Social Question

jca's avatar

Do you think that someone's ability to access healthcare (including emergency situations such as accidents) should be based upon their ability to pay, for example if they have no health insurance?

Asked by jca (28414 points ) May 12th, 2014

This thread on helmet and seatbelt laws has taken an interesting turn:

http://www.fluther.com/171658/what-do-you-think-about-mandatory-seat-belt-and-helmet-laws/

It became a discussion about whether or not someone’s access to healthcare, including emergencies, should be based upon their ability to pay.

Do you think that people should be denied healthcare because they cannot pay? Do you think in emergency situations, someone’s ability to pay should trump their receiving care? Do you think if someone has a disease, they should be denied healthcare because they cannot pay?

I am keeping my opinions out of this question so as not to skew the discussion.

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41 Answers

Adirondackwannabe's avatar

Nah, base it on race. White’s only hospitals, black only hospitals, yellow only hospitals, etc. I’m in rare form today. My apologies. Didn’t the guy that figured out blood transfusions die outside of a white only hospital? To me that makes as much sense as letting someone die because they couldn’t pay today. Maybe they’ll pay it back some other way.
@jca I’m waiting for someone to hand me my head for that answer. :)

Megan64's avatar

The answer is obvious: no.

CWOTUS's avatar

From a purely practical standpoint, no, of course not. You wouldn’t bring an unconscious person to an ER and expect him to provide proof of insurance or a blank check – which you could also validate, obviously – in order to receive care. Our emergency rooms would become smelly morgues if that were the case.

But to answer the larger question, “health care is not a right”. Nothing is “a right” that has to be provided by someone else. When we come to a point, as some think we might get to eventually, where every drink of water has to be paid for, then not even water will be “a right”.

cazzie's avatar

Humanity sucks. I hate people.

Adirondackwannabe's avatar

@cazzie Cold, but I can’t disagree.:)

JLeslie's avatar

Yes and no. Part of the reason I want socialized medicine is because everyone pays. The other reason is because I want everyone to have access to health care.

When it cme to the ER, how does the ER determine if someone can pay if they are unconscious or conscious and lying? Do we need to give the money up front? Hospitals still do that in the ER now even with current laws that all emergencies need to be treated. They come to your room, ask if you have insurance, and ask you to pay some money on the spot. I hate it, because I think their care does change depending on insurance and I think insurance is a green light to them to do every test and provide every consultation they can do to rake in the money.

cazzie's avatar

In @eno ‘s world, a drunken moron with no helmet comes in after a motorcycle crash, but because he can afford healthcare insurance up the wahzoo, he gets treated but the young pregnant girl bleeds to death due to placenta praevia which has remained undiagnosed due to her inability to afford heathcare. She and her child would simply die.

jca's avatar

Please read the thread linked above about helmet and seatbelt laws. @eno had some unique perspectives (and as I said I am keeping my opinion off this thread but you can read dissenting opinions on the helmet and seatbelt thread).

josie's avatar

If doctors want to give away their services for free, they should be allowed to.

If they want to get paid, they should be allowed to expect payment. Seems pretty simple to me.

cazzie's avatar

@josie so…. you want to have a strata of doctor’s moral ethics? You want to balance that by weighing in any malpractice liability?

Cruiser's avatar

@cazzie That was my first thought about docs giving away services and law suits are a prime factor as to the skyrocketing cost of medical care.

But that doesn’t stop groups of docs and nurses getting together to do free surgeries every 3rd Sunday of the month.

cazzie's avatar

@Cruiser that shit shouldn’t even be needed. The system in the USA is broken on both ends. It needs revolutionary dismantlement.

kritiper's avatar

No. Health care shouldn’t be about how much money you have. It should be available for all, equally. There are many homeless people around the country who have lost all they had because they got sick.

jaytkay's avatar

But that doesn’t stop groups of docs and nurses getting together to do free surgeries every 3rd Sunday of the month.

The need for that is something to be ashamed of, not celebrated.

GloPro's avatar

As I discovered researching for another conversation awhile back, Doctors have at least double overhead costs because of staff needed to process insurance claims. I think that would be a place to start. Insurance companies seem to be at the head of the table, and that’s a real problem.

I think we should accept bartering. I can offer up my first born (that I don’t want and can’t afford anyway), and all of the eggs my chicken can lay. I can paint your picket fence. I can babysit. I have many skills that I can offer up as long as I’m healthy.

Cruiser's avatar

@cazzie IMHO it needs torte reform first and foremost. Doctors and clinics have to cover their asses by testing and retesting so there proof beyond a shadow of a doubt that a patient has IBS and not something more serious they could be sued for down the road. Now this free health care will pack waiting rooms with people with just a sniffle. It’s a very complicated hot mess as in another article doctors mentioned how because homeless people don’t have insurance, end up in the emergency room with major problems that could have been solved when they were minor problems.

Jaxk's avatar

No body wants to se anyone die as a result of not having access to healthcare. At the same time no one wants to pay someone else’s doctors bills. The solution seems to be simple, give free healthcare to everyone and make the top 1% pay for it. That group is too small to have much impact and no one likes them anyway. It is a hell of a lot easier than trying to fix what ails us like a deteriorating economy and a litigious society that treats lawsuits like lottery tickets. Let’s not ry to fix anything, just make it free, yea that’s the ticket.

eno's avatar

Since medical professionals/services are unwillingly to offer free care, you have to pay.

Now, because of this, someone else will have to lose. It will be either:

A. The person who cannot afford to pay for treatment.

B. The medical professional/service who will be forced by the government (a law) to treat those who cannot afford treatment at their expense.

C. The unwilling citizens who will be forced by the government (a law) to pay the medical professional/service to treat those who cannot afford treatment. Willing citizens will not see this as a loss.

The question becomes, who do you want to lose? The only way that no one has to lose is if someone wants to willingly offer free service to those who cannot pay or pay on their behalf (charity),

My answer is the person who cannot pay, loses, unless someone else wants to willingly help him/her.

Just to clarify, option B and C are losses because it takes away people’s free will. If you believe people have the right to personal freedom, then option B and C should be erased.

GloPro's avatar

@eno Did you look at both of @Cruiser‘s links? Medical professionals ARE willing to provide care for free. In fact, according to the 2nd link, 68% of doctors currently provide charity services outside of normal business hours. That shows me that the hypocratic oath means something to healthcare professionals, and that not everyone has such little concern for the well being of others. My guess is that there aren’t as many unwilling as you are suggesting, and also that if given free will, many people are much more philanthropic than yourself. For this I am grateful.

There is no industrialized nation that does not tax everyone to some extent for the betterment of the society as a whole. It would be impossible to only support those things you agree to support and have a civilized nation.

jaytkay's avatar

“No body wants to se anyone die as a result of not having access to healthcare.”

Tea Party Debate Audience Cheered Idea of Letting Uninsured Patients Die

Dutchess_III's avatar

With the advent of the ACA that wouldn’t have been a problem IF the governors of each state had expanded Medicare. As we know, though, most of the red states refused to do so. I can’t remember hearing one singe governor give a valid reason why.

Espiritus_Corvus's avatar

No, absolutely NOT. I have been fighting this ridiculous idea since the day I decided to become a nurse. And that goes for those idiot Teabaggers, as well.

AstroChuck's avatar

@Adirondackwannabe
Charles R. Drew is the doctor you are referring to. He was killed in an automobile accident. But the story of being refused blood is an untrue rumor. I remember hearing Hawkeye Pierce on an episode of M*A*S*H tell someone that urban myth.

Adirondackwannabe's avatar

@AstroChuck Yes, he told that one to the guy that didn’t want black blood. That’s what made me think of that. Thanks!

jca's avatar

I think that a healthy population is for the public good. If people were walking around with communicable diseases because they could not afford treatment, it’s not just the patient who suffers, the entire population would suffer. As far as having people denied treatment because of their inability to pay, it seems barbaric. Would this be like a third world country, where people have broken limbs and open wounds, lying in the streets, miserable and sick?

Espiritus_Corvus's avatar

@jca It’s not only about staving off epidemics, which in itself is a good reason, but you want a good, healthy workforce. It’s good national economics. Sweden, following the research of Alva and Gunnar Myrdahl, and Irva Klein, has been all over this since the 1930s. Sweden consistently produces high quality products and they attribute this to their excellent health care and education policies. Germany, after WWII modeled these departments after the Swedes. Both Sweden and Germany, with their high wages, unions, healthy and educated workforces, were barely touched by this world-wide recession.

josie's avatar

@cazzie What is the moral question about Doctors deciding if they want to get paid or give away their services. As long as it is their choice, what is the problem.

GloPro's avatar

^^ Even if the doctors volunteer their time, who pays for the supplies?

josie's avatar

If access to medical treatment (it isn’t health care, it’s sickness care) is not based on ability to pay than it leaves only a few other options.

Only a little support here for the notion doctors, hospitals and suppliers will do some treatments pro bono, so I guess that is off the table.

I suppose the above could be forced into doing it pro bono, which would not be pro bono, but in any event that won’t work because most of them would quit. Sort of like killing the goose that laid the golden egg.

So the only thing left is to trick, coerce, or even force others to pay the bill. That seems to be the most popular option these days. And the weakest moral position in my opinion.

But as stated above, it all gets down who you want to see be the loser.

Cruiser's avatar

@josie From what I have read, “Doctors and hospitals are already paid less by public programs”. They make up the difference by passing the costs onto their other patients.

josie's avatar

@Cruiser
Per my answer-
That would be an example of tricking somebody else into paying the bill.

Cruiser's avatar

@josie the real trick is that now that the burden for free health care is shifted to us tax payers I am not holding my breath to see the costs of health care go down…I expect just the opposite to happen as it does anytime our Government is involved.

josie's avatar

@Cruiser
It’s interesting to me how people keep thinking that the Government will eventually “get it right this time” even though they really never do. You would think folks would learn…

CWOTUS's avatar

It’s also instructive to hear that “health care is too important – too fundamental! – to leave to the free market”.

Just wait until people figure out that eating every day is even more vital to everyone’s optimal survival than seeing a doctor is on occasion for most people – and we decide to nationalize supermarkets because, after all, “it’s too vital to leave to the vagaries of the free market!”

Espiritus_Corvus's avatar

@josie “It’s interesting to me how people keep thinking that the Government will eventually ‘get it right this time’ even though they really never do.

The government gets it right quite often:
The GI Bill for those coming home from WWI and later.
The TVA
The Hoover Dam
The California canal system
The interstate freeway system
It would take me all day to list the successes.

You have bought the lie: That it is a bad idea for a society to use its own tax money to re-invest into itself. You are not wealthy josie, and you are a dupe working against your own and your family’s interests.

If access to medical treatment (it isn’t health care, it’s sickness care)...
It’s all health care, josie. Don’t try to redefine it just because it doesn’t fit into your argument.

But you and Cruiser are right about one thing: this Affordable Care Act will fail. After all the congressional tweaking, it is designed to fail. The models for successful national insurance have been out there for decades, but in America it would require diverting tax money from corporate welfare into services for the common weal—from which the money came. It will fail so miserably that America will not ask for national health care again for generations to come.

Espiritus_Corvus's avatar

edit above: WWII and later…

cazzie's avatar

@CWOTUS the US food market has been nationalised and subsidised for decades. Corn syrup with your sugar beet sugar?

Dutchess_III's avatar

Nothing wrong with corn syrup.

josie's avatar

@Espiritus_Corvus

There is plenty of argument about what the government should and should not do. That being said, there is a manifest difference between the government using tax dollars to hire technical geniuses to design and build dams, roads and rockets, which have at least a measure of hope for return on investment, and a bunch of politicians and bureaucrats using tax dollars and the power of the IRS to herd the population into an ideologically driven way of life, of which ACA is one example.

Espiritus_Corvus's avatar

I agree with you on the ACA, but don’t ever say that the government never gets anything right and use that as a reason for not taking our tax money to re-invest it into ourselves, that’s bullshit and you know it. Approached properly, by using existing working models and experts like they did with those other successful projects, ACA could have been a excellent thing. But they didn’t. They did exactly how you describe above and doomed it to failure.

cazzie's avatar

America needs a proper government, then?. Most other countries manage it just fine.

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