OOTB's Political Thread . ..
- Thread starter BillyL
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You left out the important part of my answer to your only question.
"For the bills that go unpaid, hospitals can try to compensate by charging other patients more. But that doesn’t happen as much as many people – including policymakers -- think."
If you wanted to ask me what I'd rather pay then you should have phrased the question better.
Man you are confused, this is 2020. Eat the red jello before bedtime from now on, the green jello is rotting your brain.
I've got some real problems with that quote.
For starters, the author provides no evidence to support this assertion.
Secondly, everyone -- regardless of whether they have insurance or what kind of insurance they have -- gets charged the same. That's a statutory requirement (or "bureaucratic bullshit" if you're hip to the lingo). What you actually pay depends on the discounts that your insurance company negotiates with the provider, your benefit design (co-pays/deductibles/out-of-pocket maximums), etc.
Finally, what she's describing is antithetical to healthcare pricing. Medicare and Medicaid pay less than the cost of care. Uncompensated care pays nothing. Negative margins have to be remedied somehow, and that comes on the backs of commercial insurance companies (Aetna, Blue Cross, Cigna, United) and their policyholders. The author is simply wrong here.
But you're OK with using a quote you like to make a point from the very same author. Excuse me if I think that you've reduced this debate to a "I just want to win at all costs situation."
Not sure I follow. I'm trying to have an informed discussion about healthcare costs, not win a debate. It's not a matter of whether I like a quote, but whether the quote is accurate based on my professional experience. Both of the quotes cited here so far have been specious.
Yet you still used one of those specious quotes to attempt to make your point. Again, forgive me, but I doubt you are trying to have a discussion based on informed talking points.
Cool. You and @bluetoe can create your own risk pool for two. Call your employer or health insurance company today and cancel your coverage. Pay for all your medical care out of pocket (at full provider rates, not the discounted rates your insurance negotiates for you). Then you won't have to bear the cost of anyone else's healthcare expenses and vice versa. Taste the freedom!
If the point is accurate, why wouldn't I use it? And if the point is inaccurate or misleading, why wouldn't I say so? Claiming DSH = taxpayer dollars used to pay for uncompensated care is misleading because not all hospitals qualify for DSH payments, and DSH payments aren't exclusively for uncompensated care.
But that's not the same thing. I'm fine bearing the cost of other's healthcare that also pay into the healthcare system. It's the ones that don't, but still expect the benefit of said system, that I'd prefer to not get the care that they're not paying for.
So can you tell me if this part of the article is also inaccurate? "The majority of hospitals are non-profits and are exempt from federal, state and local taxes if they provide a community benefit, such as charitable care. Hospitals also receive federal funding to offset some of the costs of treating the poor." It seems like that covers a lot of hospitals.
I mean is the whole story inaccurate or just the parts you don't like?
Normally I'm right with you on freeloaders getting and deserving absolutely nothing from our government...
In this case though, it's tough to tell say a laid off bartender who is putting themselves through school that they can't get treated for something that is non-elective. You had 10% of the workforce unemployed at some point this summer and many of them had otherwise stellar job consistency.
I think, with anything, there is a middle ground. Let me keep my awesome plan with my awesome doctors that myself and my employer pay for. Then there has to be a not as good option that is socialized to some point.
But no one wants to hear nuance.
Ya, I see that as well. Maybe give anyone that did have healthcare through a job they lost the option to continue with said coverage for up to a year (would obviously get more expensive without the employer sponsored portion. I guess employers could be forced to continue paying their portion for up to a year after termination but I wouldn't exactly be crazy about that).
I think the middle ground of let people who have a good plan keep their plan, and those that don't have one getting a not as good plan is acceptable. Provided the funding for said plan is sourced from already existing entitlement programs. I don't really have an issue with that type of arrangement, but it's one of those things that once you establish the policy of everyone having healthcare even if it's shitty, then next year there will be a push for "those people have a right to equal healthcare" and driving up the cost.
you and others just don'r seem to understand that you're drinking the kool-aid, just a different flavor than what you think others are drinking. Pretty humorous to witness.
I can certainly get down with employers not having anything to do with health insurance. The subsidy they provide is cool and all, but it would be perfectly fine with me if they didn't do that anymore, paid that subsidy as wages to the employee instead, and then everyone then had to use their take-home pay to then buy health insurance in the open market.
I don't know what proportion of hospitals nationally qualify for DSH. If the whole story was inaccurate I would've said so (but you're being hyperbolic, of course). Again, I never suggested there are parts I "like" and parts I don't. Just parts that are inaccurate or misleading. If you want to accept every word of a healthcare article written by journalist who covers politics over a 25-year industry vet who has interactively explained why she's off base, go for it.
This basically already exists via COBRA. It's prohibitively expensive, especially for someone who just lost their income.
Medicaid has existed since 1965. It has never been nor will it likely ever be on par with the benefits you and I receive from our employer-provided health insurance.
Absolutely. There's no reason we can't build on the existing tapestry of health insurance options in this country. Some states have actually seen net negative expenditures after Medicaid expansion, and it's widely supported by people across the politics spectrum, but myopic legislatures have still prevented its implementation in 12 states. The kicker? If you live in a state that hasn't implemented it like North Carolina, you're already paying the federal taxes that fund it but getting none of the benefits. We're basically subsidizing healthcare for people in other states.
employers should have something or nothing to do with health insurance however they freely choose. There is no reason to dictate what an employer should offer as a benefit, whether it's insurance, a weekly manicure, or a new car for personal use. It should be considered compensation and treated accordingly.
As long as you treat them accordingly.
Yes, I had forgotten about COBRA, good point. That's unfortunate that it's prohibitively expensive. There are a lot of things that I want that are prohibitively expensive as well so I feel their pain.
Perfect. Seems like it's going great then.
I'm all for net negative expenditures, so if that can be guaranteed, then let's go for it. I guess there would have to be some sort of provision to automatically revert after 3-5 years if it turned out there weren't net negative expenditures. Trusting that it would get reversed on its own by the government if it wasn't working isn't something I'd want to put my trust in.
It's definitely a kick in the nuts to pay to subsidize other people's healthcare.
So then we can ignore your opinion that "not all hospitals qualify for DSH payments" since you really don't know how many do. And if they don't it's only because there are not enough freeloaders going to their ER's. But I'm sure you'll disagree with that.
I know, you keep saying that. The evidence here suggests otherwise.
Is explaining just you saying it isn't so over and over? I've at least provided a link to an informative article that explains what you asked for pretty clearly. You may disagree with it, but USA Today is standing by it. I'll take their word over some angry dude who thinks that as a professional he never gets it wrong. You're overplaying your hand here.
one can never tell if a poster is being disingenuous, mistaken, or just plain stupid. But almost always, they fall back on the oldest trick in the argument handbook, and that is to argue a point that was never being made.
I have to assume your obnoxiously misplaced sarcasm is based on this...
"Then there are those things that are individual matters that don't affect the group as a whole, and those things are left to the individual to indulge in as his ability to do so dictates. That would be healthcare...."
"I don't understand how healthcare works!"
If you had half a brain, you could see that I'm not talking about being in a healthcare system, but rather one's own personal healthcare outlook. And if you read the entire post, you'd understand that I was pointing out that there are actions that must be taken to protect the entire population of the ship (like avoiding icebergs, which could cause the entire ship to sink), while other actions are left to the individual since what happens to an individual doesn't affect the entire ship.
So you decide that I must be talking about being in or out of a system, because that gives you an argument. Weak sauce. All I'm saying is that if Billy Bob takes a header from the observation deck to the main deck, the ship isn't going to sink. Therefor, there's no overriding reason to provide healthcare to Billy Bob and everyone else in case he decides to take that header. But as I clearly indicated, Billy Bob is certainly free to enter a risk pool if he so desires and has the money for the premium. Otherwise, good luck. If I'm in that same risk pool, I understand that the whole reason for being in the pool is to spread the risk so that the specter of shelling out $250,000 for a catastrophic medical episode is mitigated. I also understand that generally, the more people that are in the pool, the more my risk of financial catastrophe is lowered.
What I don't want, is to have people injected into the pool who aren't inputting the going premium, which causes my premium to go up. Furthermore, insurance is designed to be a reasonably priced hedge against financial disaster, and not a kiss every boo-boo deluxe safety net. That's why I opt for more out of pocket and higher deductibles. But obamacare wants every boo-boo kissed. Fvck obamacare.
And go fvck yourself, gasbag, you severely overate yourself..
why not? But if you're smart, you have them in-house. And you compensate them with blow.
Are you watching me right now?
See... you keep wishing people had "half a brain", like you. Most of us have our entire brains at our disposal.
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As long as you stay away from this thread it's not bad. We just need more parody threads.
So true, healthcare costs shouldn't be related the employer I choose (IBM probably has a great plan, but being a self-employed doesn't).
This is a tangent but WTF is up with these Health Savings Accounts (HSA) and FSA plans which are tax-eligible? Health care is complicated enough, taxes are complicated enough, why add these things to the mix?
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