Socialized Healthcare and EMS

[So. IL Medic]

Oh believe me, I'm not suggesting a total free market free-for-all, QUOTE]

Why not? That's what built the best medical system in the world...prior to government "involvement."

 

[rmellish]

Government assistance is a slippery slope.

Sometimes I wonder what the risk is having health insurance run by groups with profit motive. I know it seems a bit abstract, but when paying for our health care is "bad" for business, and the alternative, finding ways not to pay for our health care is "good" for business, it seems like a system prone to abuse.

 

[StarOfLife]

My favorite idea is to replace private insurance with the government. This keeps most healthcare providers in the private sector, where the profit motive maintains or improves quality of care.

While the government may not pay hospitals the same fees they charge insurance companies, hopefully the increase in "paying" customers will keep costs lower.

Why should I, when I take care of myself and use the health care system very little, be forced to pay for others that do not take care of themselves and abuse the system?

I favor personal responsibility and high deductible plans with HSAs. They are not that expensive - less than most peoples' cell phone bills. People should be able to volutarily group with others for such plans and not be forced at the end of a proverbial government gun to pay for universal "care".

That is communism. Take away the "free ED" care and allow hospitals to require payment just as private debtors do. No signing off - just an agreement to pay.

 

[LucidResq]

Why? We have no model for "free market" health care. Yet we do for socialized medicine.

History provides examples of free market health care. Snake oil salesmen, woeful life expectancies, and staggering infant mortality rates all instantly come to mind.

Oh and by the way, I believe much more in a free market approach than a socialized one. However, I do think some level of government regulation must exist, and that our current system needs some serious reform; not necessarily to a more socialized system, but to a more efficient system.

I totally agree with you, StarofLife, about charging for emergency care. It's disgusting what people go to the ED for nowadays. Another huge problem is medicaid/medicare. I read an ED doc's blog a while ago talking about this woman on medicaid calling an ambulance at 3 am because she thought she might be pregnant and she didn't feel like going out and buying a home pregnancy test. After all, her medicaid will pay for it. Why bother?

 

[So. IL Medic]

I agree with the quote but most people think of us as "from the government" because 911 is usually the government. Just saying. Considering how most EMS systems are run I think Reagen may be on to something.
QUOTE]

Not around here, we're private because a private company showed that it could provide better ALS coverage for a much lower cost. Our patients also like the employee attitude of a private company serving our customers better than the previous government agency and the local one that's left treated them.

 

[StarOfLife]

Government assistance is a slippery slope.

Sometimes I wonder what the risk is having health insurance run by groups with profit motive. I know it seems a bit abstract, but when paying for our health care is "bad" for business, and the alternative, finding ways not to pay for our health care is "good" for business, it seems like a system prone to abuse.

+1 (and the obligitory additional characters)

 

[rmellish]

Are you kidding? Much higher call volume for less emergent reasons, much lower pay, much less funding, forget new trucks or new equipment - that is the way of socialized medicine for EMS.

What about private companies whose income comes almost solely from medicare? Thats government money.

 

[rmellish]

Why should I, when I take care of myself and use the health care system very little, be forced to pay for others that do not take care of themselves and abuse the system?

You already are paying for others who do not take care of themselves and abuse the system.

 

[StarOfLife]

History provides examples of free market health care. Snake oil salesmen, woeful life expectancies, and staggering infant mortality rates all instantly come to mind.

Who's mind?

Snake oil is your idea of "free market" health care? Go onto any "natural medicine" website and get a great view of such examples. They exist outside of the health care industry and always will. Buyer beware. Do you think your judgment should be provided by the government, too?

And I see no evidence of a free market connection to woeful life expectencies and staggering infant mortality rates. Like I said - there is no historical example of an unregulated free market system of health care. If so, you are talking the pre-modern era, before our current technological capabilities and medicines were available - which by the way were created by private comanies, for profit.

 

[StarOfLife]

You already are paying for others who do not take care of themselves and abuse the system.

Because medicine is already too welfare driven doesn't mean that it is a positive step to drive it further in that direction, though.

But, yes, you are correct - all income taxpayers do.

 

[So. IL Medic]

What about private companies whose income comes almost solely from medicare? Thats government money.

Do you realize how difficult it is to survive on medicare? They refuse to pay full rates, they refuse to pay their bills on time, they refuse to pay even most of the runs they're even billed for. In my family's practice, more medicare unpaid bills were written off (5 million) than came in paid during the same period. The ambulance service I run with would be bankrupt if it depended on medicare to actually pay its bills. This is inherent in any government program - much more is wasted than ever reaches intended recipients.

 

[rmellish]

Not just with income tax, but that is one of the reasons hospital bills are as steep as they are. When you have a an ER hemorrhaging money for all the non-paying customers, you have to try to stay in the black somewhere.

 

[Outbac1]

Star you're right it isn't "free". We pay taxes, a lot of taxes. So maybe it is just no immediate out of pocket payment. We all pay for others health care. If you pay for health ins. and don't use it yourself, you are paying for others. So too am I, just in another way. One of these days we all might need "health care".

As to government funded EMS, see my post under EMS-Related News, Required Reading; The Cost of EMS, 02-11-2008, 10:26 PM.

 

[rmellish]

Do you realize how difficult it is to survive on medicare? They refuse to pay full rates, they refuse to pay their bills on time, they refuse to pay even most of the runs they're even billed for. In my family's practice, more medicare unpaid bills were written off (5 million) than came in paid during the same period. The ambulance service I run with would be bankrupt if it depended on medicare to actually pay its bills. This is inherent in any government program - much more is wasted than ever reaches intended recipients.

I won't argue for a second that a company can survive on medicare payments alone, however, I was simply pointing out that the government already pays (at least in part) for a large number of ambulance transports and runs already.

 

[StarOfLife]

What about private companies whose income comes almost solely from medicare? Thats government money.

Actually, it is supposed to be paid in through payroll taxes. It is part of the FICA deduction. However, our inept government keeps bankrupting these systems. So, I cannot imagine why one would think they are capable of running the healthcare industry when they cannot run the VA and they have destroyed (which I don't really mind except now I am out what I have paid) Social Security and Medicare.

We keep thinking that government is the answer, yet it keeps slapping us with reminder after reminder that it cannot tie its own shoes.

And it is not government money - it is taxpayer money extracted from the government through income.

The private companies would learn to compete for non-government money or fail. That is how most companies work.

 

[StarOfLife]

Not just with income tax, but that is one of the reasons hospital bills are as steep as they are. When you have a an ER hemorrhaging money for all the non-paying customers, you have to try to stay in the black somewhere.

That is correct.

 

[So. IL Medic]

Not just with income tax, but that is one of the reasons hospital bills are as steep as they are. When you have a an ER hemorrhaging money for all the non-paying customers, you have to try to stay in the black somewhere.

Used to be that 2 out of every 3 dollars paid to a med facility went to paying just for government costs such as filing the right medcare forms. Thank the government for higher overhead.

 

[StarOfLife]

Star you're right it isn't "free". We pay taxes, a lot of taxes. So maybe it is just no immediate out of pocket payment. We all pay for others health care. If you pay for health ins. and don't use it yourself, you are paying for others. So too am I, just in another way. One of these days we all might need "health care".

As to government funded EMS, see my post under EMS-Related News, Required Reading; The Cost of EMS, 02-11-2008, 10:26 PM.

Agreed. However, I believe that we should all pay for the level of care WE require personally. It varies between individuals and my lifestyle is less likely (not always but usually) to create high health care bills than that of a less active person.

JMHO.

 

[StarOfLife]

By the way:

This is a great debate thread. I really have enjoyed everyone's responses - even if I don't entirely agree with all of them.

 

[rmellish]

Agreed. I think it warrants discussion because I'm willing to bet that in the next few years there will be some health care reform of some type. How much and to what extent will probably depend on the political climate.