Health Care In The USA?

[KariC]

Is medical insurance in one form or another in the States a legal requirement?



Rich::

As an employee ,nope, you may opt out, even if your employer offers it. Many will even negotiate a higher salary if they decline health insurance.

Many qualify for gov't assistance, but many don't (as PPs have mentioned).

Now, in divorces, etc....a judge can require it of parents.

But, as a rule.....it's not a legal requirement. It's a benefit.

 

[mkycrzy1971]

Is medical insurance in one form or another in the States a legal requirement?



Rich::

No, not at all.

 

[clarabelle]

Is medical insurance in one form or another in the States a legal requirement?



Rich::

No.
Many people dont' have it. Thats the problem.

 

[freckles and boo]

I agree...This is America after-all, and we are allowed to form privately owned companies if we choose (as long as it is a legal activity)...last time I checked healthcare was legal...so IMO Michael Moore is sticking his nose into something he knows nothing about...send him back to making his 2nd class movies.

Um, he is making movies. That is is medium. Just because you don't like him doesn't make him uninformed nor does it make your opinion more informed. I believe that there is very high-quality healthcare available in this country partially because of private enterprise, but it isn't available to everyone. There is a huge moral and ethical issue when you are talking about letting people languish or die in the name of profit. Of course, I haven't seen the film yet but my understanding is that this is his point. Not everything should be about money. Police and firefighters don't respond to calls based on whether someone has delinquent property taxes or not. They deal in life and death as well and they do their job without asking someone fill out their registration papers while bleeding or while their houses are burning down. This may seem like an apples to oranges comparison because hospitals are required to stabilize any patient that walks into the emergency room, but what happens after that? Many don't get follow-up care or receive additional testing and services because they can't pay. They sure aren't going to get that high-quality care those of use with decent insurance take for granted.

 

[Mkrop]

Michael Moore is correct. How can a hospital be FOR PROFIT? Better question, WHY should a hospital be FOR PROFIT? It's flat wrong. I have health insurance, and you know it is the BIGGEST PAIN IN MY you know what! The problem is I have a chronic progressive illness, which means I take away from their bottom line.... I am forever AND EVER going through circles trying to get my procedures and visits covered. I don't know how I manage it at times, at times I give up and just pay even though I know it's a covered benefit. I cannot spend all my time and more importantly, energy fighting the insurance companies... and don't even start on our prescription plan, that is even more a mess... we have to mail order all our medications, then they always have questions, or give you one refill, so every 3-4 months you're starting the process for X number of drugs all over again, new prescriptions, new forms, new everything.... our plan only covers one visit to a pharmacy per year....

Health insurance in this country is only for the healthy..... and if all you've ever been is healthy, you have absolutely no idea...

You have a problem with insurance not hospitals!

I worked for both a not for profit healthcare system and a for profit healthcare system. I worked for the for profit for 13 years. These hospitals are all across the country and most are top notch in the areas they serve. Our CEO took great pride in our JCAHO accreditations. We always scored very high in these capacities. And our hospitals treated everyone no matter what their ability to pay.

Not for profits dont just run themselves, they have to rely on revenues, cost cutting and on fundraising to in order to run daily operations just like any other business. I think many are mislead by the nonprofit status. Believe me I reported to the CFO and they totally cared about the bottom line!

The for profit has investors and can grow through that means.

DH currently work for a not for profit hospital system and you know what helps sustain them, the bunch of for profit medical entities that they have.

 

[freckles and boo]

Is medical insurance in one form or another in the States a legal requirement?



Rich::

I have heard of companies that do require their employees to select a plan as a condition of employment, but it isn't required by any governmental body.

ETA - or they must prove they are covered by a spouse's insurance.

 

[mkycrzy1971]

Um, he is making movies. That is is medium. Just because you don't like him doesn't make him uninformed nor does it make your opinion more informed. I believe that there is very high-quality healthcare available in this country partially because of private enterprise, but it isn't available to everyone. There is a huge moral and ethical issue when you are talking about letting people languish or die in the name of profit. Of course, I haven't seen the film yet but my understanding is that this is his point. Not everything should be about money. Police and firefighters don't respond to calls based on whether someone has delinquent property taxes or not. They deal in life and death as well and they do their job without asking someone fill out their registration papers while bleeding or while their houses are burning down. This may seem like an apples to oranges comparison because hospitals are required to stabilize any patient that walks into the emergency room, but what happens after that? Many don't get follow-up care or receive additional testing and services because they can't pay. They sure aren't going to get that high-quality care those of use with decent insurance take for granted.

Yeah, I understand that...he needs to stick to his 2nd class movies (that most really do not care about) and do what he does best....he knows nothing about govt....so he should not try to pretend he does....I certainly do not want someone as uniformed as he is involved in developing ANYTHING for me.

 

[mickeyfan2]

I'm uninsurable as well. The insurance companies get to cherry pick who they will or will not cover. Now when I go to the hospital, not only do I have to pay out of pocket, but I have to subsidize the payments that insurance company doesn't pay.

Example. I had surgery last year that came to around 10K. If it was covered by insurance, the insurance company will pay about 4K for it, with the rest being written off. Since I don't have insurance I'm responsible for the entire 10K.

How do you know they would only pay $4K?

For blood work that my insurance does not cover the hospital I got the blood drawn for gives a 25% discount and then lets you charge the bill.

 

[Mkrop]

Um, he is making movies. That is is medium. Just because you don't like him doesn't make him uninformed nor does it make your opinion more informed. I believe that there is very high-quality healthcare available in this country partially because of private enterprise, but it isn't available to everyone. There is a huge moral and ethical issue when you are talking about letting people languish or die in the name of profit. Of course, I haven't seen the film yet but my understanding is that this is his point. Not everything should be about money. Police and firefighters don't respond to calls based on whether someone has delinquent property taxes or not. They deal in life and death as well and they do their job without asking someone fill out their registration papers while bleeding or while their houses are burning down. This may seem like an apples to oranges comparison because hospitals are required to stabilize any patient that walks into the emergency room, but what happens after that? Many don't get follow-up care or receive additional testing and services because they can't pay. They sure aren't going to get that high-quality care those of use with decent insurance take for granted.

Michael Moore is entitled to make any movie he chooses (I have not seen this current one). The problem is he passes them off as documentaries and some believe what he throws out there. I prefer he stick with fiction

I saw fist hand how the accounting departments work in both areas so I am not an expert but I do feel well informed!

The company I worked for owned hospitals all across the country and we did not turn people away. They serve many indigent populatons in many states and wrote off many accounts to Bad Debt. There was alwasy payment plans and counselors to help people get their Medicaid qualifications.

It drives me crazy when people think that some of the healthcare costs are too high, how do you expect the staff to get paid, how do you expect the equipment to be bought, etc. Companies both for and not do cost analysis all the time and make sure the charges are on board WHY becasue MEDICARE requires it. Medicare audits hospitals to make sure their prices are legit! They cant just make up numbers and charge you a fortune for one test bc they feel like it unless they dont plan on serving Medicare patients. Medicare sets the bar! And they cant charge John X and Mary Y for the same procedure. They charge everyone they same, then based on contracts with the insurance plans (and this inlcudes Medicare and Medicaid) they decide what is paid to the hospital then the hospital can bill the patient for some and the rest has to be written off as an expense for doing business with these plans. Medicare and Mediacaid deductions are one of the highest expense lines on any hospitals P&L!

For profits are also audited by public accounting firms so the books are very well kept.

I think many people are misinformed when they dont think not for profit hospitals dont care about the bottom line and they are just giving the procedures away for free. Not for profits very much want to make a profit so they can reinvest back into the hospital.

I would not care which type of hospital I would care about the quality of care I am receiving not how they define themselves!

 

[freckles and boo]

Michael Moore is entitled to make any movie he chooses (I have not seen this current one). The problem is he passes them off as documentaries and some believe what he throws out there. I prefer he stick with fiction

I saw fist hand how the accounting departments work in both areas so I am not an expert but I do feel well informed!

The company I worked for owned hospitals all across the country and we did not turn people away. They serve many indigent populatons in many states and wrote off many accounts to Bad Debt. There was alwasy payment plans and counselors to help people get their Medicaid qualifications.

It drives me crazy when people think that some of the healthcare costs are too high, how do you expect the staff to get paid, how do you expect the equipment to be bought, etc. Companies both for and not do cost analysis all the time and make sure the charges are on board WHY becasue MEDICARE requires it. Medicare audits hospitals to make sure their prices are legit! They cant just make up numbers and charge you a fortune for one test bc they feel like it unless they dont plan on serving Medicare patients. Medicare sets the bar! And they cant charge John X and Mary Y for the same procedure. They charge everyone they same, then based on contracts with the insurance plans (and this inlcudes Medicare and Medicaid) they decide what is paid to the hospital then the hospital can bill the patient for some and the rest has to be written off as an expense for doing business with these plans. Medicare and Mediacaid deductions are one of the highest expense lines on any hospitals P&L!

For profits are also audited by public accounting firms so the books are very well kept.

I think many people are misinformed when they dont think not for profit hospitals dont care about the bottom line and they are just giving the procedures away for free. Not for profits very much want to make a profit so they can reinvest back into the hospital.

I would not care which type of hospital I would care about the quality of care I am receiving not how they define themselves!

I was referring specifically to health insurance being profit-driven, not hospitals. Of course health-care workers deserve to get paid and there is other tremendous overhead. I realize after re-reading my post that it looks like I have a beef with hospital costs, but that really isn't my issue. (I have, though, seen itemized bills with mark-ups on bandaging that would make me want to bring in my own gauze!)

I do have a question, however, about the accounts that are written off as "bad debt". If a patient flat out claims they can't pay, will they still receive bill after bill after bill that they already warned the hospital they can't pay? And are they reported to credit agencies and hounded mercilessly before this write-off happens? Or is this charity something that happens at the front end?

 

[DISUNC]

The hospital that I had my surgery at is for profit and the care it top notch. The profit goes to the country that the hospital is in. I am 100% for this.

So then you will be ok with Fire Departments, Police, Army, Navy, Marines, CIA, FBI....many othe Govt run services ALL FOR PROFIT???

Medical needs like all these others are NEEDED for a society to excsist. Why should Medical be the only "for profit" out of all these other services?

And why if every other Socialized country does National Healthcare work but wont work here?

 

[DISUNC]

I agree...This is America after-all, and we are allowed to form privately owned companies if we choose (as long as it is a legal activity)...last time I checked healthcare was legal...so IMO Michael Moore is sticking his nose into something he knows nothing about...send him back to making his 2nd class movies.

Like when he made Farheinheit 911 3 years ago and told about the horrors at Walter Reed Hospital. Anyone who saw the movie knew what was going on.
It took our government 3 years to find this out, and do something about it.....and Walter Reed is only 1 mile away from the Capital!

I think Michael Moore KNOWS precisely whats going on.

 

[mickeyfan2]

So then you will be ok with Fire Departments, Police, Army, Navy, Marines, CIA, FBI....many othe Govt run services ALL FOR PROFIT???

The FBI does bill for clearances. Who would the military bill? Around here the Fire company is all volunteers and they do bill for certain situations. We have not police department. If they billed for services and then turned over the profit (like the hospital I referenced above) then yes I would be fine with it.

Medical needs like all these others are NEEDED for a society to excsist. Why should Medical be the only "for profit" out of all these other services?

Obviously what you think is needed and what I think is needed are not the same thing. I won't list what medical stuff I think is not needed, as it may hurt the feelings of others.

And why if every other Socialized country does National Healthcare work but wont work here?

IMO ours work better than theirs. I am not going to throw the baby out with the bath water. We can improve our system, but just eliminating it is not the answer. My Canadian and UK friends all state how they wish they did not have it and would prefer a system like we have.

 

[DISUNC]

I have heard of companies that do require their employees to select a plan as a condition of employment, but it isn't required by any governmental body.

ETA - or they must prove they are covered by a spouse's insurance.

This is so in any company I worked for. You HAD to take the health Insurance, unless you can prove that you are covered by a spouse.

 

[mkycrzy1971]

So then you will be ok with Fire Departments, Police, Army, Navy, Marines, CIA, FBI....many othe Govt run services ALL FOR PROFIT???

Medical needs like all these others are NEEDED for a society to excsist. Why should Medical be the only "for profit" out of all these other services?

And why if every other Socialized country does National Healthcare work but wont work here?

It does not necessarily work in other countries....do you want to be told by the govt that your condition is not serious enough to get treatment right away...sometime not for years??? OR do you think you should be able to see a doctor anytime you wish for any condition you wish (as long as it is a covered expense by your health insurance)???

Also, some of the medical treatment is sub-par in these countries...even according to the physicians that treat patients in these countries.....I, for one, do NOT....I will take my chances and try to find other options or ways to keep medical costs down rather than have the govt control yet another aspect of my life....maybe those of your who do not mind the govt involvement could be the "guinea pig" for Hilary

 

[scooter15]

We have an HMO...and it has worked for us. DH has two medical conditions and I have to say if it weren't for our insurance provider, he'd be dead. He's got heart disease. Maybe we just know how to work the system or we just ended up with incredible doctors...who knows. Our HMO even fought another hospital on some erroneous charge when we had to take our son to the nearest ER. They charged an extra fee since he got sick during a holiday. Our insurance provider fought them and said that it doesn't matter if an emergency is on a holiday or not, its still an emergency. Our jobs provide the same insurance and we decided to be double-covered. The cost yearly is equal if one of us just carried the insurance.

As for not being approved on procedures...that happened to my friend. She picked what was supposedly the best insurance compared to mine. She said that mine wasn't that good and has a lot of problems. Yeah, that's true but I've never known a provider NOT to have any problems. So anyway, she was having difficulty breathing and went to the ER. They suspected her asthma but test showed it wasn't so they thought it was possibly her heart. An EKG would have answered that but they had to seek approval from her medical provider and that was going to take 2 weeks. Her medical provider didn't want to but she kept having breathing issues and they thought she was just having an anxiety attack. She finally got her test and found that she had weak/lazy heart valves. They prescribed her medicine and she's fine now. It took them nearly a month to get her that test. My HMO, everything is approved in an ER situation. Even if you go to another ER facility and not theirs, they won't deny that test or any test for that matter. DH had difficulty breathing as well so his boss drove him to the nearest ER. He had every...I mean every single test known to man including a CTScan, EKG, EEG...you name it he had it. Our HMO paid for everything and we didn't have to pay one dime. It was DH's heart and he's on heart medication now. All this happened within 2 days.

 

[DISUNC]

The FBI does bill for clearances. Who would the military bill? Around here the Fire company is all volunteers and they do bill for certain situations. We have not police department. If they billed for services and then turned over the profit (like the hospital I referenced above) then yes I would be fine with it..

Where do you live???? No Police dept? Billing Fire Departments?

Obviously what you think is needed and what I think is needed are not the same thing. I won't list what medical stuff I think is not needed, as it may hurt the feelings of others...

Are you a Doctor?

IMO ours work better than theirs. I am not going to throw the baby out with the bath water. We can improve our system, but just eliminating it is not the answer. My Canadian and UK friends all state how they wish they did not have it and would prefer a system like we have.

Yup this is your opinion.
My UK & Canadian Family and friends like their system.

 

[mickeyfan2]

Where do you live???? No Police dept? Billing Fire Departments?

US
Why are you surprised that we have no police department?

Are you a Doctor?

Are you? What difference does that make. I can compare costs vs. quality of life and make an educated decision.

Just because you think NHC is best means everybody does.

So which of your people are you. How do you get health care? How much of your paycheck would you pay to get NHC?

For me I pay for mine 100% and am content to keep doing it.

 

[scooter15]

And why if every other Socialized country does National Healthcare work but wont work here?

Uh...because the US is NOT a socialist country. I'd prefer that it remain that way.

 

[binny]

Where do you live???? No Police dept? Billing Fire Departments?






Yup this is your opinion.
My UK & Canadian Family and friends like their system.

A lot of Volunteer fire depts bill for certain things, especially arson.

And my Canadian friends and family DONT like it. same as our system. There are people who like it and those who dont.

Its all a matter of opinion when it boils down to it.