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It seems this has been a circuitous discussion. I was interested b/c my work deals (in part) w/ healthcare policy.
I was hoping to get some insight into what Americans think about our system, what their expectations are, what is considered reasonable, equitable . . .
And seems after all the discussion . . . we are back to "healthcare is available to anyone regardless of his/her ability to pay."
I have seen some misinformation on these pages, as well as some valuable info.
Yes, you will get treated if you show up at an Emergency Room, but not necessarily quickly or effectively.
No, you will not walk away owing nothing, unless you are indigent. If you have assets, you will be expected to pay. This can include putting a lien on your property and garnishing your wages.
Yes, you could end up in a closing on a property only to find a medical lien has been placed on your property - and even if you pay off the lien, it will still be reported on your credit report and lower your credit score.
Yes, collections agencies file medical bill delinquency reports w/ credit agencies.
Yes, you can possibly negotiate your final bill. Yes, some hospitals have foundations that will help pay part of your hospital bill.
Yes, there is already rationing of healthcare in this country.
Yes, Medicare is a form of socialized medicine.
Healthcare promotion does not mean disease prevention nor does it mean disease management. "Preventive Healthcare" is somewhat a misnomer.
Yes, insurance is wealth protection, not health protection.
Yes, health insurance has lifetime caps, and once you exceed it, you are on your own.
Yes, some people marry to get healthcare insurance benefits, and who can blame them for it.
Pharmaceuticals play a huge role in the cost of healthcare in this country.
As for the debate several pages back re: healthcare statistics, please let me know what it is exactly that any of you want to know, and I will do my best to get that info for you. Just make it specific, please.
I for one welcome somebody with actual knowledge of the health care system to the discussion.
Could you provide your own thoughts/insights on the health care situation?
I for one welcome somebody with actual knowledge of the health care system to the discussion.
Could you provide your own thoughts/insights on the health care situation?
yes, please provide some insight because the years I spent working for a company that did insurance and video conferencing systems, and helping setup RFP (request for Proposals) for the state of PA, WV, FL, NJ, NY has not provided me with enough information on how the government works with the insurance companies.
yes, please provide some insight because the years I spent working for a company that did insurance and video conferencing systems, and helping setup RFP (request for Proposals) for the state of PA, WV, FL, NJ, NY has not provided me with enough information on how the government works with the insurance companies.
And we have undoubtedly been the beneficiaries of your expertise.
It's just nice to get a "fresh" opinion sometimes.
yes, please provide some insight because the years I spent working for a company that did insurance and video conferencing systems, and helping setup RFP (request for Proposals) for the state of PA, WV, FL, NJ, NY has not provided me with enough information on how the government works with the insurance companies.
Well, obviously you have all the answers already, so what could anyone else possibly add.
And yes, we know what an RFP is. We prepare RFPs for some of our clients.
Snippiness aside . . . PGHQ . . . I actually have enjoyed reading your posts.
But in all honesty, I doubt I have anything fresh to add to the discussion, unless we want to discuss cost-shifting, for example.
Or we could discuss healthcare access . . . and that there is equitable healthcare access, as long as one has the money to buy it.
Then there is the whole discussion about non-citizens and how much they are costing hospitals in write-offs and charitable care. And how they may avoid treatment b/c they do not have insurance and b/c they do not have legal status . . . wh/ can put us all in a precarious position w/ disease management and the spread of communicable disease.
Or how predatory hospitals have gotten in re: to bill collections.
A society should be measured by how it addresses the care of its most vulnerable citizens - the frail, elderly and children. Add to that the disenfranchised and mentally ill.
It is a complex discussion when one views healthcare as an entitlement. Yet, quality healthcare should not be a "privilege" for only the financially fit.
So I don't know. Perhaps I do not have much to add to the discussion. I was enjoying sitting back and listening to the rest of you duking it out, Hee Hee.
Well, obviously you have all the answers already, so what could anyone else possibly add.
And yes, we know what an RFP is. We prepare RFPs for some of our clients.
Snippiness aside . . . PGHQ . . . I actually have enjoyed reading your posts.
I assumed you knew what RFP's were etc, but others most likely dont, unless your in the industry.
Just for the record, in all of these postings, I've never pretended to even have all (or any) of the answers. I've been asked numerous times for "answers" to the problem and I've responded that I dont have any. It would be interesting to sit on a panel that would discuss such issues though.
Overall, I think the emphasis on the "problem" is going in the wrong direction. I think there should be more of an emphasis to find out why medical care costs what it does, and not medical insurance. We spend twice per person what most countries spend, and we're not any healthier. Thats the only reason for my postings (other then the fact that we have no "right" to healthcare.. )
I assumed you knew what RFP's were etc, but others most likely dont, unless your in the industry.
Just for the record, in all of these postings, I've never pretended to even have all of the answers. I've been asked numerous times for "answers" to the problem and I've responded that I dont have any.
Overall, I think the emphasis on the "problem" is going in the wrong direction. I think there should be more of an emphasis to find out why medical care costs what it does, and not medical insurance. We spend twice per person what most countries spend, and we're not any healthier. Thats the only reason for my postings (other then the fact that we have no "right" to healthcare.. )
I felt we are on pretty much the same page. I agree with you. Insurance is not the problem. Healthcare costs are at the crux of the issue. But why do we have burgeoning healthcare costs?
SIDEBAR: My H and I have what would be considered a catastrophic healthcare insurance policy. Our coverage is there for the big expenses (hospitalization, diagnostics, surgery) but we have chosen a high deductible to lower our premiums. We consider insurance something to buffer us from complete financial ruin in the case of catastrophic illness. Otherwise, we are paying out of pocket. In addition, most people have no clue that their policies have a lifetime cap on them. Rarely is it more than $1.5 M. We shuddered when we saw what Christopher Reeve went through. While everyone else was sympathizing w/ his situation, all we could think about was - how in heaven's name was that man paying for his healthcare????
What i should do is find a link to Uwe Reinhardt, as he is one of the most articulate experts in our nation on this subject (healthcare economics).
Here is a collection of articles that are very enlightening - the first is by Uwe - but all are pertinent to this thread discussion.
There simply is no easy answer to explain why healthcare costs in the US are so high.
However, I will throw this out for anyone who does not realize that you are billed by your doctor or a hospital based on contracted rates b/n the hospital/physician and your insurance co. So you may be charged $2100 for an MRI and your neighbor, who has a different insurance carrier, may be billed $1700.
For those w/o h/c insurance . . . you are "flying solo" and you get charged the "full price," so maybe that MRI will cost you $2600. However, you can negotiate these charges. In fact, you can ask for a discount and usually receive it. When I say discount - I mean - 25% off the top. You will not be offered it, but you will likely get it if you are persistent. Crazy, huh?
Cost-shifting comes into the picture when hospitals have to "make up for" write-offs, as in indigent care for non-citizens. So for any of you who think there is free healthcare . . . well . . . it may be free for the indigent . . . but the rest of us make up for that write-off by paying more for such things as the supplies (syringes and gauze, for ex) or by paying more for other hospital services (diagnostics, pharmaceuticals). That is very simplified, of course. If the cost were not "made up" in profit in other areas of operation, then many hospitals would be out of business. For county hospitals, your tax dollars are paying for that shortfall. The best example of this would be to examine the financial losses being sustained in hospitals w/ high non-citizen and indigent use, such as in certain parts of California.
So yes, hospital Emergency Rooms are under mandate to provide care to those who show up at their doors, "regardless of ability to pay." However, this does not mean you won't get billed . . . and please be aware . . . you will have to deal w/ all sorts of paperwork to establish your ability to pay. I am also over-simplifying this . . . as hospitals are also required to provide a percentage of charitable care . . . but in districts where the majority of patients are self-pay (non-insured) or indigent . . . the shortfalls are so great . . . I am sure you can imagine the strain on hospital resources.
Well, I have probably written enuff to put everyone into a sound sleep now. I know I am ready to turn off the lights.
I am happy to find/share more info . . . if anyone is interested . . . just let me know what you want and I will do my best to find you stats, articles, etc.
Oh - and do I personally think everyone has a right to healthcare? I believe our system has spun out of control, making that proposition very difficult to attain. Access to low cost, quality healthcare should be a local, community issue - even a moral imperative. It is not that the mission is lost - healthcare providers strive to provide quality care . . . but hospitals are big business, physician practices are big business . . .technology is expensive . . . and the patient gets lost in a maze of coding, paperwork, reimbursement issues, federal regulations (medicare) state regs (medicaid), private insurance . . . and a on-going attempt for hospitals and physicians to balance their bottom lines so they can keep their doors open.
<Yawn> Don't mean to bore you all . . . I am rather passionate about the issue but enuff for now.
Ok, then give people the option to "opt out", but only if they agree that they cannot claim from the system and that they will be liable for all of their medical costs. I see it as the only way to go, to be honest. That way, you can still have your own private insurance and you can opt out of the national pool, if you wish. However, for those who cannot afford insurance (people on low incomes), it means that they are basically covered for routine medical stuff, although NOT for things like cosmetic surgery, obviously.
I think that's what I was getting at a few posts back. Since insurance companies lower premiums the larger the pool is, logically, if the pool is huge, shouldn't the premiums be much lower? Then, if the premiums and deductibles are affordable for all people, everyone could be covered for basic needs.
As far as whether or not healthCARE or health INSURANCE are a right, I think that in our current system, having proper healthcare is only possible with health insurance. I gave the example of the girl with diabetes. Without some kind of insurance or assistance, how does her family pay the $90+ for insulin every month? Some families could pay for that, this one could not. If more generic drugs were allowed, or patients were allowed to buy from Mexico or Canada, that would be a different story because patients would not be limited to name brand drugs. But these days, in the USA, if a person needs a drug to live, then there's a good chance they can't afford it since the major drug companies do a good job of controlling the market.
So, I say that healthcare is a right, and in today's society to have proper basic healthcare, one needs insurance, in the current system.
I've never had insurance that covered plastic surgery, other than in the case of an accident. I doubt that would be covered anyway.
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Hmmmmm . . .
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