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Uninsured's leave $49 billion in unpaid hospital bills

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How does a person take preventive medicine for things like high blood pressure, cholesterol, triglycerides, and type 2 diabetes if they don't go to the doctor to find out you have the diseases? How does a person got to the doctor, find out they need the medication and get the $4/month prescription if they don't have health insurance? Instead of getting treated with regular preventive checkups, people go to the intensive care with a heart attack or stroke that very likely could have been prevented for $4/month.

And I have no problem with taxing tobacco more to cover the associated health care costs. Tax it enough to cover healthcare costs related to both smoking and second hand smoke. Also, more state should follow Ohio and ban smoking in public places.

There are certainly fringe cases where preventative medicine can help, I'm not discounting that. I just haven't seen any evidence that people who would take those aren't getting those just because they don't have insurance. In most cases people with high blood pressure and cholesterol know they have that because they have a family history of it. I'm not opposed to people being checked for that, and I think it can be beneficial. I just don't see making the process easier to access making a significant difference on overall healthcare costs. Evidence of already insured people shows that most people don't bother with regular checkups. Those who do, many still ignore changing their routine (taking new medicine, changing behavior, etc). In a perfect world, people would care about it, and act proactively. We don't live in a perfect world, and most people aren't willing to act with the best interests of their long term health costs in mind.

In order for preventative care to be effective, you need to fundamentally change human behavior. The easiest way to do that is financially. For most, that doesn't mean just making it free. Adding a yearly health tax for everyone, that can be written off by people who had a checkup could work. Most people do a really bad job of acting in a way that reduces their future health care costs. Until that issue is addressed, we're looking at small improvements at best.
 
you must not be around many people who can't afford health care.

And what you want to call the fringe cases are where we spend the most healthcare dollars (outside of the cost of smoking, which I said I would handle differently).

the cost of cardiovascular diseases in the United States, including health care expenditures and lost productivity from deaths and disability, is estimated to be more than $503 billion in 2010.

and

Preventing and controlling high blood pressure and high blood cholesterol also play a significant role in cardiovascular health. For example, a 12–13 point reduction in systolic blood pressure can reduce heart disease risk by 21%, stroke risk by 37%, and risk for death from heart disease or stroke by 25%

http://www.cdc.gov/chronicdisease/resources/publications/AAG/dhdsp.htm
 
you must not be around many people who can't afford health care.

I don't see it an issue about some people not being able to afford health care. My point is that those who do have health coverage generally don't seek preventative care. Those who do generally don't change behavior to improve their health future. What's more, those cases that could be effectively solved with preventative care are a drop in the bucket of total health care.

I just haven't seen any evidence that there are a significant portion of the population who would seek preventative checkups if given the means. I haven't seen any evidence that even if those people did get regular checkups that they would alter their behavior. I'm sure there are fringe cases where some people would get regular checkups and would follow through on inexpensive ($4 a month) that they can't afford. I'm not opposed to that happening. The reason to that shouldn't be done under the guise of reducing future health care costs, because I think at best it breaks even (more healthy people who don't need regular checkups would be the ones most likely going, those who don't care about their health, are are the least healthy, wouldn't show up). There are better ways of reducing future health care costs. The two aren't mutually exclusive.
 
who do you think is less likely to get preventive care, people with health insurance or people without health insurance? And the problem isn't just preventive care, I have seen people bypass treatment because they couldn't afford healthcare. Some missed work longer than necessary because they couldn't go get treated. I even know of someone who died because they put off treatment for pneumonia until it was too late because of the cost. This sort of thing simply shouldn't happen.
 
Additionally, did you know that procedures actually cost more if the person receiving treatment is uninsured? Because insurance companies negotiate contracts with medical care providers, they get a discount on labor costs. If someone has a $2,000 procedure with health insurance, it can go up 60% without the special insured discount rate. This was meant to persuade people to get the insurance, but instead it just makes the uninsured medical bills impossibly expensive. Hence backruptcy among those who are uninsured and fall sick.

Joining the rest of the non-third world and nationalizing the process solves this loophole.

Where do you get your information? Because hospital charges do not vary based on the patient's insurance provider. At least they sure don't at my employer. The contracts negotiated between hospitals and insurance providers determine how much the insurance provider will pay based on the diagnostic resource group the patient is coded.
 
^^ I don't know what the percentage is, but when someone in my family goes to the doctor or hospital, we get two bills. The second bill always adjusts the first bill downwards to what the agreed charge is with our insurance company. The difference goes away because we have insurance. Insurance doesn't pay anything, the second, lower amount is what we pay and what counts towards our deductible. It's not always this extreme, but I've seen some charges drop from over $100 to under $5. Without insurance, there is no adjustment.
 
My wife is in insurance and places the average negotiated markdown at 40% savings for the insured. Hospital billing probably wouldn't see that until it goes through the insurance company. As previously mentioned, once the bill is recognized as unpaid by the insurance company and the individual, the cost is covered in premiums paid by the insured. With nationalized health care, everyone would pay their share. I personally don't pay any attention to the "I have a right not to pay for health coverage" people. When your life is on the line, you opt for survival and bankrupcy 10 times out of 10 instead of dying for your right to not be insured.
 
^^ I don't know what the percentage is, but when someone in my family goes to the doctor or hospital, we get two bills. The second bill always adjusts the first bill downwards to what the agreed charge is with our insurance company. The difference goes away because we have insurance. Insurance doesn't pay anything, the second, lower amount is what we pay and what counts towards our deductible. It's not always this extreme, but I've seen some charges drop from over $100 to under $5. Without insurance, there is no adjustment.

oh you wouldnt believe how bad stuff like this gets. I had an xray done at a non-emergency place (patient first) and the charged xray for insurance was 50 dollars, without it would have been 200. my dad had a some sort of dumb test done that just required someone to look at it, i think it was to test to see if there was blood in his urine (something anyone could do), the insurance cost for it was 9 dollars, the non insurance price was 75.

My sister had a seizure (she is an epileptic) and the hospital tried to charge her 5k for the visit to be there for 6 hours, because she was non-insured (had only been at the new job for 28 days instead of 30). So my dad who used to be VP of a hospital gets a hold of the billing department and tells them my sister would declare bankruptcy before she pays the non-insurable rate, and only to charge her the insurable rate.... 3 months later they give her the real bill of 2k.
 
I think the best solution is just to give everyone FREE EVERYTHING. Whatever they want they should just be allowed to take it. And let's have the government control the process, because we see how efficient and effective government is now. Nobody should have to pay for anything out of his own wallet. By making people pay for stuff, it discriminates against poor people and it fuels the hatred and envy of "rich" people. God forbid people take responsibility for their own lives and be forced to live with the consequences of shitty decision making.
 
who do you think is less likely to get preventive care, people with health insurance or people without health insurance? And the problem isn't just preventive care, I have seen people bypass treatment because they couldn't afford healthcare. Some missed work longer than necessary because they couldn't go get treated. I even know of someone who died because they put off treatment for pneumonia until it was too late because of the cost. This sort of thing simply shouldn't happen.

I'm saying that I haven't seen any evidence that a significant amount of people would seek preventative care, then follow through with the treatment but aren't currently doing so. Most people who currently are insured don't. Adding more to that group doesn't significantly change total health care costs. Now if our goal is to make sure that everyone has appropriate care, and that those who do want to be responsible can be, regardless of their financial situation, then sure, let's find a way to get them that treatment. I'm not at all opposed to that. I just don't see any evidence that it significantly effects future health care costs overall. If anything, it increases costs because those most likely to go get annual checkups are the ones most likely to take care of themselves, and the ones least likely to benefit from it. We'd be using up more time from doctors who are already over worked, with taxpayers footing the bill for most of the increased costs. At best that system breaks even. That's not an argument for not doing it, it's just calling it like it is.

We're talking about two different things here. In a perfect world, everyone with high blood pressure and cholesterol would get regular screenings and take preventative measures to lower their risks for heart disease. In a perfect world, they'd adapt their eating habits to further limit their future health care liabilities. In a perfect world you're exactly right, and that plan would save money. But we don't live in a perfect world. Many of those who have access to preventative measures now don't currently take advantage. Psychological studies show that people just don't do a very good job of planning for future health conditions, that's under the best of circumstances, where they have access to insurance. Most people don't change behavior until after costly procedures are required. They need a "wake up call", which usually isn't a doctor telling them they better start making some changes. It's unfortunate, but we won't find a real solution to the problem of rising health care costs until we start planning based on how people act instead of how we'd like them to act.

Both objectives are possible. We can certainly address the issue of people not being able to afford proper medical care as well as helping to reduce long term health care costs. They aren't mutually exclusive, but they don't both accomplish the same thing either.
 
I think the best solution is just to give everyone FREE EVERYTHING.

Like when my insurance premiums pay for the homeless guy who drinks vodka all day to get his emergency leg surgery when he trips and falls?

Honestly, opponents of the national health care plan need to turn down the Rush Limbaugh and build a stronger understanding of how insurance works. The average working family who already pays into health care stands to save money with every citizen paying through taxes. The rest of the civilized world has done the math and realized every citizen should pay for health care if every citizen is protected by the Hippocratic Oath. It's absurdly obvious. This is a matter of closing a loophole called bankruptcy.
 
I think the best solution is just to give everyone FREE EVERYTHING. Whatever they want they should just be allowed to take it. And let's have the government control the process, because we see how efficient and effective government is now. Nobody should have to pay for anything out of his own wallet. By making people pay for stuff, it discriminates against poor people and it fuels the hatred and envy of "rich" people. God forbid people take responsibility for their own lives and be forced to live with the consequences of shitty decision making.

How many Enrons, Bernie Maddoffs, Goldman Sacs, waterfall talf opportunities (http://www.rollingstone.com/politic...-look-whos-cashing-in-on-the-bailout-20110411) and mortgage backed securities frauds do we need before we stop this nonsense (http://activerain.com/blogsview/191...-on-investors-of-mortgage-backed-securities)?
 
Like when my insurance premiums pay for the homeless guy who drinks vodka all day to get his emergency leg surgery when he trips and falls?

Honestly, opponents of the national health care plan need to turn down the Rush Limbaugh and build a stronger understanding of how insurance works. The average working family who already pays into health care stands to save money with every citizen paying through taxes. The rest of the civilized world has done the math and realized every citizen should pay for health care if every citizen is protected by the Hippocratic Oath. It's absurdly obvious. This is a matter of closing a loophole called bankruptcy.

There's this idea that there is this massive group of people capable of paying for health care that aren't getting it. I just don't see that being the case. There's a lot of middle class families who should save some money. But for every one of them, there's people like my friend. He works at a small diner while he puts himself through school. He can't afford insurance, isn't covered under his family's insurance any longer and his employer isn't required to pay. He's younger and healthy, and he can get by without. He's not leaving unpaid medical bills, he's just making decisions to limit his health liability. Requiring him to have insurance is taking more money out of his already stretched pockets. He won't have to pay a lot, but he'll have to pay some. He's not the exception either. The majority of the people who will be required to have insurance will be people like him. People making enough to have to pay for insurance, but who can't afford that additional expense.
 
There's this idea that there is this massive group of people capable of paying for health care that aren't getting it. I just don't see that being the case. There's a lot of middle class families who should save some money. But for every one of them, there's people like my friend. He works at a small diner while he puts himself through school. He can't afford insurance, isn't covered under his family's insurance any longer and his employer isn't required to pay. He's younger and healthy, and he can get by without. He's not leaving unpaid medical bills, he's just making decisions to limit his health liability. Requiring him to have insurance is taking more money out of his already stretched pockets. He won't have to pay a lot, but he'll have to pay some. He's not the exception either. The majority of the people who will be required to have insurance will be people like him. People making enough to have to pay for insurance, but who can't afford that additional expense.

I was in his shoes, but it doesn't change the fact that I was lucky that nothing happened to me during my uninsured stretch. Back then, I took my own health for granted and held a general mistrust for the insurance industry. If I did discover that I was sick, it would have been like losing in Russian roulette. Look, that 49 billion in the title of this thread isn't going away. It should be burning your retinas. If that 49 billion loophole goes away, your friend could actually afford insurance instead of feeling privileged that he lives in a world where he doesn't have to pay around 75 bucks a month in taxes to fucking stay alive.
 
I think the best solution is just to give everyone FREE EVERYTHING. Whatever they want they should just be allowed to take it. And let's have the government control the process, because we see how efficient and effective government is now. Nobody should have to pay for anything out of his own wallet. By making people pay for stuff, it discriminates against poor people and it fuels the hatred and envy of "rich" people. God forbid people take responsibility for their own lives and be forced to live with the consequences of shitty decision making.

Is being born with Spina Bifida shitty decision making? I'm not looking for free anything. I'm just looking for a level playing field. As long as we have a for profit insurance system people like myself will never be aloud to take part in it. I have a choice, Medicaid, or nothing. There are 8 mil of me in the USA. All on medicaid, all can not work because of the rules to stay on medicaid. I don't envy the rich, I envy you. I envy people born healthy without pre existing conditions.
 

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