"Force Americans to get health insurance"?

So, John Doe makes $20,000 a year with no health insurance (he can't afford it... trust me, and he probably doesn't qualify for medicare). He gets into a car accident on his way to work and spends four days in the hospital and ten weeks on bed rest because of broken vertabrae. His medical bills esceed $100,000. He can't possibly pay for this (even on a resonable payment plan). He is forced to declare bankruptcy and John Q Public ends up paying for it.

And you want to keep him in jail until he does pay? Yeah, that should work.

If John Doe is poor he can apply for Medicaid and be covered. If he chooses to go without insurance and runs up a $100,000 medical bill the hospital doesn't automatically run to the government for reimbursement. The hospital will send John a bill and try to collect on it. John then has the option of paying the bill or declaring bankruptcy and having his assets seized to pay the bill. If his assets do not cover the bill the hospital will then place a claim with their insurance company. If after all this the cost of John's care is not covered, the hospital may then have the option of going to the government. But, the taxpayer is not automatically handed a $100,000 bill because John is irresponsible.

I forgot to add, you are not imprisonned in the US for failure to pay your debts.

Blowing Rock Master wrote:

I forgot to add, you are not imprisonned in the US for failure to pay your debts.

...unless those debts are federal taxes.

touché

Blowing Rock Master wrote:

The hospital will send John a bill and try to collect on it. John then has the option of paying the bill or declaring bankruptcy and having his assets seized to pay the bill. If his assets do not cover the bill the hospital will then place a claim with their insurance company. If after all this the cost of John's care is not covered, the hospital may then have the option of going to the government. But, the taxpayer is not automatically handed a $100,000 bill because John is irresponsible.

In most cases the hospital will just write it off if there is not a reasonable chance the person can pay. They will not pursue seizing assets or getting somebody's pay withheld. They would do that for a higher wage earner, perhaps, but in my experience they are quick to write it off. I think that the government does not provide a fee-for-service reimbursement for these sorts of costs, I think hospitals are reimbursed in a sort of block-grant scheme based on total number of uninsured people served, community income, etc. I'm not sure of the details of that, though.

So let's all talk about a solution. The problems are obvious.

I think a system where there is a bare minimum provided to all citizens to cover basic services and preventive care and then everyone has the option to purchase higher levels of care.

This reduces costs by not letting poor people get really sick before they seek help (emergency services, prenatal care, etc.) and it offers superior services and elective coverge for those who have more money.

I understand Germany has a plan like this and it seems to bridge the gap betweeen those favoring a market approach and those who want universal coverage.

I think also that that tying health covrage to employment is HUGE error and must be changed. How dumb is it to have people lose their livlihood and their family's insurance at the same time?

One last thought is that I think the country should pursue policy to actively get people to exercise, eat well, keep weight down, control diabetes, etc. This would require money to do (and perhaps some politicians who don't live for corporate campaign funds!), which would be paid by the taxpayer, but I think the net effect would be a serious cost decrease.

Thoughts?

what often happens is, as you said, the hospital writes off the cost of the uninsured patient. but they are running a business and ultimately must make a profit (or at least break-even). so they have to charge more to the insurance companies when they put in claims for insured patients. ultimately, the insured patient pays for it (or his employer does) through higher premiums. so one way or another, either through tax payer dollars in a "socialized" system, or through higher premiums in the current system, you are paying for the poor to get health care.both systems are terribly inefficient. do you realize that the hospital charges different amounts for a service depending on your insurance coverage? they have pre-negotiated rates for services with the various insurance companies. the bigger the insurance company, the better the rate they get. for example, in Illinois Medicare/caid is charged the cheapest rate (govt is ultimately the biggest insurer), Blue Cross/Blue Shield gets charged a slightly higher rate, Guardian an even higher rate and so forth, FOR THE SAME SERVICE. unbelievable.

Finally some original thinking. One way to do this might be via a tax credit that would allow one to buy a "disaster policy". The difference for policies providing more complete coverage would have to be paid by the individual. This allows for universal basic coverage without creating a government bureaucracy with its attendant inefficiencies and dictatorial control.

BTW, you can already get insurance outside of your employment. I get coverage for myself and my son for about $200 a month from Blue Cross.

Wrong, Germany has universal coverage. The German model is bridge between the market approach and the single-payer system. Here are some reasons why the German model should be adopted by the United States

1) universal coverage: everyone below a certain income must enter the plan while others may choose to opt out.

2) hospital care, physician care, prescription drugs, pre-natal care, long-term care, and preventative care are provided

3) NO FREE RIDE: everyone, regardless of income, has to pay to get services. this adverts the problem found in the social insurance model in Canada: since there are no fees for consumption, medical services are overused.

4) insurers don't compete on the basis of price, but rather, how well they provide coverage

5) you cannot be denied coverage--no individual risk-rating

6) FREEDOM OF CHOICE: you can see any doctor you wish to see, not limited to doctor on HMO or managed care plan.

opt out meaning getting some sort of private insurance, which is required.

I am currenty taking an "Economics of Healthcare" course. The idea of forcing healthcare on an individual is not only considered overbearing by many people, but it is also extremely inefficient. Forcing the population into a single health care pool would result in the mixture of individuals with drastically diverse care levels and moral hazards, with an astronomical cost to taxpayers. There is no such thing as free healthcare. The majority of Canada's GDP is spent on healthcare, with mixed results. The average time between diagnosis and surgery is 18 weeks, which is why there are so many Canadiens enrolled in American coverage plans.

Health insurance is good for people. Widening the pool on insureds spreads the risk and makes it more affordable. It helps save lives. We shouldn't have to pay for the GOPs Crusade against the Moslems. There's no use in wasteing American taxpayers money and lives on the Zionism, the most evil form of hatred since Jim Crow times.

I agree with you that forcing an individual into healthcare is a bad idea but I'm also being pragmatic. Slowly but surely America is moving towards the "nanny" state. However, I think that by achieving universal basic coverage via the tax credit method you avoid many of the pitfalls associated with the single payer or government provided systems advocated by many of the socialists on this board.

I guess I didn't make clear, you take your tax credit money and buy a basic plan from any insurance company you want - not from the government. If you want better insurance you have the choice of paying more to get it.

I'm confuse why so may people think that businesses will run health care better than the government. I realize everyone cites inefficient gov't etc. but that can be fixed politically, if necessary. It strikes me that a business has to make profit and will always seek to increase that profit. This profit must be gained by reducing coverage to sick people, giving less service, etc. If the gov't does it in a non-profit way then all that profit the business would take is now used to provide better service and cover more people, especially ill people who businesses will refuse.

So I'd love someone to clarify why a business is better. If the argument is that the government can't run anything, my response is that we can make them do that by voting for reasonable people (I know, good luck with that!). Furthermore, if the government is so bad at running things why do we let run the military, police, etc.? Should we farm that out to business too?

I'm not trying to be critical really, I just have never understood the argument so I'd love someone who favors that to shed some light for me.

I can give you 3 related reasons for having business run healthcare instead of government.

1. A business has to respond to its customers and shareholders in order to achieve success. Government responds to donors, lobbyists, and bureaucrats. Those receiving government services have to take what the government gives them.

2. If you are buying your own insurance and you don't like the service provided you can change to a new company. If the government is the sole provider of insurance you're stuck.

3. Command economies are slow to react to changes in demand and poor at predicting it. Remember the Soviet Union? When there was one provider of goods and services there were shortages of bread and toilet paper when there would be excesses of rubber boots. Demand economies where there are many providers quickly react to changes in demand. How often do you go shopping and find you can't get what you want?

Government can do some things well when the scope is narrowly defined; police work, killing people and blowing things up, building a road (though in reality they contract that out). Healthcare does not have a narrowly defined scope.