billvon 3,119 #276 June 18, 2009 > I'm talking going against medical advice and then suing and winning later. I agree with you there. >On the $$$ side, how do you propose providing health care in such >away that those that can't afford it still get it but treat it is a privilege, not an >entitlement . . . By making only the most basic level of medical care available without showing ability to pay. Quote Share this post Link to post Share on other sites
TomAiello 26 #277 June 18, 2009 QuoteQuoteOn the $$$ side, how do you propose providing health care in such away that those that can't afford it still get it but treat it is a privilege, not an entitlement . . . By making only the most basic level of medical care available without showing ability to pay. Another option would be to let people borrow from a government backed medical expenses fund, to be repayed in the future, and with bankruptcy not allowing discharge. Kind of like student loans, but for emergency medical expenses.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
mnealtx 0 #278 June 18, 2009 QuoteQuoteQuoteOn the $$$ side, how do you propose providing health care in such away that those that can't afford it still get it but treat it is a privilege, not an entitlement . . . By making only the most basic level of medical care available without showing ability to pay. Another option would be to let people borrow from a government backed medical expenses fund, to be repayed in the future, and with bankruptcy not allowing discharge. Kind of like student loans, but for emergency medical expenses. Interesting thought...how would you guarantee payment? Garnishment, like a defaulted student loan?Mike I love you, Shannon and Jim. POPS 9708 , SCR 14706 Quote Share this post Link to post Share on other sites
TomAiello 26 #279 June 18, 2009 QuoteQuoteQuoteQuoteOn the $$$ side, how do you propose providing health care in such away that those that can't afford it still get it but treat it is a privilege, not an entitlement . . . By making only the most basic level of medical care available without showing ability to pay. Another option would be to let people borrow from a government backed medical expenses fund, to be repayed in the future, and with bankruptcy not allowing discharge. Kind of like student loans, but for emergency medical expenses. Interesting thought...how would you guarantee payment? Garnishment, like a defaulted student loan? Yes.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
billvon 3,119 #280 June 19, 2009 >Another option would be to let people borrow from a government backed >medical expenses fund, to be repayed in the future, and with bankruptcy >not allowing discharge. Kind of like student loans, but for emergency >medical expenses. OK. Two cases, then: 1) Guy shows up in an ambulance from a car crash. He is stabilized after a few days, and released in two weeks. He refuses to give any name or ID. What's the solution there? 2) Homeless guy is treated and released. He has never worked and probably never will, at least at any reportable job. What's the solution there? Should we implement a system that rewards people like that for not working? I like the idea overall, but there are probably a few bugs to be worked out. Quote Share this post Link to post Share on other sites
TomAiello 26 #281 June 19, 2009 QuoteOK. Two cases, then: 1) Guy shows up in an ambulance from a car crash. He is stabilized after a few days, and released in two weeks. He refuses to give any name or ID. What's the solution there? 2) Homeless guy is treated and released. He has never worked and probably never will, at least at any reportable job. What's the solution there? Should we implement a system that rewards people like that for not working? I like the idea overall, but there are probably a few bugs to be worked out. In the second case, you'd probably get medicare to pay, just as they do now. In the first case, you're probably looking at the hospital eating the cost for a loss. Which is what happens with the current system, as well. Things like the guy refusing to give ID? You're not going to fix those under any system. Even under some kind of federal insurance plan or national health service, it's going to be hard to collect payment for him without showing his identity. I guess we could start warterboarding john doe patients...-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
rehmwa 2 #282 June 19, 2009 QuoteOK. Two cases, then: 1) Guy shows up in an ambulance from a car crash. He is stabilized after a few days, and released in two weeks. He refuses to give any name or ID. What's the solution there? 2) Homeless guy is treated and released. He has never worked and probably never will, at least at any reportable job. What's the solution there? Should we implement a system that rewards people like that for not working? I like the idea overall, but there are probably a few bugs to be worked out. In both cases, harvest their organs for the doctor's own personal use. Just like in LA hospitals. ... Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants Quote Share this post Link to post Share on other sites
pirana 0 #283 June 19, 2009 Quote>Another option would be to let people borrow from a government backed >medical expenses fund, to be repayed in the future, and with bankruptcy >not allowing discharge. Kind of like student loans, but for emergency >medical expenses. OK. Two cases, then: 1) Guy shows up in an ambulance from a car crash. He is stabilized after a few days, and released in two weeks. He refuses to give any name or ID. What's the solution there? 2) Homeless guy is treated and released. He has never worked and probably never will, at least at any reportable job. What's the solution there? Should we implement a system that rewards people like that for not working? I like the idea overall, but there are probably a few bugs to be worked out. With a program that gave everyone a basic coverage plan without regard to job status or ability to pay, these are not problems. Anyone refusing to identify gets the automatic minimal treatment (and corresponding coverage) and is sent on their way. One of the biggest momentum factors getting in the way of true reform is still this notion that health care financing needs to be tied to employment in general, and worse yet, to a person's specific employer. Very archaic, needs to go. Where you work, or if you work, should have nothing to do with qualifying for coverage. (Income should however determine what a person pays towards the plan they choose)." . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley Quote Share this post Link to post Share on other sites
billvon 3,119 #284 June 19, 2009 >In the second case, you'd probably get medicare to pay, just as they >do now. OK, so in your system we still have medicare; I thought this was a replacement. >In the first case, you're probably looking at the hospital eating the cost for >a loss. Which is what happens with the current system, as well. Right, but I think that's a problem that we have to solve. >Things like the guy refusing to give ID? You're not going to fix those under >any system. Agreed, but in a system that guarantees a low level of basic treatment for everyone, it really doesn't matter if they show ID or not. Quote Share this post Link to post Share on other sites
TomAiello 26 #285 June 19, 2009 QuoteWith a program that gave everyone a basic coverage plan without regard to job status or ability to pay, these are not problems. Anyone refusing to identify gets the automatic minimal treatment (and corresponding coverage) and is sent on their way. Damn, I knew I shouldn't have given my name when I went to the hospital in Italy. I ended up having to pay. I guess if I'd just refused to speak, I'd have gotten free care? QuoteOne of the biggest momentum factors getting in the way of true reform is still this notion that health care financing needs to be tied to employment in general, and worse yet, to a person's specific employer. Very archaic, needs to go. Totally agree. The reason that we're stuck with that mess is because during WWII, there were wage controls due to labor shortage. Enterprising employers were able to sneak in "non-wage" benefits as an (untaxed) extra to avoid the controls. What we ought to do is unbundle healthcare from the wage/benefit package. The simplest way of doing this is to (a) tax healthcare benefits from employers, and (b) allow employees to take additional cash payments in lieu of medical plans. QuoteIncome should however determine what a person pays towards the plan they choose. Why? Does income determine how much you pay in rent, or your mortgage, or the price of your groceries? Food and shelter are more fundamentally important than healthcare, so why not price those according to income?-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
TomAiello 26 #286 June 19, 2009 Quote>In the second case, you'd probably get medicare to pay, just as they do now. OK, so in your system we still have medicare; I thought this was a replacement. If we could make it one, that would be great. I don't know if that's really politically feasible, though. Assuming no medicare? People default on student loans. I don't see why you can't treat this situation similarly. There would be the usual attempts to collect, and eventually a write off of the expenses. Quote>In the first case, you're probably looking at the hospital eating the cost for a loss. Which is what happens with the current system, as well. Right, but I think that's a problem that we have to solve. Sure. But it doesn't have to be solved at the same time. It's probably easier to address that separately, even at a later time, because it's not (in the scope of the finances) that large an issue. QuoteAgreed, but in a system that guarantees a low level of basic treatment for everyone, it really doesn't matter if they show ID or not. So non-residents would also get free healthcare? Is there anywhere in the world that's using such a model now?-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
billvon 3,119 #287 June 19, 2009 >People default on student loans. I don't see why you can't treat this >situation similarly. The collection part of it would be no different. The big differences would be: -people need a lot more medical care than they need education and -you can always turn down people for another student loan. > It's probably easier to address that separately, even at a later time, >because it's not (in the scope of the finances) that large an issue. Well, it's a 20 billion dollar problem. I mean, if we can ignore that for now, we can basically keep what we have - people get free care and the cost is absorbed somehow by someone else. >So non-residents would also get free healthcare? Yes. Everyone gets free emergency care, just like they do now. Quote Share this post Link to post Share on other sites
Bolas 5 #288 June 23, 2009 Quote>Another option would be to let people borrow from a government backed >medical expenses fund, to be repayed in the future, and with bankruptcy >not allowing discharge. Kind of like student loans, but for emergency >medical expenses. OK. Two cases, then: 1) Guy shows up in an ambulance from a car crash. He is stabilized after a few days, and released in two weeks. He refuses to give any name or ID. What's the solution there? 2) Homeless guy is treated and released. He has never worked and probably never will, at least at any reportable job. What's the solution there? Should we implement a system that rewards people like that for not working? I like the idea overall, but there are probably a few bugs to be worked out. 1) Refusal to give proper ID? Turn them over to the police for indentification. They may have outstanding warrants. 2) Homeless person? Rather than "treat them and street them" offer them some assistance once to help them by getting them a job, detoxxed, etc. If they fail, they only get minimal basic care. Evaluate on a set schedule how effective the rehabilitation program is and adjust accordingly or eliminate government funding altogether.Stupidity if left untreated is self-correcting If ya can't be good, look good, if that fails, make 'em laugh. Quote Share this post Link to post Share on other sites
Bolas 5 #289 June 23, 2009 Quote Yes. Everyone gets free "emergency" care, just like they do now. Had to correct that... Stupidity if left untreated is self-correcting If ya can't be good, look good, if that fails, make 'em laugh. Quote Share this post Link to post Share on other sites
billvon 3,119 #290 June 23, 2009 >2) Homeless person? Rather than "treat them and street them" offer >them some assistance once to help them by getting them a job, >detoxxed, etc. OK, fair enough, sounds like that could be a better solution. (I assume you would be OK paying for that.) Quote Share this post Link to post Share on other sites
Bolas 5 #291 June 23, 2009 Quote>2) Homeless person? Rather than "treat them and street them" offer >them some assistance once to help them by getting them a job, >detoxxed, etc. OK, fair enough, sounds like that could be a better solution. (I assume you would be OK paying for that.) Sure. Everyone deserves one chance to become a productive member of society or "get back on their feet." You left off a key part of my post though: QuoteEvaluate on a set schedule how effective the rehabilitation program is and adjust accordingly or eliminate government funding altogether. This prevents wasting taxpayer $$$ needlessly if deemed ineffective. Private charitable organizations or medical bill collection agencies could then step in to help if they wanted to see it continue.Stupidity if left untreated is self-correcting If ya can't be good, look good, if that fails, make 'em laugh. Quote Share this post Link to post Share on other sites
kelpdiver 2 #292 June 23, 2009 Quote 1) Refusal to give proper ID? Turn them over to the police for indentification. They may have outstanding warrants. Papers, Comrade. Just what we need in America. Quote Share this post Link to post Share on other sites
billvon 3,119 #293 June 23, 2009 >This prevents wasting taxpayer $$$ needlessly if deemed ineffective. OK. I'd go along with that. But what do you do the 23rd time the guy comes in to the ER? At some point are you going to deny him care? If so, how do you do that? Quote Share this post Link to post Share on other sites
Rookie120 0 #294 June 23, 2009 QuoteOK. I'd go along with that. But what do you do the 23rd time the guy comes in to the ER? At some point are you going to deny him care? If so, how do you do that? Tell him,,,,,,,,,,,,,,No?If you find yourself in a fair fight, your tactics suck! Quote Share this post Link to post Share on other sites
lawrocket 3 #295 June 23, 2009 QuoteQuoteOK. I'd go along with that. But what do you do the 23rd time the guy comes in to the ER? At some point are you going to deny him care? If so, how do you do that? Tell him,,,,,,,,,,,,,,No? Can't do that under federal law. I explained EMTALA earlier. My idea is to do away with EMTALA and see what that does. I'd predict savings per year in the billions - just in California. My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
billvon 3,119 #296 June 23, 2009 >Tell him,,,,,,,,,,,,,,No? He's unconscious; he fell into a dumpster. He's bleeding out. Do you let him die? Quote Share this post Link to post Share on other sites
lawrocket 3 #297 June 23, 2009 Take him to county. It society has decided that it is society's responsibility then society will foot the bill until he can pay society back. My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
rehmwa 2 #298 June 23, 2009 Quote>Tell him,,,,,,,,,,,,,,No? He's unconscious; he fell into a dumpster. He's bleeding out. Do you let him die? 23 times??? ... Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants Quote Share this post Link to post Share on other sites
billvon 3,119 #299 June 23, 2009 >23 times??? True. After he dies the first few times, maybe you stop messing with him; parts would be falling off and stuff. (But seriously, yes, at any ER there are frequent flyers that come in with pretty serious injuries on a fairly regular basis - and are often due to stupid shit like wandering into traffic, falling into dumpsters, almost drowning from sleeping in a culvert etc. Alcohol is usually involved.) Quote Share this post Link to post Share on other sites
Bolas 5 #300 June 23, 2009 QuoteQuote 1) Refusal to give proper ID? Turn them over to the police for indentification. They may have outstanding warrants. Papers, Comrade. Just what we need in America. How do you propose to fix the issue of non payment simply by refusing to identify yourself? I guess if they just pay in cash (additional fees charged for the additional security needed) they can keep their identity secret.Stupidity if left untreated is self-correcting If ya can't be good, look good, if that fails, make 'em laugh. Quote Share this post Link to post Share on other sites
