RE: Why is US medical care so expensive? (Full Version)

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Politesub53 -> RE: Why is US medical care so expensive? (3/3/2012 5:02:15 PM)

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You have to have both. You can't simply prevent people from profiting, there will be no motivation for innovation.


Id missed this old chesnut. Motivation and innovation has taken place for over 10,000 years. Do you think the man who invented the wheel woke up and thought "Fuck me, I could sell these to General Motors"

Motivation used to be about making life easier and better. In Europe and elsehwere ideas were freely exchangedin places like the "royal societies" and picked up on by others.




Edwynn -> RE: Why is US medical care so expensive? (3/3/2012 5:58:18 PM)


He must think that all the stethoscopes and X-ray and MRI machines are designed and built by the NSA or their equivalent, too. No innovation. No motivation for improvement.

These are the same people who think that an even minimally socialised country makes it a Communist country.

We're not talking about a full deck being at play, here.







DesideriScuri -> RE: Why is US medical care so expensive? (3/3/2012 6:10:15 PM)

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ORIGINAL: SoftBonds
Also, polio doesn't cause death, since we didn't have a polio vaccine for that time period.
Also, gangrene doesn't cause death, since we didn't have germ theory for most of that time period.
Also, the black death doesn't cause death, cause back then we didn't know that rats and fleas carried the plague...

Just because something causes death, doesn't mean some humans don't survive it dude.


Are you seriously trying to use that as proof that lack of insurance causes death?!?




ConfidencePlays -> RE: Why is US medical care so expensive? (3/3/2012 6:13:17 PM)

In answer to the topic; because we do not treat illness, we treat symptoms. We do not invest in preventative care, we wait until it's too goddamn late. It's expensive because it's designed to be. Medicine in America is an industry.

Next question.




Hillwilliam -> RE: Why is US medical care so expensive? (3/3/2012 6:55:12 PM)


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ORIGINAL: DesideriScuri

quote:

ORIGINAL: SoftBonds
Also, polio doesn't cause death, since we didn't have a polio vaccine for that time period.
Also, gangrene doesn't cause death, since we didn't have germ theory for most of that time period.
Also, the black death doesn't cause death, cause back then we didn't know that rats and fleas carried the plague...

Just because something causes death, doesn't mean some humans don't survive it dude.


Are you seriously trying to use that as proof that lack of insurance causes death?!?

I won't say that lack of insurance causes death. I WILL, however, say that it hastens death. I'll even go so far as to say that the uninsured cost taxpayers and those who are insured a fucking fortune. One thing that you miss is that anyone who shows up at an ER in extremis must be treated by law regardless of their ability to pay.
If they don't have insurance, guess who pays for it? It's me and you. With universal insurance, we won't have to pay for them any more. FOX news neglects to tell you about that little tidbit.




DesideriScuri -> RE: Why is US medical care so expensive? (3/3/2012 6:58:41 PM)

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ORIGINAL: tazzygirl
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How long do you have a right to live? How long? If I die before I reach my "right to live" age, are my survivors allowed to sue for wrongful death?

Logan's Run? lol
What you are blissfully missing is this...
At some point, everyone accesses health care. Its either when the problem is minor.. or when its major.
Whats driving up health care costs is that people without insurance have to wait until the major... and then hospitals cannot turn them away.
A man has chest discomfort... if he has insurance, he will go to the hospital. If not, he will hope and pray its only heart burn, take something over the counter, and lay down. It doesnt get better... it gets worse... and he had to wait. Now he is off in a ambulance when someone could have driven him if he had left sooner. Now its code mode when he hits the ER, instead of a quiet but quick assessment and tests. Now its permanent heart damage when it very well could have been avoided.


Yet another non-answer to the question. (I know why, though, so it's okay)


Very much an answer to your question. The fact that you do not like the answer makes it no less valid But, yes, I can see why you would refuse to address it. (and thats ok)


At what point does that answer address how long you have the right to live? Or, if you don't live to your "rightful" age, whether or not your survivors can sue? That isn't answered. At all. And that makes it a ....drumroll please....non-answer.

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Aha! So, now you're admitting that your choices will have consequences for more than just yourself. If you choose a slovenly, over-consumptive lifestyle, you will have a financial impact on anyone else that lives a better lifestyle than you and is thrown into the same risk pool as you. You are now shedding responsibility for your actions.


NOW I am admitting? Dude, maybe you should spend some time and review topics on the health care bills and then the law to see what my position is. You are clueless about many things.


Don't need to. I take your posts on the threads that I read and respond to. Now, if you're going to tell me that your beliefs are different from what you've been posting here, that's one thing. I highly doubt that, so I might know more about your beliefs than you think.

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Yeah, we're such a backwards country. We've not gained anything from being based on Capitalism. We didn't build the largest economy in the World because of Capitalism.

(Pssst...yes, yes it does work...if you let it)


A country that is going under because of all that Capitalism that was left unchecked.

yeah, we all see how well it worked. [8|]


Sorry, wrong again. It wasn't Capitalism that was unchecked. It was (and still is, btw) Corporatism that has been and still is unchecked. Corporatism that is rampantly supported by both parties. The regulators were asleep at the switch, well, they were too busy watching porn on our dimes, actually. The regulations were in place already. The Congressional report even states it. The Congressional Report even went so far as to finger the Federal Reserve as the ones who are tasked with preventing this sort of thing and that they failed to do that.

You want to go into the horrible institutions that are Fannie Mae and Freddie Mac? You want to go into how they fucked us and are still fucking us? How much they've paid to those in charge of overseeing them? How Dodd, Frank, Waters, et. al. were talking about how well they're being run, how well they're being managed up to one week before they became insolvent?

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And none of these other countries profit from new technology developed there? Do you want innovation in your country or outside your country? We aren't the only country that spawns innovation and new technology. I just have this silly fantasy of maintaining the US as being one of those countries that spawns innovation and new technology.

You do realize that more health care tourism leaves this country than enters it, yes?
A McKinsey and Co. report from 2008 found that a plurality of an estimated 60,000 to 85,000 medical tourists were traveling to the United States for the purpose of receiving in-patient medical care; the same McKinsey study estimated that 750,000 American medical tourists traveled from the United States to other countries in 2007 (up from 500,000 in 2006)
As far as medical inventions....
30 Significant Medical Achievements and Their Country of Origin
I am not arrogant enough to believe the US is the best, brightest and baddest super power on earth.
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Btw, you do know that hospitals treat first and ask about insurance later in cases of emergency, right?

And that matters....how?


It matters in the cost of health care. You remember, the topic we are discussing?

Those who dont pay are driving up the costs to those who do. Hospitals and the like wont be left holding the bag, the public is.

Regardless of how you attempt tp spin it... the free market/capitalism wont pay for those who dont pay... you will. Thats why, last time I checked, a stitch in the ER cost over 600. So they charge more for all their services to compensate for those who dont pay.

Bottom line.

Joe has no insurance.

Joe has untreated high blood pressure. (Treating would cost roughly 100 a month.)

Joe has a stroke (because people like you decided he should suffer the consequences of his lack of insurance)

Joe shows up at the hospital via ambulance. *and, by law, they cannot turn emergencies away)

Joe is admitted and has everything done stat (one of those words that also means... expensive)

Joe has right sided paralysis related to the stroke.

Joe isnt able to be discharged because of his condition.

He now has the state taking care of his expenses.

You are paying for his medical care to the tune of 250,000 depending on how long he lives and if he makes a full recovery... if not, that amount will go up.

All because people felt he didnt deserve universal health care.

No, this isnt the first time I have said people with insurance pay for those without. And I suspect you know that. I am guessing you will disappear in a few months [;)]


It's true, I may be gone in a few months, but it certainly won't be because of anything going on in the message boards, or in the world of politics. It will have to do with the reason I'm on this site in the first place.

And, no, health care is not a right. It's a privilege. If it's a basic human right, we need to give it to everyone, not just US citizens or people who go into our hospitals. You see, basic human rights have been more or less defined in the Declaration of Independence. The 3 biggies are Life, Liberty and the pursuit of Happiness. They are the so-called "Natural" Rights. Every human has them. Every one of them. And, it's these natural rights that we work towards spreading 'round the world.

If I am forced into doing something regardless of what I want, that infringes on my right to Liberty. Someone not having the ability to pay for a health care procedure is not an infringement of the right to Life.






Hippiekinkster -> RE: Why is US medical care so expensive? (3/3/2012 10:01:48 PM)

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And, no, health care is not a right. It's a privilege. If it's a basic human right, we need to give it to everyone, not just US citizens or people who go into our hospitals. You see, basic human rights have been more or less defined in the Declaration of Independence. The 3 biggies are Life, Liberty and the pursuit of Happiness. They are the so-called "Natural" Rights. Every human has them. Every one of them. And, it's these natural rights that we work towards spreading 'round the world.

If I am forced into doing something regardless of what I want, that infringes on my right to Liberty. Someone not having the ability to pay for a health care procedure is not an infringement of the right to Life.

I knew it was just a matter of time before "Natural Rights" was brought up. Rather than going through the whole song and dance again, I'll just quote myself from a year ago on another site:

"I finally figured out what bothers me about the Libertarian viewpoint regarding the Constitution. Inevitably the argument ends up at "natural rights", which I suppose is derived from the theory of "Natural Law" (which is an interesting discussion in itself, but which lies in the realm of Philosophy. For those so inclined, there's a very good article at The Internet Encyclopedia of Philosophy )

"However, a secular critique of the natural law doctrine was stated by Pierre Charron in his De la Sagesse (1601): "The sign of a natural law must be the universal respect in which it is held, for if there was anything that nature had truly commanded us to do, we would undoubtedly obey it universally: not only would every nation respect it, but every individual. Instead there is nothing in the world that is not subject to contradiction and dispute, nothing that is not rejected, not just by one nation, but by many; equally, there is nothing that is strange and (in the opinion of many) unnatural that is not approved in many countries, and authorized by their customs." [http://en.wikipedia.org/wiki/Natural_law]

Charron has stated my thoughts on the matter rather more eloquently than I could have. Fundamentally, the concepts of Natural Law and Natural Rights are entirely synthetic; there is no universal morality one can identify in human behavior. What is moral and "natural" is whatever we define it as being. The only possible appeal that I can see is to a higher authority; the "Creator" of the Declaration of Independence. I reject this, as there is no Creator that can be shown to exist.

"Natural Rights" are, therefore, whatever we agree they are. And if we agree that controlling or banning firearms is a desirable goal, or that single-payer health insurance is something all should have, then there is no higher "law" preventing us from achieving those goals."




slvemike4u -> RE: Why is US medical care so expensive? (3/3/2012 10:40:49 PM)


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ORIGINAL: DesideriScuri

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ORIGINAL: Hippiekinkster
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ORIGINAL: DesideriScuri
Holy Hell Batman. Hippiekinkster, you might want to re-read what I posted and what I've posted all along. I support charities and honestly believe they are the way to get things done properly, and more efficiently than via government.
What you are either ignoring or missed in my posts was that I don't want to be forced into paying for those things. Jesus didn't force anyone. They had their own choices. Jesus made the consequences clear. It's up to you to choose and to do the right thing. Government taxing me to pay for someone else is not charity. That's theft. If you can't see the difference, well, gimme your wallet. lmao
You Social Darwinists always talk up charities as though they are some sort of miraculous panacea for taking care of the sick, the infirm, the aged, the destitute... as though these people are some sort of drain on the military, and the multinationals, and the psychopaths on Wall St. and in mid-Manhattan, and especially on the Forbes 400.
And that is where you all take a 90 from reality. Historically, charity has NEVER been able to meet the needs of the most needy and infirm. The Romans had a system of welfare and pensions. The Sung Dynasty circa 1000 M.E. had social supports. In Medeival Europe the government (The Holy Roman Empire) administered welfare via Bishops, local Priests, and Deacons. The Poor Law of 1601, Elizabeth 43 established a local system of relief. That was fine for then. The Industrial Revolution brought new problems. That is exactly why Bismarck established Health, Accident, and Old Age and Disability Insurance beginning in 1883. And why similar systems sprang up all over Europe... and WHY workers began to take things into their own hands.
You can keep your Alisa Rosenbaum dystopia, where those who can't keep up with Howard Roark can just go off and die somewhere.


So, you quote some Bible passages intending to show me how I am wrong. I show you how those Bible passages don't apply to what I am saying. You, rather than offer a rebuttal, go off on some wacko tangent. Interesting. But, in the end, point, me.



So now we know you are a lousy scorekeeper too.





tweakabelle -> RE: Why is US medical care so expensive? (3/3/2012 10:51:58 PM)

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ORIGINAL: DesideriScuri

quote:

ORIGINAL: SoftBonds
Also, polio doesn't cause death, since we didn't have a polio vaccine for that time period.
Also, gangrene doesn't cause death, since we didn't have germ theory for most of that time period.
Also, the black death doesn't cause death, cause back then we didn't know that rats and fleas carried the plague...

Just because something causes death, doesn't mean some humans don't survive it dude.


Are you seriously trying to use that as proof that lack of insurance causes death?!?

from wiki:
"The USA is the only wealthy, industrialized nation that does not ensure that all citizens have coverage (i.e., some kind of private or public health insurance).[17] In 2004, the Institute of Medicine report observed "lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States."[17] while a 2009 Harvard study estimated that 44,800 excess deaths occurred annually due to lack of health insurance.[18]"
http://en.wikipedia.org/wiki/Health_care_in_the_United_States

Yes. Lack of healthcare coverage is regarded as a direct cause of unnecessary deaths in the USA. As you can see above, the number of these deaths are measured in the tens of thousands annually. AFAIK the US is the only Western country where lack of healthcare coverage is a direct cause of death.

These claims are made by very reputable organisations - Harvard university and the Institute of Medicine, a part of the US National Academies. So, among professionals and academics specialising in this field, this claim is accepted fully.

I hope you now realise why it is important to rely on evidence and data to form views about healthcare policy, and why ideology is useless for this task.






tazzygirl -> RE: Why is US medical care so expensive? (3/3/2012 11:11:48 PM)

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Don't need to. I take your posts on the threads that I read and respond to. Now, if you're going to tell me that your beliefs are different from what you've been posting here, that's one thing. I highly doubt that, so I might know more about your beliefs than you think.


Your arrigance is showing yet again.

Allow me to enlighten you. I want a National Health Care System. I am done with insurance companies dictating hospital protocol. Got sick of it when Kaiser started pushing port partum women out of OB 8 hours after delivery.

Insurance costs are driven up by those who do not have insurance. Something I have stated for years.... But of course you believe you know my views after a few short posts. [8|]

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At what point does that answer address how long you have the right to live?


You have a crystal ball? Do you get to determine how long anyone has a right to live? Insurance companies do.. and thats what people are so fed up with.

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Or, if you don't live to your "rightful" age, whether or not your survivors can sue?


People have sued.. and won. Families have sued.. and won. You believe that will stop? I do like your fantasy world. Too bad it isnt reality.

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Sorry, wrong again. It wasn't Capitalism that was unchecked. It was (and still is, btw) Corporatism that has been and still is unchecked. Corporatism that is rampantly supported by both parties. The regulators were asleep at the switch, well, they were too busy watching porn on our dimes, actually. The regulations were in place already. The Congressional report even states it. The Congressional Report even went so far as to finger the Federal Reserve as the ones who are tasked with preventing this sort of thing and that they failed to do that.


Ah yes, Ma Bell, a perfect example. [;)]

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You want to go into the horrible institutions that are Fannie Mae and Freddie Mac? You want to go into how they fucked us and are still fucking us?


Yet these real sins have been largely overlooked in favor of imagined ones. Over at the conservative American Enterprise Institute, two resident scholars, Peter Wallison and Edward Pinto, have concocted what has since become a Republican meme: namely, that Fannie Mae and Freddie Mac were ground zero for the entire crisis, leading the private sector off the cliff with their affordable housing mandates and massive subprime holdings.

The truth is the opposite: Fannie and Freddie got into subprime mortgages, with great trepidation, only in 2005 and 2006, and only because they were losing so much market share to Wall Street. Among other things, the Wallison-Pinto case relies on inflated data — Pinto classifies just about anything that is not a 30-year-fixed mortgage as “subprime.” The reality is that Fannie and Freddie followed the private sector off the cliff instead of the other way around.


http://www.nytimes.com/2011/12/20/opinion/nocera-an-inconvenient-truth.html?_r=1


Free-market capitalism
Main article: Free market
See also: Laissez-faire
Free market capitalism consists of a free-price system where supply and demand are allowed to reach their point of equilibrium without intervention by the government. Productive enterprises are privately owned, and the role of the state is limited to protecting the rights to life, liberty, and property.


There are people here far more knowledgable about laissez-faire and the housing bubble than I. My field is medical.. I have no doubt they will come along soon enough.

Now, answer my question...


I do not have the faith in free market that you do.

Free Market Capitalism

Since we dont have one, can you point to a country that does so I can compare?


Just one country that has a free market capital system... just one.




tazzygirl -> RE: Why is US medical care so expensive? (3/3/2012 11:33:43 PM)

quote:

And, no, health care is not a right. It's a privilege.


I disagree. For me, it should be a right, as it is in other countries.

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If it's a basic human right, we need to give it to everyone, not just US citizens or people who go into our hospitals


Other countries do. Some are just starting. Some that are considered less developed than the US. Your argument here holds no water. Its the US, we need to care for our own first. But, if someone presents to the hospital in an emergency who is not a US citizen, they are treated regardless.

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You see, basic human rights have been more or less defined in the Declaration of Independence. The 3 biggies are Life, Liberty and the pursuit of Happiness.


I particularly like the Pursuit of Happiness. How can one pursue anythng like happiness when they are in contant pain, needing medical attention that they have to wait until it becomes an emergency to get taken care of.

Your argument is losing more and more ground. You are suggesting that the Persuit of Happiness is a human right, granted in the Constitution our of one side of your mouth, then deny those unable to pay to enjoy that right.

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They are the so-called "Natural" Rights. Every human has them. Every one of them. And, it's these natural rights that we work towards spreading 'round the world.


Yup, they are, see above.

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If I am forced into doing something regardless of what I want, that infringes on my right to Liberty. Someone not having the ability to pay for a health care procedure is not an infringement of the right to Life.


Might want to try this definition of what Liberty actually meant...

Virginia Bill of Rights
"That all men are by nature equally free and independent, and have certain inherent rights, of which, when they enter into a state of society, they cannot, by any compact, deprive or divest their posterity; namely, the enjoyment of life and liberty, with the means of acquiring and possessing property, and pursuing and obtaining happiness and safety."- Virginia Bill of Rights


http://en.wikipedia.org/wiki/Virginia_Declaration_of_Rights

Sound familiar? It should. Much of it was written by founding fathers... and parts of it were taken for the US Constitution.


quote:

Someone not having the ability to pay for a health care procedure is not an infringement of the right to Life.


Its an infringement on the pursuit of happiness and safety.




farglebargle -> RE: Why is US medical care so expensive? (3/3/2012 11:37:39 PM)

Here's something that's bothered me for a while.

REAL CAPITALISTS say that the Free Market functions best when there's the maximum number of knowledgeable participants.

So why are all these 'Republicans' so bent on limiting the number of healthy, educated citizens participating in the marketplace?

It *APPEARS* they're just chickenshit cowards who -- while they TALK FREE MARKET -- don't have the balls to actually compete against one they're not handicapping.




tazzygirl -> RE: Why is US medical care so expensive? (3/4/2012 12:09:05 AM)

I just want to know what country has a free market capital system. It sounds great in theory.. like trickle down.. yet no one can show me a working model.

Does anyone know?




kalikshama -> RE: Why is US medical care so expensive? (3/4/2012 5:59:44 AM)

quote:

How did we get from 1776 to 1890 without health insurance?


Health care used to be affordable.

[image]http://www.kff.org/insurance/snapshot/images/OECDChart3_1.gif[/image]




tazzygirl -> RE: Why is US medical care so expensive? (3/4/2012 8:55:53 AM)

Ah yes, the advent of HMO's... arent they just wonderful?




kalikshama -> RE: Why is US medical care so expensive? (3/4/2012 8:59:03 AM)

This is a transcript of the 1971 conversation between President Richard Nixon and John D. Ehrlichman that led to the HMO act of 1973:

John D. Ehrlichman: “On the … on the health business …”

President Nixon: “Yeah.”

Ehrlichman: “… we have now narrowed down the vice president’s problems on this thing to one issue and that is whether we should include these health maintenance organizations like Edgar Kaiser’s Permanente thing. The vice president just cannot see it. We tried 15 ways from Friday to explain it to him and then help him to understand it. He finally says, ‘Well, I don’t think they’ll work, but if the President thinks it’s a good idea, I’ll support him a hundred percent.’”

President Nixon: “Well, what’s … what’s the judgment?”

Ehrlichman: “Well, everybody else’s judgment very strongly is that we go with it.”

President Nixon: “All right.”

Ehrlichman: “And, uh, uh, he’s the one holdout that we have in the whole office.”

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not too keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”




LookieNoNookie -> RE: Why is US medical care so expensive? (3/4/2012 10:06:40 AM)

I think it's somehow related to the prices they charge for stuff.




LookieNoNookie -> RE: Why is US medical care so expensive? (3/4/2012 10:11:41 AM)


quote:

ORIGINAL: tazzygirl

Joe has no insurance.

Joe has untreated high blood pressure. (Treating would cost roughly 100 a month.)

Joe has a stroke (because people like you decided he should suffer the consequences of his lack of insurance)

Joe shows up at the hospital via ambulance. *and, by law, they cannot turn emergencies away)

Joe is admitted and has everything done stat (one of those words that also means... expensive)

Joe has right sided paralysis related to the stroke.

Joe isnt able to be discharged because of his condition.

He now has the state taking care of his expenses.



Clearly, the problem isn't the insurance companies, the "system" or even the cost of medicine....

The problem is JOE!!!!!

Where does this guy live?

Let's kill this fucker!




SoftBonds -> RE: Why is US medical care so expensive? (3/4/2012 9:50:13 PM)

DS, there is one issue that has been brought up to you over and over again, and I have never seen you respond to it. In fact, while you generally respond to anyone who quotes you or replies to you, bringing up this issue tends to render you silent. Is this because you know that this one argument renders everything you have claimed, and every argument you have made, false? Or have you just somehow managed to miss it every time it has been brought up?
To make sure I am being clear, here is the argument:
In the United States, anyone who has a life-threatening injury or illness is entitled to medical care at any hospital regardless of their ability to pay. This is the LAW right now, this instant. This isn't Obamacare, this is actually ReaganCare...
If someone goes to the ER, and can't pay, the hospitals don't "eat," that cost. The government doesn't pay for it. The costs are passed on to the hospital's other customers.
Therefore, people who have health insurance pay for the people who don't. People who don't cost more than people who do (because they can't get care until it is life threatening), and it drives up the cost of care in the US to ridiculous levels.
Defending the status quo, being against both government provided health care and universal health insurance mandate, is saying you think people who decide to buy insurance should be required to also pay for those who don't...




tazzygirl -> RE: Why is US medical care so expensive? (3/4/2012 10:13:14 PM)

The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment. [2]

EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program.[3] However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals.[citation needed] The combined payments of Medicare and Medicaid, $602 billion in 2004,[4] or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, and not just to Medicare patients.[5][6]

The cost of emergency care required by EMTALA is not directly covered by the federal government. Because of this, the law has been criticized by some as an unfunded mandate.[7] Similarly, it has attracted controversy for its impacts on hospitals, and in particular, for its possible contributions to an emergency medical system that is "overburdened, underfunded and highly fragmented."[8] Charity Care or care provided to the uninsured represent an industry average of 20% of total cost of care provided[citation needed]. The uncompensated or non-reimbursed amounts are written off as bad debt thus becoming a tax write off and the unpaid bills are also sold to third party collection agencies for an average of 20 cents per dollar[citation needed]. However, health insurance reimbursements for services provided have continually been reduced by the health insurance companies[citation needed]. Medicare and Medicaid reimbursements for services have also been reduced[citation needed]. The increasing financial pressures on hospitals and the passage of EMTALA and the additional costs of regulations that health service providers are required to maintain have caused consolidations and closures of many emergency room facilities[citation needed]. However, the number of emergency room clinics, or emergency rooms not attached to a traditional hospital, have increased, as they are generally more efficient and cost less to operate than a traditional hospital-based emergency room[citation needed]. There is debate[by whom?] about the extent to which EMTALA has led to cost-shifting and higher rates for insured or paying hospital patients, thereby contributing to the high overall rate of medical inflation in the U.S.

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act




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