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News at 11: when a service is offered for free to people, they abuse it. Now, let's return to discussing socialized medicine and subsidized healthcare, an apparently unrelated topic.
yeah, of course...like water, have you noticed all the wastrels overdosing on water? And air, geez look at those 'welfare people' they breathe way too much...if we charged for air they wouldn't waste it like that
The problem with that high copay is that some patients needing emergent transfer will balk. And can that can cause excess morbidity and mortality. A better option IMO is to have separate non-emergent medical transport system.
Hm, you make a good point. There's a balance to be struck with not having copays so high that they discourage needed care and I have never heard of the transfer issue before but that does make sense. Is there any literature on that (I trust your POV as a doctor [apologies if you're not, thought you were] so believe you without it, just genuinely curious)?
Pull your insurance card out of your wallet. If you're on a commercial plan, you'll see a low PCP copay, a low to moderate specialist copay, and a high ER copay. This isn't rocket science. You can cut the overall levels of the copays but maintain the differential for an indigent population.
I think you're not grasping my point, so let me try to clarify.
It doesn't matter if you or I have a copay. First of all, as I said, it is indisputable that even people who have insurance through private sources (like their job and not the government) do not follow maintenance and prevention schedules for their health. I presume you wouldn't dispute that. It is equally clear that people who are given their insurance by the government or heavily subsidized by the government do not then go out and enthusiastically start going to maintenance and prevention visits. You could actually make it free to go to a doctor's office for a poor person (assuming you could find someone who would accept their terrible government insurance) and it's likely they wouldn't go because they often find it too onerous to make and keep an appointment. Instead, they just utilize the ER, which they always have, which is what is seen. There is NOBODY who claims that ER visits are declining as the poor "appropriately" now go to see primary care doctors. Not even Obama claims that.
Meanwhile, on the flip side of things, these poor patients with numerous medical problems that they don't maintain or care about wait until they have some critical problem and then appear at a hospital and utilize hundreds of thousands of dollars of care. They receive all the best testing, get to see all the best specialists available, could get transferred to higher level hospitals, get any surgeries and medicines they need, and are even maintained on life support for as long as they need if they need it. In other words, they pay little to nothing and utilize vast amounts of resources. And liberals want people to believe that's sustainable and, in fact, that this will actually save people money, which turned out to be a predictable lie.
20 million people could lose their insurance. The uninsured often end up in emergency rooms, the most expensive option for receiving health care and one that taxes hospital budgets.
What are the prices charged for emergency room visits? Surely, you can provide a price-listing for local area hospitals, since they're so transparent and would never price-gouge.
That's interesting until you remember the hours they work, their training, and the fact that the liability in their profession is so high. In contrast, the liberal trial lawyers who sue them make even more than they do and have no liability, which drives up medical costs substantially.
The hours that they work?
Some are on call a lot...that's true...like surgeons.
Others work 3.5 days a week.
I think you're not grasping my point, so let me try to clarify.
It doesn't matter if you or I have a copay. First of all, as I said, it is indisputable that even people who have insurance through private sources (like their job and not the government) do not follow maintenance and prevention schedules for their health. I presume you wouldn't dispute that. It is equally clear that people who are given their insurance by the government or heavily subsidized by the government do not then go out and enthusiastically start going to maintenance and prevention visits. You could actually make it free to go to a doctor's office for a poor person (assuming you could find someone who would accept their terrible government insurance) and it's likely they wouldn't go because they often find it too onerous to make and keep an appointment. Instead, they just utilize the ER, which they always have, which is what is seen. There is NOBODY who claims that ER visits are declining as the poor "appropriately" now go to see primary care doctors. Not even Obama claims that.
Meanwhile, on the flip side of things, these poor patients with numerous medical problems that they don't maintain or care about wait until they have some critical problem and then appear at a hospital and utilize hundreds of thousands of dollars of care. They receive all the best testing, get to see all the best specialists available, could get transferred to higher level hospitals, get any surgeries and medicines they need, and are even maintained on life support for as long as they need if they need it. In other words, they pay little to nothing and utilize vast amounts of resources. And liberals want people to believe that's sustainable and, in fact, that this will actually save people money, which turned out to be a predictable lie.
Okay, sure, agreed, people won't use enough preventative care and will use too much ER care and to a lesser extent too much inpatient care regardless of copay structure. That's the default. I'm not saying that smart plan design can improve on that default. Simply that through it you can offer subsidized care without making that default much worse than it already is. You will do some harm, but the level can be managed.
Your beef seems to be more to do with EMTALA than with the ACA. Which, I dunno, do you really want the ER doc turning you away because you left your insurance card at home the day you got into a car wreck or had a heart attack?
What are the prices charged for emergency room visits? Surely, you can provide a price-listing for local area hospitals, since they're so transparent and would never price-gouge.
It's sad how defensive they get when you want them to post their prices.
Some are on call a lot...that's true...like surgeons.
Others work 3.5 days a week.
Training, yes.
Liability, yes.
Interesting, let me know when I can call any law firm I want at any time I want on any day I want, including weekends and holidays, and they charge me a small fee only and they don't get to make me share my winnings with them and I can claim that any outcome I don't like is grounds for me to sue them with another lawyer.
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