Moderator ventana Posted January 30 Moderator Share Posted January 30 A different thread and boats reply got me thinking.... Are we as a society creating a modern version of debtors prison by allowing hosptial systems to basically make up any charges they want to (as high as they want to) and then allowing these charges to be utilized against the uninsured. Not in the actual payment of them, but instead what happens when they don't pay. Case 1 ER visit and hospitalization you have HMO Blue Hospital bills $23000, accepts $3000 from insurance and bills you the $1000 coinsurance . You refuse to pay and it is sent to collections, which you refuse to pay Eventually it is written off and the Collection company sends you a 1099 for the $1000 write off Case 2 ER visit and hospitalization you have no insurance Hospital bills $23000, you manage to pay $3000 before you decide you have paid enough You refuse to pay any additional and it is sent to collections, which you also refuse to pay Eventually it is written off and the Collection company sends you a 1099 for the $20000 write off In both cases the hospital collected $3000 for the care rendered (Which is likely in line with Medicare/Medicaid rates) Case 1 - IRS is sending you a bill for taxes due on $1000 - which you likely can afford as you have insurance Case 2 - IRS is sending you a bill for taxes due on $20,000 - which you likely can not afford as you can't even afford insurance..... The gov't is actually contributing to this racket and in the end the individual is getting two very very different outcomes.... thoughts?? Quote Link to comment Share on other sites More sharing options...
iconic Posted January 30 Share Posted January 30 (edited) They aren't creating debt prisoners since people can discharge the debt in a bankruptcy, which is still FAR from a functioning system Case 2 - the hospital likely does not collect much of anything The problem is way overpaid CEOs running hospitals (and other enterprises) into the ground for their own profit Edited January 30 by iconic 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 30 Author Moderator Share Posted January 30 34 minutes ago, iconic said: They aren't creating debt prisoners since people can discharge the debt in a bankruptcy, which is still FAR from a functioning system Poor people are not quick to declare bankruptcy 34 minutes ago, iconic said: Case 2 - the hospital likely does not collect much of anything in both examples the hospital collects the same amount! 34 minutes ago, iconic said: The problem is way overpaid CEOs running hospitals (and other enterprises) into the ground for their own profit Agreed. Along with pharma and insurance companies screwing us all!! Quote Link to comment Share on other sites More sharing options...
sas5814 Posted January 30 Share Posted January 30 The whole system is a mess in many different ways and I certainly don't have the answer. People that have easy pat answers like "free coverage for everyone" or "Medicare for everyone" ignore a lot of associated issues. I have always found it confounding that, for example, BCBS which is a multibillion dollar business can, through their networks and contracts, force lower payments for services on providers and hospitals but Joe Blow and family, of the working poor variety, get saddled with an absurd unmodified bill and little recourse other than to try to negotiate with no negotiating power. Socialized medicine and "healthcare for all" has its own, different issues. Anyone that has used a socialized health care system has seen it. By socialized healthcare I mean systems where there is no cost to the patient/consumer. For many reasons they end up in the red and, by one means or another, end up with rationed care. In my mind there is a reasonable system where care is available with small investment by the consumer so everyone has some skin in the game. I have seen how systems get abused by people with the "free" healthcare mentality. European systems don't quite compare because of societal differences. First cup of coffee so I am having trouble getting to my point in a neat manner. Our system is rife with problems. There is a better way out there I just don't know what it is. 1 Quote Link to comment Share on other sites More sharing options...
iconic Posted January 30 Share Posted January 30 The care in the US is still rationed - it's rationed away from uninsured and underinsured to those who are insured and have means 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted January 30 Share Posted January 30 19 minutes ago, iconic said: The care in the US is still rationed - it's rationed away from uninsured and underinsured to those who are insured and have means I think one could argue insurance companies ration care too. I'm not sure financial constraints compare to rationing of health care. I take your point but "you can't have it" is a little different from "you can't afford it." There is, has always been, and always will be an inequality based on financial means. Even if someone waived their magic wand and tomorrow there was "health care for all" people of means would buy better /faster care than the system provides and spend their way past any real of perceived barriers . Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted January 30 Administrator Share Posted January 30 We need relational medicine, not transactional medicine. Capitation is just transactional, but perversely incentivizes an absence of relationship. Medicine must be a calling, not a business. Medicine must become a profession once more. 1 2 Quote Link to comment Share on other sites More sharing options...
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