Conventional wisdom is that you can't get medical care in the US unless you can pay for it. When I was a kid, they'd tell us to always carry your travel insurance information on your person at all times, because you can't assume a hospital will treat you until they know you're able to pay the bill.
But what happens if you go to the hospital, prove you can pay for the treatment they expect that you'll need, then it turns out to be more complicated and the complications are beyond your ability to pay? Do they turn out out of the hospital before you're fixed up? If not, what happens?
This train of thought was brought on by information I've seen in various places about the cost of childbirth, although I'm sure it applies to other situations as well. Apparently an uncomplicated vaginal birth costs four digits, a complicated c-section costs five digits, and NICU care (i.e. when the baby's in one of those boxes with tubes sticking out of him) costs six digits. I've seen, in multiple places, numbers in the $500,000 range for preemies who required a NICU stay. I would never be able to pay that - not even with a lifelong payment plan. However, I could easily afford the bill for an uncomplicated vaginal birth. But when you show up at the hospital in labour, not even the doctors can tell how complicated it's going to get. How do they handle this?
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The problem is that we already sort of have subsidized health care, by uninsured people coming into the hospital and getting the treatment that they need, and eventually the taxpayers pay for it. Because there's no systematic approach to this, the taxpayers are paying a lot more than they would if they had the ability to buy group care. I don't have a lot of personal experience in this, since I've always had private insurance when I've needed to go to the hospital. But you don't get turned away if it's an emergency and you have no health care. You might not go to the hospital unless you really really need it though, because it costs so much. You don't get turned out of the hospital, but I know that even with private insurance, you sometimes can't get the best quality care needed, if the insurance doesn't cover a particular procedure, or won;t cover it until you're tried the less-effective method first. In the case of childbith that you talked about, the doctor will do whatever she needs to, and the patient will either be stuck with the bill and/or it will eventually get written off and paid for by the government.
I don't know quite as much about this as I do about Congress, because it's so much more complicated--which is a huge problem right there.
Conventional wisdom is that you can't get medical care in the US unless you can pay for it.
This has never been true all across the boards. It depends on the hospital and their policy.
There are publicly funded (crappy) hospitals that are mandated to never turn anyone away. They aren't quality hospitals and I wouldn't want to be treated there, but they do exist.
ut what happens if you go to the hospital, prove you can pay for the treatment they expect that you'll need, then it turns out to be more complicated and the complications are beyond your ability to pay
The the hospital hounds you for payment (which they frequently do even if your insurance is paying for it) and you wrangle with your insurance company to try to get them to pay.
By the way, I don't buy travel insurance. I find it curious that Canadians are so fearful about this. I know I'm in the tiny minority about this one!
So...
1. If taxpayers eventually pay for the health care of people who can't pay for their own health care, why are people so opposed to public insurance?
2. Is the thing about having insurance information on your person at all times valid, or is that just one of those situations where grownups exaggerate to elicit the desired behaviour in children?
I don't buy travel insurance. I find it curious that Canadians are so fearful about this.
I think it's because paying hospital bills is completely outside the scope of things that we're used to worrying about. We're used to health emergencies being time and logistical problems. I need to take time off work. Someone has to collect the kids from daycare. Someone has to drive me home from the hospital. We've all given some passing thought to what we'd do in a medical emergency, so it's not like we'd be completely thrown for a loop by the need to take a couple of days off work for an emergency appendectomy. It's on the subconscious list of Things That Might Happen. But we aren't used to thinking of medical emergencies as unexpected expenses. Having to suddenly pay an extra several thousand dollars for an emergency appendectomy is not on the list of Things That Might Happen and would completely throw us for a loop, so we're happy to pay someone a reasonable and predictable amount of money to take this bizarre new worry away.
Think about if your computer needs to be replaced. That's primarily a money problem. Everyone whose computer is essential to them has thought about it, and we're all expecting that we juggle some things around, throw some money at the problem, and have a new computer in hand within a day or two. Now imagine if you discovered that in Canada, you can't just throw money at the problem. You also have to wait in one of those sidewalk line-ups where people bring tents and it lasts for days. You can't just walk into a store, you can't just by them online, you have to physically wait in line.
You'd totally pay someone to wait in line for you.
1. If taxpayers eventually pay for the health care of people who can't pay for their own health care, why are people so opposed to public insurance?
Because those costs are hidden. Most people are completely unaware that they pay for this.
2. Is the thing about having insurance information on your person at all times valid,
No. Nonexistent.
I think it's because paying hospital bills is completely outside the scope of things that we're used to worrying about.
I agree.
I say "Chances are nothing will happen, and if it does, that's what credit cards are for." People look at me as if I am a creature from another planet.
Actually, I have had experience with the need to have insurance on you at all times. I broke my ankle quite badly, and had to be taken by helicopter from my rural (and poor) area to the higher-quality hospital a few hours' drive away. I was underage so I wasn't even in the habit of carrying a wallet, much less my insurance info. They asked me if I had insurance and I said I had Blue Cross, but I didn't know the number. Apparently they assume that everyone from my rural area is told to say they have health insurance, even if they don't. So they assumed that I didn't, and let my lay there for without even so much as cleaning out my wound (though they did give me pain meds).It took a few hours for my parents to show up. By then, they actually needed to do two surgeries just to clean the dirty lake water and other debris out of my leg. I have no idea how widespread this is, if my nurses were just being bitchy, but that's what happened to me.
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