But at the same time we are all affected by said people not paying their medical bills, if they dont want insurance so be it, but they can then give up all medical treatment then as well.

Er, not really. They could pay for their bills out of their own pocket, for hyperinflated prices. It wouldn't make a difference.

Most people who say they will not get insurance though say they will not because they cannot afford it and they do not get sick ever, so when something DOES happen then how will they pay for it? They wouldnt. Although I suppose the hospitals could say pay it all upfront or no treatment, which would also be a good system to make sure they dont skip out on bills. Some people have car insurance without ever getting in an accident, doesnt mean they dont need it.

Hospitals CAN'T refuse treatment to someone because they are unable to pay. At least the hospitals here in Texas. They are regulated, and they aren't able to refuse anyone on their ability to pay or not.

I know this, THAT is why it is mandated now for people to have insurance. Because you can just run up a nice big bill and never pay!

Really, though, do you really think that people are going to purchase healthcare because it's mandated? No. Even if there is a fine (like car insurance), people will NOT pay for health care, and STILL run up those nice big bills and never pay them.
How is the government going to make SURE every single person in this country is purchasing health care? And, if they do FINE someone for not paying for healthcare, what are they going to do to those who won't pay the fine? Tack on MORE fines? In all reality, if someone DOES NOT want to pay for healthcare, they won't. Hospitals will still have to treat them.

They will take it from their tax return if they get them, its really quite easy, they already do it for child support, some court fines, some student loans as well. The government has no problem taking the money that is owed to them through fines or loans. Hospitals will still have to treat them which is exactly what I was saying, if they dont want health insurance to be mandatory that law should change, and allow hospitals to turn them away if they cannot pay for it, since there are now (or will be) more ways to get health insurance, then there is no need for people to not have it, if they happen to need it.

I agree with you Mindi. I work in the ER & you absolutely can not turn down a person even if they are an illegal alien. They can even refuse to tell you who they are, their address, telephone #, etc & you STILL have to treat them. Believe me it happens ALL the time. We have people come in that can not even speak English. So we have to pay an interpretor to interpret what they are here for, etc. And almost every time they have NO insurance, NO money to pay that day, and NO address or telephone # to be able to bill them later. So right there is THOUSANDS of dollars down the drain that the hospital will NEVER get back.

I think being mandated to have health insurance is a really great idea. Maybe if the hospitals actually got paid for every patient they seen then the prices would go down. The ones with private insurance like me are the ones having to pick up the slack for what the hospitals charge me when I get care. They bill my insurance company crazy high amounts anytime me or my family need care. My daughter was in the hospital for about 4 days 2 weeks ago & they ran lab tests, chest x-ray, & of course I will be billed for room & board. I bet you that bill will be over $10,000 or maybe even close to $20,000. So I will be out of pocket a lot on that because it will meet my deductible for the year. Plus I had to pay $50 for my copay in the ER, & $15 copay for my doctor's visit, & another $15 for my daughter's hospital check up after that.

I agree that medical bills are outrageous. But it's because hospitals are trying to stay afloat from all the unpaid debt & small amounts paid by Medicaid & Medicare by over half of their patients. So the ones with private insurance like me & my family suffer the outrageous insurance copays, deductibles, & insurance payments because private insurance companies actually pay the amount they are billed for.

Which I'll say I'm not sure if this new state assisted insurance will help because the government will decide how much they are going to pay the provider for the treatment which more than likely will be pennies on the dollar.

It is my understanding that hospitals are only obliged to provide emergency treatment. Doctors cannot perform miracles. If someone turns up with asthma or angina, or diabetes, they do not have to provide the treatment for that chronic condition if that patient cannot pay.

By the time the person turns up not breathing (from untreated asthma), or because their heart has stopped (due to a heart attack as a result of untreated heart disease or diabetes) or in a diabetic coma, it is not only very expensive to treat them, but it may well also be too late to save their life.

I get sick of hearing this 'but hospitals have to provide emergency treatment' argument, as if that is good enough. It's far from it.

Actually, I was simply stating that hospitals can't turn anyone away. I wasn't using it as any sort of argument against the healthcare bill. Although, the bill is ridiculous.

I don't know if it's different here but the emergency room I work in we can not turn anyone down for anything. The only thing we can do is refer them to a specialist. Like for example, a patient comes all the time for abdominal pain. Every time he/she is there it turns up he/she has kidney stones. The ER doctor has to always see them every time they come in but every time he does the doctor refers them to a urologist. He usually runs labs & an x-ray. Then gives her something for pain. But he really can't do anything else than that. So he can't treat her long term for her chronic kidney stones but he can refer the patient to a specialist & if the patient doesn't go to the specialist he will still have to treat her the very next day if she shows back up in the ER. It ridiculous really. I've seen people come into the ER to try & get their psychiatric medicines refilled. I've worked in two different ER's & both of them were really abused. And there is nothing anyone could do about it, we still had to treat them.

Now a private doctor's practice has the right to turn someone down because of their inability to pay & also to dismiss a patient from their practice for unpaid debt, missed appointments, or refusal of the treatment the doctor has chose for the patient.

i know at my hometown's local ER they've warned patients about getting refills. they do not tolerate it. i think they should be more strict with frequent flyers..

I agree! There is a limit. We have a woman that is in the ER in the hospital I work at least 3 times a week, each time for migraines. She comes in, presents in the same manner, always gets IV dilaudid, valium, benadryl, and phenergan, discharge instructions to follow up with her specialist, and comes back 2 days later. She has Medicare, so it isn't that the bills aren't getting paid (although the part that is left over for her co-pay isn't), but she's abusing the system. She is coming in to the ER up to 5 times a week (she has FIVE medical record charts, fixing to get her 6th, just out of ER visits..which are generally only 9 pages long each). While I'm sure her pain is real, she doesn't go back to her specialist, she doesn't go to a pain management clinic... she's allowed in our ER for non-emergent situations, filling up the room which someone who IS emergent might need, and that is unfair. LIMITS.

my aunt is like that. except she does it just for drugs. it's terrible. she's been kicked out of so many practices. you would figure they would get the red flag at the ER. people need TOLD. ughhhhh.

I live in the UK (thank goodness). But I do know a little bit about how healthcare works over there, particularly as one of my best friends is married to an American and living over there.

It was my understanding that it depended on the hospital, that only certain hospitals will treat people who can't pay? And as you say, even then, it's only emergency treatment, via ERs. My original point still stands. A chronic asthmatic can not get regular inhalers from the ER, a diabetic can not get regular prescriptions for insulin from the ER.

Emergency treatment alone is not good enough. People will die from treatable diseases regardless.

My cousin is an ER nurse here, and they are not able to turn anyone away. None of the hospitals in Texas can either... it may take forever to be seen, as the more serious cases are treated first, however, there are statements posted everywhere that no patient can be turned away because of an inability to pay for treatment.

You're right - all Emergency Room's are bound by Emergency Medical Treatment and Active Labor Act (EMTALA) laws. You legally cannot be turned away due to lack of insurance/money because of this. They can, however, triage you and if they deem your condition non-emergent, ask you to pay or leave.

That's what I was trying to say!

They usually don't, though... honestly, I've never heard of anyone being turned away. One of my former students was CONSTANTLY sick, we'd send her home, her mom would take her to the ER just to get a doctor's note stating she could come back. It happened once a week. At least.

I wasn't trying to debate your point on that. I was merely saying that some hospitals can not turn down patients no matter the condition they are coming for. Someone could sign as their condition being "asthma" & the ER doctor would still have to "treat" them (in both the ER's I've worked at anyways).

I wish the US was more like the UK in the matters of health. The doctors & nurses over here are worried that if they become state employees they will not be paid a fair wage.

Except that I work for our national health service and get paid far more than American doctors doing the same job. I also work less hours than they do, and I graduated with far less debt as university is cheaper here.

I'm pretty sure our nurses are paid more than American nurses too.

And I know that ERs have to treat the acute problem, but for chronic conditions like asthma, going to the ER and getting a ventolin nebuliser every now and again is not asthma treatment. That person needs regular inhalers, and they won't get those from an ER.

Haha I'm trying to agree with you! ;D I guess the confusion started when I thought you said that a person can not present in an American ER with a chronic condition & get treatment for it. I meant that we have to give them short term treatment, but not long term treatment or prescriptions like they need. But I see what you were saying now.

Also I try to tell everyone the same thing about the salary & they don't believe me. They think because our government is in so much debt with China that they won't be paid fairly & even if they were paid fairly eventually we are going to dig ourselves into so much debt we can never get out of it.

Ah, NOW I understand what you were saying.

And it's true, your country is in more debt than mine, so I don't really know if they could afford a public healthcare system, although I suspect in terms of staff, it would be the most senior specialists that would lose money, rather than nurses, or doctors further down the ladder. But I think doctors being salaried rather than paid per treatment does lead to patients getting more appropriate treatment, if there's no financial incentive for doctors to push them in a certain direction. Planned Parenthood for an example use shocking methods when it comes to advising pregnant girls. And that just doesn't happen here. Here they're presented with ALL the options, and the risks and consequences of each is properly explained. Because here abortions are not a business.

Just one example though.

But anyway, a publich system of healthcare isn't even on the cards right now.

In our ER they can turn you away if you dont have an ID, or if after your evaluation it is found that your condition isnt life threatening, but then they allow you to make 100 dollar deposit and be seen.