Comments on: Health insurance and “access to care” are the same thing in our system

By: Insubyvense

Insubyvense — Tue, 08 Dec 2009 05:02:30 +0000

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By: MrTom

MrTom — Fri, 20 Nov 2009 13:41:32 +0000

Are "charity" and "proper program" euphemisms for "taxes?"

By: DantheMan

DantheMan — Fri, 20 Nov 2009 01:46:25 +0000

You don't have to enter through the ER to take advantage of a hospital's charity care program. There isn't one hospital in town who doesn't provide charity care. If you truly can't cough up the $500 every ten years for a colonoscopy, you can still get one through the proper program.

By: Pete

Pete — Thu, 19 Nov 2009 19:24:05 +0000

The context here is Bush's "just go to the ER" statement.

I'll concede that you can get care for illnesses, so It is more than trauma care in that sense.

But tell me, DtM, can you get a colonoscopy for early detection of colon cancer in an emergency room? Can women get mammograms in the ER? Can a child with a chronic disease, who is taken to the ER often, have the advantages of a primary care physician, who knows the history of the illness and therefore knows how best to treat it? Do patient records of this sort even exist?

And don't come back with "they get billed". As MrTom pointed out, the poorest of the poor will never pay. Not only that, but eventually the emergency rooms could refuse to treat a person due to unpaid bills.

By: MrTom

MrTom — Thu, 19 Nov 2009 04:25:51 +0000

Yup. Everyone who shows up at the hospital will get treated. If they don't have insurance, they'll be billed. The poorest of the poor will likely never pay for this exceedingly expensive treatment (most of which could be delivered much less expensively at any clinic, but there is no law that says patients who show up at a clinic have to be treated and there is no single-payer system in place to pay the lower clinic rates, which would save gobs of money) since you can't get blood out of a stone.

The real problem is the bill received by the working poor or the middle class folks without insurance. The insurance companies contract with hospitals to make sure that their subsribers get a substantial discount, 50% is not uncommon - they're buying in bulk - and then the insurance company pays the bill except for the unrealistically small co-pay. The hospitals bill other patients the full cost of treatment. When hospitals set a full price, it is unrealistically high to cover the losses from treating the poor and to make up for the low profits from insurance contracts. These high prices drive the high bankruptcy rates.

Sounds like the best health care in the world to me.

By: MrTom

MrTom — Thu, 19 Nov 2009 04:11:31 +0000

Health care reform, even the current watered-down hundreds of pages worth, will help, although not much, since it keeps the medical-industrial complex in place, and does nothing to reform the delivery system itself. Beyond the delivery of health care, though, "liberal" ideas like funding education, encouraging job creation and retention and an equitable tax system would create the level playing field necessary for the broad-based prosperity that in itself would promote health. Giving tax breaks to the wealthiest so they can outsource and invest overseas does nothing for the vast majority of Americans.

By: DantheMan

DantheMan — Wed, 18 Nov 2009 23:57:00 +0000

Just to clarify, when I say "you are arguing against monopoly, which I support", That wording was confusing. I meant I support an anti-trust stance. I do not like monopolies, be them created by a corporation or by a government branch.

By: DantheMan

DantheMan — Wed, 18 Nov 2009 23:55:49 +0000

You are arguing against monopoly, which I support. The monopoly should not be a corporation, and insurnace company, or a government trying to make a market.

I think we all agree that injecting competition to the health insurance is good. But your vision of an eventual single payer is no better than blue cross having 90% market share.

By: DantheMan

DantheMan — Wed, 18 Nov 2009 20:19:25 +0000

Actually, you are wrong. All Americans must be seen by a doctor if they go to a hospital. That is law.

From there, all nonprofit hospitals (which, for example, includes every hospital in our area) have charity funds to cover the cost of people who are unable to pay.

So yeah, if someone is willing to fill out a few forms and demonstrate low income, they will receive health care. And if they are poor enough, it will all be free. Or perhaps not free, it is subsidized by those of us who can pay. But that doesn't sound dissimilar to a Public Option subsidies being paid for by the rich. Only with the Public Option, people making up to $80,000 get subsidized. With a hospital's charity care, the line is lower than that.

By: Pete

Pete — Wed, 18 Nov 2009 19:11:08 +0000

Agreed. This "All Americans have access to health care" canard has got to stop.

All Americans have access to trauma care, and that's it.