Health Care Question

[XingTheRubicon]

Well, I'm sittin' here getting ready to go to Church for God knows what reason and I thought of a conversation that I had with my older brother the other day. He told me that several of the teachers that he works with (predominantly black/hispanic in Dallas) do not have health care. They "opt out" or whatever, and DISD has an obviously pretty good health care plan.

Here's where it gets wierd. Upon hearing this news, he asked one of the teachers about her son who broke his ankle a few months back. She said, "Oh, we just went to the emergency room. It's free, that's my health care plan."

(Disclaimer: This is not an anti-teacher rant. This example just happens to be a teacher.)

Now, my question is:

Why are people able to do this? This POS leech probably spends thousands of $ on her hair and mani/pedis, but I get to pay for her retard son who can't ride a skateboard?



Since I am part of the "they" when someone says "oh, it's free, they gonna pay for it," I have a suggestion. A way to hold people accountable without denying them health care.

First, make Health Care similar (sort of) to student loans. Available to anyone and everyone, but you will be tracked down to your funeral for payment.

Don't have health care insurance? No problem, sign right here, and put your SSN right here. Not gonna pay? No problem, we'll garnish your wages, tax returns, etc. Just like student loans...'til you die.

Would this not be fair?

Agree? Disagree? Liberal moonbat?

[Okla-homey]

got to be more to it than that. if you go to the ER, you get a bill.

[XingTheRubicon]

yeah, you get a bill, but you don't have to pay it. A medical collection on your credit report and you can get a thousand of them with no repercussions other than bad credit...which most pieces of **** have bad credit already.

[texaspokieokie]

here in dallas county, ERs fill up with so many folks for any kind of problem,
(not emergencies) that sometimes the wait can be as long as 10 hrs.

these folks are there because they can't (or don't want to) pay a regular Dr.

they are not paying.

[AlboSooner]

To some questions there are no good answers. No matter how grave the injustice I must never bring discontent upon the Lord and his church by the words that come out of my mouth, for the devil is like a roaring lion seeking to devour.

[SanJoaquinSooner]

Health care is the toughest domestic issue.

We could do what Rub suggests but would some parents then avoid taking their kids to the doctor so they don't get that big bill?

We could mandate the teacher purchase the employer's health care plan if he/she has minor children.

Or we could deregulate the health care industry to make it much more affordable. This is what I favor.

[My Opinion Matters]

HEALTHCARE REFORM IS UNCONSTITUTIONAL! IT SAYS SO RIGHT IN THE CONSTITUTION!!!!RAWR!!!!!!!!!!!!

[SoCaliSooner]

yeah, you get a bill, but you don't have to pay it. A medical collection on your credit report and you can get a thousand of them with no repercussions other than bad credit...which most pieces of **** have bad credit already.
That is a bigger problem than people realize. I've been on many runs to pick up somebody in a nice neighborhood or they have a nice car, good job...and no health insurance. When asking them for their insurance info for the run ticket they have none. Ask them if they are employed and they have an employer who offers insurance many people do. They just reason that why should they spend the money every week when all the hospital can do is ding their credit, and the patient is "saving" money every year.

[yermom]

this is why it needs overhaul. people say they don't want to pay for other people's healthcare, but they already are.

if the system wasn't broken, this wouldn't happen IMO

the thing i don't understand is why group insurance rates are lower. why is it any better to take a whole employer at a cheaper rate than say, a town?

why does it make any more sense to offer insurance to the schlub mowing the grass at OU vs. the schlub that owns his own landscaping company?

[sooner59]

This is the part that pizzes me off the most about this whole insurance debate. If you you make a certain salary and your employer offers it, you are cheating the system by not having it and letting the ER take the hit. These people aren't helping the price of healthcare do anything but increase.

[Sooner5030]

factors:

cultural - we're fat, less active and eat tons of "satisfy my cravings" agri-big-business packaged food.

Ailments and Services - we are continuously discovering new ailments and still treating the old ones.

Pharmacy - the "magic pill" generation combined with big-connected-pharma has created consistent 18-20% increase in pharma claims/capita/year. Also, we didn't have/need ritilin/prozac/hardon-meds/etc/etc in the 80s.

managed health care - we used to have INSURANCE. You know where I paid a premium in case something catastrophic occurred and could not afford the care. Now actual appointments and check-ups (routine care) are "pooled" just like catastrophic care used to be. This has caused a change in health prevention behavior and the decision to visit the doctors office.

connected care business - it has become a business and one that is very well connected/AARP, etc. When folks like Seimens can get lobbyist and regulatory folks (through a revolving door between industry and government) to require more updated CT machines and other expense equipment even if the old stuff worked just fine it puts even more upward pressure on costs.

I am sure there are many other factors but these are some of the first that come to mind.

[Okla-homey]

yeah, you get a bill, but you don't have to pay it. A medical collection on your credit report and you can get a thousand of them with no repercussions other than bad credit...which most pieces of **** have bad credit already.

I respectfully disagree that there are no repercussions for unpaid med bills other than a credit report. Here in Oklahoma, unpaid medical providers can and do file liens. And if the person with the unpaid med bill doesn't pay, the medical creditors can and do go to court, get a judgment against the debtor, and can garnish wages and/or bank accounts until they get the money owed them PLUS court costs and their legal fees.

Now, they don't generally bother if the patient is broke, because you can't get blood out of a turnip. But in your scenario, there would most definitely be income to garnish.

That's also why some people with a lot of unpaid medical bills will file bankruptcy to get those debts discharged. But you only get to do that once every 7 years.

[Sooner5030]

don't forget that indigent care facilities already exist for those that truly "cant pay". University Hospital is one of them....they get grants based on the fact that they provide indigent care.

[Okla-homey]

don't forget that indigent care facilities already exist for those that truly "cant pay". University Hospital is one of them....they get grants based on the fact that they provide indigent care.

Those facilities generally get paid by Medicaid. Remember, Medicaid is the state funded analog to Medicare but Medicaid is for poor people. Medicare is for people on Social Security by virtue of their age (SSI) or the fact they are 100% disabled (SSDI).

[Sooner5030]

they also get block grants separate from medicaid reimbursements. At least they did when I used to audit hospitals (previous life).

[Okla-homey]

they also get block grants separate from medicaid reimbursements. At least they did when I used to audit hospitals (previous life).

I'm sure you're right. I just happen to think that the Medicaid reimbursments cover most of it.

[SouthCarolinaSooner]

This is the part that pizzes me off the most about this whole insurance debate. If you you make a certain salary and your employer offers it, you are cheating the system by not having it and letting the ER take the hit. These people aren't helping the price of healthcare do anything but increase.
Agree, the solution should be to get rid of the government system. End federal licensing requirement for medical school, pharmacies and doctors, eliminate the FDA and deregulate the health care industry in general. Prices go down, innovation goes up, everyone is happy. :D

[AlbqSooner]

One thing that makes the cost of treating the uninsured more difficult to accurately guage is the manner in which health care facilities bill insurance companies under their contracts of service.

I recently spent 4 days in the Intensive Care Unit. The total bill from the hospital was $41,000 and change. The amount paid by the insurance company was $16,000 and change. My copayment was $3,500. So when they say that they provided $41,000 in unreimbursed medical care, the reality is they would have accepted approximately $19,000. When you read the statistics on unreimbursed care, take them with several grains of salt.

[sooner59]

Agree, the solution should be to get rid of the government system. End federal licensing requirement for medical school, pharmacies and doctors, eliminate the FDA and deregulate the health care industry in general. Prices go down, innovation goes up, everyone is happy. :D

There would still need to be a nationwide "standard" though. The AMA, AOA, and other groups of the such would have to entirely take over and ensure strict standards and requirements for med schools, doctors, pharmacies, and such. Otherwise, they could set whatever standard they wanted and quality would decline. That is basically how the AMA came into existence. A little over a century ago, you could basically pay $5, take a semester of "medicine" and you were free to declare yourself as a doctor.

The FDA is was not big on and I am still not a big fan, but there is a reason for it to exist. Only about 1%-5% of all drugs made actually make it on the market at legit pharmaceuticals. This is because they haven't been shown to be safe. Given, this is why drugs are outrageously high....because a company may make tons of drugs and only one makes it through the process. Not all that even make it through are shown to be safe and they are recalled. I hate that it could take 12-16 years to get a drug on the market, but the alternative would be millions of people takes even more drugs that can harm to kill them. I took a clinical trials graduate class. I hated it and could never do that for a living, but I understood a little about why things work the way they do.

[jkjsooner]

One thing that makes the cost of treating the uninsured more difficult to accurately guage is the manner in which health care facilities bill insurance companies under their contracts of service.

I recently spent 4 days in the Intensive Care Unit. The total bill from the hospital was $41,000 and change. The amount paid by the insurance company was $16,000 and change. My copayment was $3,500. So when they say that they provided $41,000 in unreimbursed medical care, the reality is they would have accepted approximately $19,000. When you read the statistics on unreimbursed care, take them with several grains of salt.

Things brings up another reason why our healthcare system is broken. Some people simply cannot get healthcare. A preexisting condition might make it impossible or extremely unaffordable - even if the person has a decent income. Those people end up being charged 2 or 3 times as much for healthcare (assuming they actually pay their bills) because they don't have the power to negotiate their expenses.

I know some will disagree with this on free market grounds but I think we need more transparency in medical expenses and some type of standardized rate for services. It's totally unfair to charge the poorest among us the most for the care. Some poor people actually care about their debts and credit ratings and will end up paying more for services than our insurance companies pay.

[Sooner5030]

Most of us do not agree with “reform” because the current form of legislation by lobby/connections is what has gamed the system in the first place.

Providers, insurance companies, bureaucrats, pharma all have an asymmetric information advantage over the customer. All have careers, retirements, debt service and lives built around the current scheme.

The best thing a person can do is eat healthy foods, have an active life and hope that they didn’t get the short end of the heredity stick.

[XingTheRubicon]

I respectfully disagree that there are no repercussions for unpaid med bills other than a credit report. Here in Oklahoma, unpaid medical providers can and do file liens. And if the person with the unpaid med bill doesn't pay, the medical creditors can and do go to court, get a judgment against the debtor, and can garnish wages and/or bank accounts until they get the money owed them PLUS court costs and their legal fees.

Now, they don't generally bother if the patient is broke, because you can't get blood out of a turnip. But in your scenario, there would most definitely be income to garnish.

That's also why some people with a lot of unpaid medical bills will file bankruptcy to get those debts discharged. But you only get to do that once every 7 years.

The example that was given was Texas and there is no wage garnishment allowed for medical bills or defaulted credit cards.

As far as all the other states that allow wage garnishment, I bet less than 5% of all ER defaults are collected in full or even pursued because they are less than 5K for each default. Just real world numbers are all I concerned with, not a once in a blue moon liens that happen every 500 defaults.

[BajaOklahoma]

One of our employees couldn't take her daughter to the doctor for an earache. I almost volunteered to loan or give her the money - then I found out she had bought her best friend expensive concert tickets the week before.

[sooner59]

One of our employees couldn't take her daughter to the doctor for an earache. I almost volunteered to loan or give her the money - then I found out she had bought her best friend expensive concert tickets the week before.

Tell that bitch to take her daughter in and charge it on her VISA. :mad:

[Pants]

There is certainly a lack of appropriate priorities amongst people who can't afford or choose not to get insurance. We treat a ton of indigent patients every year. Many of them will come into the hospital or clinic with their expensive phones, iPods, tons of tatoos/piercings and nice cars. Not to mention they'll have cable and other luxuries. I have a fundamental problem with this. Of course this isn't always the way things are but I see it enough on a daily basis to allow it to make me bitter about things. Also there is a goo proportion of them that are rude and unappreciative of their free care they get from us. It just gets frustrating sometimes.

[sooner59]

There is certainly a lack of appropriate priorities amongst people who can't afford or choose not to get insurance. We treat a ton of indigent patients every year. Many of them will come into the hospital or clinic with their expensive phones, iPods, tons of tatoos/piercings and nice cars. Not to mention they'll have cable and other luxuries. I have a fundamental problem with this. Of course this isn't always the way things are but I see it enough on a daily basis to allow it to make me bitter about things. Also there is a goo proportion of them that are rude and unappreciative of their free care they get from us. It just gets frustrating sometimes.

I hear ya. I've seen it first hand. And I agree 100%.

[GKeeper316]

Or we could deregulate the health care industry to make it much more affordable. This is what I favor.

deregulation has lead to price-fixing on an industry wide scale.

thats what the health care bill was supposed to fix, but without a public option to act as a price control, it turned out to be another gift to the insurance lobby.

[soonercruiser]

deregulation has lead to price-fixing on an industry wide scale.

thats what the health care bill was supposed to fix, but without a public option to act as a price control, it turned out to be another gift to the insurance lobby.

The secret Democratic healthcare bill deregulated Obama's friends and political supporters only.

[Ike]

this is why it needs overhaul. people say they don't want to pay for other people's healthcare, but they already are.

if the system wasn't broken, this wouldn't happen IMO

the thing i don't understand is why group insurance rates are lower. why is it any better to take a whole employer at a cheaper rate than say, a town?

why does it make any more sense to offer insurance to the schlub mowing the grass at OU vs. the schlub that owns his own landscaping company?

The why is a very interesting question indeed, and IMO, the answer is one of the reasons our healthcare system is screwed up in the first place.

The basic argument for health insurance is that the company pools all the risk into one, and can thus have a fairly predictable cost every year, and pass that cost to it's customers as a substitute for the wide wide range of risks and costs that an individual consumer might face. This we all know.

But then it gets trickier. Multiple types of plans, multiple 'groups', etc, etc. Basically, as near as I can figure, they try to make each "group" they have a profitable group. This has the effect of sub-dividing their samples, removing some of the benefits of the pooling of risk amongst a large number of people. As it turns out, the people who buy insurance on the individual market, statistically, are the most risky of them all. They may or may not have jobs, and job security. Their risks from a health perspective are worse than the people in the same city that have employer sponsored plans. Thus, it's much more expensive for them.

A further interesting note from all of this too, is that (total) insurance premiums for someone working at a small business are much higher than premiums for someone working for a large corporation. Something that puts small businesses at a significant disadvantage to compete with large corporations.

IIRC, one of the provisions of the latest health care law is that these divisions will be done away with. Insurance companies will only be able to use "community rating", meaning that premiums are based only on the risks associated with your community. Not which sub-group you belong too. Which is a good thing, IMO.

[Okla-homey]

As far as all the other states that allow wage garnishment, I bet less than 5% of all ER defaults are collected in full or even pursued because they are less than 5K for each default. Just real world numbers are all I concerned with, not a once in a blue moon liens that happen every 500 defaults.


I'll grant you, if texass doesn't allow wage garnishment for debt, there's your trouble.

Hospitals and docs here in Okie commonly sell unpaid medical debt to collection agencies who have no problem getting a judgment and establishing a garnishment. I once helped a lady out, for free I might add, who had several garnishments all arising from her mortally ill husband's medical debt leaving them too little to pay their rent or eat.