No Politics, HC big issue for FIRE

[Pilot2013]

There's a way to talk about emotive subjects like this one, without inviting Porky, if you take a little time to think about it.

I agree, but it is easy to infer "tone and intent" in written word sometimes and the mods I think go to the safe side. There are so many views of this that it is hard to discuss without ideology. I certainly want to help those in need, and I think it can be done. I worry about having the government do it, while others worry about the private sector doing it. I don't know how they choose who gets to participate, but I like the St Jude approach of helping with no cost, based on generosity of those in better financial shape. Maybe I am duped, but those are the kind of things that I contribute to and believe are good ways to help. Just my opinion, and we all know what they say about those.

 

[CaptTom]

I worry about having the government do it, while others worry about the private sector doing it.

That's a legitimate question. The problem comes about when people don't discuss the pros and cons, but blindly root for their own political team, or just repeat talking points.

I don't know how they choose who gets to participate, but I like the St Jude approach of helping with no cost, based on generosity of those in better financial shape.

Interesting. I honestly haven't considered that. It makes sense, at first glance. I wonder how hard it would be to fund the whole system that way. My next thought is that it's kind of like "to each according to his need, from each according to his ability," which might turn a lot of people off.

 

[Mr._Graybeard]

Originally Posted by Pilot2013
I don't know how they choose who gets to participate, but I like the St Jude approach of helping with no cost, based on generosity of those in better financial shape.

Your point about St. Jude intrigued me, so I looked up St Jude on Wikipedia to find out more about them. Turns out their biggest benefactor is the American Lebanese Syrian Associated Charities. A little off topic, but interesting IMO.

I do remember Danny Thomas being active in fundraising years ago.

 

[bclover]

The Mods seem awfully touchy, but I will ask a question hoping it hasn't crossed the invisible line:

Is there really a case where someone is absolutely refused lifesaving care due to no insurance? I have always been under the impression that part of the reason our HC insurance and medical costs are so high is that they have to cover the uninsured through the insured and paying?

I have an employee ($15/hour laborer) who has a granddaughter born with congenital heart defect. The granddaughter was born to a single mom, with no job/income. The child still went through multiple life saving surgeries and I am happy to say is alive and recovering. I am pretty sure there will be bankruptcy, and a tough road ahead, but care was provided in this case. I assumed this is the norm (although a part of the reason for spiraling costs)?

WARNING: this was only my experience. please to add the "you should have" or tell me "the hospital isn't allowed to do that". they did...

My late husband was diagnosed with Acute myloid leukemia at age 53. anyhoo with blood cancers you are in the hospital for 8 weeks after chemo because the chemo kills your immune system and you are neupogenic. everything including food has to be monitored. anyhoo most hospitals have a type of family ward where they try and make things "homey" and one result is that you get to know the other patients and their families. you see them every day for 8-10 weeks.

one of my husbands floor mates was a guy name Mike, he had just finished his chemo and was into his recovery. about the 5th day we heard a ruckus in the hallway, Mike was being kicked out. He was gay and his partners insurance was balking, even though his company provided same sex benefits.

the rest of the families pitched a holy fit. How can you kick someone out KNOWING that this person would get sick and die. The nurse told us they do it all the time and what they do is wait until the patient gets ill and then sends them down to Temple University hospital.

THIS WAS A MAJOR ivy league cancer hospital in Philly. Long story short, Mike indeed caught some type of virus and died. His partner is still wrangled up in a law suit. which the other families had to give depositions.

that myth about a hospital has to treat anyone who comes in their doors is garbage. a for profit hospital will kick you out or at the very least they will get you stable then boot you out. I lived through it less than 5 years ago.

 

[razztazz]

that myth about a hospital has to treat anyone who comes in their doors is garbage. a for profit hospital will kick you out or at the very least they will get you stable then boot you out. I lived through it less than 5 years ago.

Yes, that is a myth. All they are required to do is stabilize you. That's the only care they "have to" give you. Everything else is on a "need to pay" basis

I went to the ER once at 4:00 a.m. with anaphylactic shock. First thing they did was ask about insurance then made me fill out paperwork.

 

[MRG]

WARNING: this was only my experience. please to add the "you should have" or tell me "the hospital isn't allowed to do that". they did...

My late husband was diagnosed with Acute myloid leukemia at age 53. anyhoo with blood cancers you are in the hospital for 8 weeks after chemo because the chemo kills your immune system and you are neupogenic. everything including food has to be monitored. anyhoo most hospitals have a type of family ward where they try and make things "homey" and one result is that you get to know the other patients and their families. you see them every day for 8-10 weeks.

one of my husbands floor mates was a guy name Mike, he had just finished his chemo and was into his recovery. about the 5th day we heard a ruckus in the hallway, Mike was being kicked out. He was gay and his partners insurance was balking, even though his company provided same sex benefits.

the rest of the families pitched a holy fit. How can you kick someone out KNOWING that this person would get sick and die. The nurse told us they do it all the time and what they do is wait until the patient gets ill and then sends them down to Temple University hospital.

THIS WAS A MAJOR ivy league cancer hospital in Philly. Long story short, Mike indeed caught some type of virus and died. His partner is still wrangled up in a law suit. which the other families had to give depositions.

that myth about a hospital has to treat anyone who comes in their doors is garbage. a for profit hospital will kick you out or at the very least they will get you stable then boot you out. I lived through it less than 5 years ago.

+1
Semi related.

A friend of mine lost his wife to stomach cancer, there is no cure. Just make you as comfortable as possible, at a major cancer center. They were there about 18 months and saw much.

What he noticed was the number of families who were not able to afford necessities like FOOD! The whole family was sacrificing in order to pay copays, deductibles and all the stuff(many were far away from home) that comes with a long term illness.

He's actually started a charity(in his wife's memory) to provide food and necessities of life to people in that situation. Actually I used to w*rk for this man, he was perhaps the nicest human I've ever met.

 

[Pilot2013]

OK, well.... My daughters (both of them), were encouraged to volunteer at our local hospital by my MIL while she was alive (closest woman to a saint I've ever known). They experienced many cases of indigent and homeless being cared for in that local hospital, at no cost to themselves. I am sure there are cases on both ends of the spectrum. I won't refute the negative ones you may have heard about or experienced.

 

[Pilot2013]

Your point about St. Jude intrigued me, so I looked up St Jude on Wikipedia to find out more about them. Turns out their biggest benefactor is the American Lebanese Syrian Associated Charities. A little off topic, but interesting IMO.

I do remember Danny Thomas being active in fundraising years ago.

I'm good with that. They do a tremendous amount of good IMO, and that's what counts.

 

[explanade]

But can churches and other religious or charitable organization scale to help all the people who can't afford health care?

There are probably hundreds or thousands of anecdotes about how various organizations help people in need.

Unfortunately, there are millions who are unable to pay for health care or insurance.

 

[GTFan]

Exactly. Charities do a ton of good but there's just no way they can afford to be a universal HC insurance provider for everyone without insurance. There's a lot of folks that slip through the cracks and die or suffer horribly - if all of them were able to get the same quality of care charity alone could not cover it.

Still not following how the gov't can mandate stuff like auto liability, motorcycle helmet use etc. and not HC insurance. It's the same principle - we're probably going to be liable for it at some point, we should all pay into the system.

I think the end-all of this, after we've tried and failed at ACA, is to raise the Medicare payroll tax enough to cover everyone then go single payer. Biggest hurdle being how to answer all those people mad about losing their heavily subsidized employer coverage. And that, unfortunately, is a very big hurdle.

 

[Koolau]

The Private system will ONLY work if it is NOT FOR PROFIT.

Sorry so late to the party:

A few years back (in my old state) a news organization (think it was a newspaper) did a state wide study. The city where I lived had two Not for profit hospitals (no for profit hospitals). IIRC the NFPs cost about 60% more than the FP hospitals within 50 miles within the state. IIRC, ALL NFPs were more expensive than FPs and "quality" was not predictable based on price.

What I saw was incredible waste in the NFP hospitals. Each of them went through a 15 year rehab program. Every single room was redone (electric, plumbing, wall coverings, communications, windows (fuel efficient), on and on. Within a year of completion of the projects, each hospital abandoned the now rehabbed buildings and built new ones in a different (much less centralized location.) The old buildings would have seemed to be perfect for care-home type buildings. Instead, one building was essentially abandoned (keeping a small emergency room) and the other building was torn to the ground and a new care-home was built on the site.

Lots of other details I could give as I saw it all. My point isn't that all NFPs are "bad" and all FPs are "good." Just saying that any entity can be inefficient (and thus over priced) when there is little or no competition. NFP is a true misnomer IMHO. As always, YMMV.

 

[ChiliPepr]

Still not following how the gov't can mandate stuff like auto liability, motorcycle helmet use etc. and not HC insurance. It's the same principle - we're probably going to be liable for it at some point, we should all pay into the system.

The Gov't can mandate HC insurance, they did it last year.... The new administration just reversed the decision...

 

[Gumby]

Sorry so late to the party:

A few years back (in my old state) a news organization (think it was a newspaper) did a state wide study. The city where I lived had two Not for profit hospitals (no for profit hospitals). IIRC the NFPs cost about 60% more than the FP hospitals within 50 miles within the state. IIRC, ALL NFPs were more expensive than FPs and "quality" was not predictable based on price.

What I saw was incredible waste in the NFP hospitals. Each of them went through a 15 year rehab program. Every single room was redone (electric, plumbing, wall coverings, communications, windows (fuel efficient), on and on. Within a year of completion of the projects, each hospital abandoned the now rehabbed buildings and built new ones in a different (much less centralized location.) The old buildings would have seemed to be perfect for care-home type buildings. Instead, one building was essentially abandoned (keeping a small emergency room) and the other building was torn to the ground and a new care-home was built on the site.

Lots of other details I could give as I saw it all. My point isn't that all NFPs are "bad" and all FPs are "good." Just saying that any entity can be inefficient (and thus over priced) when there is little or no competition. NFP is a true misnomer IMHO. As always, YMMV.

"Not-for-profit" just means management doesn't have to share the loot with any pesky shareholders.

 

[razztazz]

Sorry so late to the party:

A few years back (in my old state) a news organization (think it was a newspaper) did a state wide study. The city where I lived had two Not for profit hospitals (no for profit hospitals). IIRC the NFPs cost about 60% more than the FP hospitals within 50 miles within the state. IIRC, ALL NFPs were more expensive than FPs and "quality" was not predictable based on price.

What I saw was incredible waste in the NFP hospitals. Each of them went through a 15 year rehab program. Every single room was redone (electric, plumbing, wall coverings, communications, windows (fuel efficient), on and on. Within a year of completion of the projects, each hospital abandoned the now rehabbed buildings and built new ones in a different (much less centralized location.) The old buildings would have seemed to be perfect for care-home type buildings. Instead, one building was essentially abandoned (keeping a small emergency room) and the other building was torn to the ground and a new care-home was built on the site.

Lots of other details I could give as I saw it all. My point isn't that all NFPs are "bad" and all FPs are "good." Just saying that any entity can be inefficient (and thus over priced) when there is little or no competition. NFP is a true misnomer IMHO. As always, YMMV.

That means only those NFP were ineffectively run. Doesn't mean that is symptomatic of NFP. Simply run them right and by definition they can only be more efficient that FP's. Profit is a symptom of lack of efficiency anyway. Diverting funds to pockets and awat from goods/services. It's always in the how things are done and the people doing them The "system" is a minor factor.

 

[USGrant1962]

The Gov't can mandate HC insurance, they did it last year.... The new administration just reversed the decision...

To be precise, the government mandated a tax penalty if you did not have health insurance that met ACA minimum requirements, and Congress eliminated the penalty in the new tax law (actually set it to zero). The requirement is still there, but moot at this point.

 

[Doribe]

OK, well.... My daughters (both of them), were encouraged to volunteer at our local hospital by my MIL while she was alive (closest woman to a saint I've ever known). They experienced many cases of indigent and homeless being cared for in that local hospital, at no cost to themselves. I am sure there are cases on both ends of the spectrum. I won't refute the negative ones you may have heard about or experienced.

I believe where I live the costs for the indigent are picked up by the local taxpayers. The hospitals take in a certain number of indigent instead of paying property taxes.

 

[GTFan]

We're all paying for indigent care in the form of jacked-up hospital billing, doesn't matter how it gets factored out. As long as the law mandates that all comers will be cared for, we're going to pay for it.

So I don't understand why mandated universal coverage is a bad solution to fix the problem, with the necessary taxes to pay for it of course. It could be a combo of provided basic coverage + subsidized extra coverage picked from a marketplace, which is pretty much Medicare today and has already been done in many countries. So the hospital always gets paid and doesn't play all these silly cost-shifting games to stay afloat.

And yes that means some will get extra coverage and won't be paying taxes for that because they're poor, but how is this worse than today? They're already not paying.

 

[explanade]

We're all paying for indigent care in the form of jacked-up hospital billing, doesn't matter how it gets factored out. As long as the law mandates that all comers will be cared for, we're going to pay for it.

So I don't understand why mandated universal coverage is a bad solution to fix the problem, with the necessary taxes to pay for it of course. It could be a combo of provided basic coverage + subsidized extra coverage picked from a marketplace, which is pretty much Medicare today and has already been done in many countries. So the hospital always gets paid and doesn't play all these silly cost-shifting games to stay afloat.

And yes that means some will get extra coverage and won't be paying taxes for that because they're poor, but how is this worse than today? They're already not paying.

Because there's a perception that people are freeloading on social programs, whether they're member of certain ethnic groups or illegal immigrants.

So another program that explicitly helps pay for some people's health care is going to draw ire.

Of course free-riding is still an issue with the emergency room care costs which end up being spread to all the paying patients.

 

[Gumby]

Just a wild idea, I know, but how about if we base our public policy on actual facts instead of perception and emotion?

 

[REWahoo]

Just a wild idea, I know, but how about if we base our public policy on actual facts instead of perception and emotion?

Who gets to choose the facts? There's the rub.

 

[GTFan]

So another program that explicitly helps pay for some people's health care is going to draw ire.

Of course free-riding is still an issue with the emergency room care costs which end up being spread to all the paying patients.

We would be replacing a distortion that already pays for their care with a program that pays for everyone's care. And yeah, let's get the perceptions out of this and look at the actual costs either way.

ER (and medical care in general) misuse is always going to be there, I don't know what the answer is for that. Education and access to clinics (including urgent care etc.) is all I can think of. You can't use the stick and say insurance won't pay like BCBS tried to do here in the ATL for ER abuse, because the hospital is going to get stuck with the bill anyway. IOW you can't make folks that don't have money put skin in the game, which is the usual answer for this problem.

Still think this is all fantasyland, though, as long as employer-provided insurance is ruining any chance of real reform. The 10% or so of us that don't have it are political footballs at this point.

 

[kimcdougc]

Again, Single Payer works. BUT for some reason we are so afraid of the "T"(ax) word, that we seem to be very happy to give way more money to an Insurance company than pay 1/5th the amount we give them in extra taxes. It really does not make sense to me as one who has actually experienced 2 single payer systems before emigrating to the USA. What the difference is between a profit based company making decisions on our healthcare, than a single dedicated funded government department making them is, I do not know.

I respect your opinion but just look at our nation's 20 trillion debt and that should tell you why we don't want the government to run our healthcare system. Just my humble opinion.

 

[samcat]

We gave up our health insurance December 1 and signed up for Christian Healthcare Ministries which is a non profit where you share your medical bills after getting cash discounts. We are self employed. In 2005, we paid $361 for insurance that was just better than major medical. We were healthy and it worked for us. In November, we found out our $2261 per month silver plan was being discontinued and we were being mapped to a $2700 per month silver plan. There was no way we could afford that. We thought about switching to a bronze plan at over $2300 per month. Most all bills were subject to a $12k family deductible. We couldn't afford it. We found CHM. We researched it and believe it will work for our family. $475 a month which will go to $325 a month once our boys have real jobs by the end of the year.

Health insurance has to change. After our experience, I can't imagine what others do and it makes me sad people have to choose between paying bills and medical care.

 

[Gumby]

I respect your opinion but just look at our nation's 20 trillion debt and that should tell you why we don't want the government to run our healthcare system. Just my humble opinion.

I know it's fashionable in some quarters to criticize the government, but for any given medical procedure, who do you think pays the provider more - Medicaid/Medicare or a commercial insurer? Having had occasion to see the comparative rates, I can tell you that it's virtually always the commercial insurer who pays more. The government drives a hard bargain in buying healthcare services.

 

[ShokWaveRider]

I respect your opinion but just look at our nation's 20 trillion debt and that should tell you why we don't want the government to run our healthcare system. Just my humble opinion.

One will never know till one tries.... "Take a Chance".