Much writing about the Ron Paul-Wolf Blitzer exchange at the last Republican debate relative to health care insurance. Blitzer asked Paul, who is a straight shooter, about a hypothetical where a younger man chooses not to buy health insurance, but has a medical emergency occur that he cannot afford. The question is what happens to such a person under a Republican health care system. Ron Paul’s answer, while evasive, gave a broad hint that we just cannot take care of everyone, and that freedom has consequences. When Blitzer asked if that means the person should be allowed to die due to lack of financial resources Paul refused to directly answer, saying that charity would take care of such an individual. So what is the right answer to the question?
Let him die?
Impose an individual mandate so there are no free riders?
Treat him at taxpayer expense?
Is there a fourth option I have not thought of?
What lesson should be taken from the scattered cheers for the let him die option?
Your thoughts?
Bill Manzi.com 
Your Honor,
Answers to “cheap shot gotcha” politics.
Whether or not he dies is dependent on the state of his illness or injury and the medical care he does or does not get. (I assume you will agree)
1. No insurance = no payment for care. If you think about it, Your Honor, if the injured or sick automatically receive care at taxpayer expense, why would anyone buy insurance? Just do away with Romneycare and Obamacare. Everyone just shows up to the nearest ER when ill or injured. Isn’t that simple? Actually we now have an official illegal alien uninsured program. They just show up to the ER and your constituents pick up a very heavy tab. (Looks like we are getting an equivalent education program, also picked up by you your constituents.)
There is a fourth option. All citizens of the commonwealth would be liable for their medical expenses through insurance. They can opt out (an Obama favorite), but they are still liable for all expenses. If underage the liability fall to the guardians, otherwise they pay for expenses of saving their lives with their own cash or assets. Everyone would have to sign a document acknowledging the rules.
Your friends won’t except this because it would be a proper process of a free society of taking reprehensibility for their actions.
Of course accommodation would have to made for indignant people.
The scattered cheers you heard were from Democratic operatives planted in the audience by the MoveOn.Org and DailKos left wing society.
These are my thoughts.
Jules
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Jules,
Not sure I follow you here. Are you saying everybody who is not insured gets free medical care at the Emergency Room? Is your “fourth option” an individual mandate? Please clarify! Which one of my listed options would you choose? And by the way those scattered cheers, with all due respect, were not from Democrats. Those were folks who believe that society should not have to provide health care to those who cannot afford such care.
Bill
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Your Honor,
The Phrase was; the individual in question CHOSE not to buy insurance they (could afford).
The 4th option (not and individual mandate) requires every adult to acknowledge that if they voluntarily do NOT purchase insurance they are still financially responsible for medical care that may arise from unforeseen conditions. If a the individual is a dependent, the guardians must pay from their own resources, and if an adult they must use their own resources to pay. RESULT = THE PERSON WHO CHOOSES NOT BUY INSURANCE IS RESPONSIBLE TO PAY FOR HEALTHCARE ARISING FROM THE LACK OF INSURANCE.
My other point was that if the state MUST pick up the tab because an individual chooses not to buy insurance, then what is the incentive for ANYONE in the state to buy insurance. Just show up at the ER for treatment. Obamacare and Romneycare are not needed, we have Manzicare; free for all anytime.
What is your point about the scattered cheers? Are you trying to lay blame on the entire tea party movement? There are morons everywhere. Do you want to discuss the Democratic Black Caucus?
Your last sentence is inaccurate. The affordability of the healthcare was not an issue.
As I said in the earlier post, healthcare will have to be provided to those who TRULY can’t afford health insurance.
I hope this clears up some points. Let me know.
Jules
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Jules,
A bit clearer, but your “solutions” are truly unworkable. So lets look at the following example.
Citizen A can afford to make insurance payments but chooses not to do so. Citizen A falls ill, and racks up medical bills at Local Hospital B. Said bills amount to $500,000. While we said Citizen A could have managed (barely) to afford health insurance premiums Citizen A could never hope to pay a bill of $500,000. Under your scenario citizen A will be assessed the $500,000 and made to pay, but he cannot come close, so a court orders Citizen A to make payments of $100 per month for 5000 months, or 416 years, whichever comes first. Meanwhile Hospital B must have the full payment, or it cannot pay its creditors, and will go bankrupt. Who is responsible for the upfront payment of $500,000 while the hospital waits for its legal judgement. And if the Hospital knows Citizen A could not afford the $500,000 in bills do they treat Citizen A, or do they not treat? Please be specific in your response. As far as healthcare being provided for those who TRULY cannot afford it does the above qualify as such a case?
Bill
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This argument illustrates well the problem that faces us. When people don’t have insurance and wait for conditions to get so bad that they must have treatment and go to the most expensive medical treatment option emergency room, what happens? They say they don’t have insurance, sign whatever they have to sign to say they will accept personal responsibility for their bills, and then cannot pay them in the end and the hospital ends up eating it, or being reimbursed by the state because the person qualifies for “free care.” This is the CURRENT STATE OF OUR SYSTEM. So for those who think they should not have to pay for the uninsured to get medical care, or the here’s the dirty little secret: they already do, whether it be through state subsidation or increased fees to the rest of us because the hospitals and doctors have to make it up somehow..
This is why this issue must be addressed, and that the argument against the health care bill that was already passed is based on smoke and mirrors, because those who speak out against it use the argument that the public shouldn’t have to pay, but they already do!! And to those who argue that this was not the right plan to enact, what the hell did YOU do about the problem during the years and years of total Republican control of the Presidency, the Senate and the House of Representatives to fix it? Clinton tried to pass something, and it was dead on arrival.. How many times did George W Bush talk about or propose a health care plan? Don’t all rush to answer NONE!! The Obama plan might not be perfect, but it’s a starting point. Many social plans were not perfect upon passage, but responsible legislators, not ones who are only interested in the “other guy” getting no credit at all, fixed it as they went along.
This issue is a microcosm of what is wrong with our country today. From the time Obama was elected president, the Republicans put on the top of their agenda the goal of making him a one term president. And when the next Republican gets elected, the Democrats will do the same thing. I, for one, am disgusted by the the negativity and self interest of all of them.
And those clowns who cheer at the concept of allowing someone without insurance to die from their illnesses? That, in my opinion, is the consequence of “hate talk” mongers, on the radio, in print, on TV, from both sides of the fence, who have made disagreements over issues reasons to belittle and despise those who don’t see things your way.
The third part of the problem is the “anonymous” post..you know, it’s easy to say anything you want, whether true or not, filled with hatred and vitriol, when you don’t have to sign your name to it. It’s a LOT different when you do have to sign your name to it. The media has played right into the hatred by allowing people to post anonymously. If we made people put their names to their words, they would be more responsible with them. That’s not a freedom of speech issue, it’s just a responsibility issue.
I’ll get off my soapbox now, but I, for one, am totally disgusted by what we have become as a society. The inaction will destroy us, and I want something better for my child’s future.
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Your Honor,
Since you created the scenario let’s see what happens in a perfect Democratic world.
Citizen A turns out to be illegal alien (Democratic favorite) and (1) did not buy insurance and shows up to the ER expecting medical attention, which, according to your scenario, will cost $500,000. Hospital B is still in financial trouble.
What happens here? Finish the scenario.
Keep in mind this person will never go to court because he is protected by all law enforcement entities that can be brought to bare.
Let’s take it by steps.
Tina,
If you want something better for your child’s future turning to the federal and state Government is the wrong place to go.
Just keep in mind; 600 elected legislators, a President, and an army of anonymous, faceless bureaucrats who will decide on your child’s education, health and welfare. How is that better?
Jules
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Tina,
Well said. It is a disgusting spectacle, and platitudes cannot solve any problems, but especially our health care problems. I am still waiting on the response to my sample above, which happens much more frequently than we would like to think.
Bill
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Jules,
Your answer gives dodging the question new meaning. I did not ask about “illegal immigrants” getting health care. So let’s talk about that later. The original scenario please. Citizen A is an American citizen. Who pays the $500,000?And knowing that he cannot pay should the hospital treat him? Specific answers please.
Bill
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Jules,
I am not turning to any government to make my child’s future better, not by a long shot. What I am doing is expressing my frustration at the fact that NONE of these politicians are doing their jobs because of partisan politics. I simply used the health care issue as an example of that. Whether we like it or not, government must and does play a role in our lives, and there have been a multitude of social programs passed in our history that speak to that: social security, anti-discrimination laws, to name a couple.
I think I am right in believing that you are from the Republican side of things, and I will freely admit that I tend to come from the Democrat side of things, though not always. I respect your arguments, as I would hope that you do mine. I do not think you are evil because we disagree. I will also freely admit that I am equally upset with the Democrats for their refusal to work with Republicans as I am with the Republicans for refusing to work with the Democrats. This refusal to compromise has put our government at a stalemate. Nothing is being done about important issues that face our country: the economy, immigration, crime, all need to be addressed, and they are not, nor were they under President Bush, because of the partisan sniping.
But the answer, I believe, is not to snipe back at each other, but to try to tell our elected leaders that it is time to stop worrying about which party gets the credit for fixing things and get to work finding common ground. Because it doesn’t have to be a situation of mutually assured destruction, it can work if both parties can point to their roles in moving the country forward and then just let the people choose whose approach they like better. Right now, the pendulum just keeps swinging, and the only choice is between who is in power, and who is not, without anyone really being able to point to accomplishments, because nothing is getting done.
Call me naive, but I think we need to turn back the clock to a time when every issue wasn’t treated like the future of the world depends upon it. The stakes need to be lowered, we need to stand down and get some work done.
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Your Honor,
Your concern in this scenario had to do with a hospital on the verge of bankruptcy. That hospital should not be taking in patience without insurance coverage.
To finish your original scenario; since the individual did have the ability to buy insurance and the hospital did have financial problems, the hospital should not accept high cost patients and the individual is transferred to a more financially stable hospital who in turn sues the individual.
You can assemble a million scenario to try to sell your point. I stand on the simple principle of responsibility.
Now I ask you a simple question which you have avoided twice.
If individuals can choose to not protect themselves with health insurance, even though they can afford it, and receive free care. why should I (or anyone) buy health insurance when it’s free upon demand under your system?
I await your reply.
Jules
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Jules,
First off lets be clear here. Your assumption that I am highlighting the potential financial problems of a sample hospital is ridiculous. The question centers around WHO PAYS FOR THE CARE???? This scenario is played out every day, and the hospital finance issue is raised so that people can’t just say what you appear to be saying, which is to let the hospital pay. Is that your answer? Please elaborate. Should the hospital be made to pay for such an occurrence? Do you really believe that a “financially stable” hospital would willingly accept a patient (transfer) that was going to run up a $500,000 bill and not be able to pay? What happens to patient A when Hospital C refuses to accept the transfer? Please answer the question under the scenario given please. Please do not change the scenario, or talk about other issues that you would like to misdirect to. I will answer the question on insurance in one post, and answer it just as you asked, without trying to defer. Now finally please tell me what happens to patient A under the scenario where your suggestion of a transfer is not accepted by the “rich” hospital? Please be specific.
Bill
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Your Honor,
Then the bankrupt hospital has to do the medicine and collect from the patient A and sue for the charges. If the hospital can’t collect then it should declare bankruptcy. THAT HOW ALL THE OTHER ENTITIES HAVE TO LIVE.
Patient A as well as all citizens is responsible for their commitments. The patient had choices.
That is my position all along.
Now Your Honor, tell me if, in your world, if patient A who can afford insurance chooses not to and then can demand “free” care if required–why isn’t that available to all-rich or poor? Simply don’t buy insurance, get care anywhere.
Jules
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Jules,
To your point/question it is obviously true. “Free riders” who play health care roulette have no incentive to get insurance if free care is waiting for them at the end. So then, since we agree on that, what is the solution? The individual mandate was designed to prevent your scenario from happening. But Republicans, who initially (see Heritage Foundation and Mitt Romney) supported an individual mandate, now oppose that prescription for “free riders”. So you have identified the problem, but you pose no solutions.
As far as the scenario outlined goes I guess you are saying you would mandate that hospitals cover the uninsured, and be forced to accept the financial consequences. You claim “that is how all other entities have to live”. REALLY? What business entities in America are forced to give away their product for free? Name one business model that requires that? And how long do you believe any hospitals would be open, even wealthier ones, under your scenario? Ridiculous on its face.
So what do hospitals facing that predicament actually do today???? Well we all know that since they do not want to go out of business they simply allow their paying patients to absorb that cost by pricing the service accordingly. So Jules our health insurance rates pay for that “free care”, and government tries to help by creating things like “uncompensated care” pools with tax dollars, which provide hospitals with some compensation for these services. That is the system that Republicans are striving to protect. Sounds suspiciously like “socialized” medicine to me. Especially those “uncompensated care” pools. I am shocked that you would advocate that a non-profit hospital just be allowed to go bankrupt in response to requests for uninsured care.
Now what part of what I just wrote is not true?
Bill
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Your Honor, I just read your entry and I am flummoxed. I’ll need time to unravel your logic, then I will respond.
OFF TOPIC
Meanwhile, check out the story (URL Below) that shows the results of Obama’s class warfare
phttp://www.ny1.com/content/top_stories/147351/social-networking-spurs-wall-street-protestrogram.
Jules
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Your Honor
URL did not load properly. Try again.
http://www.ny1.com/content/top_stories/147351/social-networking-spurs-wall-street-protest
Jules
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Your Honor,
I see the topic is about to go to archive. If I enter a comment are you notified or is all over.
Answer one question for me. If an Illegal alien goes to the ER how does the hospital legally handle the costs retrieval? Need info to frame my response.
Jules
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Jules,
Yes it comes to me. If the illegal has no insurance then the hospital suffers a loss, but in Mass (and other states) they are at least partially paid by an “uncompensated care pool” made up of tax dollars. The balance is paid by spreading those costs among paying customers, raising hospital rates, and health insurance rates. True socialized medicine.
Bill
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