Name them. Smarter people than you and me have tried to figure it out, and they ended up making laws that say you have to treat people who don't have health insurance regardless, which means the rest of us have to absorb the cost.
CBS news story on ACA cost debunked by...Fox News? What?
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FenderBender
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Well for one allowing hospitals to collect payment for emergency care. I don't think doctors got in to their job to just let people die. That being said, they should be allowed to get payment for their treatment. Hospitals can offer needs based assistance to reduce the cost they end up incurring. They can offer payment plans or seek charitable help to create emergency funds.
I agree that people smarter than us have considered options. But where we disagree is thinking that they've all come to the same conclusion. I don't think it is immoral to ask the people who've received emergency care to pay for their services. People need food and shelter to live as well, but we don't force grocery stores to hand out food for free or for construction companies to build houses without payment. And technological innovation has done more to improve life quality than any government regulation ever has.
You're right, we'd not force those companies to hand out services for free, we tax everyone and subsidize nutrition and housing for the poor via SNAP and HUD.
I fail to see your point, other than you are arguing in SUPPORT of the ACA now.
FenderBender
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Huh? We have a law on the books that forces hospitals to provide emergency medical care, and doesn't give them the chance to get paid for the service they provide. That has nothing to do with subsidies. I've explained why I'm opposed to subsidies, but those are a separate set of laws. I guess since I have to state it more explicitly, I'm opposed to subsidies like SNAP, ACA and HUD, and I'm opposed to laws that might send doctors to jail for not providing their services without getting paid.
It does allow them to collect payment. They collect via higher charges for other services which get passed onto people with health insurance.
You can't get blood from a stone, man. What are you proposing, that the hospitals collect payment via debtor's prison? Indentured servitude?
I know, hospitals can make them be their butler! Seinfeld figured that shit out 20 yrs ago!
A lot of these people do not have money to pay the hospitals, not just that they don't have insurance. So, the plan is to get them all insurance, get them preventive care, and lower the costs all around.
What you don't get is that you and I are already subsidizing these people, BECAUSE THERE IS NOWHERE ELSE FOR THE HOSPITALS TO GET THE MONEY (on iPhone, italics button doesn't work for some reason, excuse the caps).
At least the ACA is trying to dilute the costs across the population while also reducing the costs overall.
FenderBender
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That's like saying you're not stealing from Walmart, because they will raise their prices to cover their losses. Even if that is technically true it doesn't make it right.
I described a variety of ways that hospitals could mitigate their costs. Being a butler is like distant 5th on that list.
I get that I'm subsidizing the costs. I don't actually have a problem subsidizing the costs. I don't want to see people die, so I would gladly donate to prevent these deaths. My problem is the stealing money from a group of people and using someone else's suffering to justify it. Practically speaking, the emotional appeal of these arguments is why I don't expect people to start dying in the streets if we repeal these laws. But let's be clear about what has happened here. It was wrong to pass a law forcing hospitals to treat patients without letting them get payment for the cost of doing so. And now we're trying to fix that wrong by using another wrong to force people to buy insurance.
FenderBender
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People die every day for lack of care. It's not sufficient to say, "look tragedy, therefore this is your responsibility". My point was exactly that people who don't want to see people turned away at hospitals can make charitable donations to prevent this from occurring. I'm sure that there would be enough interest for this. It's wrong to force hospitals to treat people and not give them the opportunity to recover costs for the service. And forcing people to buy insurance is another wrong that we're saying is necessary to fix the problems the first wrong created.
We intuitively get this everywhere else. Like I said, if someone walked in to a Pathmark and said "I'm starving." The manager of Pathmark wouldn't go to jail for refusing to give him food. That says nothing about whether the manager actually would give him food. It's not a law that we provide soup kitchens for the poor and yet people run soup kitchens for the poor. It's a red herring to say that things will only be done if someone holds a gun to your head and makes you do it.
And as far as making it compulsory, the unintended consequences of EMTALA are that it has forced a lot of hospitals in to bankruptcy, further straining the remaining hospitals, reducing the supply of health care, increasing the demand of emergency care, and therefore making health care less accessible to the people this was law was supposed to make it available to.
It used to be the way you are arguing for, and people were dying from it, so a law was passed to fix it (note that I don't disagree with it being a bad law). Not enough people gave to charity to save all the poor people. It just didn't happen. So, they made a law, and a bad one at that.
Now, they are making another law to clean up the vast oversight in the first law. From a theoretical perspective, but in this case based on data from other developed countries, we ought to be able to give these poor wretches PREVENTIVE health care cheaper than we give them emergency care currently, all while increasing the pool of contributors.
Massachusetts did exactly this and has been quite successful. People there aren't that much different than anywhere else in this country, so it probably will work once they get their heads out of their asses and makea functional website.
Now, they are making another law to clean up the vast oversight in the first law. From a theoretical perspective, but in this case based on data from other developed countries, we ought to be able to give these poor wretches PREVENTIVE health care cheaper than we give them emergency care currently, all while increasing the pool of contributors.
Massachusetts did exactly this and has been quite successful. People there aren't that much different than anywhere else in this country, so it probably will work once they get their heads out of their asses and makea functional website.
This brings up another point that is constantly contested between liberal and conservative types.
The claim I so often hear is that liberals think people are stupid and can't be trusted to care for themselves. Now aside from the fact that usually this statement is preceded by "you stupid liberal" which is very self defeating, isn't it obvious that people are generally stupid and short sighted? Those that aren't a combo of those two things are usually just overwhelmed with information and choices.
To me it's obvious that the discussion should focus on just how much we handle for people. Retirement saving is always very low, so social security prevents packs of old people from roaming the streets and begging for handouts. Drugs can be bad for you, but maybe it's your choice to get all drugged up. etc. History really lends weight to the liberal side of the argument.
The claim I so often hear is that liberals think people are stupid and can't be trusted to care for themselves. Now aside from the fact that usually this statement is preceded by "you stupid liberal" which is very self defeating, isn't it obvious that people are generally stupid and short sighted? Those that aren't a combo of those two things are usually just overwhelmed with information and choices.
To me it's obvious that the discussion should focus on just how much we handle for people. Retirement saving is always very low, so social security prevents packs of old people from roaming the streets and begging for handouts. Drugs can be bad for you, but maybe it's your choice to get all drugged up. etc. History really lends weight to the liberal side of the argument.
BigMattTheHobo
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Uhhh, unless it's different where you live, states in my region have indigent health care funds managed by county governments. A hospital that treats someone and doesn't get paid applies for indigent funds. The county gets reimbursed by the feds. 100% of costs aren't covered, but it's better than nothing.
This method will decrease if everyone has to buy insurance. The responsibility is shifted from taxpayers to the individual in most cases.
FenderBender
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This is exactly what I've been talking about. We make it legal to steal from doctors, and then to "fix" that we steal from the general public to pay the doctors back for the original theft. Now we'll go one step further and force everyone to get insurance so that we won't be stealing from doctor's, but we'll still steal from the general public to make sure you can afford the insurance we're forcing you to buy.
But you have not proffered an alternate solution (though you say you have). Maybe you did it in another thread, or maybe it is in this thread and I missed it...but I believe you recommended "charity."
That didn't work in the past, what makes you think it is going to work now?
FenderBender
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Well, first, I don't think that I have to come up with a workable system just to point out that the current system is wrong. When you're under arrest for stealing, you can't say, "What's your system for how I get a TV without paying?" as a defense.
Second, contrary to popular belief we don't live in a utopia. "Solutions" don't always exist, and the bottom line is that we don't have enough healthcare to go around to everyone. Economics is about scarcity, not abundance. So as I said, in trying to make sure that nobody died from lack of care we took action that resulted in higher costs and fewer hospitals. And the reality is that now even though a hospital is required to stabilize you, once that's over if you can't afford healthcare you will still likely die from lack of continuing care. Now the ACA is the next proposed "solution", but as I said I'm skeptical that this is going to be our silver bullet for the same reasons that EMTALA wasn't. In the meantime, forcing bystanders to foot the bill for all of this experimentation is still wrong.
BigMattTheHobo
Mexican and fabulous
So both ways end up creating obligations for the general public. I think we can agree so far.
But the latter puts more responsibility on the individual, and as a bonus, it requires preventative care, which will reduce costs over the long haul by catching problems before they turn into a six figure surgery.
The former doesn't address personal responsibility, preventing serious health problems, or how hospitals lose money when people can't pay.
FenderBender
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No, we don't agree on this. Forcing doctors to treat patients without payment is problem 1. If it's ACA or indigent funds we're talking about two different approaches for fixing the first problem we created. Maybe the ACA is "better" than indigent funds, but in my books neither are as good as repealing EMTALA, and letting doctors figure out the way to best get their product to the people who need it.
...while the people die on the mats outside the automatic doors at the ER.
That's the problem you keep avoiding. "Let the docs figure it out" is what happened in the past that lead to the creation of the EMTALA. That train has sailed, so we have to look at something else. The EMTALA sucks, and the ACA has a logic behind it to fix it; execution is a whole other matter, and I'm not supporting the execution in the least.
BigMattTheHobo
Mexican and fabulous
Doctors don't get paid because the people are uninsured! Make people buy insurance and the doctors will be paid.
FenderBender
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Did you read my response?
Assuming that people getting emergency care and not paying really is the driving force in the cost of healthcare, EMTALA produced a lot of unintended consequences that made healthcare less available, not more available. Assuming that the ACA is a solution is wrong. The problem of people dying on the mats outside of the ER is a problem of not enough healthcare to go around. The ACA will not increase the supply of healthcare, it will increase the demand.
And none of this changes the fact that we're still dealing with the immorality of stealing from some people to support other people.
No doctors don't get paid because a law says they have to stabilize anyone who comes in the door and they aren't guaranteed reimbursement for the cost of doing it.
So, aside from morality, fairness and all that hoo haw.
Is there a net productivity gain to society if on average people are healthier and do not face financial ruin in the event of a major illness? Various things like unemployment, social security, welfare are called the social safety net for a reason. Humans are risk adverse. Without some type of guaranteed support for people who take risks and fail (or just fail) then our economy would tend to stagnate.
Would you risk a new job if losing that new job meant your kids would starve to death? No, you would probably just keep plugging away at your current job. Economic mobility decreases and the whole economy grinds to a halt.
Is there a net productivity gain to society if on average people are healthier and do not face financial ruin in the event of a major illness? Various things like unemployment, social security, welfare are called the social safety net for a reason. Humans are risk adverse. Without some type of guaranteed support for people who take risks and fail (or just fail) then our economy would tend to stagnate.
Would you risk a new job if losing that new job meant your kids would starve to death? No, you would probably just keep plugging away at your current job. Economic mobility decreases and the whole economy grinds to a halt.
Hospitals. Not Doctors. The Doctors are still getting their paychecks.
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