The Sad Case of the Patient Protection and Affordable Care Act

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Along similar lines I thought the bill pushed a couple years ago that required a $50 copay (I would probably do $20) for every ER patient was a good idea. Ideally it would keep some of the most frivolous cases out of there. If someone was truly needy I'm sure there would be charities that would reimburse them for it.

That doesn't sound like too bad of an idea, either! Granted, there was a religious challenge a few years back that said even $5 was considered a financial burden, so you'd still need to repeal the old law.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

I would really like some sort of program where the people getting asst should have to give back. They have some food bank programs that work on this principle. In order to get food you do community service. One of my family members used to clean an elderly lady's house and do her shopping and then get a voucher for the food bank.

This sounds reasonable to me; perhaps it is too extreme for some of the others here? we'll see.

I definitely agree there is a culture of those who are in the system and have very little exposure to those successful out of it. You would think that they can absorb the 'right' culture in school/ church, whatever but it is so foreign to them it would be like me going to Russia, not speaking the language and missing all but the most blatant cultural rules. Even if they do see they should be doing something different they are going without a road map. The best thing is a mentor who has gotten out of that lifestyle but it isn't easy to find one. Add to that the lack of daycare (if you work for min wage the going rate for day care around here for an infant is more than you make in a week) and you have a recipe for failure even in a motivated person.


This is going to sound weird but the lack of Home Ec classes and IT classes something that really misses an opportunity. When I was a kid we had Home Ec and learned how to price shop, what a nutritious meal consisted of and various other basic housewifey things. Both Boys and girls had to take it. We had to make a budget and were assigned things like going to the grocery store to see what we could buy for meals on our budget. These seem like basic skills but you would be absolutely shocked how many people we have who are in financial distress and we teach them this stuff at the Dr's office. They are unaware of basic nutrition and a lot of the money saving things that the previous generations took for granted.

There was a program that combined mentors with "at risk" high school students. One of the most effective and dramatic improvements came when the mentors bought the students alarm clocks and taught them how to use them. Some of the most basic life skills, that many of us take for granted, are indeed alien to far too many.

Interesting juxtaposition you have presented as well....people could be taught parenting skills while also learning how to provide daycare, as part of the "trade" in which they engage to receive benefits....

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Seriously, how much of your income do you want directed to someone who does absolutely nothing, ever, in return?

This discussion has nothing to do with lawyers.

Yes, of course I know "free" means I pay taxes so somebody who can't afford services gets them. I actually just did my taxes today, in fact, so I am more aware of it than usual. And I recognize that entitlement and laziness are problems that have to be guarded against (I have raised teenagers). But I don't accept the notion that everybody with no money is a deadbeat any more than I accept the notion that everybody with lots of money is a job creator. My standard for extending a basic level of health care is not a William Graham Sumneresque notion of "social utility." It is that the fundamental standard of civilization is that we make sure everybody at least stays alive, even the young, the old, the weak, the stupid, and the lazy.

It will never "pay" to be indigent. The incentive for working hard and succeeding is not eroded by having a floor beneath which we don't let anybody sink.

[Bob Gray]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Sounds good to me. In general I like the idea of having to do a bit for your community when you get benefits from the government. Maybe do the same who get education grants from the government. A bit of community service is good for both the community and those doing it.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

It will never "pay" to be indigent. The incentive for working hard and succeeding is not eroded by having a floor beneath which we don't let anybody sink.

that sounds nice in theory. in the way we practice it, we do have a problem, Houston....our "floor beneath we don't let anybody sink" is not related to some basic standard of material well-being, it is indexed to everyone else's income. there is something subtly perverse about that arrangement.

Like I said, I don't mind helping out people in trouble; I do mind being taken advantage of. In this case I am far angrier at the despicable practices of certain career politicians for fomenting this kind of system than I am for the poor hapless folk who are condemned to a lifetime of involuntary servitude under it.

"vote for me every two years, and I'll take care of your basic needs in return" can sound quite seductive upfront; but it is sort of like a Venus flytrap or a pitcher plant, "you check in but you can't check out."

"trading one's birthright for a bowl of porridge" certainly fits this situation.

sounds like we agree on the concept and disagree on the execution of the concept.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Then repeal the law that forces that sort of treatment. It sounds like a good trade-off to me.

That has as much a chance of happening as Ron Paul being elected President.

Look, I agree with the idea that people should be a lot more productive and self reliant. The problem is, they're not. That's the reality (there's that word again) of the situation right now. Hence the idea of everybody has to get insurance. Grifters (love that word) are now paying up. So are hypochondriacs. In fact with any insurance plan I've had if you go to the ER needlessly they charge you for it. It would be nice if 1) people didn't delay getting care until it required an ER visit, 2) people didn't go to the ER needlessly, and 3) medical professionals didn't have to run tests once you're there for things that could have been treated by their regular doctor or which should have been caught years ago before it became serious. Unfortunately there's only two options that I've seen:

1) Allow ER's to deny coverage if you can't produce proof that you can pay which is ridiculous and unworkable, or

2) Require everyone to get insurance to get down on freeloaders.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Like I said, I don't mind helping out people in trouble; I do mind being taken advantage of. In this case I am far angrier at the despicable practices of certain career politicians for fomenting this kind of system than I am for the poor hapless folk who are condemned to a lifetime of involuntary servitude under it.

Funny. I feel exactly the same way about the Warfare State.

I'll trade you one for the other, any time.

(I have a feeling this would actually be a win-win for you personally, but there are plenty of folks caterwauling about the Terrible Tragedy of Welfare Plantations and other myths who would get very angry about it.)

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

That has as much a chance of happening as Ron Paul being elected President.

Look, I agree with the idea that people should be a lot more productive and self reliant. The problem is, they're not. That's the reality (there's that word again) of the situation right now. Hence the idea of everybody has to get insurance. Grifters (love that word) are now paying up. So are hypochondriacs. In fact with any insurance plan I've had if you go to the ER needlessly they charge you for it. It would be nice if 1) people didn't delay getting care until it required an ER visit, 2) people didn't go to the ER needlessly, and 3) medical professionals didn't have to run tests once you're there for things that could have been treated by their regular doctor or which should have been caught years ago before it became serious. Unfortunately there's only two options that I've seen:

1) Allow ER's to deny coverage if you can't produce proof that you can pay which is ridiculous and unworkable, or

2) Require everyone to get insurance to get down on freeloaders.

So because people aren't productive and self reliant, we have to reward them for that fact? No wonder people behave badly in this society. The government promotes it!

How is an Emergency Room denying care unworkable? It involves a two letter word.

[ScoobyDoo]

Re: The Sad Case of the Patient Protection and Affordable Care Act

So because people aren't productive and self reliant, we have to reward them for that fact? No wonder people behave badly in this society. The government promotes it!

How is an Emergency Room denying care unworkable? It involves a two letter word.

Awesome. We agree. Stop them at the door. No insurance, no proof you can pay, no service. That means of course if you're bleeding to the point of death at the Emergency Room and can pay but have no proof that you can or could we're just going to have to let you die cause what if you couldn't?

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Funny. I feel exactly the same way about the Warfare State.

I'll trade you one for the other, any time.

You seem to have me confused with someone else. It was President Eisenhower, a former general, who warned us about the dangers of the "military industrial complex" and I find Eisenhower ranks pretty high on my list of Presidents. I am not a Republican partisan; I am merely a concerned citizen who is increasingly uncomfortable with the idea of invoking "those terrible rich people" and those "poor deprived innocents" for short-term temporary partisan advantage.

Frankly, I'm not even sure what you mean by the "Warfare State." In my history textbooks, going to war was the first response for any embattled incumbent government to avoid necessary internal social change; it was a way to distract people from domestic problems and try to exploit a natural sense of pride in one's country.

I do agree that the "Welfare State" and the "Warfare State" have one extremely significant element in common: totally cynical, manipulative leaders who care nothing about the lives of the people they exploit to remain in power no matter what the cost might be to others.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Awesome. We agree. Stop them at the door. No insurance, no proof you can pay, no service. That means of course if you're bleeding to the point of death at the Emergency Room and can pay but have no proof that you can or could we're just going to have to let you die cause what if you couldn't?

That'd be up to the judgement of the ER. Don't assume the negative case. Just because they have the ability to deny you doesn't necessarily mean they will.

[Rover]

Re: The Sad Case of the Patient Protection and Affordable Care Act

So because people aren't productive and self reliant, we have to reward them for that fact? No wonder people behave badly in this society. The government promotes it!

How is an Emergency Room denying care unworkable? It involves a two letter word.

As we have no proof that you are either productive or self reliant, one has to wonder if you're being rewarded for the very behavior you abhor.

The ER scenario is unworkable because it will never be enacted into law. You are free to start a citizens initiative in your state to get this passed if you'd like. However, if someone's in a life or death situation where every second counts, or if they may be incoherent due to their injuries, I'm not so sure going through their pockets to secure payment up-front is the best use of the ER staff's time....

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

As we have no proof that you are either productive or self reliant, one has to wonder if you're being rewarded for the very behavior you abhor.

The ER scenario is unworkable because it will never be enacted into law. You are free to start a citizens initiative in your state to get this passed if you'd like. However, if someone's in a life or death situation where every second counts, or if they may be incoherent due to their injuries, I'm not so sure going through their pockets to secure payment up-front is the best use of the ER staff's time....

Someone didn't read post #206...

[GrinCDXX]

Re: The Sad Case of the Patient Protection and Affordable Care Act

That'd be up to the judgement of the ER. Don't assume the negative case. Just because they have the ability to deny you doesn't necessarily mean they will.

But in your world it should be completely legal for hospital staff to force someone to show proof of ability to pay before they prevent them from bleeding out?

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

But in your world it should be completely legal for hospital staff to force someone to show proof of ability to pay before they prevent them from bleeding out?

I forgot that liberals lack common sense.