4 ms·

Hospitals in the US with emergency rooms are not allowed to turn away patients who are sick. Ultimately it's the taxpayers who foot the bill. (Federal, State an

by vondur 7y ago

Hospitals in the US with emergency rooms are not allowed to turn away patients who are sick. Ultimately it's the taxpayers who foot the bill. (Federal, State and Local Governments pay for it I believe.) This also explains why so many private hospitals have shut down their emergency rooms. I also believe that many private hospitals will transfer patients who cant pay to public hospitals.

paublyrne 7y ago
Is it likely that many people without insurance will be reticent to go, fearing they'll end up with a huge bill they can't afford?
- claudeganon 7y ago
  Yes, self-rationing care is already a huge problem in the US.
- kasey_junk 7y ago
  Actually most of the uninsured in the States are covered by public funds and consume more healthcare than other cohorts. It’s the underinsured and those with high deductible plans that may not go to a doctor due to cost, The outcome is the same but the health cohort might be a surprise depending on your mental model.
- webninja 7y ago
  Many people with money but without insurance do go and get b*tch slapped later by their ~$10k-$200k medical bill. It’s a reason why medical debt is the LEADING cause of bankruptcy in the US. Many people without money or insurance also go but since they don’t have assets, they just don’t pay and the hospitals can’t collect on them. So the hospitals have to raise costs on people with money to pay for people without money. The second scenario actually caused a hospital I knew of in Dallas Texas to close down because it had (according to the locals) “too many illegal immigrants taking advantage of free healthcare”. Dallas Texas is somewhat close to the Mexico border. I personally knew of a vagrant woman with a prior medical issue that bragged about happily racking up the hospital over a million dollars in expenses after staying in a hospital bed for a few months. She didn’t express concern about having to pay for any of it since she doesn’t work. I wasn’t sure how to feel about that. I once paid $8k while my health insurance paid $43k when I spent just half a day in a hospital bed in Colorado after I fell and broke a bone.
  - ceejayoz 7y ago
    > I personally knew of a vagrant woman with a prior medical issue that bragged about happily racking up the hospital over a million dollars in expenses after staying in a hospital bed for a few months. The on-paper cost and the actual cost are wildly disparate. It's not uncommon to see a $40k bill get "adjusted" to something like $4k when insurance is present.
  - TMWNN 7y ago
    >Many people with money but without insurance do go and get b*tch slapped later by their ~$10k-$200k medical bill. It’s a reason why medical debt is the LEADING cause of bankruptcy in the US. Only 4% of US bankruptcies are because of medical bills https://www.washingtonpost.com/blogs/post-partisan/wp/2018/03/26/the-truth-about-medical-bankruptcies/ https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0... . A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.
    - webninja 7y ago
      My citation says 66% of US Bankruptcies are tied to medical issues. Which of our citations is right? https://www.google.com/amp/s/www.cnbc.com/amp/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html https://www.google.com/amp/s/www.cnbc.com/amp/2019/02/11/thi... You’re quite clever in saying that bankruptcies are caused by lack of income. I suppose more income would solve 100% of bankruptcies lol
      - TMWNN 7y ago
        >My citation says 66% of US Bankruptcies are tied to medical issues. Your citation says >A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work. (My emphasis.) In other words, people going bankrupt because health problems = lack of work = lack of income. That does not contradict my citation which states that 4% of US bankruptcies are because of medical bills; that is, bills for health care treatment exceeding available income. Your article goes on to quote a study author who carefully elides the difference between the two. Oh, by the way, he is a prominent proponent of Medicare for All! Imagine that.
cdumler 7y ago
While true the hospitals cannot turn away patients who are sick, it pretty much guarantees anyone who has any form of assets will never do so. U.S. is based on percentages, ie. company may be allowed by law to make only 20% profit. So, the bill is made multiple orders of magnitude higher at first bill. Then, "insurance earns its money" by lowering that bill. Then, you usually have to negotiate the final bill and deal with all the associated third-party charges. Finally, medical bills are very hard to discharge. The only people who think the U.S. has a good health care system are the rich who can afford anything and the poor who watch the news (propaganda) extolling how good our system is but don't actually take part in it. Even if you have insurance, you have to be very careful about what you use and when.
dboreham 7y ago
I believe the patient also gets bankrupted in the process.

by vondur 7y ago

paublyrne 7y ago

Is it likely that many people without insurance will be reticent to go, fearing they'll end up with a huge bill they can't afford?

claudeganon 7y ago
Yes, self-rationing care is already a huge problem in the US.
kasey_junk 7y ago
Actually most of the uninsured in the States are covered by public funds and consume more healthcare than other cohorts. It’s the underinsured and those with high deductible plans that may not go to a doctor due to cost, The outcome is the same but the health cohort might be a surprise depending on your mental model.
webninja 7y ago
Many people with money but without insurance do go and get b*tch slapped later by their ~$10k-$200k medical bill. It’s a reason why medical debt is the LEADING cause of bankruptcy in the US. Many people without money or insurance also go but since they don’t have assets, they just don’t pay and the hospitals can’t collect on them. So the hospitals have to raise costs on people with money to pay for people without money. The second scenario actually caused a hospital I knew of in Dallas Texas to close down because it had (according to the locals) “too many illegal immigrants taking advantage of free healthcare”. Dallas Texas is somewhat close to the Mexico border. I personally knew of a vagrant woman with a prior medical issue that bragged about happily racking up the hospital over a million dollars in expenses after staying in a hospital bed for a few months. She didn’t express concern about having to pay for any of it since she doesn’t work. I wasn’t sure how to feel about that. I once paid $8k while my health insurance paid $43k when I spent just half a day in a hospital bed in Colorado after I fell and broke a bone.
- ceejayoz 7y ago
  > I personally knew of a vagrant woman with a prior medical issue that bragged about happily racking up the hospital over a million dollars in expenses after staying in a hospital bed for a few months. The on-paper cost and the actual cost are wildly disparate. It's not uncommon to see a $40k bill get "adjusted" to something like $4k when insurance is present.
- TMWNN 7y ago
  >Many people with money but without insurance do go and get b*tch slapped later by their ~$10k-$200k medical bill. It’s a reason why medical debt is the LEADING cause of bankruptcy in the US. Only 4% of US bankruptcies are because of medical bills https://www.washingtonpost.com/blogs/post-partisan/wp/2018/03/26/the-truth-about-medical-bankruptcies/ https://www.washingtonpost.com/blogs/post-partisan/wp/2018/0... . A tipoff that [insert large percentage here] of bankruptcies aren't actually because of medical costs is that only 6% of bankruptcies by those without health insurance are because of that cause. The biggest cause of bankruptcies is lack of income, which health insurance doesn't affect.
  - webninja 7y ago
    My citation says 66% of US Bankruptcies are tied to medical issues. Which of our citations is right? https://www.google.com/amp/s/www.cnbc.com/amp/2019/02/11/this-is-the-real-reason-most-americans-file-for-bankruptcy.html https://www.google.com/amp/s/www.cnbc.com/amp/2019/02/11/thi... You’re quite clever in saying that bankruptcies are caused by lack of income. I suppose more income would solve 100% of bankruptcies lol
    - TMWNN 7y ago
      >My citation says 66% of US Bankruptcies are tied to medical issues. Your citation says >A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work. (My emphasis.) In other words, people going bankrupt because health problems = lack of work = lack of income. That does not contradict my citation which states that 4% of US bankruptcies are because of medical bills; that is, bills for health care treatment exceeding available income. Your article goes on to quote a study author who carefully elides the difference between the two. Oh, by the way, he is a prominent proponent of Medicare for All! Imagine that.

cdumler 7y ago

While true the hospitals cannot turn away patients who are sick, it pretty much guarantees anyone who has any form of assets will never do so. U.S. is based on percentages, ie. company may be allowed by law to make only 20% profit. So, the bill is made multiple orders of magnitude higher at first bill. Then, "insurance earns its money" by lowering that bill. Then, you usually have to negotiate the final bill and deal with all the associated third-party charges. Finally, medical bills are very hard to discharge. The only people who think the U.S. has a good health care system are the rich who can afford anything and the poor who watch the news (propaganda) extolling how good our system is but don't actually take part in it. Even if you have insurance, you have to be very careful about what you use and when.

dboreham 7y ago

I believe the patient also gets bankrupted in the process.