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The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an

by rdouble 14y ago

The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an immense bill.

bitcartel 14y ago
Friend at Google with probably the best insurance plan in the country, broke an ankle, and after seeing doctors and physios, still had to pay out-of-pocket close to ten thousand dollars.
- rdouble 14y ago
  Cool story, but what does that have to do with my comment?
  - bitcartel 14y ago
    Just clarifying your point about the system bankrupting people. Lots of folk outside the US are under the impression that once a person has healthcare insurance everything is hunky dory. The truth is, the current system can bankrupt anybody, regardless of insurance.
    - rdouble 14y ago
      That is a big problem with even attempting reform. All viable options build off the existing insurance system, which is terrible.
scarecrowbob 14y ago
I don't believe that this is true, although admittedly I only have anecdotal evidence. I have known several people who otherwise would possibly be alive if they had access to primary care in the earlier stages of their cancers.
- rdouble 14y ago
  It's illegal to turn someone away from the hospital. Access to primary care is another story altogether.
  - bunderbunder 14y ago
    It's illegal to turn someone away from the emergency department. For the other 90% of the hospital it's a different story entirely.
    - rdouble 14y ago
      Right, but there's no other front line of entry to anywhere else in the hospital. If a person walked to a hospital and demanded to see a brain surgeon they would be turned away even if they had health insurance. A major issue with the american health care system is there is a severe shortage of front line care outside of the ER. This is a side effect of the way doctors are compensated. There is no financial incentive to be a GP, so there aren't enough GPs.
      - bunderbunder 14y ago
        > Right, but there's no other front line of entry to anywhere else in the hospital. Yes there is. It's called a "primary care provider", and many of them have their offices right there in the hospital. Though the ones who operate out of separate clinics can often be less expensive, if not more conveniently located. If you don't already have one, you really should. The emergency department really hates it when people clog up their waiting rooms by going there with non-emergency issues instead of seeing a PCP. And your health insurance (assuming you have it) really hates it when you drive up their costs by going to the ED instead of seeing a PCP. And, if there were any price transparency in the American system, then your fellow citizens would also really hate it when you force the health insurance company to drive up their costs by going to the ED instead of seeing a PCP.
        rdouble 14y ago
potatolicious 14y ago
Sort of, kind of. Health care institutions do routinely refuse to treat people - just not when there is an immediate threat to life and limb. I have a friend (Canadian) who had an internship in the US. He got a major (and quite serious) bout of the flu, and although he was insured (by a Canadian company) absolutely refused to see him until he coughed up a hefty (multi-hundred) deposit - evidently they didn't find the Canadian firm trustworthy enough. This is a pretty core issue in US healthcare - early-stage care is routinely denied to people, either economically before they walk through the door, or at the door itself. This pushes a lot of health issues to ERs where costs are high and effectiveness reduced.
bunderbunder 14y ago
Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients they believe cannot pay except in the case of a life-threatening emergency. What this means is that in the USA it's common for people to have to allow earlier-stage, less expensive to treat problems develop into serious problems before finally going into the ED to seek treatment. Which increases all of our health care costs overall. Not only does the problem that eventually gets treated end up being more expensive than it needed to be, but the place where the care is provided is also the most expensive option. And since they don't pay, health care providers are forced to raise everyone else's rates to cover the cost of this unnecessarily expensive care that they had to provide. Long story short, the range of things that health care providers have to treat is much wider in countries with more socialized systems than it is in the USA. And that is yet another reason why the USA has such enormously high health care costs despite providing poorer quality of care.
- carbocation 14y ago
  > Actually, it does refuse to treat people quite regularly. Let's not play with words like that. People in the US get treatment—you even say so later, despite your ominous lead sentence. They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about, not the (false) specter of non-treatment.
  - potatolicious 14y ago
    > "They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about" You two aren't disagreeing. You say we should talk about the epidemic of people unable to afford primary care, pushing treatment later and later, eventually into the ER where they may not even be able to be saved - and even if they do, suffer long-term health effects due to the delay in treatment. And he's saying that this is because the system does refuse to treat people - especially at the primary care level. These two topics seem to line up just fine.
jibbist 14y ago
> it doesn't refuse to treat people. Implying the NHS refuses to treat people?
Osmium 14y ago
Isn't that the same thing? Practically speaking, for many people who'd rather be ill than ruin their family with debt. The thing that gets me is the attitude is that some people don't deserve free(-at-point-of-use) healthcare. For whatever reason; they haven't paid their taxes, or they've made mistakes in life. It seems unspeakably sad to me. Surely a civilised society should help everyone, regardless? It's the humane thing to do. It's as simple as that.
- rdouble 14y ago
  Most people would rather be bankrupt than be dead. I agree that a civilized society should help everyone, but don't agree that the USA is a civilized society. There is definitely an attitude that poor people don't "deserve" stuff. That's been an American notion since the first settlers arrived and won't change anytime in the near future.
  - Osmium 14y ago
    > Most people would rather be bankrupt than be dead. True, but what if it's something less serious? Some people would rather be ill than bankrupt. And then what if it gets worse, and then it's too late? People shouldn't have to make that choice, especially because most people--not being doctors--are going to make bad decisions about when something is serious enough to get checked out.
rmc 14y ago
"Sure we'll treat you, but it'll bankrupt you". is, essentially, "refusal" by another name.

by rdouble 14y ago

The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an immense bill.

bitcartel 14y ago

Friend at Google with probably the best insurance plan in the country, broke an ankle, and after seeing doctors and physios, still had to pay out-of-pocket close to ten thousand dollars.

rdouble 14y ago
Cool story, but what does that have to do with my comment?
- bitcartel 14y ago
  Just clarifying your point about the system bankrupting people. Lots of folk outside the US are under the impression that once a person has healthcare insurance everything is hunky dory. The truth is, the current system can bankrupt anybody, regardless of insurance.
  - rdouble 14y ago
    That is a big problem with even attempting reform. All viable options build off the existing insurance system, which is terrible.

scarecrowbob 14y ago

I don't believe that this is true, although admittedly I only have anecdotal evidence. I have known several people who otherwise would possibly be alive if they had access to primary care in the earlier stages of their cancers.

rdouble 14y ago
It's illegal to turn someone away from the hospital. Access to primary care is another story altogether.
- bunderbunder 14y ago
  It's illegal to turn someone away from the emergency department. For the other 90% of the hospital it's a different story entirely.
  - rdouble 14y ago
    Right, but there's no other front line of entry to anywhere else in the hospital. If a person walked to a hospital and demanded to see a brain surgeon they would be turned away even if they had health insurance. A major issue with the american health care system is there is a severe shortage of front line care outside of the ER. This is a side effect of the way doctors are compensated. There is no financial incentive to be a GP, so there aren't enough GPs.
    - bunderbunder 14y ago
      > Right, but there's no other front line of entry to anywhere else in the hospital. Yes there is. It's called a "primary care provider", and many of them have their offices right there in the hospital. Though the ones who operate out of separate clinics can often be less expensive, if not more conveniently located. If you don't already have one, you really should. The emergency department really hates it when people clog up their waiting rooms by going there with non-emergency issues instead of seeing a PCP. And your health insurance (assuming you have it) really hates it when you drive up their costs by going to the ED instead of seeing a PCP. And, if there were any price transparency in the American system, then your fellow citizens would also really hate it when you force the health insurance company to drive up their costs by going to the ED instead of seeing a PCP.
      - rdouble 14y ago

potatolicious 14y ago

Sort of, kind of. Health care institutions do routinely refuse to treat people - just not when there is an immediate threat to life and limb. I have a friend (Canadian) who had an internship in the US. He got a major (and quite serious) bout of the flu, and although he was insured (by a Canadian company) absolutely refused to see him until he coughed up a hefty (multi-hundred) deposit - evidently they didn't find the Canadian firm trustworthy enough. This is a pretty core issue in US healthcare - early-stage care is routinely denied to people, either economically before they walk through the door, or at the door itself. This pushes a lot of health issues to ERs where costs are high and effectiveness reduced.

bunderbunder 14y ago

Actually, it does refuse to treat people quite regularly. Aside from emergency department, health care providers are generally free to refuse care for patients they believe cannot pay except in the case of a life-threatening emergency. What this means is that in the USA it's common for people to have to allow earlier-stage, less expensive to treat problems develop into serious problems before finally going into the ED to seek treatment. Which increases all of our health care costs overall. Not only does the problem that eventually gets treated end up being more expensive than it needed to be, but the place where the care is provided is also the most expensive option. And since they don't pay, health care providers are forced to raise everyone else's rates to cover the cost of this unnecessarily expensive care that they had to provide. Long story short, the range of things that health care providers have to treat is much wider in countries with more socialized systems than it is in the USA. And that is yet another reason why the USA has such enormously high health care costs despite providing poorer quality of care.

carbocation 14y ago
> Actually, it does refuse to treat people quite regularly. Let's not play with words like that. People in the US get treatment—you even say so later, despite your ominous lead sentence. They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about, not the (false) specter of non-treatment.
- potatolicious 14y ago
  > "They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about" You two aren't disagreeing. You say we should talk about the epidemic of people unable to afford primary care, pushing treatment later and later, eventually into the ER where they may not even be able to be saved - and even if they do, suffer long-term health effects due to the delay in treatment. And he's saying that this is because the system does refuse to treat people - especially at the primary care level. These two topics seem to line up just fine.

jibbist 14y ago

> it doesn't refuse to treat people. Implying the NHS refuses to treat people?

Osmium 14y ago

Isn't that the same thing? Practically speaking, for many people who'd rather be ill than ruin their family with debt. The thing that gets me is the attitude is that some people don't deserve free(-at-point-of-use) healthcare. For whatever reason; they haven't paid their taxes, or they've made mistakes in life. It seems unspeakably sad to me. Surely a civilised society should help everyone, regardless? It's the humane thing to do. It's as simple as that.

rdouble 14y ago
Most people would rather be bankrupt than be dead. I agree that a civilized society should help everyone, but don't agree that the USA is a civilized society. There is definitely an attitude that poor people don't "deserve" stuff. That's been an American notion since the first settlers arrived and won't change anytime in the near future.
- Osmium 14y ago
  > Most people would rather be bankrupt than be dead. True, but what if it's something less serious? Some people would rather be ill than bankrupt. And then what if it gets worse, and then it's too late? People shouldn't have to make that choice, especially because most people--not being doctors--are going to make bad decisions about when something is serious enough to get checked out.

rmc 14y ago

"Sure we'll treat you, but it'll bankrupt you". is, essentially, "refusal" by another name.