A question for the Azbob and other anti-Obamacre folks

[Duff Miver]

I know a man who operates a medium-sized restaurant with about 25 employees. This is a long-established business, and many of these employees are in their 40s and 50s. He pays them about $10/hour, or a bit more than the fast food joints. He provides no benefits.

He is pissing and moaning about Obamacare.

So, here's the question:

These folks take-home is about $325/week. Some of them have preexisting conditions.

As you can easily figure out, they don't earn enough money to buy any sort of decent health Insurance.

So, let's say one of them ends up in the ER with a serious heat attack, bad car wreck, cancer. The ER will treat them, and the hospital will admit them, perhaps for weeks. The bill could easily be $100K+

Here's the question: Who should pay the bill?

To help you along, here are three hints -

This large non-profit hospital is the only one of it's kind in the immediate area.

The financial report from this hospital shows break-even on Medicare rates.

This hospital finds 35% of their charges are noncollectable.

I know who pays now - the patients whose bills are inflated to cover non-payers.

So, the azbob, who should pay?

And, wouldn't be financially better for all if these folks received routine preventive care so that, for example, they didn't end up on long term kidney dialysis?

What's your solution, the azbob?

NO, "fuck'em" isn't an answer.

 

[azbob]

1. Take responsibility for proviing insurance out of the hands of your employer and put it in the hands and choice of the consumer.

2. Split the risk between:
a) routine and preventative care
b) catastrophic care

Think of your dental coverage...

For routine/preventative...it is a free market...insurance companies develop products tailored to (for instance) college students, single mothers, seniors, etc and people buy what they can afford and what meets their specific needs without limitations of state lines. Higher risk patients will pay more than lower risk patients who don't access services or who want limited services (analogy...cleaning your teeth once per year because you choose to floss everyday or not eating at McDonalds everyday because you don't want to be obese). Professional groups, employers, churches, etc can form pools to contract purchase but, individuals have a choice of joining a pool or buying an individualized policy.

To be specific in answering your question...the consumer pays for this coverage.

For catastrophic care, at the state (not federal) level the same types of organizations noted above have the abiltiy to form pools plus the state can revamp the the $264b they spend on welfare today to form catastrophic care pools including tax dollars at the state level contributed by corporations and individuals (just like today) to reimburse healthcare organizations based on risk-adjusted patient populations, access and qualtiy outcomes. That care extends past hospital discharge moving into rehab activity including linkage to a PCP. Hospital foundations for non-profits also play a huge contributing role.

To be specific in answering your question...individuals and tax dollars pay for this coverage.

Benefits:
1) you don't filter off all of the tax dollars now in the system that are wasted moving from the home state to Washington and then back.
2) you build consumer choice into the equation which you don't have now...no one asks and no consumer knows what any service in the hospital costs...there is no other business with this as a model
3) you divorce the provision of benefits from the employer relationship which now locks you into specific coverage and allows your employer to be aware of your healthcare issues directly or indirectly
4) you force insurance companies to respond to consumer need rather than focused on contracts with employers who are motiviated by their own P/L rather than coverage for employees
5) you allow consumers to self-select into pools of people that are like themselves to shop for the best deals on insurance coverage
6) you provide hospitals with a more reliable and stable revenue source for non-compensated care
7) the IRS is not the healthcare police...a fact, not often mentioned, that will be the #1 problem with ObamaCare

Stipulations:
1) insurance companies get to make money
2) individuals make better decisions for themselves rather than the government telling them what to do
3) healthcare is a business so it should have a business model that allows customers to make good choices based on cost and quality
4) everyone doesn't get everything...in the future, Mickey Mantle doesn't get a new liver although that is unrelated to my response to your question and my solution

Your Question:
1) Your statement that the patient pays the bill is completely in error. The number of self-pay patients is about 3% even though that number is growing. The government pays most of the bill.
2) In your medium-sized restaurant, please alert the authorities if any of those employees are being held there against their will. If not, they choose to work there so good for them.
3) FYI...the bill in your hospitalization scenario will be well over $1m not just over $100k.
4) Hospitals don't "break even" on Medicare

Finally, I agree that it would be great if every citizen had a full range of prevetative care and that would reduce healthcare costs. But, I also think that I don't want to dictate to another person not to smoke, eat a cheeseburger, take drugs, party all night, engage in high risk activity, be a coal miner, live in a city or live their life the way the government wants them to just because it reduces risk. They have the ability to make choices and live with those choices.

Those who make bad choices may end up in the ED, in a job without benefits or in the Superdome...I don't think I should have to pay for their bad choices even though, through my taxes and whatever I choose to donate, I am certainly contribuing to offering them the opportunity to pursue happiness.

Their choices and circumstances dictate the level of routine and preventative care they will get...not a government mandate.

 

[Duff Miver]

1. Take responsibility for proviing insurance out of the hands of your employer and put it in the hands and choice of the consumer.


4) Hospitals don't "break even" on Medicare

Kindly show me, the azbob, where someone taking home $17K per year, particularly past age 50 and with a preexisting condition, can buy health insurance.

You can't, you cunt.

Our local hospital states in their annual financial report that they break even on Medicare pts. If yours doesn't, they need to sharpen up.

Typical azbob response: "Hungry? Pick the peanuts out of my shit."

 

[theGibber1]

Kindly show me, the azbob, where someone taking home $17K per year, particularly past age 50 and with a preexisting condition, can buy health insurance.

You can't, you cunt.

Our local hospital states in their annual financial report that they break even on Medicare pts. If yours doesn't, they need to sharpen up.

Typical azbob response: "Hungry? Pick the peanuts out of my shit."

Not a 100% sure but I believe that this person would qualify for Medicaid depending on what state he is in... But most states use the poverty line as a guideline which I believe is anything under $19k per year.
Medicaid will also cover pre existing conditions.

 

[Duff Miver]

Not a 100% sure but I believe that this person would qualify for Medicaid depending on what state he is in... But most states use the poverty line as a guideline which I believe is anything under $19k per year.
Medicaid will also cover pre existing conditions.

You are correct, but that does nothing for the person making $10 per hour $20,800/yr)and taking home $17K. However this state, among others, is refusing Federal Medicare grants, so that option will go away.

I know what health insurance costs, and I'm still waiting for the azbob to tell me where a $10/hr employee can buy comprehensive for-profit health ins. It will be a long wait.

The azbob's only answer so far is don't work for $10.

He must be a decedent of Marie Antoinette.

"They have no food? Let them eat cake."

 

[azbob]

I was surprised you asked a somewhat intelligent question as evidenced by the fact that I took time to respond.

Your response was profanity and the usual inability to comprehend the written word or form a thoughtful retort.

The election will determine the direction of healthcare. You asked me a question, I answered it.

You can wallow in whatever satisfaction you get from your attitude. I'm confident others on this site understand your dynamics and, if they write a comment or not, I trust they are thinking the same thing I am about you, your intellect, your position in life and your future.

 

[Duff Miver]

I was surprised you asked a somewhat intelligent question as evidenced by the fact that I took time to respond.

Your response was profanity and the usual inability to comprehend the written word or form a thoughtful retort.

The election will determine the direction of healthcare. You asked me a question, I answered it.

You can wallow in whatever satisfaction you get from your attitude. I'm confident others on this site understand your dynamics and, if they write a comment or not, I trust they are thinking the same thing I am about you, your intellect, your position in life and your future.

Typical azbob: dodge the question and act like an offended high school girlie.

Duffy said an unkind word to me, so I'm going to sit in the corner and cry. Booo-hooo-hooo

Here. try again, azbob: Where can a person who earns $10/hr, and takes home $17K/ year buy decent healthcare insurance from a for-profit company.?

Your pink silk panties are showing.

 

[The Sponge]

Just received this in the mail Duff. I want to thank Obama for the affordable care act.

Here is your rebate from Aetna.

Sometimes our medical cost are higher than we projected. Sometimes they are lower. Under the health care reform law plans must spend a minimum on medical cost and quality improvement activities. When our cost are less than the min we pay rebates.
We've also enclosed a notice of Health Insurance premium rebate. The centers for Medicare and Medicaid Services created this required notice. The notice had details about the law and the rebates.

 

[Duff Miver]

Just received this in the mail Duff. I want to thank Obama for the

:0074 :toast:

The azbob will choke on his Martini. :mj07:

 

[StevieD]

Duff, what is wrong with you? Obviously the $10.00 an hour emplyee chose to be that. So if he can't afford Health Insurance let him get a job as a CEO of something then he could afford it.
As for the fact that we, the tax payers, are covering the cost of the guys health care is lost. Geesh! Simple, get a better job!

 

[Duff Miver]

Duff, what is wrong with you? Obviously the $10.00 an hour emplyee chose to be that. So if he can't afford Health Insurance let him get a job as a CEO of something then he could afford it.
As for the fact that we, the tax payers, are covering the cost of the guys health care is lost. Geesh! Simple, get a better job!

The gal who runs the fry grill would probably rather move up to thoracic surgeon, but the kid who mops the floors has his eye on Jamie Dimon's job.

I guess that means the azbob will have to fry his own burgers - a small demotion for him.