do we do to fix it?

 

[lets-retire]

modatter--I know it's not the focus of your post but just one clarification. Your ex-housekeeper can not covey US citizenship to her husband simply by becoming US citizen. She does covey US citizenship to her children under certain circumstances.

 

[modhatter]

I think your wrong on this. It was my understanding at the time. Also, I had a more recent acquaintance who was illegal, and she went to an attorney who ultimately advised her to marry a US citizen. She paid someone $5,000 to marry her. She had interviews with immagration officials and she was coached by an attorney what they would ask her and how to answer questions and what to say. She also had to do other things like open a joint checking account.

Are you saying that because she became a citizen, but was not a natural citizen (born in US), the law does not apply to her? I just googled this and don't see anything requiring them to be a natural citizen.

 

[M Paquette]

Also, I had a more recent acquaintance who was illegal, and she went to an attorney who ultimately advised her to marry a US citizen. She paid someone $5,000 to marry her. She had interviews with immagration officials and she was coached by an attorney what they would ask her and how to answer questions and what to say. She also had to do other things like open a joint checking account.

That won't get her citizenship. The marriage will allow her to apply for permanent residency status. She can enter under an Immigrant Petition for Alien Relative (I-130), and once here (or if already here) can obtain a K-3 visa (LIFE Act). See INA Section, 8 CFR 214.2(k) 101(a)(15)(K)(ii).

Immigration law appears to be inspired by US health insurance...

 

[missionfinder]

Read what modhatter posted again. She obtained her citizenship first, as many legal immigrants do. It was after that she got married. Since she was already a citizen, her husband could become one. That was the sequence of events, not that they became married and suddenly were citizens as a result.

 

[modhatter]

"That won't get her citizenship. The marriage will allow her to apply for permanent residency status. She can enter under an Immigrant Petition for Alien Relative (I-130), and once here (or if already here) can obtain a K-3 visa (LIFE Act). See INA Section, 8 CFR 214.2(k) 101(a)(15)(K)(ii)."

Maybe that is true in the second case I mentioned. I know she was going through a legal process, had an attorney and entered into a phony marriage.

However, the housekeeper was sponsored and attained legal residency and had to wait I think it was five yrs. before she could apply for her citizenship. Looking at the law now, it says she has to be a citizen for three years, before her husband can apply for citizenship. It was a long time ago, but it did not seem like three years. Perhaps the time frame was different then.

This really got off subject, as I was trying to point out the fact that someone with no real means of support wound up here in US with 8 children, no skills other than housekeeping, abandoned by her husband, and because she has no money she can obtains free health care for herself and her children. It is a sad story and yet a dilemma for us.

 

[M Paquette]

This really got off subject, as I was trying to point out the fact that someone with no real means of support wound up here in US with 8 children, no skills other than housekeeping, abandoned by her husband, and because she has no money she can obtains free health care for herself and her children. It is a sad story and yet a dilemma for us.

You don't have to be a foreigner to wind up in that position. There are several local families that have a similar story, ending with a mom and a whole bunch of kids living off of a WIC card, general assistance, and the local food bank.

None of these folks are likely to have bought health insurance, and are probably not paying cash in advance at the clinic or hospital.

In another post "A Modest Proposal" I suggested that we implement a strict Pay As You Go policy to eliminate free use of healthcare facilities. That would address the problem that people have with others getting 'free' health care on their dime, and reduce the surplus population.