"Preventive Services Coverage" Mandate Effective 9/23/2010.

[somarco]

No one is gaming the system. Just following the rules as set up by carriers.

I do this with some frequency in small group. Can't qualify for individual coverage? Have a business with a payroll? Got you covered.

Every one of my 2 person groups is a money loser. So what? Carriers make the rules, not me. I just play along.

 

[Crabcake Johnny]

As a society we've deemed that life is more important than money; hence the federal law mandating that hospitals must accept all emergency cases regardless of insurance.

It doesn't matter if that hospital has to suck on a $100,000 bill - the life is more important. Although hospitals have kicked, screamed and whined about this, I certainly don't see any hurting in my area and I'm sure if you looked at investor/owner income in those hospitals, they're crying all the way to the bank.

All of those unpaid tabs get recouped as higher costs. Unfair? Certainly. Would we really watch someone die in the ER because they can't pay? Absolutely not.

 

[somarco]

FWIW, several ER's have closed in Atlanta as have maternity wards. All due to losses in these departments.

A town north of here closed their maternity ward a year or so ago. If you are ready to deliver you have to drive 30 miles to the nearest hospital with maternity services.

For profit hospitals can eliminate services if they can't cover the bills. Even not for profit hospitals are cutting back on services that lose money.

Grady is the taxpayer funded hospital in Atlanta. They have been losing millions for years and started trimming services last year. One of the programs that was due to close was the dialysis unit. Used mostly by indigent and Medicare patients, there was a big uproar. Some local companies and wealthy folks made donations that allowed the unit to remain open.

Other free clinics, such as for eye exams have had to close. Patients screamed when Grady announced the cost of an Rx was increasing from $1 to $3 but they did it any way.

EMTALA requires hospitals to stabilize emergency cases regardless of citizenship or ability to pay. It is a good law but one that is abused.

Same for Medicaid.

Over half the live births in GA are paid for by taxpayers and many of those are born to non-citizens.

 

[arnguy]

As a society we've deemed that life is more important than money; hence the federal law mandating that hospitals must accept all emergency cases regardless of insurance.

It doesn't matter if that hospital has to suck on a $100,000 bill - the life is more important. Although hospitals have kicked, screamed and whined about this, I certainly don't see any hurting in my area and I'm sure if you looked at investor/owner income in those hospitals, they're crying all the way to the bank.

All of those unpaid tabs get recouped as higher costs. Unfair? Certainly. Would we really watch someone die in the ER because they can't pay? Absolutely not.

Good post, John. I agree 100%.

 

[Crabcake Johnny]

FWIW, several ER's have closed in Atlanta as have maternity wards. All due to losses in these departments.

A town north of here closed their maternity ward a year or so ago. If you are ready to deliver you have to drive 30 miles to the nearest hospital with maternity services.

For profit hospitals can eliminate services if they can't cover the bills. Even not for profit hospitals are cutting back on services that lose money.

Grady is the taxpayer funded hospital in Atlanta. They have been losing millions for years and started trimming services last year. One of the programs that was due to close was the dialysis unit. Used mostly by indigent and Medicare patients, there was a big uproar. Some local companies and wealthy folks made donations that allowed the unit to remain open.

Other free clinics, such as for eye exams have had to close. Patients screamed when Grady announced the cost of an Rx was increasing from $1 to $3 but they did it any way.

EMTALA requires hospitals to stabilize emergency cases regardless of citizenship or ability to pay. It is a good law but one that is abused.

Same for Medicaid.

Over half the live births in GA are paid for by taxpayers and many of those are born to non-citizens.

While that's unfortunate and extreme, there's another extreme. That other extreme is someone comes into the ER with a life threatening emergency with no insurance and no way to pay so they put them off in a corner to die.

Sorry - they have to be treated and as a society we need to come up with other ways to address the issue. Maybe stopping billions and billions in waste and fraud would help.

We don't have this issue in MD. Maybe GA needs to get new priorities.

 

[Dave020]

This is a big problem in California and the solution would be to do away with free services that encourage people to go uninsured.

When someone shows up at an ER for a major issue and has no insurance nor a method to pay, often that person has been using free county/city services for basic care which encourages them not to have health coverage.

I have lost track over the years of the number of small employers here who could not set up group coverage because they could not meet 75% participation. Employees, especially Mexican/Mexican-American, frequently refuse to participate, even if fully funded by the employer 100%, because they don't want to pay $20 co-pay since they can get the same services for free from the county. Disincentive to be insured. When the big bill/emergency hits, the disincentive has created the financial problem.

I'd say eliminate free access to state/county/city medical services to those without medical coverage to encourage them to buy a plan. If they are eligible for Medicaid, they need to be enrolled, period. But that gets into mandates and everyone freaks out about mandates.

 

[Crabcake Johnny]

This situation is going to be "solved" within 10 years through single payer. With all of its flaws - which are many - we are approaching the time when you're going to get an insurance card mailed by the federal government.

 

[Dave020]

This situation is going to be "solved" within 10 years through single payer. With all of its flaws - which are many - we are approaching the time when you're going to get an insurance card mailed by the federal government.

Agreed. PPACA is a designed fail.

 

[Crabcake Johnny]

And it's going to hurt a hell of a lot of people as it fails.

 

[669comche]

You really think we will end up with a single payor system?

That would be a seismic change for the US.