And if you have a thought, don't be shy about commenting. It really doesn't hurt a bit, and you may help us learn something or consider something differently.
"You are correct when you say that at some point The Law mandated that healthcare providers, in the form of emergency rooms, were required to give away their services for free to anybody that asked. But that is pure socialism and slavery by another name, and it is wrong. Of course we do not want people dying by the side of the road just because they lack the means to pay for simple catastrophic insurance or because they could afford expensive medical insurance but chose to forgo it. The problem is that government consistently drives up the cost of health insurance through mandates of various kinds (and because somebody has to pay for all that free medical care being given away). If government would butt out of the health insurance business, a lot more people could afford it. Then all you have to do is to modify the current emergency care law to minimize the immense amount of freeloading now going on. Simply allow the hospital to bill people who use the service but do not have insurance. It's called personal responsibility and we need to give it a try.
The problem, as it has always been, is not that someone will choose "who lives and who dies" by virtue of the medical care they can or cannot receive but rather WHO DECIDES. It should not be some faceless bureaucrat in Washington DC. It should be somebody standing at the emergency room door – on both sides – both taking responsibility for their personal actions. That is what Republicans want. How is that wrong?" Anon
If you use the "Search This Blog" function off to the right, and enter Healthcare. You will see that this is a favorite topic of mine, and we have had many discussions on it. Since it involves money, ethics, religion, personal choice, etc. I don't think many people here see that as wrong, though I see it as impractical.
Holding the patient who neglected to get health insurance and is broke responsible is easy if society is willing to do it. Let them die. Unfortunately then the ambulance chasers will show up and try to make the hospital responsible for turning them away unless the law allows it.
Holding the ER Doctor responsible is pointless, they don't control the budget and the hospital can't fund all of the Doctor's choices. Talking about responsibility without authority... Or maybe we should have the triage nurse make the choice.
Now if you are a supporter of getting Gov't out of healthcare, how do you feel about physician assisted suicide? And pro-choice/pro-life? Just curious..." G2A
"Why health care costs are out of control in America is a complex and little understood problem. Because of the polarized and political nature of the issue, there just isn't an independent understanding of this issue. For one thing, it's not obvious to me that whatever mandates we have in the United States are any more onerous than those in countries where health care costs are much lower. I do believe the inefficient and unaccountable way we redistribute the costs of "free" health care is a factor, but hey that's just my unsupported opinion. Other countries don't have "free" health care, it's paid for in ways that are understood and accountable, which I believes results in a controlling of costs." Hiram
"Or, you could simply treat them and send them a bill. Make them FINANCIALLY responsible and, if they can't pay, you give them easy payments or write off the debt from the hospital's taxes, just like everybody else does with bad debt. This cuts off the freeloaders of both kinds, because they will find (if government would allow it) either that basic non-emergency care is cheaper WITH the insurance, or that serious emergency care is VERY expensive without it.
As for health care costs, we know that getting the government out of health care, in four simple ways, would cut our costs in HALF while improving quality of care." J. Ewing
"Since most of these hospitals are not big profit centers, especially in the neighborhoods where the poor live. I assume this bad debt would put them in the red pretty quick. Would you advise tax credits to help them stay afloat? (ie write offs don't work without profits)
And how would this be different than today? Other than a bunch of broke folks would get a lot of collection calls. I guess the upside is it would create jobs in the collections and bankruptcy industries.
I don't doubt that it would keep people from getting unnecessary treatment, however I don't see that as a big cost driver. Most folks I know do what the Doctor says, and don't sit around wondering when they can spend more time in the Doctor's office. (Imagine: "Doctor, Please can I have another colonscopy. Pretty please.")
Maybe if we had the Doctor pay for any tests that don't yield useful information. That would cut back on the running of tests. Though the consequences may not be desirable." G2A
8 comments:
"Or, you could simply treat them and send them a bill. Make them FINANCIALLY responsible and, if they can't pay, you give them easy payments or write off the debt from the hospital's taxes, just like everybody else does with bad debt."
This is pretty much a description of the status quo. You know, the one that has resulted in the highest health care costs in the world, and health care spending that is generally unaccountable and totally out of control. And you notice, the result with respect to unreimbursed costs are the same. They are paid by taxpayers, directly indirectly, in this case through the use of tax write offs for bad debt.
The burden of health care costs is there. It's simply a question of how best to manage it.
--Hiram
I don't think you understand the system at all. Emergency rooms are clogged with people with all manner of normal ailments just because that treatment is "free" BY LAW. They are freeloaders, pure and simple. Some could afford to pay modest amounts, at least, for routine treatment or for insurance if it was available (which it isn't, again BY LAW).
And the reason health care costs in the US are so high is because of government distortion of the health care marketplace. Get government out and costs drop by half. Get government MORE involved, and costs go up further.
J. Ewing
"Get government out and costs drop by half. Get government MORE involved, and costs go up further."
. . and yet, in nations with comprehensive national health care, costs are half of ours here.
--Annie
And the reason health care costs in the US are so high is because of government distortion of the health care marketplace.
To say that markets are distorted is to say that there is one correct view of them. This is simply not the case. Markets are what they are, it's the perspective that changes. Where health care is concerned the problem isn't distorted, rather the problem is that markets largely don't exist. If you don't believe me, try getting a bit for a tonsillectomy on eBay.
One problem with the status quo is freeloaders. This morning I see at least two solutions to that problem. First, we could deny them care, possibly through the establishment of death panels. Or secondly, we could require them to pay, i.e. some form of mandate.
The choice is yours and the American electorate's.
--Hiram
We often speak of market distortions. For reasons I have said, I don't believe that markets are distorted very much. The problems markets often have problems with liquidity, and inefficiency, and on occasion, these problems can be severe, that markets cease to exist altogether. But even an illiquid market is not a distorted. It's simply one way a market can be.
"Distortion" is a value laden term, but stripped of the value, what it means, at least in the health care market is that the nature of it's customers affects the way businesses operate. If for example, you have one big customer on which your business depends, in all likelihood you will spend a lot of time tailoring your business to that customer's needs. This is natural and obvious. And maybe on bad days, when your best, and most essential customer is giving you a hard time for whatever reason, you might even mutter to yourself, "this guy is distorting my business model, making me do business in ways I don't want." But that's just so much irrelevant muttering. As a practical matter, you either respond to your best customer's needs, or you prepare to find another best customer. That's the way business works, and there isn't anything wrong with it.
--Hiram
You are correct, hiram, as far as you go, but what you overlook is that when your biggest customer is SO big that you are forced to do business with him or go out of business, and when that same customer does business with all of your competitors on exactly the same terms, where is the competition? That's market distortion, because it eliminates the actions of the competitive market. There must be competition between sellers but also competition between buyers.
J. Ewing
You are correct, hiram, as far as you go, but what you overlook is that when your biggest customer is SO big that you are forced to do business with him or go out of business, and when that same customer does business with all of your competitors on exactly the same terms, where is the competition?
Competition can be nonexistent. And that's the way the world works. Sometimes you have market power, sometimes you don't. To quote James Earl Jones, sometimes you eat the bear, sometimes the bear eats you.
You make it sound like we are powerless to change what government is doing to the health care system. I do not believe that is the case. Again, if we could get government clear out of it, we could cut costs in half.
J. Ewing
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