Government Spending Per Capita

[carlfense]

I am in no way claiming the current system works perfectly. It obviously needs to have some type of "fix" because health costs are going way out of whack.

 

There is a big part of this health care bill that doesn't make sense to me.

 

At first, it sounds great. Require everyone to purchase health insurance. (not sure that's constitutional but that is for another argument). BUT, in practice, does that really work? Let's look at our population. We have a group that is wealthy, a group that is middle class and a group that is poor.

 

Obviously the wealthy people can afford it. I'm just guessing but I would assume that most of the middle class can get health care through an employer.

 

That leaves what we happens with the poor. These people are anywhere from homeless and broke to having a job but doesn't pay hardly anything. How do these people pay for mandated health insurance plan? Well....I'm told they will fall under a part that gives them free coverage through the government.

 

What leaves me scratching my head is.....isn't that what we had before? We had a large amount of our population that either can afford their own coverage or get it through their employer and then we have a large group that the government gives it to them for free.

 

So, this "individual mandate" to me sounds great but it really isn't what it sounds like.

Now, admittedly, it has been a long time since I have read anything on this. But, I'm honestly confused on how this helps anything.

One way it works (in theory) is that people don't have to wait to use the ER to obtain medical services that they could not pay for up front. (ER medicine is generally considered less efficient and far more expensive.) Just an example . . . but hopefully an illustrative example.

[BigRedBuster]

And, I fully understand that. I used to work in the medical field and it was sickening (pun intended) how many people use the ER for little stuff.

 

However, all you have to do is tell doctor's offices that Medicaid will pay them to see these people. That can be accomplished without all the questionable constitutional issues that come with the mandate. Also, as pointed out above, the mandate really is different than what it sounds like. It sounds like everyone is required to pay for health insurance. When, in reality, a very large amount of our population is still getting free health care through the government very similar to the way they always have. Just hopefully not using the ER as much.

 

For which, I doubt very seriously if the number of poeple coming into ERs for this stuff goes down much. What I found is that many of these people come into ERs after hours. They do that for the flu even though they could just wait till the morning and go somewhere else. BUT, the ER is the only place open at 11:00 at night.

[carlfense]

And, I fully understand that. I used to work in the medical field and it was sickening (pun intended) how many people use the ER for little stuff.

 

However, all you have to do is tell doctor's offices that Medicaid will pay them to see these people. That can be accomplished without all the questionable constitutional issues that come with the mandate. Also, as pointed out above, the mandate really is different than what it sounds like. It sounds like everyone is required to pay for health insurance. When, in reality, a very large amount of our population is still getting free health care through the government very similar to the way they always have. Just hopefully not using the ER as much.

So you'd expand Medicaid instead? What would be your proposed cut off? And isn't that expanding government control of medicine even more than requiring individuals to participate in the private health insurance market?

 

For which, I doubt very seriously if the number of poeple coming into ERs for this stuff goes down much. What I found is that many of these people come into ERs after hours. They do that for the flu even though they could just wait till the morning and go somewhere else. BUT, the ER is the only place open at 11:00 at night.

People are crazy.

[BigRedBuster]

So you'd expand Medicaid instead? What would be your proposed cut off? And isn't that expanding government control of medicine even more than requiring individuals to participate in the private health insurance market?

 

That's what I don't get though. It really wouldn't be an expansion of Medicaid or taking over more of private health care. Medicaid would simply pay doctor's offices instead of ERs.

 

I am a firm believer that there needs to be a certain level of safety net in our society. This is a case where there always has been a safety net but it was just not working right. But, instead of simply making little fixes to make a big difference, it appears to me that they created this monstrosity of a health care bill.

[BigRedBuster]

And, as far as "people are crazy". I look at it as more of there is a certain level of people with a mental capacity that doesn't understand the difference. They are not going to go through the thought process of saying...."Hmmm....it will be cheaper for the government if I wait till morning and go to a normal doctor's office." They are simply going to be sick, the ER is open so they go there.

[carlfense]

That's what I don't get though. It really wouldn't be an expansion of Medicaid or taking over more of private health care. Medicaid would simply pay doctor's offices instead of ERs.

Emergency care providers often end up unreimbursed by Medicaid . . .

 

http://articles.latimes.com/2012/jun/18/nation/la-na-emergency-care-20120619

[carlfense]

And, as far as "people are crazy". I look at it as more of there is a certain level of people with a mental capacity that doesn't understand the difference. They are not going to go through the thought process of saying...."Hmmm....it will be cheaper for the government if I wait till morning and go to a normal doctor's office." They are simply going to be sick, the ER is open so they go there.

It's possible.

[BigRedBuster]

That's what I don't get though. It really wouldn't be an expansion of Medicaid or taking over more of private health care. Medicaid would simply pay doctor's offices instead of ERs.

Emergency care providers often end up unreimbursed by Medicaid . . .

 

http://articles.lati...y-care-20120619

 

Not sure how that story fits in with the discussion of people using the ER for non emergency visits.

 

That 1986 law came into practice about the time I started working in the medical field. And, in general I agree with the law. If someone has a car accident, the ER should not be letting the guy bleed to death while they check out if he can pay or not.

 

However, bringing this back to what we were discussing, I may have missed it in the article, but, if this is a poor person, why wasn't it covered under Medicaid?

 

If this is a person who could afford health insurance but chose not to, then this was a risk the patient took and his personal wealth should be used up and then Medicaid help with the rest. At least that is my first thought on the subject.

[carlfense]

Not sure how that story fits in with the discussion of people using the ER for non emergency visits.

You'd said that those non emergency visits were covered by Medicaid anyways . . . but that's not always true.

 

That 1986 law came into practice about the time I started working in the medical field. And, in general I agree with the law. If someone has a car accident, the ER should not be letting the guy bleed to death while they check out if he can pay or not.

 

However, bringing this back to what we were discussing, I may have missed it in the article, but, if this is a poor person, why wasn't it covered under Medicaid?

 

If this is a person who could afford health insurance but chose not to, then this was a risk the patient took and his personal wealth should be used up and then Medicaid help with the rest. At least that is my first thought on the subject.

Patients can be ineligible for Medicaid (not fitting into one of the defined categories or within the 133%(?) poverty limit) and still be judgment proof.

[JJ Husker]

I would presume you are referring to the individual mandate. My comment would be that those aren't necessarily the most partisan Republicans it is offending but rather maybe some Republicans with a mean libertarian streak in them.

You presume correctly . . . and it's possible that the most die hard Republicans that I know have that libertarian streak . . . but what part of Obamacare do you think was more controversial than the individual mandate?

 

I would like to see the individual mandate slightly tweaked and then I would be happy with it. I know that the only way to address the problem is to require everyone to have health insurance. But, semantically, I would like people to have the option of opting out but, that decision would have to preclude them from receiving care without paying up front. It is a fine line but I think an important one. Something deep down tells me our government should not be able to force us to purchase health insurance even if it is for our own good. But I doubt my way would ever be taken seriously because no way the bleeding hearts are going to make people responsible for making a bad decision. Of course that would also require refusing emergency care to illegal immigrants and we know that doesn't/won't ever happen.

I'm fine with tweaking the law to make it more effective but I don't think that an opt out option is feasible given our current law.

 

I see only two possible options for the future of healthcare . . . the individual mandate works and private health insurance survives . . . or single-payer government provided healthcare. Out of those options I think that the former is less radical.

I do believe the individual mandate was the most controversial part. However, it is not the part I disliked the most. As I stated, I realize the ind mandate is necessary for it to work and my problems with that portion are on principle alone. I plan to always have health insurance so the mandate doesn't bother me personally. And, I know a lot of the problem with healthcare is due to the people who do not have health insurance. the ind mandate is a step in the right direction to fix it. BTW- the parts I most dislike are A) I do not believe they satisfactorily addressed the rapid increases in insurance and care costs and B) I think there was too much extraneous BS thrown in. And, I just plain didn't like how it got passed. The morons didn't even know what was in the bill at the time they signed it. I don't believe that is a good way to govern.

 

I would agree with your two possible options. I would like to think the free market could handle it but I think they have proven they can't.

[strigori]

With regards to the ER. As it is against the law to turn people away from an ER, many uninsured end up in there for something that has gone really bad, that could have been fixed with visit to a GP. So something that could have cost relatively little, ends up costing thousands, and that gets passed along to everyone else. And I have actually overheard people talking where the reason the object to Obamacare is the mandate, since they don't want to pay for it when they can just use the ER...I hate those people.

 

With regards to cutting costs in the healthcare industry, Congress could pass a very, very simple law that I think would do wonders. Pass a law that all medical services/providers must show a price list for all drugs, procedures, or tests. Getting prices upfront can be next to impossible, as they change the price based on how you are paying.

 

Our current system makes no sense. Imagine going into a grocery store. Nothing has prices listed. You fill up your cart, head to the checkout. They ring up your items, still you have seen no pricing. Then they ask you how you want to pay. You select your option, then sign a legally binding agreement for payment, and only after you are bound to pay, do you actually see the prices. Welcome to the American healthcare system.

 

How about starting by forcing the free market onto doctors and hospitals.

[Conga3]

With regards to the ER. As it is against the law to turn people away from an ER, many uninsured end up in there for something that has gone really bad, that could have been fixed with visit to a GP. So something that could have cost relatively little, ends up costing thousands, and that gets passed along to everyone else. And I have actually overheard people talking where the reason the object to Obamacare is the mandate, since they don't want to pay for it when they can just use the ER...I hate those people.

 

With regards to cutting costs in the healthcare industry, Congress could pass a very, very simple law that I think would do wonders. Pass a law that all medical services/providers must show a price list for all drugs, procedures, or tests. Getting prices upfront can be next to impossible, as they change the price based on how you are paying.

 

Our current system makes no sense. Imagine going into a grocery store. Nothing has prices listed. You fill up your cart, head to the checkout. They ring up your items, still you have seen no pricing. Then they ask you how you want to pay. You select your option, then sign a legally binding agreement for payment, and only after you are bound to pay, do you actually see the prices. Welcome to the American healthcare system.

 

How about starting by forcing the free market onto doctors and hospitals.

 

...and patients.

[BigRedBuster]

With regards to the ER. As it is against the law to turn people away from an ER, many uninsured end up in there for something that has gone really bad, that could have been fixed with visit to a GP. So something that could have cost relatively little, ends up costing thousands, and that gets passed along to everyone else. And I have actually overheard people talking where the reason the object to Obamacare is the mandate, since they don't want to pay for it when they can just use the ER...I hate those people.

 

With regards to cutting costs in the healthcare industry, Congress could pass a very, very simple law that I think would do wonders. Pass a law that all medical services/providers must show a price list for all drugs, procedures, or tests. Getting prices upfront can be next to impossible, as they change the price based on how you are paying.

 

Our current system makes no sense. Imagine going into a grocery store. Nothing has prices listed. You fill up your cart, head to the checkout. They ring up your items, still you have seen no pricing. Then they ask you how you want to pay. You select your option, then sign a legally binding agreement for payment, and only after you are bound to pay, do you actually see the prices. Welcome to the American healthcare system.

 

How about starting by forcing the free market onto doctors and hospitals.

 

...and patients.

This has been happening. Companies are being forced to go to high deductible policies. This forces patients to think before they just run off to the doctor every time they have a runny nose.

 

[strigori]

With regards to the ER. As it is against the law to turn people away from an ER, many uninsured end up in there for something that has gone really bad, that could have been fixed with visit to a GP. So something that could have cost relatively little, ends up costing thousands, and that gets passed along to everyone else. And I have actually overheard people talking where the reason the object to Obamacare is the mandate, since they don't want to pay for it when they can just use the ER...I hate those people.

 

With regards to cutting costs in the healthcare industry, Congress could pass a very, very simple law that I think would do wonders. Pass a law that all medical services/providers must show a price list for all drugs, procedures, or tests. Getting prices upfront can be next to impossible, as they change the price based on how you are paying.

 

Our current system makes no sense. Imagine going into a grocery store. Nothing has prices listed. You fill up your cart, head to the checkout. They ring up your items, still you have seen no pricing. Then they ask you how you want to pay. You select your option, then sign a legally binding agreement for payment, and only after you are bound to pay, do you actually see the prices. Welcome to the American healthcare system.

 

How about starting by forcing the free market onto doctors and hospitals.

 

...and patients.

This has been happening. Companies are being forced to go to high deductible policies. This forces patients to think before they just run off to the doctor every time they have a runny nose.

Have you actually tried to get a quote on the cost of something? Many places simply will not disclose the price, or you get left on 'hold' until you go away.