individual mandate and EMTALA
I have a simple question for anyone who believes that it's 'wrong' or 'unconstitutional' to be forced to have insurance. What should happen to someone who opts out of insurance (voluntarily) and then has a catestrophic event such as a car accident? This question simply MUST be answered, yet I never seem to be able to get a straight answer or even an aknowledgement of the problem here. I'll tell you what currently hapens.
Right now, it doesn't matter whether you have insurance in the short run. Paramedics (publically funded) will scoop you off of the street and take you to the nearest emergency room, hopefully a trauma center, without even looking at whether you are insured. Once there, the hospital is obligated to stabilize and treat you due to EMTALA. If you need surgery, you'll get it. If you need several pints of blood, you'll get it. Your subsequent ICU stay could cost $10,000 per day, maybe more. Even once you're out of the ICU you will likely need weeks of rehab and inpatient management. Your total bill before the end cold easily be several miillion dollars. And then you're going to need home services and rehab, not to mention that you may lose your job and income or even your ability to generate income if your injuries are severe enough. Nonetheless, if you have chosen to opt out of insurance, there will be social workers who will try to enroll you for public programs such as Medicaid, though of course that's not always possible.
Let's say that you make a quick recovery and your bill only amounts to a measely million dollars, or even half a million dollars. What is your payment plan, since you've opted out of insurance? As I noted in my last post, EMTALA is a completely unfunded mandate. That means that the government has said 'you can't turn anyone away' but then the government refused to find a way to pay for it. The burden of payment is on the patient and the responsibility to collect it falls on the hospital. I know of very few people who could afford a medical bill like the one I outlined. Ultimately hospitals end up eating many of these bills. Even after going to collections, destroying the patient's credit and sometimes taking their assets, most of that medical bill will simply not be paid. Every year, hospitals give away literally billions of dollars in medical care. It's not free; the price is the patient's financial life and assets. But in the end, the care given is eaten and is money lost. If this scenario happens too often, a hospital will be forced to close (this has happened in the past).
So again, I ask: if you willingly opt out of insurance, what should happen to you (and I realize that not everyone voluntarily opts out)? Since you are clearly a responsible citizen, you wouldn't expect your care to be provided for free would you? Should we leave you to die since you have decided not to take part in the health system? My understanding is that private fire departments took a similar tack before public departments took over. You paid a contracted amount, and in return got a medallion or sticker on your home. If you had a house fire and had the sticker, they put the fire out. If not, well, too bad.
I have a hard time seeing how you can have it both ways. If you want to opt out of the system entirely, that's fine by me. Then don't expect me to resuscitate you when you come to my emergency department. Your choice should be clear. I suspect that you want me to do everything I can however and deal with the billing however. In that case, suck it up and get some insurance.
No one who's whining about the individual mandate has adequately even addressed this question. If any of you can enlighten me, please do!
Right now, it doesn't matter whether you have insurance in the short run. Paramedics (publically funded) will scoop you off of the street and take you to the nearest emergency room, hopefully a trauma center, without even looking at whether you are insured. Once there, the hospital is obligated to stabilize and treat you due to EMTALA. If you need surgery, you'll get it. If you need several pints of blood, you'll get it. Your subsequent ICU stay could cost $10,000 per day, maybe more. Even once you're out of the ICU you will likely need weeks of rehab and inpatient management. Your total bill before the end cold easily be several miillion dollars. And then you're going to need home services and rehab, not to mention that you may lose your job and income or even your ability to generate income if your injuries are severe enough. Nonetheless, if you have chosen to opt out of insurance, there will be social workers who will try to enroll you for public programs such as Medicaid, though of course that's not always possible.
Let's say that you make a quick recovery and your bill only amounts to a measely million dollars, or even half a million dollars. What is your payment plan, since you've opted out of insurance? As I noted in my last post, EMTALA is a completely unfunded mandate. That means that the government has said 'you can't turn anyone away' but then the government refused to find a way to pay for it. The burden of payment is on the patient and the responsibility to collect it falls on the hospital. I know of very few people who could afford a medical bill like the one I outlined. Ultimately hospitals end up eating many of these bills. Even after going to collections, destroying the patient's credit and sometimes taking their assets, most of that medical bill will simply not be paid. Every year, hospitals give away literally billions of dollars in medical care. It's not free; the price is the patient's financial life and assets. But in the end, the care given is eaten and is money lost. If this scenario happens too often, a hospital will be forced to close (this has happened in the past).
So again, I ask: if you willingly opt out of insurance, what should happen to you (and I realize that not everyone voluntarily opts out)? Since you are clearly a responsible citizen, you wouldn't expect your care to be provided for free would you? Should we leave you to die since you have decided not to take part in the health system? My understanding is that private fire departments took a similar tack before public departments took over. You paid a contracted amount, and in return got a medallion or sticker on your home. If you had a house fire and had the sticker, they put the fire out. If not, well, too bad.
I have a hard time seeing how you can have it both ways. If you want to opt out of the system entirely, that's fine by me. Then don't expect me to resuscitate you when you come to my emergency department. Your choice should be clear. I suspect that you want me to do everything I can however and deal with the billing however. In that case, suck it up and get some insurance.
No one who's whining about the individual mandate has adequately even addressed this question. If any of you can enlighten me, please do!