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> "They didn't pay, so they die." This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. First responders- police, ambula

> "They didn't pay, so they die." This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. First responders- police, ambulance, fire fighters- will save any life they are able to. Preventative health care is a different story, and even that is complicated. Unincorporated land holds a very tiny percentage of the population of the US; trying to use this as an analogy for the rest of society is just disingenuous. > Other countries have orginisations that deal with entire areas. So does the US. Even unincorporated land falls under the jurisdiction of whatever county it happens to be in as well as the state and federal governments; the only difference is it doesn't have a local town government... because there is no local town.

cheriot 4y ago
> This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay This is the bare minimum to avoid a PR disaster. When someone is dying slowing of a chronic condition (diabetes, heart disease, kidney disease) the US system will just watch them die unless they have insurance.
- EvanAnderson 4y ago
  It's not done for "PR". US hospitals are required to treat emergency cases, by law. The Emergency Medical Treatment and Active Labor Act[0], passed under President Reagan, codifies the mandate. (This is, to my mind, what caused the United States to end up with socialized medicine-- albeit a socialized medicine system where we don't get to have public discourse about how it works.) [0] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
  - yamtaddle 4y ago
    We don't have "socialized medicine". You can go to the ER without insurance and with signs & symptoms of a heart attack and they'll try to keep you from dying, but they won't give you the triple-bypass and medicine you need to keep it from happening again in a month—unless they think you'll be able to pay for it.
    - EvanAnderson 4y ago
      Without making any moral argument one way or the other: If people who can't pay and would otherwise die are given "free" treatment then we have socialized medicine. The costs are spread over everyone else. Uninsured and under-insured people are cited as one reason why treatment costs are so high. Whether these cases actually contribute to costs in a substantive way doesn't stop the mandate to provide free emergency care being used as a political football.
      - yamtaddle 4y ago
        This is hair-splitting for no reason, to the point of destroying communication. Nobody (because this is HN: yes, apparently at least one person, but you know what I mean by this) means ERs having to eat the cost of stabilizing uninsured dying/in-labor people when they say "socialized medicine". You can draw some parallels, but trying to put that, plus all the things people actually mean by the term, under the same umbrella, is a step toward making it meaningless. This is like a burger joint telling you they don't serve onion rings, and then you insisting that in fact they do, because they put circle-cut onions on their burgers, and technically those are both rings and onions. Like... OK? So what? Which framing: "this place serves onion rings", or "this place does NOT serve onion rings", is more likely to confuse a diner? The only times I've seen people really, seriously try to frame this as "socialized medicine" is when they don't understand how very limited the mandated scope of care is. It doesn't amount to much more than "you can't let someone simply die or give birth on the curb right outside your ER". The vast majority of what counts as medical care isn't part of it.
        EvanAnderson 4y ago
        I fully admit to being hyperbolic. Where I live, in a rural area of a red state with a lot of wealth disparity, giving free medical care to anybody absolutely is seen as "socialized medicine". (Of course, there'll be a healthy dose of divisive racial and class politics mixed in to the argument, too.) The reasons behind that opinion are absolutely motivated by lack of understanding, but there are strong political beliefs there as well. I'd like to see substantive discussion about how the US healthcare "system" really works. This is a detail that a lot of people don't know about or understand. I think the idea that "we already don't let people who can't pay just die" has a good moral argument behind it.
  - cheriot 4y ago
    It's lawmakers trying to avoid the PR disaster.
that_guy_iain 4y ago
>This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. First responders- police, ambulance, fire fighters- will save any life they are able to. Preventative health care is a different story, and even that is complicated. The US has the highest preventable death rate in the developed world. People die because they don't get to see a doctor. First responders will save you. However, the amount of deaths because people couldn't pay is massive for a so-called developed country. Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery. > Unincorporated land holds a very tiny percentage of the population of the US; trying to use this as an analogy for the rest of society is just disingenuous. As used with the multiple other examples, it's an entire culture. Not just "Oh unincorporated land, that's just crazy". It's disingenuous to act like my point is hinged on unincorporated land. > So does the US. Even unincorporated land falls under the jurisdiction of whatever county it happens to be in as well as the state and federal governments; the only difference is it doesn't have a local town government... because there is no local town. There are state troopers who have jurisction over certaint things. However, there is then an array of other law enforcement agencies such as towns having a police department and sheriff departments which have jurisictions over certain things. They don't have a simple police force that deals with everything in that area. This results in crimes not being truly investigated because no one is sure whose job it is. There is no regional fire department as shown in the linked news article. The fire department that was paid by a neighbour to ensure they didn't get fire damage ignored a fire nearby because they weren't paid by someone else. The ignoring of that fire resulted in fire damage to the paying customer. A regional fire department would have dealt with that.
- Aunche 4y ago
  > The US has the highest preventable death rate in the developed world. They also have by far the highest obesity rate in the developed world. > Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery. I'm supportive of universal healthcare, but this is a huge exaggeration. If policy decisions are motivated by uninformed memes like this, then if we ever do get universal healthcare, it will be a disaster. You can buy human insulin for $25 a vial at Walmart. It's not as good, but it's what people used a couple decades ago. Countries with nationalized healthcare often have long backlogs for treatments. The cancer backlog in the UK is over 2 million people and it's continuing to grow [1]. Also, if you are insured, you're typically going to get new and more sophisticated treatments on the US compared to most places with nationalized healthcare. [1] https://news.cancerresearchuk.org/2020/06/01/over-2-million-people-in-backlog-for-cancer-care/ https://news.cancerresearchuk.org/2020/06/01/over-2-million-...
rqtwteye 4y ago
“Hospitals will stabilize anyone, regardless of ability to pay.” They will stabilize you and then kick you out to the curb quickly. And depending how they felt that day they will send you an outrageous bill.
- vxNsr 4y ago
  This is false, a hospital cannot kick you out, you need to agree that you are ready to leave.
  - linuxdude314 4y ago
    That’s BS. I’ve been to the hospital plenty of times in USA and have never been asked if I’m ready to leave. Patients get discharged when doctors say so.
justin66 4y ago
> > "They didn't pay, so they die." > This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. It's weird that you think you've offered a retort here. A person who cannot afford medical treatment and experiences one or more of these emergency room visits followed by immediate discharge as soon as legally permissible is likely to die before their time, perhaps shortly after being discharged. > First responders- police, ambulance, fire fighters- will save any life they are able to. They do that sometimes when it suits them, but they certainly aren't legally obligated to.

cheriot 4y ago

> This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay This is the bare minimum to avoid a PR disaster. When someone is dying slowing of a chronic condition (diabetes, heart disease, kidney disease) the US system will just watch them die unless they have insurance.

EvanAnderson 4y ago
It's not done for "PR". US hospitals are required to treat emergency cases, by law. The Emergency Medical Treatment and Active Labor Act[0], passed under President Reagan, codifies the mandate. (This is, to my mind, what caused the United States to end up with socialized medicine-- albeit a socialized medicine system where we don't get to have public discourse about how it works.) [0] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
- yamtaddle 4y ago
  We don't have "socialized medicine". You can go to the ER without insurance and with signs & symptoms of a heart attack and they'll try to keep you from dying, but they won't give you the triple-bypass and medicine you need to keep it from happening again in a month—unless they think you'll be able to pay for it.
  - EvanAnderson 4y ago
    Without making any moral argument one way or the other: If people who can't pay and would otherwise die are given "free" treatment then we have socialized medicine. The costs are spread over everyone else. Uninsured and under-insured people are cited as one reason why treatment costs are so high. Whether these cases actually contribute to costs in a substantive way doesn't stop the mandate to provide free emergency care being used as a political football.
    - yamtaddle 4y ago
      This is hair-splitting for no reason, to the point of destroying communication. Nobody (because this is HN: yes, apparently at least one person, but you know what I mean by this) means ERs having to eat the cost of stabilizing uninsured dying/in-labor people when they say "socialized medicine". You can draw some parallels, but trying to put that, plus all the things people actually mean by the term, under the same umbrella, is a step toward making it meaningless. This is like a burger joint telling you they don't serve onion rings, and then you insisting that in fact they do, because they put circle-cut onions on their burgers, and technically those are both rings and onions. Like... OK? So what? Which framing: "this place serves onion rings", or "this place does NOT serve onion rings", is more likely to confuse a diner? The only times I've seen people really, seriously try to frame this as "socialized medicine" is when they don't understand how very limited the mandated scope of care is. It doesn't amount to much more than "you can't let someone simply die or give birth on the curb right outside your ER". The vast majority of what counts as medical care isn't part of it.
      - EvanAnderson 4y ago
        I fully admit to being hyperbolic. Where I live, in a rural area of a red state with a lot of wealth disparity, giving free medical care to anybody absolutely is seen as "socialized medicine". (Of course, there'll be a healthy dose of divisive racial and class politics mixed in to the argument, too.) The reasons behind that opinion are absolutely motivated by lack of understanding, but there are strong political beliefs there as well. I'd like to see substantive discussion about how the US healthcare "system" really works. This is a detail that a lot of people don't know about or understand. I think the idea that "we already don't let people who can't pay just die" has a good moral argument behind it.
- cheriot 4y ago
  It's lawmakers trying to avoid the PR disaster.

that_guy_iain 4y ago

>This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. First responders- police, ambulance, fire fighters- will save any life they are able to. Preventative health care is a different story, and even that is complicated. The US has the highest preventable death rate in the developed world. People die because they don't get to see a doctor. First responders will save you. However, the amount of deaths because people couldn't pay is massive for a so-called developed country. Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery. > Unincorporated land holds a very tiny percentage of the population of the US; trying to use this as an analogy for the rest of society is just disingenuous. As used with the multiple other examples, it's an entire culture. Not just "Oh unincorporated land, that's just crazy". It's disingenuous to act like my point is hinged on unincorporated land. > So does the US. Even unincorporated land falls under the jurisdiction of whatever county it happens to be in as well as the state and federal governments; the only difference is it doesn't have a local town government... because there is no local town. There are state troopers who have jurisction over certaint things. However, there is then an array of other law enforcement agencies such as towns having a police department and sheriff departments which have jurisictions over certain things. They don't have a simple police force that deals with everything in that area. This results in crimes not being truly investigated because no one is sure whose job it is. There is no regional fire department as shown in the linked news article. The fire department that was paid by a neighbour to ensure they didn't get fire damage ignored a fire nearby because they weren't paid by someone else. The ignoring of that fire resulted in fire damage to the paying customer. A regional fire department would have dealt with that.

Aunche 4y ago
> The US has the highest preventable death rate in the developed world. They also have by far the highest obesity rate in the developed world. > Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery. I'm supportive of universal healthcare, but this is a huge exaggeration. If policy decisions are motivated by uninformed memes like this, then if we ever do get universal healthcare, it will be a disaster. You can buy human insulin for $25 a vial at Walmart. It's not as good, but it's what people used a couple decades ago. Countries with nationalized healthcare often have long backlogs for treatments. The cancer backlog in the UK is over 2 million people and it's continuing to grow [1]. Also, if you are insured, you're typically going to get new and more sophisticated treatments on the US compared to most places with nationalized healthcare. [1] https://news.cancerresearchuk.org/2020/06/01/over-2-million-people-in-backlog-for-cancer-care/ https://news.cancerresearchuk.org/2020/06/01/over-2-million-...

rqtwteye 4y ago

“Hospitals will stabilize anyone, regardless of ability to pay.” They will stabilize you and then kick you out to the curb quickly. And depending how they felt that day they will send you an outrageous bill.

vxNsr 4y ago
This is false, a hospital cannot kick you out, you need to agree that you are ready to leave.
- linuxdude314 4y ago
  That’s BS. I’ve been to the hospital plenty of times in USA and have never been asked if I’m ready to leave. Patients get discharged when doctors say so.

justin66 4y ago

> > "They didn't pay, so they die." > This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. It's weird that you think you've offered a retort here. A person who cannot afford medical treatment and experiences one or more of these emergency room visits followed by immediate discharge as soon as legally permissible is likely to die before their time, perhaps shortly after being discharged. > First responders- police, ambulance, fire fighters- will save any life they are able to. They do that sometimes when it suits them, but they certainly aren't legally obligated to.