Philisophical question

[rufus]

If we're going to have publically funded healthcare, then have PUBLICALLY funded healthcare. Tax everyone for it, and supply the service, whether or not people choose to use it. That's well within constitutional limits. Requiring citizens to buy a product from a private company is not at ALL the same thing. And clearly goes well beyond what even a very broad reading of the constitution could justify. -But hey, what do you expect from Mitt Romney and the Heritage Foundation? -Who championed this long before BHO was ever heard of.

This is exactly why the left loves Romney, it lessens Obummer's accountability. Right on cue dude, way to go.

 

[rolandson]

That's the irony of it all though. We all pay for others who don't have health insurance. Health costs are so high because providers charge insurances through the nose in order to try and make up the money lost on those who can't pay. About 3-4 months ago I saw a story on the Riverbend Hospital in Eugene. They wrote off $90 million worth of care and were on track to exceed $100 million for the next reporting period of time. I don't know how a business can continue to do this year in and year out. And it's only going to get worse considering the economy and that more and more people are living like you are: no healthcare insurance.

Having health insurance may not be a right but it sure in the heck is a necessity if you don't want to go through a bankruptcy (even at that bankruptcy due to medical bills is the most common reason for filling).

BTW, thans to everyone for your thoughts and keeping this apolitical for the most part and not getting the thread shut down. You gave me some things to ponder and I appreciate that.

It's not only ironic, it's expensive. As an employer, the benefit package was a major burden...and the only real benefit I offered was health insurance; as an employee I couldn't have been happier that someone else was paying that burden. My wife's employer offered to pay her not to have coverage.

 

[mcathcart]

We all pay for others who don't have health insurance.

No... no you dont. Stop saying that.

You cant say "they write off 90M" and then turn around and say "they need to recoup the losses" from insurance premium payers.

I suspect you dont know how Health insurance and healthcare providers actually work.

 

[mortre]

Thanks mortre. No offense to others but I feel like your answer gets down to the core part of the issues. With that in mind, and based on the essence of some of the other posts I'd like to ask the questions in a different way.

Why do you feel health care is a privilege and not a right? If you are a person who has insurance are you privileged and deserve more access to the system versus someone who is equally in need but doesn't have the money?

Hopefully I can cut to the crux of the issue again, although this is a far more difficult to put into words for me.

Anyone can receive medical care as emergency rooms cannot legally turn away people for lack of insurance. Emergency room care will keep you alive, albeit it is not the best care, it's basic no-frills. A baseline amount of healthcare so to speak.

Additional and more robust care can be had from private doctors and specialists who are able to keep costs down by only dealing with insured individuals. This means that they are guaranteed at least SOME pay for their services. Now anyone can get healthcare as an individual. The issue is misrepresented as not available, it is. What people are actually complaining about is that employers offer plans to their employee's at a discounted rate. Companies offset healthcare for their employees however they see fit. And how much 2 people pay for the same healthcare IS different, but that is because the company has to decide how much they CAN offset it to maximize employee efficiency. These benefits are also part of a workers compensation for their work, no different than vacation time, salary, or retirement plans. In the end it's not a question of whether healthcare is a right or a privilege because it IS available equally to anyone.

One reason is that companies do this is that workers are more likely to utilize private doctors if the costs are offset by their employer. The employer will then loose less man-hours from the employee due to injury or illness. Also, there is less lost work time from other employee's caused by the spread of illness by contagious employee's showing up to work. That's the same reason these employers will send home a sick worker and provide sick leave.

How much a company compensates an employee for their work is set by multiple individual factors as well. The employee's education level (GED or High School Diploma or Associates Degree or Bachelors Degree, so on and so forth), or said another way would be how much the employee has spent to make himself more marketable. How valuable the employee's skill set is to the company. In other words, how much profit the employer can make because of, or how much of the employer's loss can be reduced by the employee. And also, how many people there are that can perform the function the employer is looking for.

Saying healthcare is not available equally is akin to saying the muscle car pictured earlier in this thread is not available equally, because of how expensive said car is. But the truth of the matter is that it is available equally, because it is available to anyone that is willing to put in the work required to earn the money to buy it.

 

[Blitzkrieg]

Since it is actually statistically VERY likely that you will at least one time in your life cause damage to another while driving, AND that damage is not unlikely to be more than you could reasonably pay back, you can make a case for mandatory insurance because driving on a public road is PRIVILEGE.

No it's not..read my post above yours with the link. My how quickly we give up essential liberty

 

[Gunner3456]

No... no you dont. Stop saying that.

You cant say "they write off 90M" and then turn around and say "they need to recoup the losses" from insurance premium payers.

I suspect you dont know how Health insurance and healthcare providers actually work.

I can say that because it's true. After all of the "free" or "written off" care the hospital gives, it still has to collect enough from those who pay to keep the doors open.

As a matter of fact, I do know how the system works. My wife is an exec at a very large hospital, and has oversight responsibilities for two hospitals and two medical clinics which the company which owns the hospitals also own.

The Federal Government requires any hospital which receives any kind of Federal Funds to treat to the point of stability anyone who enters the door. Medicare payments are Federal funds.

Also, the Federal government gives grants to hospitals and hospitals have people who specialize in applying for those grants. They are as bad at feeding at the trough as anyone. The grant might be for expansion, expensive equipment, even parking structures, or whatever's needed. We all pay for that too.

Since 47% of all adults pay no federal income taxes at all, it is left to the real earners and taxpayers to subsidize that too.

"There ain't no such thing as a free lunch."

 

[Blitzkrieg]

Real unemployment is at least 15% and may be much higher.. some years ago they stopped counting long term unemployed as if they did not exist

If the facts don't fit their agenda they just ignore and try to hide them. The global warming hoax is a perfect example

 

[Gunner3456]

Real unemployment is at least 15% and may be much higher.. some years ago they stopped counting long term unemployed as if they did not exist

If the facts don't fit their agenda they just ignore and try to hide them. The global warming hoax is a perfect example

They also don't count the underemployed - people who had a real good job and are now flipping burgers. They also don't count the self employed who aren't making a living - perhaps some realtors and trades people etc.

 

[mcathcart]

So tell me, how a hospital can write off the actual cost of the charitable care that they provide from their earned income revenue, and then still say they need to recover the loss that they incurred?
Between 2-5% of care is claimed as charitable care.
Additionally, hospitals are property tax exempt.
Cost shifting is an illegitimate argument. Don't buy into it.

 

[Gunner3456]

So tell me, how a hospital can write off the actual cost of the charitable care that they provide from their earned income revenue, and then still say they need to recover the loss that they incurred?
Between 2-5% of care is claimed as charitable care.
Additionally, hospitals are property tax exempt.
Cost shifting is an illegitimate argument. Don't buy into it.

I

Well, at least you aren't an accountant, LOL. Every business, even if non-profit, has to take in more money than it spends or its doors close. Write-offs are irrelevant. They still have to take in enough money to be able to pay for that.

You could give $100 million to charity tomorrow, but you'd be bankrupt. You can only give to charity and write off what you have. The money has to come from somewhere.

 

[mcathcart]

Well, I tried folks, Some here cant read and refuse to look at the facts.

Between 2-5% of care is claimed as charitable care.

http://blog.cleveland.com/medical/2009/04/local_nonprofit_hospitals_say.html

 

[Gunner3456]

Well, I tried folks, Some here cant read and refuse to look at the facts.

Local nonprofit hospitals say they write off about 2 percent of revenues on charity care | cleveland.com

You need to completely read your article, and then completely understand. Charity care, and then losses on unpaid bills are two different things. It's the unpaid bills which are turned over for collection and rarely paid which really add up. Charity care is voluntary. Dead beat bills aren't.

You are listing only charity care, not deadbeat bills from all of those uninsureds who show up.

Look at your linked article:

"In addition to their charity care expenses, the hospitals also say they lost millions more because people did not pay their bills, and Medicaid and Medicare do not fully reimburse."

Now, just get it that you don't know the biz. Get it that you don't know the difference between the small charity giving, and the big unpaid deadbeat bills

 

[mcathcart]

ahem...

The trade group reported unpaid medical bills, in aggregate, totaled 5.8% of hospital expenses. The association's data included costs reported by 4,985 hospitals for the year 2010.

Read more: A closer look at hospital write-offs - Of Interest, the healthcare finance blog by Modern Healthcare's Melanie Evans A closer look at hospital write-offs - Of Interest, the healthcare finance blog by Modern Healthcare's Melanie Evans
?trk=tynt

Modern Healthcare reported charity-care spending in December. Here's a recap:

The bottom 25% of hospitals spent 0.69% or less of budgets on charity care and the median hospital spent 1.52%. The top 25% reported spending 2.73% or more of expenses on charity care.

And here is a similar breakdown for bad-debt numbers:

The bottom 25% of hospitals reported spending 1.43% or less of expenses toward bad debt. The median hospital reported bad debt totaled 2.45% of expenses. And the top 25% of hospitals spent 3.89% or more of expenses on bad debt.



Read more: A closer look at hospital write-offs - Of Interest, the healthcare finance blog by Modern Healthcare's Melanie Evans A closer look at hospital write-offs - Of Interest, the healthcare finance blog by Modern Healthcare's Melanie Evans
?trk=tynt

You should not throw such insults, but try to dialogue respectfully.

 

[fd15k]

That's the irony of it all though. We all pay for others who don't have health insurance. Health costs are so high because providers charge insurances through the nose in order to try and make up the money lost on those who can't pay.

That's an interesting theory. I always believed it is due to for-profit operation of our medical industry. It starts with education, leaving new doctors with as much as half a million dollars of debts. Then it is pharmaceutical corporations, backed by the patent law, charging through the roof for the drugs. Then there are manufacturers of medical equipment. Only then you can add insurance companies into the mix, also fighting for their piece of a pie.

Does one have a right for the healthcare ? I don't think so. But there is compelling government and ultimately societal interest to keep people (taxpayers) healthy. I don't like Obama's healthcare plan, partially for reasons stated above by other posters. But largely because it doesn't go far enough. I want government education, hospitals and medical research, to cut some of those mentioned parties out of the equation. It doesn't have to be perfect - most people don't require heart surgeries. But it has to be out-of-pocket affordable.

 

[Gunner3456]

ahem...

You should not throw such insults, and try to dialogue respectfully.

This is your idea of respectful, LOL?

Well, I tried folks, Some here cant read and refuse to look at the facts.

So, it's well known that nationwide, larger hospitals spend about 6% of their revenue on charity and bad debts.

Here is a summary for the largest hospital in Medford, OR. It's Rogue Valley Medical Center, owned by Asante. It is incorporated as a charitable organization, as are most hospitals. It had gross revenues for one year of $610 million. If it "lost" 6% of that to charitable giving and bad debt losses, that would be about $36 million dollars in one year.

Link

Who made up that difference? Where did that money come from? "There ain't no such thing as a free lunch."

 

[Gunner3456]

I might add how "charitable" works. When a patient can't pay a bill, they can ask the hospital for forgiveness of the bill. Solely at the discretion of the hospital, the debt might be forgiven. If it is, it is written off as "charity." If it isn't, collection is attempted.

Most people don't pay the bills if for no other reason than they are so high, but some people can and do pay the bills even if they don't have insurance.

Another loss as hinted by your article is that medicare and medicaid don't always pay the full bill. They have strict criteria and if the hospital goes beyond that, they don't get paid. One criteria is how long a patient may stay in the hospital for a given procedure. If things aren't "average" and the hospital decides to keep the patient an extra day or two, it's the hospital's nickel.

 

[mcathcart]

Get it that you don't know the difference between the small charity giving, and the big unpaid deadbeat bills

So, it's well known that nationwide, larger hospitals spend about 6% of their revenue on charity and bad debts.

So what would you like us to conclude from your previous 2 statements?

 

[Gunner3456]

So what would you like us to conclude from your previous 2 statements?

Something rational, such as when any business loses money whether to employee theft, shoplifting, spoilage, or bad debts, it has to be made up somewhere.

Now I'm unsubscribing from this thread because I'm not getting anywhere, even though my wife is the one who is authorized to forgive debts and write them off as charity, and deals with this stuff daily, and we're in it up to our eyeballs.

I tried.

 

[mcathcart]

 

[Blitzkrieg]

They also don't count the underemployed - people who had a real good job and are now flipping burgers. They also don't count the self employed who aren't making a living - perhaps some realtors and trades people etc.

I am one of them. I am starting anew now but only because I have serious raw resources (valuable timber) and know how to take it to the retail market as finished products as well as selling some retail to hobbyists, cabinet makers and such

I had to close both my businesses and am having to start that new biz now finally which will be a sure fire thing if the economy does not totally collapse.. and my next door neighbor is certified to be LE as well as having a computer graphics degree.. a sharp guy with good IQ and he is a caregiver for the disabled now, although he and his wife were able to buy a small business with a loan from a friend and that may work out for them