30 year old decides not to buy health insurance

[geauxtohell]

Overturn EMTALA and federal mandates and this becomes a different discussion. But, at this point, the hospital has no choice but to treat them.

I've found myself wondering lately if the Republican FY12 budget passed in April does exactly that. EMTALA applies only to "participating hospitals," i.e. hospitals that file provider agreements with HHS agreeing to accept reimbursements from CMS for Medicare patients. That is, hospitals that agree to be part of the provider network for Medicare-the-insurer are also agreeing to the EMTALA requirements that require their emergency departments to stabilize patients without regard for ability to pay. And, indeed, part of the way they recoup loses from that is through DSH adjustments baked into Medicare reimbursements.

But the Republican budget would take the feds out of the insurance business: Medicare-as-insurer would eventually cease to exist and thus it wouldn't have a provider network (and thus no leverage by which to require hospitals to agree to EMTALA).

Granted, it wouldn't happen overnight. Their budget doesn't closing up shop at Medicare for a decade, and even then it still directly pays providers for its grandfathered-in population until they gradually die or opt out (although as the pool of Medicare beneficiaries shrinks, its provider network may well start shrinking).

So it's not really that far-fetched to consider what happens in a post-EMTALA world, given that a major political party is now on record supporting its elimination.

A good point. I never thought about it from that angle.

The party of "life" indeed.

The medical community will revolt. Everyone wants to see changes, but no one wants to be a part of a system where the poor are simply left to suffer and die because the suits in the hospital administration have to turn a profit to keep the hospital running.

As I said, the system is heading towards a meltdown. With the way things are, I am of the mind that there is going to have to be a crisis before anything meaningful gets done.

What is ironic is that many of the people who fought tooth and nail against reforms will be the ones that are screwed when the system collapses.

Also, guess what happens if we get rid of medicare/medicaid? Medical residencies lose all of their funding. That means you are basically stopping medical education in this country.

And people think there is a Doctor shortage now.

 

[percysunshine]

Yes. The Hippocratic Oath means nothing in this debate as it is a non-legally binding entity that basically serves as window dressing for Medical School White Coat Ceremonies:

Here is the original HO



The "enforcement" body behind the oath (the persons who would prosecute the persons in the Hippocratic Guild who violated it) is relegated to Greek polytheism. Specifically, Apollo, Asclepius, Hygieia, and Panacea.

The Oath also prohibits surgery and teaching medicine to those outside the guild (as well as having sex with patient's slaves).

To further bolster the notion, no one is required to take the Oath. It's basically seen as some nice "feel-goody" sentiments that are only proximately relevant to the practice of medicine today.

It has no legal authority. No one in this country has ever been prosecuted for violating the Hippocratic Oath, and thus, it has absolutely no bearing on the debate in this country.

The modern HO has basically been watered down and is different. I guess some people didn't want to swear to Apollo or something.....

Except that there is the argument in the debate that society as a whole should be subject to the oath, not just doctors.

It is the debate.

LMAO! Where did you get that? I haven't seen anyone in healthcare that pays much attention to the HO. It's one of those things that is never mentioned after you go through the ceremony. Now, you'll hear about HIPAA and EMTALA until you are blue in the face, but the HO?

I don't think you are grasping the notion of just how superficial the HO is. As I noted, some medical schools don't even use it and no medical student is required to swear by it (as it could violate their beliefs).

It means zilch. Everyone can get behind the notion of doing your best for your patients, which is in the HO (basically) but as some sort of all encompassing and enforcing bond?

That's simply not the case. Sorry.

It is the case. The entire case.

Why and when should society refuse care?

This isn't rocket science.

Oh, and thanks for posting the exact Oath.

 

[geauxtohell]

Except that there is the argument in the debate that society as a whole should be subject to the oath, not just doctors.

It is the debate.

LMAO! Where did you get that? I haven't seen anyone in healthcare that pays much attention to the HO. It's one of those things that is never mentioned after you go through the ceremony. Now, you'll hear about HIPAA and EMTALA until you are blue in the face, but the HO?

I don't think you are grasping the notion of just how superficial the HO is. As I noted, some medical schools don't even use it and no medical student is required to swear by it (as it could violate their beliefs).

It means zilch. Everyone can get behind the notion of doing your best for your patients, which is in the HO (basically) but as some sort of all encompassing and enforcing bond?

That's simply not the case. Sorry.

It is the case. The entire case.

Why and when should society refuse care?

This isn't rocket science.

Oh, and thanks for posting the exact Oath.

If the entire case hinges on an oath from the 5th century, you are going to lose that case.

This is a policy issue. You can't "guilt" people into doing what you deem to be right.

A pragmatic case needs to be made to the American public about why we need to reform the current system.

Unfortunately, every time people try to discuss it in an intelligent manner, Caribou Barbie and the other paid insurance company shills start screaming about "death panals" and everyone goes all crazy and nothing changes.

 

[Cuyo]

Then the hospital is stuck. What if he lives?

I guess the point is that the hospital will subsidize his bill through the bills of other paying customers.

The difference is, when someone's afraid to go to the doctor for fear of the bill, they tend not to show up until it's a lot more expensive than it had to be.

And you guys talk like "Bill the man" is different than what happens currently. The problem is that there's a reasonable chance that if he couldn't afford health insurance, he's not going to be able to afford the bill, either. You can litigate him into poverty, but you can't litigate the money he doesn't have into existence.

 

[Full-Auto]

I can only go off of what you tell us. As you are being somewhat vague (even refusing to list the vendor), I am only left to infer.

If you want to tell us what your plan consists of, the go for it.

Vendor? I have bluecross through the Master Builders Association.

So, as I understand it, you think Healthcare should be reserved for catastrophic care and not regular office visits?

You need to rephrase.

Health care and health insurance are two different animals....................

 

[percysunshine]

LMAO! Where did you get that? I haven't seen anyone in healthcare that pays much attention to the HO. It's one of those things that is never mentioned after you go through the ceremony. Now, you'll hear about HIPAA and EMTALA until you are blue in the face, but the HO?

I don't think you are grasping the notion of just how superficial the HO is. As I noted, some medical schools don't even use it and no medical student is required to swear by it (as it could violate their beliefs).

It means zilch. Everyone can get behind the notion of doing your best for your patients, which is in the HO (basically) but as some sort of all encompassing and enforcing bond?

That's simply not the case. Sorry.

It is the case. The entire case.

Why and when should society refuse care?

This isn't rocket science.

Oh, and thanks for posting the exact Oath.

If the entire case hinges on an oath from the 5th century, you are going to lose that case.

This is a policy issue. You can't "guilt" people into doing what you deem to be right.

A pragmatic case needs to be made to the American public about why we need to reform the current system.

Unfortunately, every time people try to discuss it in an intelligent manner, Caribou Barbie and the other paid insurance company shills start screaming about "death panals" and everyone goes all crazy and nothing changes.

Then explain the existence of Obamacare?

It is the law of the land.

 

[geauxtohell]

Vendor? I have bluecross through the Master Builders Association.

So, as I understand it, you think Healthcare should be reserved for catastrophic care and not regular office visits?

You need to rephrase.

Health care and health insurance are two different animals....................

You think health insurance should be reserved for catastrophic care and not regular office visits?

 

[geauxtohell]

It is the case. The entire case.

Why and when should society refuse care?

This isn't rocket science.

Oh, and thanks for posting the exact Oath.

If the entire case hinges on an oath from the 5th century, you are going to lose that case.

This is a policy issue. You can't "guilt" people into doing what you deem to be right.

A pragmatic case needs to be made to the American public about why we need to reform the current system.

Unfortunately, every time people try to discuss it in an intelligent manner, Caribou Barbie and the other paid insurance company shills start screaming about "death panals" and everyone goes all crazy and nothing changes.

Then explain the existence of Obamacare?

It is the law of the land.

Not really.....

It is going to have to survive the SCOTUS first.

At this point, no one has been required to pay for their health care.

 

[Full-Auto]

So, as I understand it, you think Healthcare should be reserved for catastrophic care and not regular office visits?

You need to rephrase.

Health care and health insurance are two different animals....................

You think health insurance should be reserved for catastrophic care and not regular office visits?

I think I should get to choose the coverage that is right for me.

That is my point. Not forced to purchase more then I need.

 

[geauxtohell]

Not totally true because against their oath they will be forced to chose the least expensive method of care. From the doctors themselves.

you mean, due to Insurance company arrangements that dictate what they will pay for....?

or you mean death panels

It's not "Death Panels" when private companies do it, silly!

 

[uscitizen]

NINH
NO insurance no hospital.

It was a bad business decision on the hospitals part to take him in?

People who say stuff like that are completely ignorant of how healthcare works. I don't claim to be an expert at all, but I do at least know it's federal law that you have to treat patients.

Overturn EMTALA and federal mandates and this becomes a different discussion. But, at this point, the hospital has no choice but to treat them.

(Not that I have a problem with that, just pointing out how clueless some people are).

I know the law. Just a poor attempt at sarcasm.

 

[geauxtohell]

You need to rephrase.

Health care and health insurance are two different animals....................

You think health insurance should be reserved for catastrophic care and not regular office visits?

I think I should get to choose the coverage that is right for me.

That is my point. Not forced to purchase more then I need.

And that is your current arrangement under Blue Cross?

 

[geauxtohell]

NINH
NO insurance no hospital.

It was a bad business decision on the hospitals part to take him in?

People who say stuff like that are completely ignorant of how healthcare works. I don't claim to be an expert at all, but I do at least know it's federal law that you have to treat patients.

Overturn EMTALA and federal mandates and this becomes a different discussion. But, at this point, the hospital has no choice but to treat them.

(Not that I have a problem with that, just pointing out how clueless some people are).

I know the law. Just a poor attempt at sarcasm.

I know. I was adding on to your comment, not making a rebuttal. I should have been more clear.

 

[Full-Auto]

You think health insurance should be reserved for catastrophic care and not regular office visits?

I think I should get to choose the coverage that is right for me.

That is my point. Not forced to purchase more then I need.

And that is your current arrangement under Blue Cross?

Nope. Plus it is headed to get much worse.


You do realize why they ( the admin) granted waivers..................... TO HIDE THE PREMIUM INCREASES necessary for the new mandates.

 

[geauxtohell]

I think I should get to choose the coverage that is right for me.

That is my point. Not forced to purchase more then I need.

And that is your current arrangement under Blue Cross?

Nope. Plus it is headed to get much worse.


You do realize why they ( the admin) granted waivers..................... TO HIDE THE PREMIUM INCREASES necessary for the new mandates.

Perhaps you should take that up with Blue Cross. Maybe you can change insurance companies.

I know I won't be taking it up with Blue Cross, because as a healthy 30 year old who doesn't drink and has no pre-existing conditions, I was denied coverage because my wife and I are expecting a child.

I guess "Husband to expectant mother" is a pre-existing condition. Luckily, it tends to cure itself in about 9 months and they told me I could try for insurance then, provided the child doesn't have any complications that might require them to actually pay a hospital bill or two.

Yeah, in no way is this system "broken".

 

[Full-Auto]

And that is your current arrangement under Blue Cross?

Nope. Plus it is headed to get much worse.


You do realize why they ( the admin) granted waivers..................... TO HIDE THE PREMIUM INCREASES necessary for the new mandates.

Perhaps you should take that up with Blue Cross. Maybe you can change insurance companies.

I know I won't be taking it up with Blue Cross, because as a healthy 30 year old who doesn't drink and has no pre-existing conditions, I was denied coverage because my wife and I are expecting a child.

I guess "Husband to expectant mother" is a pre-existing condition. Luckily, it tends to cure itself in about 9 months and they told me I could try for insurance then, provided the child doesn't have any complications that might require them to actually pay a hospital bill or two.

Yeah, in no way is this system "broken".

The story about your wife and child is BS too. Not your story, but the insurance company reaction.

Im soon to be 54. My premiums have exceeded need at minimum 10 times over. I dont need to pay for your spouses Birth control. Simple example but you get the point. Yet it is mandated.

 

[The T]

The person should be treated regardless, and billed. I think the Hipppocratic Oath stills has merit, no?

 

[jillian]

The person should be treated regardless, and billed. I think the Hipppocratic Oath stills has merit, no?

hippocratic oath or no, that's what happens now.

 

[geauxtohell]

The story about your wife and child is BS too. Not your story, but the insurance company reaction.

I agree. To make matters worse, my wife has her own health insurance. Blue Cross and USAA both rejected me. Once again, I am a health 30 year old Medical Student who doesn't smoke and has no pre-existing conditions.

There is nothing inherently unique to my situation, expectant fathers that apply during the course of their wives pregnancy are universally rejected by Blue Cross simply because there *might* be a complication in the pregnancy.

These are the companies whose bottom line is routinely protected by congress.

So, we can agree the system isn't universally fair. I mean, how many times does the "irresponsible" 30 year old who didn't have health insurance get blamed?

Here is one situation of a 30 year old that is trying to be responsible and not put a burden on the taxpayers being rejected for a stupid reason. I mean, I get why they rejected me (possible pregnancy complication, could force them to cover the child, blah blah blah), but it's stupid.

In the meantime, you can be 50, smoke like a chimney and have every coronary artery disease risk known to man and they'll ensure you if you can cover the massive premium that mitigates their risk because they know that your lifespan is drastically less then a newborn child who might be born with some sort of pathology that could require a lifetime of intense treatment.

Im soon to be 54. My premiums have exceeded need at minimum 10 times over. I dont need to pay for your spouses Birth control. Simple example but you get the point. Yet it is mandated.

We have insurance. We pay our own bills, thank you very much. At any rate, no matter what your previous plan was under Blue Cross that you are convinced has been changed due to "Obamacare" until you have that catastrophic event, your money is going to pay for other people's routine care.

I find it weird that you guys think waiting for a catastrophic event is more cost effective then regular health maintenance.

You are 54. Have you had a colonoscopy? I would bet "no" as you deem that un-necessary (or non-catastrophic). Colorectal cancer is the number three cancer killer in this nation. It's also insidious. You could have a cancer cooking right now that could simply be taken out in a 1 hour outpatient procedure or you could wait until you have become symptomatic, at which point, it has likely spread to the point where you need the full package with a total colectomy, ostomy bag, and then the take down and subsequent increased care for a lifetime of missing most of your colon and whatever other organs that weren't spared.

I guess, in your point of view for saving money for the rest of the premium payers, if you are lucky you'll simply die. But you might not and now you've become a huge expense to Blue Cross.

Premiums have exceeded needs ten times over? Let's take the cancer with the highest incidence among men: prostate cancer and see what the average 5 year cost is: around $42K for five years. So, we'll round down to $8K. So, if you make it through life with one simple and very common pathology with little risk factor other then being a male, you've paid $80,000 in premiums in 30 years? So, you've paid roughly $2666 a year for catastrophic care alone? I doubt that. The truth is that you can't predict what is going to happen to you and you can only guess at how much care is too much or too little. If you've been lowballing your coverage, that is fine, but in the end, you likely are going to exceed what you've paid in and someone else is going to bitch about treating you too.

We don't life in this discrete world where people are either "sick" or "not sick".

http://www.winningcancer.com/txt/costs-of-cancer-treatments/

 

[Full-Auto]

And that is your current arrangement under Blue Cross?

Nope. Plus it is headed to get much worse.


You do realize why they ( the admin) granted waivers..................... TO HIDE THE PREMIUM INCREASES necessary for the new mandates.

Perhaps you should take that up with Blue Cross. Maybe you can change insurance companies.

I know I won't be taking it up with Blue Cross, because as a healthy 30 year old who doesn't drink and has no pre-existing conditions, I was denied coverage because my wife and I are expecting a child.

I guess "Husband to expectant mother" is a pre-existing condition. Luckily, it tends to cure itself in about 9 months and they told me I could try for insurance then, provided the child doesn't have any complications that might require them to actually pay a hospital bill or two.

Yeah, in no way is this system "broken".

Could you call off your little bitch.

Jullian just neg repped me For agreeing with you that the insurance company actions was bull shit.

I realize jullian is a coward. But if your pissed at me man up...................

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Regards,
jillian