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The US health care system is partly socialized. Health care is provided for the unemployed or low income and the employed are covered as employers are required

The US health care system is partly socialized. Health care is provided for the unemployed or low income and the employed are covered as employers are required to provide health coverage. The odd ones out are typically small business owners who don't insure themselves and choose to take on the risk of potentially large medical bills. In all cases treatment is required by law, regardless of payment.

shiroiushi 2y ago
>In all cases treatment is required by law, regardless of payment. No, it's not. This is a myth. The only thing that's required is to stabilize the patient. If you need surgery to repair your shattered leg bone so you don't get an infection and need an amputation, you're not going to get that surgery without payment. But once you get a bad infection and need the leg amputated so you don't die, they'll do that for free.
- trimethylpurine 2y ago
  I'm not sure where this is happening, and I'm not saying you're wrong, but where I live, doctors are paid salary and they care for patients, so from my perspective what you're referring to sounds like a myth. My friends, who are doctors, operate all the time on people who have no identification and they do their absolute best. And there is no monetary incentive to do otherwise and they would quit and find a different hospital if there were. Anecdotal? Maybe. I'm open to hear from a doctor that says otherwise. As best I can tell, the medical community and education system would reject a doctor in the US from licensure for any other attitude towards health care.
  - shiroiushi 2y ago
    Doctors have absolutely nothing to do with who gets care and who doesn't: that's controlled by hospital administration and other hospital staff. The doctors are just employees. When was the last time you saw a doctor in the ER reception room talking to new arrivals and deciding if they need to see a doctor or not?
    - trimethylpurine 2y ago
      I'd love to go to a hospital where the administration determines if my health condition is emergency or not. That's a cash in hand settlement case.
      - shiroiushi 2y ago
        Please show me a hospital where actual doctors are manning the ER intake desks and triaging patients instead of actually working with patients in exam rooms.
        trimethylpurine 2y ago
        I didn't say that. But at the very least a nurse or PA will take your vitals while you wait for the doctor. And the doctor will determine when you are low risk enough to be discharged. They aren't taking your vitals in the lobby anywhere I've seen, unless that's where you collapse.
        shiroiushi 2y ago
        The whole conversation here is about Americans not getting life-saving healthcare, and you haven't refuted my claim. If you need chemotherapy for cancer, for instance, you're not going to get that in an ER. If you need bone reconstruction, you're not going to get that in an ER either. These are things that are done by appointment after consultation with specialists. They're not immediate life-threatening emergencies (you're not going to die in an hour without chemo), so the hospital has no responsibility to provide these treatments to you without regard for payment. Their only obligation is to stabilize you so you can see a specialist later.
        trimethylpurine 2y ago
        You're right. They will help you get your forms filled out so that you can get the insurance coverage to handle that. It would be a huge oversight to let people walk away who could be a major profit center for the hospital if they'd just fill out the paperwork. It was, of course, the hospital lobby who pushed for a ban on refusing coverage for preexisting conditions. And they did succeed. That would delay treatment, sadly, same as it would everywhere else in the world. Filling out forms is a barrier to healthcare no matter where you go. That barrier does seem to be bigger in the US. No doubt. But healthcare is available, it is partly socialized, and given enough effort, it does work for a large majority of cases, as is evidenced by life expectancy. I think what's unique about the US is that the burden of cost for the average American is put on their employer, which for many is a rich cooperation. It's a tax on the rich. It's not perfect. But it's far from bad when compared with most other countries. Maybe even all others. Not sure.
- trimethylpurine 2y ago
  Just wanted to post back to share that I researched such incidences and except for a few cases where the hospital was sued and lost and doctors fired, I didn't find any examples of this as an accepted or legally viable practice. If you have some examples to share, I'll be interested.
daemonologist 2y ago
It's a patchwork, with a lot of holes for people to fall through: * Hospitals must treat or stabilize regardless of payment, but only for emergencies - they just have to try to keep you from dying on the spot * The ACA (or Medicaid) subsidizes insurance for the unemployed, if your household income for the calendar year is low enough * Employers are required to offer coverage to their employees, provided they work more than 30 hours a week at that company and it has at least 50 full time employees (this extends to dependent children but not spouses or other dependents) This is better than nothing, don't get me wrong, but it could be a lot better still. We have the technology.
dragonwriter 2y ago
> In all cases treatment is required by law, regardless of payment. Screening for and stabilization of emergency medical conditions is required at all emergency departments by law, regardless of ability to pay, but that's much more limited than "in all cases, treatment is required by law, regardless of payment", and even then, hospitals skirt the rules.
- trimethylpurine 2y ago
  And how does this differ from care elsewhere? To contrast, my sister lives in Europe and needs shoulder surgery and unless she pays for a private treatment (by the same doctor) she will not be treated for 12 months. Guess what I paid for. Is that any better?
gregjor 2y ago
Not true except for immediate emergency care. Many employers do not provide coverage. They skirt the law by employing people part-time (Walmart, Amazon) or as gig workers. Even if the law reads as you claim that doesn’t mean you can get care in the US.
- trimethylpurine 2y ago
  And that's different from other countries how? I can walk into a hospital in any country in Europe as a non-citizen and request non emergency care and receive it? >Many employers do not provide coverage For under 50 employees, making less than 50k, Healthcare.gov covers those cases. You can visit there now to confirm my claim. And yes, it means you can get care in the US. I brought my Euro girlfriend here and she got care under a bullshit name. And they treated her, the same as any other patient. And she never paid anything. It was non emergency and we went to an emergency room anyway. Do you have a counter example? If so please share.
  - gregjor 2y ago
    Counter examples that don’t involve fraud, as you describe? Yes, many, but I don’t see any reason to try to refute the nonsense you posted.
    - trimethylpurine 2y ago
      The point is that hospitals in the US indeed treat anyone with or without ID. Emergency or not. I'm not sure what point you were making, or refuting, but I didn't catch it.
      - gregjor 2y ago
        You got lucky. US hospitals routinely turn people away for non-emergency conditions. That probably happens everywhere but I was only responding about US medical care. https://journalofethics.ama-assn.org/article/obligation-provide-services-physician-public-defender-comparison/2006-05 https://journalofethics.ama-assn.org/article/obligation-prov...

shiroiushi 2y ago

>In all cases treatment is required by law, regardless of payment. No, it's not. This is a myth. The only thing that's required is to stabilize the patient. If you need surgery to repair your shattered leg bone so you don't get an infection and need an amputation, you're not going to get that surgery without payment. But once you get a bad infection and need the leg amputated so you don't die, they'll do that for free.

trimethylpurine 2y ago
I'm not sure where this is happening, and I'm not saying you're wrong, but where I live, doctors are paid salary and they care for patients, so from my perspective what you're referring to sounds like a myth. My friends, who are doctors, operate all the time on people who have no identification and they do their absolute best. And there is no monetary incentive to do otherwise and they would quit and find a different hospital if there were. Anecdotal? Maybe. I'm open to hear from a doctor that says otherwise. As best I can tell, the medical community and education system would reject a doctor in the US from licensure for any other attitude towards health care.
- shiroiushi 2y ago
  Doctors have absolutely nothing to do with who gets care and who doesn't: that's controlled by hospital administration and other hospital staff. The doctors are just employees. When was the last time you saw a doctor in the ER reception room talking to new arrivals and deciding if they need to see a doctor or not?
  - trimethylpurine 2y ago
    I'd love to go to a hospital where the administration determines if my health condition is emergency or not. That's a cash in hand settlement case.
    - shiroiushi 2y ago
      Please show me a hospital where actual doctors are manning the ER intake desks and triaging patients instead of actually working with patients in exam rooms.
      - trimethylpurine 2y ago
        I didn't say that. But at the very least a nurse or PA will take your vitals while you wait for the doctor. And the doctor will determine when you are low risk enough to be discharged. They aren't taking your vitals in the lobby anywhere I've seen, unless that's where you collapse.
        shiroiushi 2y ago
        The whole conversation here is about Americans not getting life-saving healthcare, and you haven't refuted my claim. If you need chemotherapy for cancer, for instance, you're not going to get that in an ER. If you need bone reconstruction, you're not going to get that in an ER either. These are things that are done by appointment after consultation with specialists. They're not immediate life-threatening emergencies (you're not going to die in an hour without chemo), so the hospital has no responsibility to provide these treatments to you without regard for payment. Their only obligation is to stabilize you so you can see a specialist later.
        trimethylpurine 2y ago
        You're right. They will help you get your forms filled out so that you can get the insurance coverage to handle that. It would be a huge oversight to let people walk away who could be a major profit center for the hospital if they'd just fill out the paperwork. It was, of course, the hospital lobby who pushed for a ban on refusing coverage for preexisting conditions. And they did succeed. That would delay treatment, sadly, same as it would everywhere else in the world. Filling out forms is a barrier to healthcare no matter where you go. That barrier does seem to be bigger in the US. No doubt. But healthcare is available, it is partly socialized, and given enough effort, it does work for a large majority of cases, as is evidenced by life expectancy. I think what's unique about the US is that the burden of cost for the average American is put on their employer, which for many is a rich cooperation. It's a tax on the rich. It's not perfect. But it's far from bad when compared with most other countries. Maybe even all others. Not sure.
trimethylpurine 2y ago
Just wanted to post back to share that I researched such incidences and except for a few cases where the hospital was sued and lost and doctors fired, I didn't find any examples of this as an accepted or legally viable practice. If you have some examples to share, I'll be interested.

daemonologist 2y ago

It's a patchwork, with a lot of holes for people to fall through: * Hospitals must treat or stabilize regardless of payment, but only for emergencies - they just have to try to keep you from dying on the spot * The ACA (or Medicaid) subsidizes insurance for the unemployed, if your household income for the calendar year is low enough * Employers are required to offer coverage to their employees, provided they work more than 30 hours a week at that company and it has at least 50 full time employees (this extends to dependent children but not spouses or other dependents) This is better than nothing, don't get me wrong, but it could be a lot better still. We have the technology.

dragonwriter 2y ago

> In all cases treatment is required by law, regardless of payment. Screening for and stabilization of emergency medical conditions is required at all emergency departments by law, regardless of ability to pay, but that's much more limited than "in all cases, treatment is required by law, regardless of payment", and even then, hospitals skirt the rules.

trimethylpurine 2y ago
And how does this differ from care elsewhere? To contrast, my sister lives in Europe and needs shoulder surgery and unless she pays for a private treatment (by the same doctor) she will not be treated for 12 months. Guess what I paid for. Is that any better?

gregjor 2y ago

Not true except for immediate emergency care. Many employers do not provide coverage. They skirt the law by employing people part-time (Walmart, Amazon) or as gig workers. Even if the law reads as you claim that doesn’t mean you can get care in the US.

trimethylpurine 2y ago
And that's different from other countries how? I can walk into a hospital in any country in Europe as a non-citizen and request non emergency care and receive it? >Many employers do not provide coverage For under 50 employees, making less than 50k, Healthcare.gov covers those cases. You can visit there now to confirm my claim. And yes, it means you can get care in the US. I brought my Euro girlfriend here and she got care under a bullshit name. And they treated her, the same as any other patient. And she never paid anything. It was non emergency and we went to an emergency room anyway. Do you have a counter example? If so please share.
- gregjor 2y ago
  Counter examples that don’t involve fraud, as you describe? Yes, many, but I don’t see any reason to try to refute the nonsense you posted.
  - trimethylpurine 2y ago
    The point is that hospitals in the US indeed treat anyone with or without ID. Emergency or not. I'm not sure what point you were making, or refuting, but I didn't catch it.
    - gregjor 2y ago
      You got lucky. US hospitals routinely turn people away for non-emergency conditions. That probably happens everywhere but I was only responding about US medical care. https://journalofethics.ama-assn.org/article/obligation-provide-services-physician-public-defender-comparison/2006-05 https://journalofethics.ama-assn.org/article/obligation-prov...