Fines proposed for going without health insurance

Harshaw said:

The cost of uncompensated treatment is about $40 bn a year.

The total medical expenditure is $2.5 tn a year.

Uncompensated treatment makes up about 1.6% of medical expenditure.

There's not much of a "problem" to address.

Question, though -- how many people who could afford insurance, but choose not to buy it, then go on to seek treatment and stiff a hospital on the bill?

In other words, does this "solution" address any problem at all? If so, what are the numbers of these well-off medical bill stiffers?

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Healthcare reform is the liberals' 9/11.

Zyphlin said:

So are you telling me that the majority of the costs from treating uninsured people has to do with life threatening, emergency, bleeding to death in the street type of issues?

Somehow, from over the years of reading on this stuff, those circumstances don't seem to be the majority that is the biggest issue across the country. There is a difference between a hospital choosing to help a dieing man, and being forced to give emergency care to someone that comes in with a dinged up wrist or a lingering cold.

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Consider the opportunity costs of treating the dinged up wrist or lingering cold. Given that there are a fixed amount of both hospital beds and physicians in your average ER, treating the wrist could cost more than meets the eye. Say for instance, someone with a knife wound is forced to wait. The longer this person waits, the more costly it will be to treat them (blood loss, infection).

So while you are correct in your assessment of ER use as a primary physician, there is more to it than explicit costs.

And indeed, if the vast majority of this issue is people who simply can't "Afford" health insurance, then why are you going to punish people who could afford it but choose not to...and if something happens to them may be financially well off to take care of it save for extreme circumstances...while letting those that are causing the problem continue to cause the problem.

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That is just not a rational expectation. Can someone forgo insurance and still be able to pay their immense health care cost if "**** happens"? Maybe, but first and foremost that is borderline retarded, and secondly, that is creating a great deal of waste. Now a rich person is going to have to sell 10's of thousands of dollars of assets, or take 10's of thousands of dollars out of the bank (and more like hundreds of thousands) to pay for something that would have cost $2,000 + $200/month? And we are expected to take that persons opinion seriously? I find it very hard to do so....

Liberals keep harping on a right to privacy, a right to determine things for your own body. My health is my own god damn body and its private to ME and its none of the governments business to tell me what I must or must not do to keep it healthy, nor am I going to get on board with anything that further makes my body, my health, MYSELF "Government Interest". History has shown us, far to many times, what happens when you start making something come under the umbrella of what the government says it has a vested interest in and there's no way I'm going to give my body as one of those things. It amazes me at the hypocracy of liberals who shout down and decry conservatives non-stop over the abortion thing, over a right to privacy, over ones own choice to do what they want with their body and the government shProxProxy-Connection: keep-alive
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ld have zero control over it at all.....and yet want the government interfering with our bodies in every other way.

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Our bodies are already government interest, and have been for quite a long time. This is why there are many product safety labels, smoking bans, restrictions on chemicals/animals/massive weapons. The government says that i cannot take my own life, and courts can force surgery deemed necessary by attending physicians.

While i agree that having the government for an end all solution in health care is nothing short of frightening, the facts that motivate policy implications, specifically a public option, are rather difficult to logically deny. This is not a NHS style proposal, but more along the lines a solution in which to "internalize the externality".

These costs are simply unsustainable. You cannot really blame private companies for not wanting to insure the most risky possible people. At the same token, you cannot blame government for stepping in and providing a back drop for the most risky possible people to insure, the elderly. Nobody says **** about this because we know that we all will get old, and yet, there is not a private solution to this problem that does not create an even greater social and private cost, coupled with greater dead weight loss. So the government provides Medicaid, because the majority of seniors would not be able to obtain private health care given their financial means and potential risk to the insurer.

You can however blame smokers, the self created obese, and those who can purchase health care but choose not to and wind up ****s creek when **** happens.

SouthernDemocrat said:

Not at all. However, liberty is also limited in that one individuals choices cannot limit the liberty of others. Moreover, there is the whole concept of social contract. In order to get to live and work in the United States, this great piece of prime real estate we have here, certain things are required of you. You have to pay taxes, you can't just dump toxic chemicals out in you yard, you have to insure your vehicle if you drive on our roads, and so on.

Its not as black and white as those on either side would like it to be.

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Ah hah!

Which is why someone like myself, who considers themselves a libertarian, can support a public option.

Now, SD said something in another thread and I don't know if maybe I am misunderstanding what it seemed the story was implying or if its just his own thought....

But I would have no issue with the government issuing a fine to you if you go to a hospital, don't have insurance but are above a certain amount of income level, and get treatment while stiffing the bill. Essentially, not a pre-emptive tax or fine that essentially assumes you're going to do the above action but one that hits IF you do it.

Perhaps instead even make it apply to everyone, and make it a % of income possibly modified slightly by amount of service you must recieve. Or perhaps community service of some kind could replace the "fine" for those that do it but are under the certain income level.

I do agree, going to the hospital without insurance and getting free coverage is a drain on everyone else in the system and doing so is wrong. I would not have issue with some light punishment to try and disencourage that. My issue would be for punishing EVERYONE that chooses not to have insurance by assuming that they're going to be a drain when they've done nothing wrong.

I wanted to start a comprehensive thread on the health care debate - one that wasn't filled with hyped up opinions and personal put-downs, but this thread seems as good as any to get things started on the right track. So, here we go...

As I mentioned in the "26 Lies..." thread, there are (at least) 12 forms of health care reform legistlation/proposals currently being pushed by our nation's government:

• H.R. 3200 - the leading health care reform bill proposed by Democrats
• Senate Finance Committee "Policy Options" (the leading health care proposal by Republicans)
• Senate HELP Committee "Affordable Health Choices Act"
• A joint-bill submitted by Senators Coburn, Burr, Ryan and Nunes; "Patients' Choice Act of 2009" (S. 1099 and H. R. 2520)
• Congressional Rep. J. Conyer's "U.S. National Health Care Act" (H.R. 676)
• Congressional Rep. J. Dingell's "National Health Insurance Act" (H.R. 15)
• And the President's "Principles for Health Reform"
• Empowering Patient's First Act (H.R. 3400)
• The American Health Security Act of 2009 (S. 703)
• The American Heath Care Act of 2009 (H.R. 193)
• The healthy Americans Act (S. 391)
• A joint-proposal by former Sens. Baker, Daschle and Dole, "Crossing the Lines: ...Reform U.S. Health Care System"

*Links provided where available

The Kaiser Family Foundation has prepared a chart which provides a side-by-side review of each HCR bill/proposal mentioned above. For what it's worth, I think when people take the time to at least review the chart, what they'll find is that of the two leading HCR proposals - H.R. 3200 and the Policy Option - both share many similarities. For example, both proposals recommend that:

• all Americans are covered by affordable health care
• est. some form of a public option (Health Insurance Exchange or state-sponsored insurance "gateway")
• employers pay an excess tax on insurance premiums
• individuals who do not obtain health insurace are penalized
• employers who do not provide health insurance to their employees are penalized
• Medicaid is expanded to cover more individuals
• small business have a means to providing affordable health care to their employees
• no one should lose their health insurance due to change of employers, divorce or death of primary insurance holder
• no one be denied health insurance due to a pre-exsisting condition
• a review/audit "commission/committee" is established to ensure insurance benefits are similar in both the public and private sectors
• a caps is set for how much individual and families pay toward health care expenses per year or per health care "incident"
• quality care and preventive medicine are promoted over "treatment"
• information technology (IT) is utilized to "share" health information and promote prompt payment systems via electronic funds transfer (EFT)
• states have the choice to establish their on state-sponsored HIE

Both sides - Dems and Reps - want the same thing. They just want to go about reaching the objective(s) differently. For example, everyone's up in arms over a "government (public) option" mainly because they don't think the government can run the business of health care any more affectively than the private sector. Moreover, they're concerned that the government will get into their personal business and start cherry-picking which health care benefits one is entitled to. But what people have come to realize is that the VA, Medicare and even the care our active duty military and their families receive under TriCare are all government sponsored health care systems that work pretty darn good. Not the greatest, but pretty good.

When the cry against socialized health care goes out, I throw up the Medicaid system which is co-finances between the states and the government.

When folks complain about rationed care in general, I'm quick to point out that your health insurance company and hospitals are already doing that. You just don't know it. That's part of being "pre-approved" for certain medical care is about only people don't normally see it as "rationed care".

What I would like from posters on this debate is less reliance on "talking points" and a halt on personal attacks and a real debate on the issue of health care reform. If you're opposed to H.R. 3200 (seeing that it's the leading piece of legistlation out there), why? What specific issue(s) do you have against the bill? Why? And what do you propose to fix it?

(And BTW, now that you (Conservatives) have been made aware that some in your party are asking for pretty much the same things in health care reform as the Democrats, where do you now stand on the issue? Is H.R. 3200 still a piece of crap? And if so, why is it that much worse than what the SFC "Policy Option" is proposing? And mind you, according to The Kaiser Family Foundation, the price tag for the PO is estimated to be about $900 million compared to H.R. 3200 which is estimated at $1.2 trillion - just $100.2 million difference.)

Zyphlin said:

But I would have no issue with the government issuing a fine to you if you go to a hospital, don't have insurance but are above a certain amount of income level, and get treatment while stiffing the bill. Essentially, not a pre-emptive tax or fine that essentially assumes you're going to do the above action but one that hits IF you do it.

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You know what the argument against that likely will be, self-contradictory though it may be?

This will discourage people from seeking medical attention, making the "condition" worse, and will cost "everyone" more in the long run.

Bottom line beliefs for me are these:

1. Americans overwhelmingly want some form of major HC reform to lower their HC expenses.
2. If we get NO HC reform, the winners will be:
..a.Insurance companies
..b. the GOP (who want to "Break" Obama)

3. The losers will be......The American people who will still be at the mercy of the real Death Panels in this country......Insurance company accountants.

formerroadie said:

Welcome to the Baucus, watered down plan. This is what the Republicans wanted, right? A watered down plan that did nothing real? This is what that looks like. No public plan, you get this crap. No single payer, you get this crap. Sorry, but the Moderate Dems and Conservatives have done this. Welcome to your Representatives' crappy ideas.

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I think it's great. I don't want any kind of government involvement in health care to start with. I have to give the moderate Dems and Republicans the highest of fives if they put an end to the whole affair.

If this is true, which I doubt, it is incredibly heavy-handed and stupid. No sane man will buy into this.
The solution is more taxes, particularly on the wealthy, and limited government funded health care.
Insurance ?
Not good, this is part of the problem - excessive profits and waste for the insurance companies.
Ever notice how much they advertise ?

I have the Medicare($1,000 plus per annum) and VA care.
This costs me, but does not break me.
IMO, this is the way it should be, at least for the retired or the working man..

The only way to rid ourselves of these insurance companies is to have election/champaign reform, where politicians can no longer buy and lie themselves into our government.

Devil505 said:

Bottom line beliefs for me are these:

1. Americans overwhelmingly want some form of major HC reform to lower their HC expenses.
2. If we get NO HC reform, the winners will be:
..a.Insurance companies
..b. the GOPThey are corrupted and polluted with the radical right wing and hate mongers (who want to "Break" Obama)

3. The losers will be......The American people who will still be at the mercy of the real Death Panels in this country......Insurance company accountants.

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I concur, 95%.
What we need is the moderates from both parties working together to accomplish an improvement..

Of course, one thing this plan WOULD do is turn a whole lot of twenty-somethings, who as a group often choose to forgo insurance for quite rational reasons, into conservatives.

Harshaw said:

Of course, one thing this plan WOULD do is turn a whole lot of twenty-somethings, who as a group often choose to forgo insurance for quite rational reasons, into conservatives.

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Doubtful. American Conservatism anymore is largely an ideology of reactionaries, fundamentalists, and social conservatives. Its not as though they will all of a sudden turn into social conservative authoritarians. If anything, many twenty-somethings are more left leaning libertarians than anything else.

Kandahar said:

That's just stupid. You could say the same thing about private insurance. The other members of your private insurance plan are taxpayers too. That doesn't mean "the taxpayers" are paying for it.

[......]

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The fundamental difference is that one CHOOSES to participate with an insurance company, and may opt out for another at any time. You don't have a choice when it comes to whether or not you pay taxes.

SouthernDemocrat said:

Doubtful. American Conservatism anymore is largely an ideology of reactionaries, fundamentalists, and social conservatives.

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Even if that's true about the Republican Party, I didn't say "Republicans." I said "conservatives," which is what I meant -- your own baggage notwithstanding.

Its not as though they will all of a sudden turn into social conservative authoritarians.

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Aside from the smug crap here, did I say that they would? Indeed, I did not. I do not use your self-serving definitions of these things.

If anything, many twenty-somethings are more left leaning libertarians than anything else.

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Did you see the part about "turn into"?

other said:

The fundamental difference is that one CHOOSES to participate with an insurance company, and may opt out for another at any time. You don't have a choice when it comes to whether or not you pay taxes.

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Never mind that forcing someone to carry insurance is basically propping up the insurance industry . . . which I thought was, as a whole, bad?

Harshaw said:

Even if that's true about the Republican Party, I didn't say "Republicans." I said "conservatives," which is what I meant -- your own baggage notwithstanding.


Aside from the smug crap here, did I say that they would? Indeed, I did not. I do not use your self-serving definitions of these things.


Did you see the part about "turn into"?

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This probably should be discussed in its own thread. But for all practical purposes, an ideology is defined by what the majority of its adherents think it is. For the majority of Americans that claim to be conservative, conservatism is reactionary and social conservatism / authoritarianism. Thus, for all practical purposes, that is what it is.

SouthernDemocrat said:

This probably should be discussed in its own thread. But for all practical purposes, an ideology is defined by what the majority of its adherents think it is. For the majority of Americans that claim to be conservative, conservatism is reactionary and social conservatism / authoritarianism. Thus, for all practical purposes, that is what it is.

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I don't think there's a smiley which has its eyes rolling so hard they pop out. If there were, I'd use it.

Zyphlin said:

Here's a WILD idea...

How about instead of fining people for choosing, you know that whole freedom thing, not to purchase insurance and choosing to take that chance simply because it may cost hospitals money you remove the requirements that hospitals MUST care for people regardless of whether or not they can pay?

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This idea has already been debunked numerous times in other threads. It is impractical and simply does not work. I'm not going to get into all the details again, so I'll just sum it up in a simple question: When someone is brought into the emergency room, bleeding and unconscious, do you want the doctors to treat them immediately or rummage through their pockets for an insurance card first?

jamesrage said:

Not the same thing. With private insurance everyone who has private insurance is agreeing to this and are free to leave it any time they wish. Forcing tax payers to pick up the tab and people voluntarily getting insurance are two separate things.

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No one would be forced to be part of the government plan, and they would also be free to leave it any time they wish. The mandate would just be that you have to have SOME kind of health insurance.

Kandahar said:

This idea has already been debunked numerous times in other threads. It is impractical and simply does not work. I'm not going to get into all the details again, so I'll just sum it up in a simple question: When someone is brought into the emergency room, bleeding and unconscious, do you want the doctors to treat them immediately or rummage through their pockets for an insurance card first?

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Umm, perform life saving measures, stabilize the patient and then rummage for the insurance card which should be somewhere close to the ID that they are going to look for anyway.

Then present them with a bill with payment options and allow them to pay it just like any other bill. If they don't, well then some authority can get involved to enforce payment.

This isn't rocket science.

Harshaw said:

Of course, one thing this plan WOULD do is turn a whole lot of twenty-somethings, who as a group often choose to forgo insurance for quite rational reasons, into conservatives.

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This twenty-something strongly supports a health care mandate, as does most everyone else I know. In fact, young people are the demographic most supportive of health care reform.

other said:

The fundamental difference is that one CHOOSES to participate with an insurance company, and may opt out for another at any time. You don't have a choice when it comes to whether or not you pay taxes.

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A public option would be funded through PREMIUMS, not TAXES, just like a private plan. You could choose to opt out of the public plan if you found another plan you liked better.

Kandahar said:

A public option would be funded through PREMIUMS, not TAXES, just like a private plan. You could choose to opt out of the public plan if you found another plan you liked better.

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You say to-may-to, I say to-maw-to; It's still a tomato.

How do you differentiate between taxes and premiums paid to the government? ...they sound awfully similar.

jallman said:

Umm, perform life saving measures, stabilize the patient and then rummage for the insurance card which should be somewhere close to the ID that they are going to look for anyway.

Then present them with a bill with payment options and allow them to pay it just like any other bill. If they don't, well then some authority can get involved to enforce payment.

This isn't rocket science.

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By the time the hospital has "stabilized the patient," they've likely already incurred several thousand dollars in medical expenses. If it turns out the patient doesn't have insurance, then the hospital is SOL.

Saying "just don't treat people without insurance" is impractical. Hospitals are ALREADY under no obligation to treat anyone without insurance, EXCEPT in the emergency room.

theangryamerican said:

How do you differentiate between taxes and premiums paid to the government? ...they sound awfully similar.

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One is a user fee for a service that you personally are using (e.g. health insurance, postage stamps, public bus fares, etc.) The other is a source of revenue collected from the population as a whole for things that ostensibly benefit the population as a whole (e.g. law enforcement, environmental cleanup, highways, etc.)