What would you do if the govt made you labor for nothing?

[The Sauce]

Well that could never happen, right? I mean, that would mean that we live in a communist country, wouldn't it? Surprise. Health care is already operating under socialist principles. The government mandates that hospitals evaluate, treat and pay for the care of anyone who comes though the door, regardless of their need for care or their ability to pay. Does the government reimburse hospitals for said treatment? Not one red cent. So...when you boil it down, the government mandates slave labor from healthcare providers. Rates of "bad debt" for hospitals and ERs across the country are skyrocketing. To keep afloat staffing is dropping and wait times rising. People have learned - we can go to the ER, they have to see us, and we don't have to pay. US ERs are now Free Care Clinics for everyone without insurance. And for people who do have coverage? Medicare and Medicaid reimbursement rates are staying the same or dropping - presently about 35-40% of the actual cost of care. How is it that the federal government can force free labor out of one industry but not others? Well, I guess health care is a right after all, and no one needs to pay for it...for now. I need a new job. There is some bad shit coming down for sure.

 

[Ronstang]

The funniest part about our broken health care system is that it is government that brought us to this point.....and now they claim they are our saviours and are the only ones that can fix it.

 

[jhu]

What's your solution then?

 

[her209]

What if your profession required you to perform pro bono work? Is that communism?

 

[ayabe]

The funniest part about our broken health care system is that it is government that brought us to this point.....and now they claim they are our saviours and are the only ones that can fix it.

Nixon created the HMO monopoly, still fucking us from beyond the grave, way to go Dick.

 

[PingSpike]

Man, laboring for nothing would be improvement. Right now I labor for assholes that I hate. If I labored for nothing, when I got done I could say "That sucked, but at least I didn't have to give a bunch of money to some fuckstick banker!"

 

[jonks]

Obama is Stalin, Hitler, and Mao reincarnated into one soul and placed on earth to destroy the United States.


Or is he?

(see, that question means I'm just curious about whether or not the first part is true, I'm not claiming it is true. Why am I the only one asking these questions?)

 

[QuantumPion]

Nixon created the HMO monopoly, still fucking us from beyond the grave, way to go Dick.

Actually it was FDR's wage and price controls during the great depression which started everything. Companies offered benefits (e.g. health care) since they could not offer competitive wages.

 

[rudder]

What if your profession required you to perform pro bono work? Is that communism?

The company probably gets a tax break. communism for you.... capitalism for the company.

 

[rudder]

Regarding the OP... the doctors and staff are not working for free. Some hospitals are taxpayer funded on a local. Other hospitals make up the loss in other ways like billing an insurance company $5 for a 500mg ibuprofen tablet.... which cost the ones with insurance.

Some of the uninsured are getting free health services... but it is only free to them.

 

[The Sauce]

What if your profession required you to perform pro bono work? Is that communism?

Um... well that would be voluntary. I am a voluntary member of my profession and professional organizations. No correlation there at all that I can see. I work in a free clinic, no complaints about that.

 

[Robor]

Obama is Stalin, Hitler, and Mao reincarnated into one soul and placed on earth to destroy the United States.


Or is he?

(see, that question means I'm just curious about whether or not the first part is true, I'm not claiming it is true. Why am I the only one asking these questions?)

Not true. Cartman was asking those questions just last week. :awe:

 

[The Sauce]

Regarding the OP... the doctors and staff are not working for free. Some hospitals are taxpayer funded on a local. Other hospitals make up the loss in other ways like billing an insurance company $5 for a 500mg ibuprofen tablet.... which cost the ones with insurance.

Some of the uninsured are getting free health services... but it is only free to them.

Your view is the common one out there, but it lacks insight into the true workings. Sure there has traditionally been some cost-shifting onto private insurers. That was like putting a finger in the dam. Government forces free services, then says "go find someone who can pay for them and charge them more." Since it seemed to work initially, the government has poked more and more holes in the dam and said "get it from somewhere else." It is at a point where in certain areas of the country (bad payer mix) it is not working anymore.

As far as hospitals being taxpayer funded. Wow...just completely not true, anywhere that I know or have worked. Not-for-profit hospitals don't pay taxes but that's about as far as that goes. There are no municipalities shelling over money to hospitals - rather they are looking for ways to pay them less (i.e. freezing or cutting Medicaid and Medicare reimbursement rates).

No, at the present moment I am not working for free, but my hospital is deep in the red. I am on the finance committee and there does not seem to be a way out. Pretty safe to expect that either services will be cut further or it will close. No hospital for about 45 miles from us.

 

[The Sauce]

What's your solution then?

Well, for one thing, it would be nice if we were not forced to provide free, but expensive care repeatedly to people who do not need it - Examples:

- Welfare mom with 8 kids who brings them to the ER 3 times a week with sniffles to "just get them checked out."

- Alcoholic who comes by ambulance to the hospital 3 times per week with vomiting from gastritis who we will fix up so he can go back home and drink some more.

- Narcotic addict coming by ambulance with a "toothache" 4 times a week to get more "percs." (FYI - not treating "pain" is an EMTALA violation and punishable with personal fines and possible prison time for physicians.)

- Personality disorder patients who claim overdose repeatedly so that they can get 3-hots and a cot for the weekend and a vacation at the local "retreat."


It's nice for the government to say that everyone must get medical care but then place no restrictions on the public to moderate that and expext the health care system to pay for it. Believe me, if the government had to pay for this shit, people would be going to jail for calling ambulances when they didn't have an emergency (think balloon boy parents). People who abuse public emergency services get prosecuted. People who abuse free emergency health care services get a free ride to the ER, dinner, a survey to rate the quality of their care, and a taxi voucher home.

 

[WhipperSnapper]

Well that could never happen, right? I mean, that would mean that we live in a communist country, wouldn't it? Surprise. Surprise. Health care is already operating under socialist principles. The government mandates that hospitals evaluate, treat and pay for the care of anyone who comes though the door, regardless of their need for care or their ability to pay. Does the government reimburse hospitals for said treatment? Not one red cent. So...when you boil it down, the government mandates slave labor from healthcare providers.

Anyone who wishes to leave the health care field is welcome to do so at any time. I haven't heard about any laws that would prevent people from leaving that industry. Under true slavery it would be illegal for them to quit.

The problem you have described is that as a society people do want to have national health care. However, the U.S. is doing a horrific job of implementing it because too many self-interested parties are in the way.

Well, I guess health care is a right after all, and no one needs to pay for it...for now.

It's not an individual right. Rather, the issue is, "Do we as a society want to have national health care and is it in our rational selfish interest?"

Real socialized medicine has proven to be far more rational, beneficial, and efficient than our current amalgam of free market medicine and socialism, and it would be better than any free market system. Our current system is bloated and suffers from the inefficiency of having people push insurance and billing paperwork around without actually being involved with the delivery of health care.

The U.S. is spending about 17% of its GDP on health care that leaves tens of millions of people uninsured or under-insured and with the rest of the populace living in sheer terror of losing their jobs and health insurance while also suffering hundreds of thousands of medical bankruptcies each year (many from people who did have insurance) while also burdening businesses with insurance concerns.

In contrast, other nations are spending a much smaller percentage of their GDP on health care while having 100% coverage, a more content populace, zero medical bankruptcies, and unburdened businesses. In fact, they regard Americans as being completely retarded on this issue.

So what is your solution? True capitalist health care? If your insurance company's Death Panel denies your cancer treatment what will you do, sue them? Will your cancer put itself on hold while your case moves through the courts? Who will pay for the expensive first-rate lawyers you will need to fight your insurer's first-rate defense attorneys?

The sad fact of the matter is that health care is not something that works well under the free market for a number of reasons. First there is a tremendous amount of information asymmetry between what the general public knows about health care and 500 page insurance policies and what insurance companies know about them. Do we really want people to have to hire lawyers to do their insurance shopping for them? If the insurance companies hire the top lawyers to come up with ways to trick the affordable lawyers who serve the general public, will people then have to hire even better, more seasoned, and more expensive lawyers to examine policies for them?

Secondly, health insurance can become prohibitively expensive for the sick people who actually need it and insurance companies will either drop sick people's coverage, deny them coverage via a Death Panel ("So sue us!"), or dramatically increase their premiums to the point where it will defeat the purpose of having insurance.

The other large issue is whether or not we want the poor and the sick who cannot afford insurance to suffer and die. It's amazing how many free market dogmatists naively believe that they will never become incapacitated or unemployable or otherwise unable to afford food, clothing, shelter and medical care. One of the very selfish reasons for supporting real socialized medicine and other government welfare programs is that you yourself or a loved one may need it some day.

 

[WhipperSnapper]

Um... well that would be voluntary. I am a voluntary member of my profession and professional organizations. No correlation there at all that I can see. I work in a free clinic, no complaints about that.

One issue that doctors need to keep in mind is that the government and the AMA have protected them from having an oversupply of doctors. If we had real free market medicine, the number of physicians would increase to the point where doctors merely earned about $120,000/year (if that) and no longer had almost guaranteed job security and little competition. Seriously, a huge number of bright, hard-working, motivated, qualified people are turned away from medical school every year--doctors have it so good that a huge number of people want to train to become doctors.

The same thing happened in the legal profession and now a law degree is almost the economic equivalent of a poly sci degree. It's great if you can find a job at a large or medium-sized firm and retain it long-term. Since lawyers did well decades ago and were almost guaranteed financial success, the general populace came to believe that a JD was a golden ticket to the gravy train, and so people flooded into the law schools but unlike medicine, the ABA did nothing to control the numbers and now most JD degrees have little economic value. (Actually, they have tremendous negative economic value since law school costs time and money and it makes you unemployable for work in other fields since other employers will assume that you are a huge loser if you couldn't find a law job since they mistakenly believe, like the general public, that all lawyers are very rich and successful.) Sadly, this once honorable profession and a ladder of upward mobility for people from modest backgrounds has been completely destroyed. Perhaps that is what real free market health care might be like for doctors?

If you are a physician, be thankful, be very thankful that the supply of doctors is not the same as the number of people who would like to become doctors and who could successfully matriculate from a legitimate medical school and residency program. Be humble and realize that much of your income and job security is based on a non-market, artificial shortage of physicians. If everyone who could get through medical school and who wanted to go could go, I am sure that the MD would be just like the JD and that there would be an oversupply of MDs and that MDs would have to face the reality of unemployment, underemployment, and cutthroat competition.

 

[BlahBlahYouToo]

Well, for one thing, it would be nice if we were not forced to provide free, but expensive care repeatedly to people who do not need it - Examples:

- Welfare mom with 8 kids who brings them to the ER 3 times a week with sniffles to "just get them checked out."

- Alcoholic who comes by ambulance to the hospital 3 times per week with vomiting from gastritis who we will fix up so he can go back home and drink some more.

- Narcotic addict coming by ambulance with a "toothache" 4 times a week to get more "percs." (FYI - not treating "pain" is an EMTALA violation and punishable with personal fines and possible prison time for physicians.)

- Personality disorder patients who claim overdose repeatedly so that they can get 3-hots and a cot for the weekend and a vacation at the local "retreat."


It's nice for the government to say that everyone must get medical care but then place no restrictions on the public to moderate that and expext the health care system to pay for it. Believe me, if the government had to pay for this shit, people would be going to jail for calling ambulances when they didn't have an emergency (think balloon boy parents). People who abuse public emergency services get prosecuted. People who abuse free emergency health care services get a free ride to the ER, dinner, a survey to rate the quality of their care, and a taxi voucher home.

that's some fucked up shit.
who ends up paying for that?

 

[cubeless]

that's some fucked up shit.
who ends up paying for that?

ummm, you? if you have insurance, that is... but most certainly me, because i do pay for insurance...

i can't wait for the new order to fix all this...

 

[her209]

Well, for one thing, it would be nice if we were not forced to provide free, but expensive care repeatedly to people who do not need it - Examples:

- Welfare mom with 8 kids who brings them to the ER 3 times a week with sniffles to "just get them checked out."

If the mom is on welfare with 8 kids, she's most likely would be on Medicaid as well.

 

[shira]

Hospitals do poorly BECAUSE of the high number of uninsureds, whom they must treat. In a country without universal coverage, what's the alternative? Let them die in the streets?

The high number of uninsureds is a CONSEQUENCE of our current, private-insurance-based system, not a consequence of government intervention. If government regulation of the insurance industry didn't exist, even fewer Americans would be insured.

For example, it is government regulation that requires that group policies be offered to any company that wants one If that type of regulation didn't exist, you can be sure that smaller companies would be shut out, as would companies that had staffs of higher age than average. Also, absent regulation, insurance companies would be able to drop - or severely raise the rates for - anyone who received a diagnosis of a potentially costly medical condition, practices that generally are barred under current regulations.

So now government is stepping in and will regulate the insurance industry and force them to insure everyone, regardless of risk, and at a reasonable price. That change alone will greatly reduce (but not eliminate entirely) the problem of health care facilities having to treat the uninsured.

The right acts as though regulation is bad and unfettered free markets are good, regardless of the weight of evidence that for some industries (the financial sector, health care, the oil industry, the nuclear industry) that simply isn't the case and is in fact potentially disastrous.

 

[RoloMather]

If you are a physician, be thankful, be very thankful that the supply of doctors is not the same as the number of people who would like to become doctors and who could successfully matriculate from a legitimate medical school and residency program. Be humble and realize that much of your income and job security is based on a non-market, artificial shortage of physicians. If everyone who could get through medical school and who wanted to go could go, I am sure that the MD would be just like the JD and that there would be an oversupply of MDs and that MDs would have to face the reality of unemployment, underemployment, and cutthroat competition.

I agree. Keep in mind that as pay rates go down for physicians, smarter people will go to a different field, leading to more incompetent doctors.

 

[sandorski]

HealthCare Reform is trying to remedy the situation. Funny that there's also a vocal Movement yelling "Freedom" concerning the issue of 100% Insured though.

One way or another 100% coverage of the Population has to be achieved to address the issue put forth in the OP.

 

[RoloMather]

I would not work for nothing. How to live?

 

[bfdd]

Hospitals do poorly BECAUSE of the high number of uninsureds, whom they must treat. In a country without universal coverage, what's the alternative? Let them die in the streets?

The high number of uninsureds is a CONSEQUENCE of our current, private-insurance-based system, not a consequence of government intervention. If government regulation of the insurance industry didn't exist, even fewer Americans would be insured.

For example, it is government regulation that requires that group policies be offered to any company that wants one If that type of regulation didn't exist, you can be sure that smaller companies would be shut out, as would companies that had staffs of higher age than average. Also, absent regulation, insurance companies would be able to drop - or severely raise the rates for - anyone who received a diagnosis of a potentially costly medical condition, practices that generally are barred under current regulations.

So now government is stepping in and will regulate the insurance industry and force them to insure everyone, regardless of risk, and at a reasonable price. That change alone will greatly reduce (but not eliminate entirely) the problem of health care facilities having to treat the uninsured.

The right acts as though regulation is bad and unfettered free markets are good, regardless of the weight of evidence that for some industries (the financial sector, health care, the oil industry, the nuclear industry) that simply isn't the case and is in fact potentially disastrous.

You know who created the current system? The government. What makes you think they're going to be able to fix it?

 

[RoloMather]

You know who created the current system? The government. What makes you think they're going to be able to fix it?

If other first world governments can do it, why can't ours?

Unless you think our government is somehow worst than other countries' governments.