Suburban Chicago Hospital Will Close After Being Crushed By Too Many Uninsured Patients

If you’re in the market for an excellent 410 bed hospital, the Chicago suburb of Blue Island has one that it’ll let you have for free, says the Chicago Tribune.

In a stunning development underscoring the plight of non-profit hospitals struggling with the increase in uninsured patients, the Catholic ownership of St. Francis Hospital & Health Center on Wednesday said it will shutter the hospital because nobody would buy it.

The religious order of nuns that oversees St. Louis-based SSM Health Care said it could not even give the hospital away to other health facilities “for free.”

Saddled with tens of millions of dollars in losses from uninsured patients who could not pay their medical bills, St. Francis would be abandoning its core mission of caring “for the people of its communities regardless of their ability to pay.” SSM will seek a closing application with the state, a process that could take several months.

The closing would erase a deeply established health-care facility in a struggling south suburban town, forcing residents to travel further from home and potentially stressing other facilities with an influx of thousands of patients, many with limited means.

“Unfortunately, in spite of St. Francis’ outstanding clinical reputation, reimbursement from commercial insurers could not cover the cost of providing care to the growing number of Medicaid and uninsured patients,” said Sister Mary Jean Ryan, SSM’s chief executive officer.

Established in 1905, the Tribune says that St. Francis was known for its excellent cardiology program housed in a $34 million state-of-the-art addition that was completed in 2003. Any takers?

Maybe a network needs a realistic set for a TV doctor show?


SSM to Close St. Francis Hospital & Health Center (Press Release)
[St. Francis]
The hospital they just couldn’t save [Chicago Tribune via WSJ Health Blog]

Comments

Edit Your Comment

  1. Toof_75_75 says:

    I could use it as a house…if it’s free!

  2. DeleteThisAccount says:

    Meg, Thanks for keeping me up to date on things going on in my own area. It is really nice to have a Chicago input on this site.

  3. AlteredBeast (blaming the OP one article at a time.) says:

    Fox should take it over, I’m sure they could find some use for it.

  4. TheBestMaxEver says:

    Awww man! This is heart breaking. We’re already short on doctors, nurses, and other qualified health care staff. Now we’re losing our hospitals. Schools are shutting down. People losing their homes left and right. Is it me or is our country devolving?

  5. Skankingmike says:

    Move to Canada.

  6. am84 says:

    Depressing.

  7. telepheedian says:

    This is why we need proper border patrol… they funnel money out of the economy and make the government or charitable organizations pay.

  8. Superborty says:

    Ah, the beauty of illegal immigration. Now who will treat (for free of course) the diseases they bring to the US that we wiped out a century ago? Illegal immigration never hurt anyone…..

  9. Superborty says:

    Illegal immigration….

  10. Pherias says:

    Toof_75_75: Living in an abandoned hospital, horror movie in the making.

  11. AaronC says:

    I’m not going to question the economy as there are pleanty of other areas that have growth.

    I do think there is aproblem with the health care system here in the US. And i do not believe it is the governments job to provide health care. I have no doubt that as soon as health care is abolished completely, as well as insurance. Medical costs will drop tremendously. 35 dollars for a pill is outrageous, and they only get away with it because insurance will help cover the cost. if no one can buy it, they will lower the price.

  12. johnva says:

    @Toof_75_75: I doubt you’d want to pay the property taxes.

  13. Diet-Orange-Soda says:

    My wife says the same thing. Most of the patients she cares for aren’t paying one way or the other. The debt is coming down on her floor in the form of cheaper equipment, cut staff, etc. Not a good situation to be in.

  14. Diet-Orange-Soda says:

    @johnva: It would totally be worth it. Deck it out in a Silent Hill way. Get some bloody limbless nurses and creepy babies. Oh man, that would be awesome.

  15. johnva says:

    @Superborty, @telepheedian:

    Why did you both just assume that illegal immigration was the cause of this? More likely, it mostly has to do with uninsured Americans and people on Medicaid. Insurance companies are also constantly ripping off hospitals and delaying payment for as long as possible, which can’t be helping their cashflow. Hospitals are going bankrupt all over the place, and it’s not primarily due to illegal immigration except possibly in places that have a high concentration of that.

  16. Bladefist says:

    @TheBestMaxEver: it’s just you.

    This is partly because of illegal immigration. But surely there are many legal citizens w/o health insurance.

    Bring on all the pro-universal healthcare people. The solution to this is health-care reform, (NOT universal healthcare). Bring healthcare back into the markets, with competition. Put the price on the wall. Competition will drive prices down, thus more can afford good healthcare.

  17. Superborty says:

    @johnva: Actually, can you prove that is more likely? Probably not because it isn’t. Fact is illegal immigration is killing our healthcare (insurance companies are certainly trying to do their part too). It is the local taxpayers who have to pick up the bills or in this case, the private hospital that has to shut down to the detriment of the local residents. It is time people start talking about these issues.

  18. HannerHearse says:

    that is so sad, and it really underscores the problems in our current system of healthcare

  19. Geekybiker says:

    Well in Chicago in might not to have a lot to do with immigration. I know a lot of hospitals near the border with Mexico have a lot of issues with illegals showing up and the hospital being unable to refuse care.

  20. Bladefist says:

    I think everyone here will agree the price for health care is too expensive. Both Republicans and Democrats can agree on that. I think both parties see a need for reform. Democrats may think republicans are satisfied with the system, we’re not. Our differences lie in the solution to the problem, not the problem itself.

    The costs aren’t going to go away. Whether you pay for insurance, and your insurance pays the bill, or whether your taxes go through the roof, and the government pays the bill, either way you will be paying for it. However with the government involved, you’ll be paying the same, or higher cost. I don’t think that solution will drive down costs, mainly because it’s driving out competition and market change.

    What we need is to reform the way we talk to insurance companies, and the way they talk to our doctors and hospitals. By making a doctor visit more like getting your car fixed, that will drive down costs. If costs subside, insurance will come down, hospital prices will come down, medical technology will come down. Everything will come down. If you don’t atleast agree with me on Supply and Demand, I give up.

  21. consumerd says:

    @Toof_75_75:

    I could use it as a house…if it’s free!

    Yep, just turn the 410 rooms to about 41 really rich units and basically… profit!!

    I figure the following

    3-bedroom
    2-bath
    1-living/entertainment room
    1-kitchen
    1-storage
    1-office
    1-dining room

    Now you can make variations on this say

    4-bedroom
    2-bath
    1-living/entertaiment
    1-storage/office
    1-kitchen/dining area

    See I have ideas… we could turn the largest parking lot to a drive in covered parking lot.

  22. johnva says:

    @Bladefist-안녕: “Universal health care” is not the same thing as government or socialized healthcare, just to let you know. We could have universal healthcare in a private system if everyone could afford it. But we both know that’s not going to happen.

    Look, this story shows problems with both private payment of health insurance AND government payment. The hospitals are the loser in both cases, because the uninsured people can’t pay and the private insurers and government insurer (Medicaid) don’t pay enough. Reform is needed, no matter what you favor.

    But I’m not going to accept conservative/libertarian dogma that free markets are always the most efficient solution. There is a lot of evidence that healthcare is a relatively unique case where that’s not going to work out and we need (at the very least) a heavily regulated system. It sort of combines aspects of fire department coverage (where no one wants to pay for it until they need it) and roads (where government ownership yields large economic benefits by removing barriers to trade and economic activity).

  23. Orv says:

    @Bladefist-안녕: The problem with that theory is if I have a broken leg, I’m not going to comparison shop hospitals to see which one has the best price. Health care is never going to work like other markets, because the need for it is often both urgent and inelastic.

    One thing this story reveals is that, universal care or not, we all end up paying for medical care of uninsured people. Hospitals cannot legally turn away people who need urgent care, so they pass the cost along to other patients. The punchline is that urgent emergency care is the most expensive way to deliver health care — we’d be better off overall if we found a way to get preventative care to many of these people before their health conditions turned into emergencies.

  24. Orv says:

    And, incidentally, the importance of preventative care is the hole in the argument I usually hear from conservatives — that the problem with the health care system is people are getting too much care, because they don’t see what it costs. Asking people to stay away from their doctors and not get checkups would be a false economy.

  25. johnva says:

    @Superborty: The facts don’t agree with you, outside of areas with a high concentration of illegal immigrants. Do you have any concept of how many people are on Medicaid? Or how many Americans are uninsured? Or how many insurance companies pay ridiculously low amounts as reimbursement for procedures? All of these things dwarf the illegal immigrant problem. I’m not saying that’s not contributing to the problem; it surely is. I’m just saying that it’s only a lesser part of why hospitals are going bankrupt all over.

  26. scooby2 says:

    Wow, our country is full of morons if you think illegal immigration is the main cause of this. The south side of Chicago is obviously not a wealthy area. Most people living in that area (actual Americans) do not have any type of health insurance. To go to any type of doctor this means hitting up the emergency room for free visits. Sore throat? emergency room. Am i pregnant? emergency room. etc etc.

    Illegal immigrants may be a small percentage of the problem but the main problem is too many people in this country do not have health insurance. The health insurance industry is all about making a buck instead of saving lives. National health insurance may not be perfect but it cannot be any worse for those with no insurance! Everyone in this country deserves health insurance. Black, white, yellow, green, whatever the race/ethnicity.

  27. KD17 says:

    With the current cost of health care I’m actually surprised with don’t see this more often. There is always a lot of talk about health care reform but I never seem to see any real action being taken.

    Now I rarely listen when a politicans talk about it. Well I listen but they just sound like charlie brown’s teacher to me , waa whaa-whaa waa

  28. Bladefist says:

    @Orv: @johnva:

    Good commentary. I’ll agree with you that healthcare is special. But I stand by my beliefs it can be solved by the market and people. Not government.

    We don’t even try anymore. Everytime something isn’t ideal, we look at our government. It’s like we’re trained little lap dogs.

    I’ll say this, I wish/want everyone to have good health care, however, my money is my money, and I do not want to pay my for my neighbors healthcare. Beyond that, do whatever.

    For 4 years in college, I had to pay 75$ a semester for on-campus healthcare. I never went once. Such BS. I couldn’t even opt out. I had health insurance from my parents job. I didn’t need anything they offered. So whatever this country does, let me opt out. I’ll always take care of myself.

  29. el_smurfo says:

    sure, close the border…but make sure all the lawyers are on the other side first…

  30. Superborty says:

    @johnva: Yea, no illegal immigrants in Chicago. Never hear of such nonsense….

  31. johnva says:

    @Bladefist-안녕: Competition and price transparency are not silver bullets here. Patients receiving care at a hospital are not often in a position to “shop around” for cheaper care…usually you’re stuck with the set of providers associated with that hospital. Second, patients are not experts on healthcare (nor should they have to be), and are not in a position to correctly weigh the costs vs. benefits of a particular medical treatment or diagnostic test. Third, pricing is not a great way to encourage/discourage use of healthcare resources…sometimes people simply NEED a certain procedure, and they won’t be discouraged because it’s expensive (or if they are, they could “pay” with their health). Healthcare should be based on scientific evidence that weighs the best outcome for the best value, not just on “market forces”. That’s another big problem with just expecting the public to shop around for their own healthcare…lots of people would pick slickly marketed woo-woo “alternative” treatments peddled by quacks over real care, and end up making their conditions worse (costing the real healthcare system MORE down the road).

    It’s not just a disagreement about the means that I have with conservatives. It’s that conservative economic ideology is fundamentally at odds with the facts and reality in this case. Y’all like to make tidy arguments that assume everyone is rational and that there is a magic market-based solution to everything. The reality is different. Conservatives don’t present real solutions to the problems. Instead, they choose solutions that agree with their ideological preconceptions, without bothering to think deeply about the problems, too often. I actually used to agree with you, but I’ve experienced too much of this myself and had too many conservations with knowledgeable people to agree anymore.

  32. @Superborty: Perhaps the folks that employ those illegal immigrants? From what I hear, they save a pretty penny on labor costs…

  33. Skankingmike says:

    @johnva: Even people with medical insurance don’t receive amazing treatment or get it at all. Nobody has any idea what Illegal Immigrants from all countries cost us they make numbers up based on some statics they generally pull out of their ass, both republicans and democrats.

    The real problem is Immigration in general.

    Yes we all immigrated here(except the Mexican’s and Indian’s we just took their land). But there comes a time in any countries life that they need to stop allowing people in when immigration no longer helps your country grow.

    We need to close all borders off and tighten the belt on hand outs.

    Giving grants to people who just came over seas (legally) while our own citizens starve is the dumbest thing I’ve ever heard of. And if you don’t think we do Come to NJ I’ll show you around the cities of Edison where it’s the largest Indian City out side of India in the entire world. And they have a system of importing their own here and setting them up with government grants to open their own businesses .

    look it up it’s sick.

  34. johnva says:

    @Bladefist-안녕: Depending on what your healthcare costs are like, that $75 a semester could have been a bargain. A lot of campus health clinics offer copay-free treatment, which can be really nice for people who need a lot of doctor visits or expensive prescription drugs.

  35. SpdRacer says:

    I’m sad, that is where I was born!

  36. Bladefist says:

    @johnva: Well I 100% believe the opposite of you. You’re description of conservatives is my exact description of liberals. Word for Word.

    There will never be global, universal, social, whatever else healthcare in America. We cannot afford it, Obama cant make it happen, Hillary cant make it happen. We are a two party system, and it’ll just never happen. Mark my words. The costs just cant be done with how america is setup.

  37. johnva says:

    @Superborty: Did I say there were “none”? No. I said that it was a smaller fraction of the problem than the other things mentioned. A high fraction of Medicaid and uninsured patients are specifically cited in the article as causes of this particular bankruptcy. There are a lot more uninsured Americans than there are illegal immigrants in this country. I feel you’re just harping on this issue because it’s a convenient way to place blame instead of fixing the deeper problems.

  38. bohemian says:

    If you don’t have cash cows to balance out your non payers (or underpayers) you go out of business. Period. So if the bulk of your patients don’t pay or on medicaid you run in the negative with no overly positive cash flow to balance it out.

    Being a hospital in a huge city located within a large section of the lower income neighborhoods would create the negative cash flow situation.

    The small metro I live in, the two hospital groups found a way to balance it out. It also helps that geographically they end up serving all sections of society. They put in high priced medical spas and these swanky high tech athletic performance medical clinics in the south side of town. The people with too much money to throw around flock to these places and pay some pretty crazy amounts of money for non-mandatory services. Both hospitals also own their own health insurance programs that they rake quite a bit of cash out of. This compensates for the money they lose from uninsured, elderly and illegal immigrants. But I can tell you that the clinic facilities in the poor part of town vs. the swanky part of town are night and day different.

    But at least they are not going out of business.

  39. @Bladefist-안녕: You are already paying for others healthcare. The cost of the uninsured is rolled into the amount (still exorbitant) you pay when you go to the doctor. However medical costs are too high. I know they pay ridiculous amounts for malpractice insurance and other cost but as other have pointed out aspirin should never cost $35 (which I have billed). I use to work for a health insurance company and we investigated how charges were higher for the insured, especially those with medicare/medicaid, than those bills we saw that paid out of pocket. So while I agree that the insurance industry needs to be looked at so do the healthcare providers as well.

  40. refurb says:

    @AaronC:

    You need to understand why a pill costs $35. Most of it is due to the extensive testing required by the FDA. People sue Merck because Vioxx causes heart attacks, even though the FDA cleared the drug for sale to the public?

    You want drugs that are 100% safe? Be prepared to pay $35/pill.

  41. Bladefist says:

    @johnva: I was 21 years old. If its a cold, stay home until its cured, if its cancer, you’re not going to the campus center anyway. From what I hear that place was pretty much always a ghost town. Boy did that liberal ran college make a killing off its students.

  42. refurb says:

    Healthcare costs are rapidly rising in the US because there is no rationing of healthcare like there is in gov’t universal healthcare.

    Canada can keep it’s healthcare costs down because they tell patients to wait weeks for an MRI or months for orthapedic surgery.

  43. chauncy that billups says:

    I wonder if the cost of uninsured patients is really what put this hospital under. What put this hospital under is the cost of the procedures and hospital services that had to be covered because the uninsured couldn’t pay. And what causes those costs to be so outrageously high is the malpractice insurance. My son just had tubes put in his ears. 10 minute surgery. Gas mask anesthesia. Total cost: $4000. Of which I paid 1k +20%. Now, I can scream that the surgeon’s fee of $1300 (before insurance) for a 10 minute procedure is asinine, which it is. But how much of that is going to cover his malpractice insurance for when some disgruntled patient sues him for $10 million because timmy’s tubes fell out 1 month early? In other words, even if hospitals could stand to substantially reduce the cost of their services (what kind of price is $1200 for sitting in a cubicle bed for 25 minutes), they still have to tack on significant sums to cover their insurance, which they obviously pass on to the patients. The whole system is broken. But giving people health insurance willy-nilly isn’t going to fix it.

  44. johnva says:

    @Bladefist-안녕: The costs are lower than what we’re doing right now, according to most estimates. Private insurance (especially through employers) is an incredibly inefficient way of funding healthcare. We pay at least double the administrative overhead of any other country in our healthcare costs. So if we can afford what we’re doing now, we can afford single-payer national health insurance. I also find it amazing that anyone thinks we can’t “afford” it when we’re one of the biggest economies in the world. We CHOOSE NOT TO spend the money on that, but that doesn’t mean we can’t. I agree that it’s going to be a tough political fight though, mainly because of people like you. I’m kind of doubtful that it can happen unless there is a filibuster-proof Democratic supermajority in Congress. Instead, we’ll probably get a watered-down public-private hybrid system. Neither Hillary nor Obama has proposed single-payer or nationalized healthcare, BTW.

  45. Beerad says:

    @telepheedian: @Superborty: @Skankingmike: Yes, I think we’d all like to see some evidence at all to back up your rather large claims.

    Put your money where your mouths are, trolls. Please provide any shred of evidence whatsoever that illegal immigrants put this hospital out of business.

    @Skankingmike: Bonus points if you can possibly explain why having Indian immigrants open businesses with government grants (likely legal, per your statements that they are from India and qualify for business grants) is worse than having Jersey remain economically stagnant. I think it’s been a while since Trenton was a shining jewel of of a city, no?

  46. 00exmachina says:

    @Bladefist-안녕: Supply and demand can’t be applied, at leat in the free market way I think your’ re implying should eb used for healthcare.

    Supply and demand systems only really come into economic play when time is not at a minimum. If you’re having a heart attack, or bleeding to death from the results of an accident, you don’t have time to shop around. Which kind of defeats the application of the free market and supply and demand.

    The only choice in a free market health care system, in an emergency situation, is choosing to pay or choosing to die. Which is generally not regarded as a choice per se to most people.

    With a purely free market system, the paramedics could realisticly demand payment for services, before they load you up and take you to the hospital. And that’s not even a straw man argument.

    Health insurance, at least hypothetically, allows the free market into the system in some scale, by allowing people to shop around for a service price they find acceptable before the fact.

    I’m not saying the system doesn’t need changes, and some major ones at that, but before suggesting to scrap everything you should consider why and how things would up in place.

  47. Bladefist says:

    @johnva: We cant afford it because we have low taxes, when compared with countries that have socialized care.
    [en.wikipedia.org]

    As far as its costing us more, eh. My health insurance here is free. You could argue that if my company wasn’t paying for it, I would make slightly more money. You could argue that. If we switched to gov healthcare tomorrow, I doubt my boss is going to come down to my office and give me a 300$/mo raise because he isnt paying my insurance anymore. just wont happen lol

  48. wiz561 says:

    Well, here are my thoughts about the hospital closing. I have really close ties with the hospital and over the years, a number of homeless and drug addicts walk in off the street and request care.

    In the winter time, they have a warming area to keep the homeless warm. Now, being that I have medical insurance, if I slice my finger, I’m going to go down the street to Palos or Christ. Why? Well, when you walk into the emergency room and it smells and all you see are homeless, it makes you wonder what kind of place this is. And unfortunately, since they are homeless, they don’t have any money or care.

    Next topic, drug and alcohol addicts. There are times where these addicts don’t want to spend the money to buy drugs, so they will go to the hospital and get them for free. Doctors there will give patients morphine, vicodin, and anything in between. Why would you pay somebody on the corner some money when you can just walk in and get the drugs, a warm place to stay, and some food all for free!?!

    As bad as this sounds, if St. Francis wanted to start making some money, they would throw out the homeless and addictions and start cleaning everything up. It looks like it’s too late for that now and the hospital will close. It’s sad, but what else can they do.

  49. johnva says:

    @Bladefist-안녕: You have a narrow view of healthcare that is colored by your own experiences. Not everyone is healthy at 21 years old. People have chronic illnesses, etc, which have to be treated regularly. A lot of females in college use the clinics to get birth control at lower cost. You may need some other prescription drug monthly, too (antidepressants are a big one in college). In other words, there is a lot in between a “cold” and “cancer”. Maybe your campus health clinic just sucked. The ones at the two universities I attended were very good and highly utilized, and could provide even specialty care in areas common among college students. And again, $75 a semester is REALLY CHEAP for what most of those places provide.

  50. unklegwar says:

    Wait, doesn’t the catholic church have billions of dollars? Trillions? I guess that’s better spent on gold-plated steps for the vatican.

  51. DimitroffVodka says:

    I love how everyone says we can’t afford universal health care but how can we not afford to have it! Right now we are paying more per captia than anyone in the world for poorer health care. Imagine all the money that would be saved with something as simple as advertisement for drugs. The market does not solve everything.

  52. Beerad says:

    @Bladefist-안녕: “If its a cold, stay home until its cured, if its cancer, you’re not going to the campus center anyway”

    Yeah, I guess it’s a good thing that college students only get either colds or cancer, huh? I bet you would have been happy if you sprained an ankle or had an infection or anything else that would have cost several hundred bucks to treat. $75 bucks would probably seem like a bargain in that case.

  53. rellog says:

    @Bladefist-안녕: Yeah, cause that’s working so well in the pharma industry… (note the sarcasm…)

    Much like the energy market, the healthcare industry needs strict regulation. Too many possibilities for corporate corruption otherwise. Just look ast how deregulating the banking industry and the airlines opened the door to abuse…

  54. Beerad says:

    @unklegwar: “Wait, doesn’t the catholic church have billions of dollars? Trillions?”

    I don’t know, how much have you tithed to them recently?

  55. NotATool says:

    @Geekybiker: Chicago and the surrounding area has a large Hispanic population. There are lots of “seasonal” workers here who make money during the spring, summer and fall and then spend the winter in Mexico with their families.

  56. Bladefist says:

    @johnva: That comment was a little more fun then seriousness. What I’m trying to say is, why didn’t I have the right to opt out? I know why. Because they need a percentage of people to pay, who will never use the services, to afford and profit off the people who use it.

    I was used. I was a poor college kid made poorer. The government can do whatever they want w/ healthcare, as long as I can opt out. I wish the rest of you luck w/ your new system. I’ll find a means to pay for premium health care, even if it means I have to drive a pinto.

  57. johnva says:

    @Bladefist-안녕: The tax thing is easily solved: raise taxes to pay for it. I would gladly pay more in taxes if it removed the cost of health insurance benefits from the private sector. If it costs less to have government care, then why does it matter whether you’re paying the government or paying an insurer? At least the government isn’t taking a profit margin out before they even start paying for expenses.

    Also, I think you’re being inconsistent in your application of “free market” ideology. Why do you think that employers offer health insurance benefits now? They do it because it helps them compete with other employers for quality employees. So if they no longer had the cost of providing healthcare, they would still need some other way to compete for the best employees. For this reason, many WOULD pay higher salaries with at least part of the savings from not paying for health insurance anymore. The free market would force them to. But government health insurance could end up being a win-win for employers and employees. In addition to the cost, employers would also be free of the administrative overhead of the health benefit plans and the risk of them becoming more and more expensive over time. Both are good reasons why employers might support single-payer.

  58. Orv says:

    @Bladefist-미칬어: The reason you weren’t allowed to opt out is because insurance plans depend on healthy people paying in to offset the payouts they make to sick people. A basic principle is that you can’t allow self-selection in the risk pool; otherwise all the healthy people opt out and you end up either losing money or charging prohibitive premiums. This self-selection problem is why private health insurance is so expensive, and why you usually can’t opt out of employer-provided plans. This is also one reason why a single-payer system might actually provide some savings — a risk pool encompassing the entire population would include as many healthy people as possible.

  59. Rufdawg says:

    @bilups: People like to blame malpractice lawsuits for the high cost of medical care until a negligent doctor cuts off the wrong leg or leaves a scalpel in their abdomen during surgery.

    Medical care is expensive because people who pay for their care must subsidize people who don’t. So, to reduce individuals’ costs, either hospitals must deny care to those who cannot afford it or costs must be spread over more people.

  60. Orv says:

    @johnva: Some of the biggest employers, especially automakers, *have* come out in support of some sort of socialized health care. Their contention is that their competitors in countries with socialized medicine have an advantage, because they don’t have the overhead of paying for employee and retiree health care.

  61. Rusted says:

    @Skankingmike: Or move the Canadian border south of me.

    Some of us did immigrate but some of us were born here. So which country do I go “back” to? England? Sweden? Spain? Scotland? Denmark?

    @Bladefist-미칬어: Umm, you are paying for health insurance. Don’t think for a moment that wasn’t figured in your compensation.

    @HRHKingFriday: Yes they do save a bundle but even though the illegals are hard workers, detail nor quality are their strong points. Spent much quality time cleaning and fixing after.

    @Superborty:Be glad people still want to come here. For now.

    @GZA: I was uninsured but I still paid my bill. Even at that, it was still cheaper then what the premium would be for the year.

  62. Bladefist says:

    @johnva: look at my icon, i don’t want taxes raised. Taxes hold people down. Taxes hold successful people down by taking their money. They hold poor people down, by giving them money and not encouraging supporting themselves to rise above, and be successful. Raising taxes is very bad.

    Also, come on you, you know our government. Right? There is a ton of corruption there. Have you researched Social security and medicare? Those are government healthcare, just for certain people. Look into it, they steal money out of the pot and use it other places, which is why we need all kinds of reform there too. Because at the end of the year, those pots are always in the hole. If you research into SS and medicare, you’ll see why it doesn’t work, and never will.

  63. Bladefist says:

    @Orv: True. But I can opt-out of insurance. The college thing I didn’t have a choice.

  64. Beerad says:

    @Bladefist-미칬어: “Because they need a percentage of people to pay, who will never use the services, to afford and profit off the people who use it.” (emphasis added).

    That’s the whole point. If ten of us go in on an insurance plan, we’re betting that only one of us will need to get sick and use the pooled money. It’s a risk-sharing device.

    @Bladefist-미칬어: “as long as I can opt out. I wish the rest of you luck w/ your new system. I’ll find a means to pay for premium health care, even if it means I have to drive a pinto.”

    NO YOU WON’T! I promise you that when you get badly hurt in a car crash and require heart transplant surgery, you aren’t going to gasp out “no — I can’t cover the $300k medical treatment… just let me die, thanks.” Everyone else who is on your plan will cover your costs. But that’s okay, because that’s how it’s supposed to work. You can walk everywhere for the rest of your life and eat rice, and you’ll never be able to pay off a catastrophic medical emergency. But in a shared-risk system, that’s the point. It’s unrealistic to think that you could, so by pooling resources with others you make sure that someone who needs the coverage can have it.

  65. cashmerewhore says:

    And y’all think HMOs pay enough for a hospital to break even?

    The only way hospitals really make money off services is if you happen to go out of network and then your insurance happily pays 100% of charges, which is extremely rare.

    I work in billing, it’s not uncommon to get $100K on a $1M bill. And I’m seeing more and more $1M bills (the remaining $900K is a contractual adjustment).

    Where can I buy a house on a contract like that???

  66. johnva says:

    @Bladefist-미칬어: Yes, of course some people are going to end up paying more and getting less in any situation where the costs are pooled. But that applies to private insurance just as much as it does to socialized systems. We could just not have pooled costs, and make everyone pay out of pocket for all health expenses. But that would put a lot of financial risk on individuals. There is a reason why we use insurance (not just in health care). I suspect your campus made paying the clinic fee compulsory because they know that otherwise a lot of college students would forgo needed care. I doubt they were profiting from it (I know that a lot of these clinics actually have to be subsidized by the universities, in addition to these fees).

  67. rellog says:

    @Bladefist-안녕: “Well I 100% believe the opposite of you. You’re description of conservatives is my exact description of liberals. Word for Word.”

    Like Johnny, I’m another former republican conservative who has felt or seen the reality of life and the unfairness of the system when it is run by conservatives. I am more a moderate democrat now. I do not discount personal responsibility, but I also realizethat
    A.) People aren’t always capable (or willing) to do the “right” thing.
    and
    B.) Corporations rarely care about anything besides the almighty dollar. Peoples’ lives be damned. Doning the “right thing” is nearly unheard of in todays business world. Other than Costco, I can think of no other that repeatedly acts in an ethical manner…

  68. cashmerewhore says:

    And most of the employees will likely just move to other area hospitals. When Columbus Community Hospital shut its doors years ago, many of their staff relocated to surrounding hospitals (both professional and clerical).

  69. modenastradale says:

    @Bladefist-안녕:

    I appreciate your sentiment, but I don’t think the health insurance market is particularly suited to a competition model. The fact is, a health insurance policy is a monstrously complex beast filled with exclusions and equivocations and provisos. I consider myself a pretty smart guy, but I know I don’t have a good grasp of my own policy except for the very basics.

    The complexity extends beyond the contract itself, to the administration. For example, it’s hard to know at the outset whether a particular insurer is going to be needlessly bureaucratic, whether your legitimate claims will be denied several times before finally being approved, whether the network of specialists (especially in a specialty for which you’ll have an unknown future need) is deficient, etc.

    With the product being so complicated, I’m afraid that putting the “price on the wall” will do little to enable consumers to make informed choices — especially to such a great extent that insurers begin jockeying with one another for lower rates and better care.

    External ratings boards and media coverage may provide some help with those informational challenges. But we’re still stuck with an even more foundational problem: insurance is inherently unsuitable to a large number of small providers (the kind of conditions that would be required for competitive pressures on the scale you’re discussing). Insurance is about risk diffusion; providers can’t effectively diffuse risks when they’re small. And if they’re large, the market will never be highly competitive.

    On top of this, bear in mind that most insurance policies are associated with an employer group. Employers choose insurers based on what is best for the employer. Employees have little choice on an individual level. That further reduces the number of genuine participants in the market.

  70. mduser says:

    This is happening in a number of hospitals around the country, including my own backyard. Prince Georges Hospital (Largo, MD) came very close to shutting down as well for the exact same reasons, too many people defaulting on the bills. It took an emergency cash gift to keep it going, but right now Dimensions Healthcare (the current owner) is looking for someone to buy it.

  71. Bladefist says:

    @Beerad: I wasn’t talking about going without healthcare. Even with universal healthcare, you think bill gates is gonna share the same hospital room with you? He will still have premium healthcare insurance, and I’m saying I would do whatever it takes to afford that same extra, private insurance. Because the government will give me DMV service, and the rich people are gonna have a private club w/ all the good doctors. Eh, maybe.

  72. johnva says:

    @Bladefist-미칬어: Social Security is NOT government health care. It’s a cash payment for retirees. And yes, Medicare and SS have problems, and need adjustment. But I wouldn’t call either a failure. They are pretty successful at making sure that old people who can’t afford their care are not totally destitute.

    Anyway, our government is corrupt largely because people don’t care about fixing it. They don’t trust it, and just write it off. The fact that socialized health care works fine in a number of other countries if proof that it’s simply not true that it can “never work”.

  73. ChuckECheese says:

    @Bladefist-미칬어: I love markets! They give me Best Buy, AT&T, Comcast, airlines, Wal-Martses, and much, much more! The free market does a great job of protecting our pocketbooks, our safety, our sanity, and our human needs. Any Fox News watcher can see that. So why don’t we have a market-based military over in Iraq? Oh yeah–Halliburton and Blackwater–my bad.

  74. Orv says:

    @Bladefist-미칬어: No employer I’ve worked for that offered health insurance at all has let me opt out of having at least a basic insurance plan. One of them told me explicitly that their insurance provider said they’d terminate their contract if they let people opt out. Again, they’re trying to avoid self-selection.

    (I suppose I could have opted out by quitting my job, but I’m guessing that’s not what you mean.)

  75. johnva says:

    @Bladefist-미칬어: If you allow people to “opt out” of paying into a shared-risk system, the costs go up for everyone still in the plan. Especially if the people who “opt out” can still receive care free of charge if they truly need it and can’t pay for it. That’s part of the current problem we have with healthcare.

    What I want is single-payer care for most normal care, with the option to purchase supplementary private insurance that covers more things or reduces your out-of-pocket expenses. I feel everyone deserves some baseline care and that everyone should have to pay into the system that provides that to everyone. But I’m fine with people have the option of buying ADDITIONAL insurance if you want more luxurious care.

  76. ThomasD3 says:

    I find really sad to read how public healthcare is demonized.

    If one looks at European countries or Canada: they have it and it does work. No matter if the evil governement is behind it, etc: IT DOES WORK

    The real problem is that the US gov is so crooked that they would manage to ruin it and make it worse. That is what needs to be fixed.

    Want private healthcare? think it’s better? well, you have it! we have private healthcare, we had it for the longest time and it is a total failure. Many of the things private healthcare proponents suggest have already been done and they have already failed. Why do people propose more of the same? you will never be able to trust insurance companies where your well being is in direct contradiction with their bottom line.

    As a reader of The Consumerist, one should know we can not trust businesses, especially not to run something that serious.

    Free market? YES, but history has proven that a free market can NOT regulate itself without abuses.

    On the other side, we have a system that has worked for decades in other countries, but because we’re too proud to admit we never managed to care for our own, we’d rather bash it instead of listening.

    For reference, I lived in the USA, Canada, France and Germany. Guess where you pay the most to get the least if you need to go to a hospital? Guess who has the lowest life expectancy?

    America is great, but when it comes to healthcare, even Iran and Cuba do better than us.

    It’s time for America to shut up and learn instead of trying to preserve / fix systems that have already failed.

  77. bohemian says:

    @00exmachina: Maybe people should be thinking twice about the whole “free market” thing in light of the current Bear Stearns/Mortgage meltdown mess. We all can see how well the free market handled that.

    Healthcare isn’t a pair of designer shoes. Designer shoes are a free market commodity where consumer demand and price tolerance can steer that market. Dying children needing to go to an ER and people having heart attacks are not.

    Even for my non emergency routine health care you can not get prices up front.

  78. Bladefist says:

    @ChuckECheese: wow, thanks for that. learned a lot.

    @Orv: yea not what i meant

    @johnva: I guess i’m not good at explaining my thoughts. I agree, people opt-ing out costs more for the people who are in, but I dont care. Not my problem. But if you opt-out, your out. Thats the way it is. You don’t get care in an emergency. That’ll never happen though. Not worth talking about. I guess I may seem a little arrogant. And I don’t think I know it all. I don’t think I have the best ideas. Just looking to the government for, well, anything, just doesn’t sit well with me.

    Hopefully smarter people then myself can figure this out.

  79. cashmerewhore says:

    @bohemian:

    Hospitals have to release pricing for many common procedures so you can shop around town (these are estimates for complication-free services). If you have an 80/20 plan it’s good to know how much each hospital network in town charges for a standard Labor & Delivery.

    Google your state + hospital pricing

  80. modenastradale says:

    @johnva:

    Not picking a fight with you, because I agree with your basic premise. But your description called to my mind the infamous British system. I haven’t read much about its structure, but the level of care provided by NHS seems to be poor. I’m curious: why do you think that is?

  81. johnva says:

    @Bladefist-미칬어: It’s already the case that the richest people get better healthcare than everyone else. There are actually doctors who don’t accept insurance at all and that cater mainly to rich people who can pay for everything out of pocket. Sometimes these providers will do things like provide 24-hour on-call care, home visits, and other perks that “normal” patients don’t get. This wouldn’t change under a single-payer system if you still allowed private supplementary insurance. I’m mainly saying that we should have single-payer for healthcare services that aren’t optional. Home visits, having a personal physician, cosmetic surgery, fertility treatment, etc are optional. Getting care for your cancer or diabetes is not.

  82. modenastradale says:

    @Bladefist-미칬어: Actually, if other people are sick and can’t obtain needed care, it very much *is* your problem. You just don’t realize it. We live in a society of interdependence, whether you recognize it or not. Sick people drag the economy down, for one thing. For another thing, when the uninsured stick providers with the cost of care they can’t afford, it will raise YOUR prices. Since we’re all bearing the costs (in various forms) anyway, why not establish a proper risk pool to minimize them?

  83. cybrbanana says:

    Re: malpratice insurance premiums – I have heard it suggested that we do with medical malpractice like they do with vaccine related complications; a fund where people who truely are hurt by incompetance get some money (not millions) for the genuine pain and suffering. That way, most of the treatment related (or death related, if it comes to that) costs are taken care of, and doctors don’t have to spend hundreds of thousands of dollars per year on insurance premiums, leading to reduced health care costs for all.

    New Zealand no fault compensation

    National Vaccine Injury Compensation program

  84. Bladefist says:

    @johnva: Well rich people could pay the tax and the extra care. I wouldn’t want to pay the tax. Just the premium insurance.

  85. Bladefist says:

    @modenastradale: I guess in my Ideal world everyone takes care of themselves and their families. Everyone makes sure they have insurance. If you got to sell your house and move into an apt, you do so to afford insurance. Unfortunately we will always have people who abuse the system. Since we have that, you’re right.

    I am capable of recognizing ideology and realism. Ideology is out the door. Since we all agree we’ll take care of the schmucks, or in some cases, just the extermely unlucky people, you are right, damn’d if you do, damn’d if you dont. Some people dont mind that. I do.

  86. Beerad says:

    @Bladefist-미칬어: “He will still have premium healthcare insurance, and I’m saying I would do whatever it takes to afford that same extra, private insurance.”

    Do you know what that premium insurance that Bill Gates uses will be called? It will be called “I’m rich enough to pay for all of my own medical costs!” No offense, but you won’t be able to afford it. As others have pointed out, by “opting out” of an insurance group you are basically saying “I don’t want all you sick/unlucky people to drag me down with your costs, so I’ll take my chances that I won’t need coverage.”

    I’m having some trouble understanding why you were so upset at $75 per semester coverage at college because you couldn’t opt-out, but at the same time think that it would be okay to opt-out of a government program so you can “do whatever it takes to afford…extra, private insurance.” Do you really think that you could have found $150 per year private coverage as a college student?

  87. Bladefist says:

    @Beerad: Didn’t need to find it. Already had it through my father, since he was responsible enough to pay for private insurance for the whole family. I was double covered. And when I’m sick, you can be damn sure I won’t be going to some lame campus doctor, I’ll go see the real thing. The campus doctor, assuming he was just as qualified, has nothing to gain or lose. While my real doctor, makes money on my visit.

  88. johnva says:

    @Bladefist-미칬어: Well, since you agree that our government will never actually ban people who don’t pay into the system from receiving care, why do you think we should allow people to opt-out anyway? Banning them from receiving care at all is the only way the people still in the plan wouldn’t end up paying for them one way or another. And even if they were banned, costs would STILL go up for people in the plan because healthier people would be the ones more likely to opt out. Risk sharing simply works best with as big and diverse a pool as possible. You seem very focused on wanting to avoid paying for others, but you’re failing to acknowledge the whole point of insurance, which is that you’re intentionally paying for the costs of others in exchange for being covered when you need it. You’re getting something in return, in other words.

    @modenastradale: I’m probably not informed enough to make an educated statement about the specific problems with the NHS. But I would guess that it comes down to funding. The political system needs to provide the necessary funding for level of care to remain high. And there obviously is going to be a tension over that between people wanting to pay lower taxes and people wanting better quality of care (we’re seeing this right in this thread). One of the main risks of allowing any supplementary private insurance might be that it provides a wedge for political opposition to reduce the services provided by the single-payer system. After all, if many or most people have supplementary policies, they need to rely on the socialized system less. And therefore have less incentive to support its continued funding and maintenance politically.

  89. modenastradale says:

    @Bladefist-미칬어: That’s not quite what I was saying. It’s not just that there are irresponsbile scoundrels out there who will dirty up your pristine ideal. It’s that your ideal is defective on its own terms.

    You want everyone to “take[] care of themselves and their families. Everyone makes sure they have insurance.” But that’s an impossible task. It isn’t a matter of selling off the house and taking an apartment so that you can pay Pacificare. Because some of us don’t have a house to sell off, do we? And some of us can’t really downgrade our apartment unless we want to live on the streets, can we? And some of us are so ill that we can’t work, right? And some of us were not as fortunate as you, to be born with the intellectual ability to attend college and have a solid earnings capacity, were we?

    I’m not expecting you to be moved by the injustice of those facts. I just ask that you recognize that not everyone is in your position, and that there are significant, external economic costs associated with an “I’ve got mine; go get yours” mindset. The costs will come back to you in the end, I’m afraid.

  90. @Superborty: Thank you for trying so hard to demonise illegal immigration, but what about the 45 million Americans without health insurance? Do we send them to Mexico too?

  91. Bladefist says:

    @modenastradale: I reconize.

    This has been a wonderful debate. Thanks John, beerad, and modenastradale.

    I learned some, got some others ideas, wasn’t cursed at. It feels weird.

  92. johnva says:

    @Bladefist-미칬어: The problem with “everyone taking care of themselves and their family” is that not everyone CAN do that, either because they don’t have the financial resources or because their medical expenses might be so high. Could you afford paying $1.5 million for care if your kid got leukemia or something? I’m sure you’d be willing to pay it to save them, but the question is whether you actually could. Again, there is a purpose to insurance. I’m just advocating for a different insurance model that I think is more fair and more efficient.

    re: your campus doctor: that’s nice that you were lucky enough to have the luxury of going elsewhere on your parents’ insurance. Not everyone does; a lot of people work their own way through college without insurance. Those people would probably just not go to the doctor if it meant paying $300 or whatever for a visit. And anyway, most campus doctors I’ve dealt with were every bit as good as any other doctor. In fact, they were often better, since they are very experienced in dealing with the particular health issues that frequently affect young people.

  93. johnva says:

    @modenastradale: Yeah, one of the things that eventually sold me on single-payer once I started reading about it was that it actually REDUCES the free-rider effect. Conservatives complain about other people (like illegal immigrants, the uninsured…) getting free care all the time, but single-payer actually has the potential to make that care NOT free to those people. It’s much harder to avoid paying payroll taxes (and by that I mean a tax like the FICA tax, not like the income tax) than it is to avoid paying a medical bill, since we don’t throw people in jail for not paying their debts in this country. Even though poorer people would pay less in absolute dollars into the system under a payroll-tax funded single-payer system, they would be guaranteed to be paying something. So that could reduce costs right there.

  94. Bladefist says:

    @johnva: the illegals still wouldnt be paying, the unemployed wouldn’t be paying. Still lots of free-loaders.

    In absolute dollars, I bet they pay more. They out number the rich by a ton. Middle class sustains america.

  95. modenastradale says:

    @johnva: Actually, that was a great sum-up. Thanks for the information. I hadn’t really thought of “tip-ups” as a wedge, but it makes perfect sense.

  96. Trai_Dep says:

    I fail to understand that, on a consumer-focused site, of all places, a simple, one-step way to reduce health care costs by at least 30% is met with such hostility. Well, by those fed by AM talk radio.
    Remove the for-profit insurance companies that make both providers, patients AND doctors miserable, while stealing around a third of every health care dollar.
    Let them offer supplemental insurance and lifestyle type programs. Get them the heck out of our doctors’ offices.
    Of course, that’d make too much sense, and what would the pols do (the same ones – including our fine, FINE President – who enjoy lifetime, socialized healthcare*) for their lobbying slush funds?

    If it’s good enough for our President, our lovely Conservative legislators and others, I’d guess it’s good enough for us Americans.

    * Or, Do As I Say, Not As I Do (Ha – Suckahs!)

  97. modenastradale says:

    @Bladefist-미칬어: Well, bear in mind that “the illegals” provide a subsidy to goods and service prices, because most of the time, they perform labor that natural-born residents wouldn’t do, at wages they wouldn’t accept. Something people who bash illegal immigrants often overlook.

  98. Trai_Dep says:

    Oh. Make a Federal law restricting current and past Presidents and Congresspeople (and their families) from “Socialized” medicine until ours is fixed. This year. Watch how fast the Conservatives will flip-flop on that issue.

  99. Landru says:

    @Superborty:

    Your “facts” and claims are all anecdotal.

    @Skankingmike: As I understand it, we are dependent upon immigration to keep our economy growing.

  100. johnva says:

    @Bladefist-미칬어: Illegal immigrants wouldn’t be paying ASSUMING they and their employers are also committing payroll tax evasion. A lot of illegal immigrants actually are paying taxes, because instead of working totally off the books they use fake SSN’s and actually pay these taxes (without the possibility of ever collecting Social Security). Anyway, the crime of employing off-the-books workers should be dealt with for reasons besides just this – personally, I think it would be much easier to enforce those laws by going after the U.S.-based employers instead of the illegal immigrants themselves. Republicans, BTW, are a large part of the opposition to that sort of enforcement – their big business base LIKES the cheap labor that illegal immigrants provide.

    Unemployed people are a separate problem, but they have plenty of reasons to get a job besides just this. I don’t think we need to screw them further like we currently are by denying them affordable healthcare. Actually, people need good insurance the most when they are between jobs. And our unemployment rate is pretty low.

    And by “absolute dollars” I was referring to the amount of taxes paid per person.

  101. johnva says:

    @Trai_Dep: Sometimes people who are heavily invested in a particular ideology have to hear a LOT of opposing facts, and believe them, before they will alter their views. That’s part of why I post so much on these threads here and elsewhere. Luckily I think cracks are forming on this issue. Now, at least, MOST conservatives will at least admit there is a problem with our healthcare system. So now that they agree we need reform, we’re halfway there. We just need to convince them that single-payer really is the best solution out there, pragmatically, and that free markets aren’t really the best solution to everything. I know we’re up against a powerful lobbying and propaganda machine fueled by big money, but I’m at least somewhat hopeful.

  102. Trai_Dep says:

    A fair analogy might be fire departments.
    In fact, at first they all were private. You could pay for one of several competing ones beforehand, pay when your house caught fire (auction-style, with several competing firetrucks bidding the price up while your house burned) or the crews would simply gather around your burning house and injured children and taunt you for being a short-minded tightwad.
    You’d have “wars” between competing fire companies who’d block each other on the way to fires, either to “reduce competition” for bidding or to damage a competitors’ reputation. “Accidentally”, of course.
    Obviously, this didn’t work well. The Free Market fails for essential services needed urgently. Public entities do the job much more effectively and fairly. When we don’t like the services they provide or how they provide it, we whine until our representatives fix things.

    Same thing with health care – structurally, it makes no sense.

  103. jimconsumer says:

    @Geekybiker: know a lot of hospitals near the border with Mexico have a lot of issues with illegals showing up and the hospital being unable to refuse care.

    No, it’s everywhere. I live less than 500 miles from the Canadian border and our town is full of illegal aliens of Hispanic origin. In fact, I, as a white male, am now a minority in my own community: More than 50% of residents are Hispanic. A vast majority of them are illegal. I know because the recruiters I work with get large numbers of job applicants on a daily basis attempting to pass fake IDs and other people’s social security numbers.

    Most of the crime is also performed by people with Hispanic surnames. This is not racist, it is fact. Open up the “crime” section of the local paper. Fully 9/10ths of them are Garcia, Valdez, Hernandez, and on and on.

    Illegal immigration is a HUGE problem for communities across the entire country. It is in no way limited to southern states. They are burdening our hospitals, schools and other social systems heavily. My taxes continue to rise every year to support local schools due to continued influxes of Hispanic children whose (usually illegal) parents don’t buy property and thus don’t pay into the system. It’s not right and I’m mad as hell that our legislators aren’t fixing this.

  104. jimconsumer says:

    @johnva: Republicans, BTW, are a large part of the opposition to that sort of enforcement – their big business base LIKES the cheap labor that illegal immigrants provide.

    And Democrats like them for their votes. Yes, they’re voting with those stolen SSNs as well, and by and large they vote for the people who give them more free shit: That’s Democrats.

    I am neither Republican nor Democrat but I am very conservative and usually vote Republican when I’m not voting Libertarian. As a conservative, I do NOT like cheap, illegal labor, and my hard core Republican parents and extended family members want the illegals out, too.

    I also DO want to see health care reform, but not the kind of “reform” Hillary is talking about. She just wants to pay everyone’s way (how? With your own money, you dumb asses. You think you’re going to get “free” health care? Hah! They’ll take it out of your paycheck whether you use it or not in the form of 50%, 60%, even 70% tax rates. Still think it’s a good deal? It’d be cheaper for you to just pay out of your pocket and buy insurance with a $5,000+ deductible in case of emergency.). I want to see real reform, where the middle men stop collecting billions of dollars and where it doesn’t cost me (or my insurance company) $1,200 for an E.R. doc to spend literally 10 minutes sewing my cut hand closed and charging $120 for a little bottle of painkillers that cost a quarter to produce.

  105. meneye says:

    @Skankingmike: yeah because the health care system is SO much better in Canada. Idiot.

  106. Zombilina says:

    @Orv: Agreed. I live in an urban area, and when my boyfriend lacerated his chin on a Sunday evening, I was shocked to discover that our only option was to go to the emergency room. The laceration was deep and super-bloody and he needed stitches, but otherwise it wasn’t really an emergency. It wasn’t like his appendix burst, but he needed care in a timely manner.

    In my hometown, which is in the middle of nowhere, the hospital had an urgent care clinic for this very thing. It was cheaper and faster than going to the emergency room, and had extended hours. The area in which I live now has just about everything, but if they took a hint from this little hick town, my boyfriend could have saved $1000.

  107. Orv says:

    @modenastradale: Not to mention that private insurers can and often do refuse to insure people they consider a poor risk.

  108. Orv says:

    @meneye: Yes, Canada’s health care system is so bad that they outlive us by 2.34 years on average.

  109. Cycledoc says:

    I read the Chicago Tribune article on this hospital and guess what? There was no hint that this was a “immigration problem.” The financial failure of this hospital is like the canary in the coal mine and is an early warning of our failed non-system of care.

    Ours is the only industrialized nation without such a national health plan. We spend twice as much as other countries and have mediocre outcomes. Is that the American way?

    For those suggesting that the free market is the answer, “free markets” will inevitably fail in health care. They won’t work because of the decades long patent monopolies which result in higher costs across the board; because there is no negotiation of costs; because consumers are not fully knowledgeable about choices and outcomes; and because consumers have the idea that higher cost=higher quality. Lastly and perhaps most importantly they cannot work when there is a life or death urgency to decisions (one cannot objectively weigh options and pricing in the ambulance on the way to the hospital).

    http://www.medicynic.com

  110. chatterboxwriting says:

    @johnva: Great points, outlined in a well-reasoned way. You are correct about Medicaid reimbursements being very low – Medicaid in PA pays $12 for a doctor’s office visit. While we could all sit and argue that doctors charge too much for an office visit, is $12 really fair compensation?

  111. johnva says:

    @jimconsumer: Attacking illegal immigration by removing their ability to get work would be the best way to deal with this problem. Because work is the main reason they come here. And while you and your Republican family may oppose illegal immigration strongly, your view is far from unanimous within your own party, in case you haven’t noticed. Many Republicans really do quietly oppose effective enforcement measures like making employers responsible under the law for verifying the legality of the employees they hire. They know that our economy depends on these people. Even Bush and McCain realize this.

    As for your last paragraph, eliminating the “middlemen” is exactly what those of us who want single-payer are proposing. Insurance is taking about 30% of every dollar we pay for healthcare out, before we even pay for anything. They are also responsible for the phenomenon you mentioned of being billed such exorbitant prices (the providers have to do this to get the insurers to pay them a more reasonable amount). We want to put a stop to that. And no one who supports single-payer has said it’s “free”. We have said that it’s cheaper than what we’re currently doing if you count the cost of insurance the same as the increased taxes. And BTW, neither Hillary nor Obama has proposed single-payer! And single-payer, under most proposals, would be funded by a flat payroll tax rather than an income tax anyway. Your taxes would not go up to 70% (incidentally, that rate is not historically unprecedented in the U.S.).

    Here are the only main differences with single payer:
    1. Government-run insurance vs. private insurance.
    2. One big risk pool for everyone instead of many small individual ones.
    3. Funded by payroll taxes instead of premiums charged to employers and individuals.

  112. JustAGuy2 says:

    @Bladefist-미칬어:

    Won’t really help, unless you give hospitals the right to turn people away, which they can’t do today.

  113. johnva says:

    @chatterboxwriting: $12 is, of course, absurdly low. It’s no wonder that lots of doctors don’t take Medicaid patients. This touches on a point I made earlier: these programs will be neglected and underfunded by the government if they are perceived as “poor people” programs or welfare. That’s one reason why I think universal single-payer is a better idea than just providing some sort of subsidized insurance for the poor as a welfare program. Moreover, Medicaid currently has a lot of the most high-risk patients in it, which is part of why it is having trouble paying our reasonable reimbursement for things like doctor visits. By making it a welfare program instead of putting everyone together, we set it up for financial failure since the poor are more likely to have health problems in the first place.

    My dad is an anesthesiologist, and he’s one of the only ones at his hospital that takes Medicaid patients who are having babies (because the reimbursement is lower). This is a serious problem, because in his state over 50% (!) of the babies being born are to Medicaid mothers. This really needs to be addressed, and I think the best way to do this is comprehensive reform instead of just throwing more money at Medicaid. If we just leave things as they are, the system is going to collapse under the strain pretty soon. The few doctors who are providing these sorts of services to Medicaid patients can’t handle it all. As it is, my dad does this partially out of an altruistic streak. He tells me does it because he’s afraid no one else will if he doesn’t.

  114. jimconsumer says:

    @johnva: Attacking illegal immigration by removing their ability to get work would be the best way to deal with this problem.

    I completely agree. We just need to do it right – today, they steal others’ identities to get around the laws. The recruiters I know turn away a lot but they still get duped by the smarter ones, only figuring it out 3 or 4 months later when the guy slips up or the person whose identity he’s stolen figures out what’s going on. It’s hard to fault the employer in a case like this. But, we could start by nailing intentionally complicit employers to the wall. At least we’d be doing SOMETHING.

    And while you and your Republican family may oppose illegal immigration strongly, your view is far from unanimous within your own party, in case you haven’t noticed.

    Well, again, I’ll reiterate they’re not my party, I just identify more with them than others on most issues. Certainly, I’ve noticed they’re as useless on the issue of immigration as the Democrats. Both parties have too many conflicts of interest to do squat for us.

    Here are the only main differences with single payer:

    I hadn’t heard of this approach before. It’s an interesting idea. The only thing I take issue with is the last point – funded by payroll taxes. I’d rather it be funded by individuals, and optionally. If people choose NOT to enroll, then when they have a major event and don’t have insurance we should take everything they own to pay their bill. But I would not support taxing people for their own health care.

  115. Bladefist says:

    @Orv: That is way out of context. That could be their diet, environment, stress, etc.

    @JustAGuy2: Yea, and I’m not really saying they should turn people away. I *wish* people didn’t take advantage of hospitals, so that the people who did use their services for free, were the ones with no other options. If you got no options, you got no options. But I’m willing to bet a lot of those people either have options, or made bad decisions and now don’t have options.

  116. Bladefist says:

    @johnva: While you may not agree with republicans, please note that this nations founding fathers are conservative. The constitution is conservative. And you have a lot of prosperous times under conservative presidents and congress. You’re were fun to debate with, but now you are getting insulting. There isn’t a lack of understanding here man, there is just a lack of agreeing. And republicans are fully against illegal immigration, as am I. Haven’t you read the news man? Bush is building the fence. He is asking congress to let him tip toe over some local laws to get the fence built. I absolutely hate it how people think republicans are corrupt because they are capitalist. These ‘republicans’ who are hiring the illegals, do you think these lawn mowing company presidents are well respected ‘republicans’? Are you saying that a democrat business owner would never save a buck? You’re out of your element donnie.

  117. ThomasD3 says:

    what I still don’t understand is that after decades of history showing that a free market can not provide these things, we’re still debating how to fix it?

    The analogy above with the firefighters is excellent. If tomorrow your house catches fire and you don’t have enough income for firefighting insurance, should we let your family burn?

    or if you get a house invasion, but your police insurance is not accepted by the local precinct, shall we let you all get raped then murdered?

    Free market solves comfort items, not necessities. And without government subsidies and regulations, almost everyone here that does not live in a major city wouldn’t have streets, electricity and much less phone or the internet.

    Free market can not provide these service (trust your cable / phone company lately? they’re not screwing you more because of regulations, not because free market regulates itself).

    But, can you name a single country where free market has solved safety, education or medical needs? we tried, and failed, to be that one.

  118. jimconsumer says:

    in his state over 50% (!) of the babies being born are to Medicaid mothers. This really needs to be addressed

    I agree completely. Let’s start with policies that encourage (perhaps even force) personal responsibility. In other words, if you’re poor and living on “government” (read: taxpayer) assistance – if the rest of us are being forced to pay your way – then you really have no business making more babies you can’t afford to care for.

    There are a variety of non-cruel ways to deal with this: Offer free birth control, or small financial incentives to go on birth control, or make birth control mandatory for welfare recipients. You trade a shot in the arm for a check every month. Simple. Or, instead of giving welfare mothers MORE money for every child they have, instead give them more baby food and less money. “Well, we were giving you $1,000 a month to live, but you went and had another baby. Now you get $800 a month and an extra case of formula.” So we’ve ensured the children are cared for while discouraging mom from popping another one out.

  119. ThomasD3 says:

    Bladefist: I have to agree here; our current president has nothing to do with Republican ideology.

    I am personally totally for capitalism, but only after necessities have been taken care of. Necessities (food, health, safety, education, infrastructure) are not luxury, they are essential services, after that it’s all fair game.

    Look at the picture:

    – Our airlines suck

    – Our cable / satellite companies suck

    – Our phone companies suck

    – Our infrastructure is not adequate anymore

    – Our education is behind other industrialized countries

    – Our healthcare is a joke compared to other countries

    – Our safety is low compared to other modern cuntries

    – We have more people in jail than anyone

    – We have more people shot than anyone

    – We have more drug problem than many other places

    – We have big businesses telling the gov what to do

    – We have much less freedom than a lot of other countries

    – We have more enemies that most other countries

    – We let businesses abuse people more than many other too

    All these problems have to do with an incompetent governement. For example if phone companies had to compete on quality vs. finding new way to screw people over, maybe service would be better.

    We’ve tried for decades to not have the government too involved, now we’re lagging behind while we used to lead. Obviously, the choice we made is wrong because it didn’t go that bad for the others; ironically most other modern countries have adopted similar structures and we stand out. We were ahead, not anymore. I don’t get why it is so difficult to accept a change when something has failed over and over again, instead of trying to find small excuses and tweaks.

  120. johnva says:

    @Bladefist-미칬어: Not all of the Founding Fathers were conservative. There were conservative aspects to the revolution, but there were also very radical aspects (especially for the time). The Declaration of Independence and the Constitution were radical ideas at the time. The idea that government should answer to the people was even fairly radical at the time. “Rights” were radical at the time.

    I’m not trying to be insulting towards Republicans. Sorry if I come off that way sometimes; it’s not my intent. I just strongly disagree with Republican ideology. I’m actually a pretty moderate Democrat (against gun control, against racial or gender affirmative action, against ill-advised government interference in the mortgage market, etc). I support the free market where it has a demonstrable track record of doing a better job, and socialized solutions where those have a record of doing better. Healthcare is simply an instance of the latter, in my view. The last 40 years have been a failed experiment in for-profit healthcare. It’s time to move on.

  121. modenastradale says:

    @Bladefist-미칬어:

    I don’t think that’s very convincing. Yes, the principles of most of the country’s founders were quite conservative by today’s standards. But it was a radically different world. Back in those days, respected political figures owned slaves. Nations communicated with one another via letters sent on ships. The dominant form of economic activity was agricultural.

    Yes, founders did a good job of establishing something unique back in their day. But they were not infallible deities. Their plans had flaws, many of which proved quite serious and many which persist today. Let’s not make the mistake of putting the founders and their political philosophy beyond reproach, especially not in a world that is now so vastly different.

  122. johnva says:

    @jimconsumer: I agree that we shouldn’t encourage people on welfare or who are otherwise too poor to reproduce. That’s also a reason I think birth control and abortion should be freely available, heavily subsidized by the government, and “encouraged” in some cases. Unfortunately it’s often conservatives who oppose that sort of thing, while simultaneously removing supportive funding from Medicaid, etc to pay for all the babies that are getting born. Regardless of social engineering ideas, it’s a crisis that so many babies are getting born to these people and that so few doctors will deal with them. THAT needs to be dealt with immediately.

    Ultimately, the best way to discourage irresponsible reproduction is to lift people out of poverty. Richer, more educated people have fewer kids, despite the fact that they have more resources available to pay for them. This is called the Demographic-economic paradox. It sounds counterintuitive, but it’s true.

  123. Orv says:

    @Bladefist-미칬어: Building a fence won’t help unless action is taken against employers. If the jobs are there, people will find a way to get to them, no matter how high a fence you build. The fence is just the Bush Administration’s way of looking like they’re doing something without drawing the ire of the business community by taking actions that would actually stem the flow of cheap, illegal labor.

  124. Roy Hobbs says:

    I’m jumping in here at the tail end, but it seems to me that much of the problem is the basic issue between Democrats and Republicans (or Liberals/Progressives and Conservatives). Republicans believe that Democrats at their heart want to increase taxes and the size of the government so that everything will be “free”. Democrats seem to believe* that Republicans want to leave things to the market, and that they don’t want to spend money on the common good.

    I have a hybrid idea, and I don’t understand why it is not being tossed around:

    Mandate that every employer (even sole proprietorships) must provide some minimum level of health insurance for their employees. This takes away the Republicans’ belief that all Democrats want socialized medicine. It also deals with the whole “market forces” argument. Finally, it satisfies the Democrats, who have been way out in front on this whole health care thing along the way.

    Now, there are bunch of problems with this, not least of which is that the cost of everything would go up immediately upon implementation. But it is time for all of us to collectively realize what health care costs. It is clear that we all want it, might as well (pardon the pun) rip the band-aid off all at once.

    * Full disclosure – I am a conservative, so I am not absolutely certain of this

  125. modenastradale says:

    @johnva: Woah. I agree that there’s a problem with birth rates among the poor and the lack of available resources to care for them… but are you really suggesting that some women be “encouraged” to have abortions as a way of alleviating limited resources? That sounds dangerous to me (and immoral, but I recognize that’s a hot-button subjective issue).

  126. johnva says:

    @modenastradale: Maybe I shouldn’t have used the scare quotes. I don’t think anyone should be forced to have an abortion in order to receive welfare or whatever. I would however, possibly support counseling on that option for women who are in horrible economic situations. Basically, I just want it to be destigmatized because I think that it’s often a good decision. But I admit that it’s just my subjective bias that there is nothing immoral about abortion and maybe that one’s a little too radioactive.

  127. johnva says:

    @modenastradale: Oh and fundamentally I believe the problem is that we have underfunded Medicaid while not doing much to decrease costs among the people covered by it.

  128. modenastradale says:

    @johnva:
    Ah, yeah. I thought you were suggesting conditioning benefits on having an abortion. Sounded like China!

    I should restrain myself from discusing abortion because it’s too emotional a subject for me to talk sensibly about. And, predictably, people just end up saying “you’re weird”. :-) (I’m quite liberal but also very strongly opposed to abortion, in nearly all cases).

  129. johnva says:

    @Roy Hobbs: That’s actually quite similar to part of Obama’s plan to reform healthcare. I suspect his intent is to improve the situation while trying to dodge the “socialized medicine” label. Read about it here. Unfortunately, I personally don’t think his plan goes far enough. The Massachusetts mandated health insurance plan (which is quite similar to Hillary’s) is showing signs of failure because despite the mandates and penalties a lot of people still aren’t covered by insurance. The hard part is enforcing the mandate. And even if it worked really well at combating the free-rider problem it does little to control costs that are inherent to the private insurance model (like the 30% cost overhead caused by their administration and profit margin).

  130. Concerned_Citizen says:

    Why can’t they become a non emergency room hospital? That would give them the ability to turn away the uninsured and ambulances won’t be able to just drop you off there.

  131. modenastradale says:

    @johnva:

    Yeah, I don’t really think those proposals help. I’m not even sure that they’re a step in the right direction.

    Having health care be tied to one’s employer is a bizarre and unfortunate thing by itself. I had a colleague who wanted nothing more than to quit her job and focus on her small business, which could have been quite a solid little venture. But she couldn’t, because one of her kids had health issues and no insurance company would offer any reasonable coverage to her. Her existing job didn’t pay the premiums, but at least it offered membership in a group plan. So she continued to work full-time in the job she hated, didn’t get her business off the ground, and I believe that we all lost something because of that.

    I’ve got another acquaintance who is very desperately ill right now, and making every possible sacrifice to cling to his job (even though he should be trying to recover — it’s a life-threatening condition). He does this because, paradoxically, if he gets so sick that he loses his job, he’ll also have no access to health insurance! (Spouse makes an OK living but is self-employed — again, no coverage.)

  132. Roy Hobbs says:

    @johnva: Wait, I agree in principle with a Democrat? Wha happen?

    Seriously, though, this is an issue that has come to a point where it needs to be solved. I don’t know how to deal with the 30% overhead from insurers, but having a single payer probably isn’t it. Let them compete, but regulate the industry so that a) they pay on time and don’t screw up health care providers’ cash flow, and b) actually have competition (so we don’t see 3 mega-insurance companies in 5 years after a whole lot of mergers).

    Enforcing the mandate should be something the government is good at. We have OSHA Mandates, EPA Mandates, Food Inspectors, etc. etc. Just have everyone tick a box on their taxes each year about whether or not they are covered by their employer; the offenders would be found out pretty quickly.

  133. johnva says:

    @modenastradale: You make a great point that I think should be a point of common ground between Republicans and Democrats. Tying insurance to employers DOES discourage entrepreneurship and hiring by employers. The problem is that buying insurance on the individual market sucks by comparison to the group plans that employers have access to (pre-existing conditions and expense are a HUGE problem in that market, as your friends discovered). So while I think it’s a good thing to decouple insurance from employers, we also need to tackle the problem of getting people an affordable health insurance option that isn’t employer-based without it succumbing to adverse selection. I can’t see a good solution to this latter problem that isn’t government-based, since the for-profit insurers always are going to have a conflict of interest with people who need to buy individual insurance. We need risk pooling, but without the tie-in with employers. Single-payer seems like the simplest solution to me, but there are certainly others. We should look at all the different types of public-private hybrid systems other countries have implemented to see what works and what doesn’t, and why, if we aren’t going to go single-payer.

    @Roy Hobbs:
    You’re also being pretty reasonable for a Republican :) though I don’t agree with you that single-payer wouldn’t work IF we could somehow get it politically in this country without lobbyists and special interests distorting it beyond recognition. As far as mandates, I don’t think it would be too hard to enforce an Obama-style mandate that employers provide insurance (he does it by forcing them to pay a tax if they don’t provide the insurance). The more problematic part is enforcing a mandate on individuals who are not employed, are sole proprietors, etc. Hillary’s plan apparently tries to force all those people to buy insurance; Obama’s does not, except for requiring that parents buy insurance for children. You need the penalty to be high enough that people are actually deterred, but you don’t want to just fine people for being too poor to buy insurance.

  134. ChuckECheese says:

    @Bladefist-미칬어: You’re welcome–sometimes you just need somebody to explain it to you.

  135. ChuckECheese says:

    @johnva: Tying insurance to employment/employers in the U.S. is the reason why Stouffer’s frozen entrees are made in Canada instead of in America, where they are scarfed. Their cheap health care system means manufacturing costs are lower.

    @Roy Hobbs: We got single payer: schools, post offices, militaries, all sorts of stuff. Why does the doctor have to be different? Why the irrational fear of making sure everybody is covered in the simplest way possible?

  136. MykalBloom says:

    @AngrySicilian: Agreed.

  137. LintySoul says:

    On the topic of health care, my state, Oregon, recently had a lottery to fill some open spots in the state health care system. These are spots for people with no health insurance, who consider themselves “low_income”. There were 3,000 open spots, I believe, and 80,000 people signed up for the lottery. The health care system is in desperate need of an over haul. Staggering numbers for Oregon.
    As for racism, this has no place anywhere.
    I can understand the sudden influx of population causing strain on local resources, usually we all learn to adjust to this over time.
    If you complain that your neighbor is not paying taxes, thus making yours go up, then perhaps you should consider these the flaws of the tax system and not those of your neighbors. And by “consider” I do not mean vote for and search for ways that the tax-fist can be tightened.
    I see racism as a way to keep us all well divided, scared of each other, which makes us easier to manipulate.

  138. Skankingmike says:

    @Beerad: New Jersey is in a bad way because of Politicians mostly. But that doesn’t mean that Illegal Immigration and LEGAL immigration doesn’t put stress on the economy.

    Indian’s aren’t all bad and they do buy and contribute to some of our economy, but like a lot of the immigrants that came from Europe in the late 19’th century and early 20’th, they tend to stick together in their own communities. However unlike the Immigrants from Europe, their life styles and customs hardly fit with the “American” way of life.

    They also found a way to cheat our own system, hooray for them I suppose, but if you wonder why taxes are so damn high, then think back to them getting Grants and Tax free land for a set amount of time. Then just when their Tax free property runs out they bring over their brother/cousin/uncle/wife/sister whatever and rinse and repeate. Tell me where White/Black AMERICAN’s get to do these endeavors LEGALLY. No where.

    @Rusted:

    I was born here, but technically so were Mexicans, 40% of America used to belong to Mexico a little over 150 years ago.

    I would say I’m a good mix and I even have some Native American in me (wish I tanned like they do). Let’s see let me go back to… Ireland/North America/Hungry/England/Demark/Germany that’s all I know.

    But that doesn’t mean we need immigrants to keep coming here. We’re done we have enough go to Europe their currency is better anyway.

    @Landru:

    Not sure if I understand that one, more people = more money?

    But who’s getting this money are you rich because of all these people that come into this country?

    And what jobs are created and who works in these wonderful jobs? Unionized Government workers.. Yea that’s helping me how?

    You can keep your hoards of people I want our government to focus on fixing AMERICAN problems first.

  139. Pithlit says:

    @johnva: The cracks are forming, and they’re getting bigger. I post a lot about this issue, too, here and other places. There will always be some who are stubborn in their views, but a lot of people are coming around. I think we’ll see a push away from private healthcare at some point, because we’re spiraling downward, and eventually it will get to the point where we have no choice. The sooner we switch, the better off we’ll all be. Continue to spread the word. It does make a difference.

  140. Pithlit says:

    @jimconsumer: Even the illegal immigrants are paying into the system. They most likely pay rent, which eventually gets paid into property taxes by the landlord. They pay taxes in the form of income and sales tax. That money goes toward the schools, too. I’m not saying that immigration isn’t a problem, or that it isn’t adding some strain to local governments. I’m not for opening our borders freely and eliminating all immigration laws. But, I’m not sure if advocating keeping their kids out of the schools is such a good idea. Those kids will spend their days somehow. I think having them in school is probably better for everyone. Besides, even if you and I may not like it, many of kids are probably going to stay here. Having them educated makes more sense. The best way of dealing with the problem of immigration is crack down on the companies and individuals who are hiring them illegally in the first place.

  141. Bladefist says:

    @modenastradale: I’m a constructionalist. I don’t believe the constitution is like the bible. It is what it is, you dont need to revise it, you don’t need to analyze it. It’s easily spelled out. Thats it. If you don’t like it, you amend it. But you do not interpret it. It is what it is. If the government owed the people health insurance, it would be in there. It’s not. If 51% of america thinks we need it, we need to amend it. But that ain’t gonna happen.

  142. johnva says:

    @Bladefist-미칬어: The constitutionality of national health care is not really in doubt. If Medicare/Medicaid are constitutional, single-payer is constitutional. If you don’t think Medicare is constitutional, then I suspect you think a great deal of the current functions of the U.S. government are unconstitutional. But the Supreme Court would disagree with you.

  143. goodkitty says:

    It’s kind of amazing to think that a whole hospital is only worth about the same as one jet fighter. Maybe Boeing can get into the health care field.

  144. modenastradale says:

    @Bladefist-미칬어:

    I’m afraid you’re shadowboxing.

    Your original post sought to defend conservatism on the grounds that “this nations founding fathers were conservative. The constitution is conservative.” I pointed out that while the nation’s founders were indeed conservative by present-day standards, that fact itself does not reinforce the value of conservatism because there is nothing magical about the founders. They did some great things and some awful things and were, ultimately, just people.

    In response, you’ve pointed out that you believe the constitution should be construed strictly. I don’t really understand how that’s relevant. Strict constructionism is not itself a political philosophy, nor does it inherently favor “conservative” policies over “liberal” ones. It is merely method of statutory interpretation that purports to lend greater policymaking power to the legislature than to the judiciary.

    Unfortunately, the Constitution isn’t as clear as you may think it is. Simple commands such as “Congress shall make no law . . . abridging the freedom of speech” become devilishly slippery once you try to apply them to a real case. For example, may Congress prohibit me from going on TV and discussing highly classified national security information? In the most literal sense, that would be a law abridging my freedom of speech — actually limiting my ability to (legally) open my mouth and say what’s on my mind. But is the First Amendment really saying that I have an unlimited right to say whatever I want whenever and wherever I want, consequences be damned?

    I doubt that you’d say yes. And if your response is “study the text of the Constitution more closely,” I’m afraid we’ll be studying for a very long time — that document has little else to say about our dilemma.

    That’s not an extreme example I just cooked up. It’s downright typical; the fact is, the Constitution is simply too thin to set out anything but the broadest strokes.

    Given that, courts have two options when controversies come to them: (1) attempt to establish rules within the framework of the statute/Constitution; or (2) decide each case arbitrarily. Since having each case decided arbitrarily gives citizens no confidence in the stability of the law, #1 is really the only practical choice. And therefore, like it or not, admit it or not, all courts and all judges (even Antonin Scalia himself) must “interpret” — and therefore write — the law.

    With all of that said, I’m not trying to suggest that the Constitution is so flexible that it stands for nothing. To the contrary, I do actually believe that the Supreme Court transgressed some clear-cut constitutional boundaries. That has been happening from the very beginning, but a lot of the “damage” was done during FDR’s presidency. Regardless, whether it should or should not have been done, the fact is , our Constitution today is not really represented by the 240 year-old document. And it can never be. At least, not unless we’re willing to scrap decades upon decades of this country’s development — the cost of which is nearly unfathomable.

  145. friedfish says:

    I just love those people that feel “every person has the right to healthcare”. You have a right to life, liberty and the pursuit of happiness. You have the right to bear arms, etc. In a perfect world we all would just get along, but we don’t! The world is not a perfect place, Pollyanna. All the ills of the world, our country, state, town and even block are never gonna be solved. It’s just the way it is; always has been and always will be. Can we, as individuals, make a difference? Hell yes! But to sit there and impose your version of nirvana on all the rest of us is just insane. It has never worked and it never will.

  146. MisterE says:

    Oh boy. Here we go again…

  147. AmbiUbi says:

    @Bladefist-미칬어: $75 a SEMESTER???? I’ll gladly pay that for what I rarely use. Right now my husband and I pay about $6000 a year for health insurance that we barely use. And this just went up from $3600 a year because ONE person’s WIFE in the group is going through cancer treatment, and another woman had a baby. So this is a prime example of what other posters are saying, that eventually, we all have to pay for what others can’t afford. The insurance companies will always find a way to make a profit.

  148. jfarnsy says:

    Interesting, this article – quite a contrast from the front page story in the WSJ on how non-profit hospitals are EXTREMELY profitable because of their tax-exempt status.

  149. Bladefist says:

    @modenastradale: Well, my point was more so, this country was founded on conservative ideals. Liberals are trying to change this country 360. They are never happy. Wake up every morning with nothing but contempt for their country.

    This has gone way off topic. It was fun while it was a debate, but when It turned to bashing parties, that’s when the whole thing went down hill. I cant stand when people say republicans are corrupt, or idiots, or anything of that matter. It’s a believe system. You have successful countries under conservative beliefs, and successful countries under liberal beliefs (as long as it doesn’t go too far left to socialism). So it’s pretty lame. Someone said earlier, “We got hte first step, getting conservatives to realize there is a problem” why are we being talked down to? We’re just as educated.

  150. johnva says:

    @Bladefist-미칬어: I’m not talking down to you. I’m just going based on my experience. The reason I said that is that just a few years ago most of my conservative friends and family (yes, I’ve got quite a few) simply would not admit there were any serious problems at all with our healthcare system. They would say something like “sure, it’s kind of expensive. But it’s not that bad, and anyone with a job can afford it”. They would tell me that only the lazy people didn’t have insurance. What has changed is that we have now had a few years of double digit percentage increases in the cost of healthcare. And as a result we now have so many uninsured people in this country that it’s obvious it’s due to a serious problem with our system and not just people choosing not to buy it or choosing not to work hard. I’m not saying that conservatives are uneducated, or that there are not uneducated, uninformed liberals. What I am saying is that conservatives tend to be biased towards status quo solutions. That shouldn’t be insulting, since it’s pretty much the definition of “conservatism”. So it’s something of a testament to how serious the problem has gotten if even conservatives agree that there is a need for some kind of change, even if they disagree on what that should be.

    Liberals do not have “contempt for their country”. They just love it in a different way than you do. We see flaws in the way things go here, and we work to try to fix those, precisely because we care about this country. I care about this country, but I don’t think it’s perfect. And the things we’ve discussed in here are hardly a radical change. They are mostly just an incremental improvement.

    And I really don’t think it got that far off-topic. These issues are acutely connected to the reason many hospitals are failing financially. You seem to be taking a lot of this very personally for some reason – you seem very insulted by even mild criticism of the Republican Party (and yes, what I said was mild compared to what I often say about them…I was trying to keep things civil). Please understand that we aren’t attacking you; we’re arguing with your ideas.

  151. vladthepaler says:

    It’s a shame that the people who can pay, or who are insured, are going to suffer because some people can’t pay their debts. If the hospital denied coverage to those who can’t pay/aren’t insured, it could continue to operate and serve at least some of the population, instead of closing and serving nobody.

  152. Bladefist says:

    @johnva: Alright fair enough. I feel passionately about this country as well. I’ve trying to be civil as well.

    There is no way to say this without sounding like a mindless zealot, but that’s fine if people want to call me that, have you ever listened to Rush Limbaugh or Bill O’Reilly. I always try to push people to listen to them, not so much because I want them to fall in line with those beliefs, but, they are more informed on day-2-day topics then most. They present a different bias of news then the rest of the networks present, and if nothing else, can help you brain storm more about your idealogies.

    Through listening to these people, which is about the only conservativism I get daily. Everything I read and watch is on liberal networks (I dont even get the fox news channel), I have determined that Liberals want to change way too much about this about this country. And each success they get, paves the way for more changes. You give them an inch, they take a mile. Today its healthcare, tomorrow we’re japan. Monday we’re china. That may sound extreme to you, but I think it’s because your fairly intelligent, and you sound moderate. But don’t forget the people in power are usually not. Hell, look at this: [en.wikipedia.org]

    Yes, we have a senator that is a self-proclaimed socialist. This is not good. We are being stripped of our culture to be ‘fair’ to everyone. Life isn’t fair. This private hospital was closed for being fair. I hope no one dies in an ambulance having to go the extra miles down the road to the next hospital.

  153. physician says:

    unfortunately, there are many issues at play in regards to modern healthcare in the united states. many excellent comments have been made thus far, but i would like to add a few:

    1. illinois medicaid (IDPA) is notorious for late/slow payments. it is not unusual for my group to have payments 6 MONTHS in arrears from the state. you can call the state one time to find out when payment is forthcoming. while IDPA does reimburse as well (if not better than some private party payers) for prental care and delivery services, they reimburse horribly for nonpregnancy related office visits and gynecologic surgery.

    2. this hospital is located in cook county – which now occupies the number three slot in the ATRA’s list of “judicial hellholes” after southern florida and the rio grande valley. while we can debate whether or not this has any direct bearing on malpractice insurance rates, the companines providing malpractice insurance believe that it does. as a consequence, malpractice rates are quite high in these counties. in the two southern illinois counties (madison and st. claire), premiums for high risk specialties like OB/GYN, orthopedics, general surgery, and neurosurgery can approach $100,000 per year regardless of claims history. if one receives about $2000 for routine prenatal care and delivery (basically nine months of care), you have to deliver 50 babies to pay for malpractice alone.

    3. several commenters have suggested turning away or refusing care to patients that cannot pay. this is illegal and violates the federal emergency medical treatment and active labor act (EMTALA).

    4. several commenters have mentioned the national healthcare plans of western europe or canada. while it is true you will be eligible for care, you may wait a long time to receive it.

    5. many people do not understand the billing process involved in medicine. i can say a charge a gazillion dollars for a procedure, but reimbursement is set by a rate contracted by the payor. this rate is rarely significantly different from provider to provider. if you are paying in cash, then you can often negotiate your rates. if you have insurance, you really do not have all that much wiggle room.

    6. most medicaid programs do offer generous benefits for contraception (birth control pills, injectables like DepoProvera, and even permanent sterilization). i can understand why people would like to be able to limit reproduction in persons that require state assistance. this, however, is viewed ethically in a poor light. whether the indigent patient understands this, or not, is immaterial. reproduction is viewed as an inherent human right. legislating or mandating reproductive behavior is no different than mandating government control over other personal behaviors. the federal government takes the sterilization of medicaid patients very seriously. permanent sterilization procedures in medicaid patients require a MANDATORY documented 30 day waiting period (with some reasonable, but rare exceptions) prior to performance of the procedure. lack of compliance means lack of all reimbursement to both the provider and the hospital.

    anyway, these are some other points to ponder.

  154. jimconsumer says:

    @LintySoul: If you complain that your neighbor is not paying taxes, thus making yours go up, then perhaps you should consider these the flaws of the tax system and not those of your neighbors.

    Not sure if this was directed at me, but: If the neighbors are illegal immigrants working under the table, that’s not a flaw of the tax system, that’s entirely on the shoulders of the neighbors who are breaking the law to be here and not paying their way while using our social services extensively and, in many cases, bankrupting them.

  155. Rusted says:

    @Skankingmike: My point, is that I’m an American. Bad or worse that’s what I am. I’m not a European.

  156. aldo37 says:

    This is funny, on the front page of the Wall Street Journal today is a totally contradictary report: “Nonprofit Hospitals, One For the Poor, Strike it Rich” and goes on to describe how many non-profits are earning $250 million a year now and do better and for-profit ones.

  157. johnva says:

    @aldo37: It doesn’t seem to me that that article contradicts this. It says that the 50 largest non-profit hospitals are pulling in great income, mainly by cutting out charity care (in other words, caring for the uninsured) and catering to wealthier people by building fancy facilities and such. Actually, that supports what I’ve been saying. They are increasing the cost of care through these building binges, high executive salaries, etc and they’re doing it at the expense of the uninsured getting care. There are plenty of other non-profit and for-profit hospitals going bankrupt, often because they actually care about providing services to people that can’t afford it.

  158. modenastradale says:

    @Bladefist-미국사람:

    The biggest problem I have with your philosophy is that you seem to suggest that maintaining the status quo is possible. It isn’t.

    You claim that liberals “want to change too much about this country” and that you “give them an inch, and they take a mile.” But liberals are not the cause of change — change is the cause of change. The fact is, as time progresses, social, economic, and geopolitical circumstances shift dramatically. True, the country’s *policies* may remain fixed, but the practical result of those policies cannot.

    As an example, imagine if you owned a family restaurant. Imagine that, after many years, the restaurant has perfected its menu — filled with rich and indulgent dishes. Now imagine that consumers begin to gravitate to healthier lifestyles. What will happen? Well, you can do nothing, reasoning “my restaurant is perfect, and by God, I’m not going to change it because of those health Nazis.” But if consumers’ priorities have shifted, you will be driven out of business if you don’t adapt.

    It’s exactly the same with countries. In the 1950s, for example, society was simpler. Back then, for example, it was possible for a (white) family to lead a comfortable middle-class existence, with the father putting in 40 hours a week at the steel plant and the mother caring for the children and the home. Such families found it practical to own one car, to own their home, and to visit the family doctor (or get a house call!) when one of the kids was sick.

    After five decades of economic development, the picture is radically different. Prices for many necessities — housing, food, transportation, and especially medical care — far exceed those of the ’50s (even adjusted for inflation), even as wages for most people haven’t risen enough to compensate. A typical “middle class” family now has both parents working, often 50-60 hours a week, struggling to pay bills, and unable to afford a home. Dad’s job at the plant is no longer secure; the plant has been bought by a behemoth corporation that will lay off 15,000 loyal workers without batting an eye.

    Meanwhile, the nation has become far richer — only thing is, all the gains went to people who were already rich to begin with. So, most of the population isn’t feeling any richer, although a highly visible superclass jets about with its $200,000 cars and $17 million homes. (This result is an inevitable consequence of unchecked capitalism, by the way.)

    So, what’s the country to do? We could do nothing, maintain the status quo, and preserve its conservative principles. But if social inequality continues to grow at this rate, a total breakdown of the social order could occur.

    Some of us think that’s a bad idea. So, we’re proposing to fix the system — to create safety nets and regulations to alleviate these unsustainable patterns. Apart from criticizing us as “liberals,” do you have a better suggestion?

  159. coolkiwilivin says:

    Those cheap christians, providing free healthcare and then when they can’t afford it anymore bailing out! I’m surprised liberals aren’t blasting christians b/c of this. Bladefist, love the Korean comments and commments in general. Government run healthcare is NEVER the solution. Think about that girl who was denied treatment and died on the day the treatment was approved. The people can protest against a company, how are you going to protest against a nameless, faceless bureaucrat? The real issue is liability insurance. When presidential candidates can become uber rich from phony science and sue the crap out of companies then the system has no nope. Pointless lawsuit after lawsuit can pile up and just drown the system. Reform is more than just lowering costs but finding out the reasons why costs are out of control.

  160. MrEvil says:

    The argument that I keep hearing from Bladefist and the rest of his trust fund baby bretheren is that socialized health insurance would make the waiting room at the ER longer than it is. I don’t blame them, its just the way they were raised and the fact that they listen to assholes like Rush Limbaugh and Bill O’RLY as though they spoke the gospel truth.

    The thing that makes ER waiting lines so damn long in the first place though is that Any hospital that has emergency facilities is REQUIRED TO TREAT REGARDLESS OF ABILITY TO PAY. That’s according to the law. Ear nose and throat doctors offices don’t have such a requirement nor do any other outpatient offices. So the poor people that can’t afford a primary care doctor go to the ER because the ER has to treat them. If these frequent ER visitors had health insurance, they would probably instead find an outpatient doctor to go to and go to him regularly and follow the physicians’ directives when tests are ordered. They get BETTER healthcare than they would at the ER and also ease the burden on ER staff so they have more time to take care of actual emergencies.

    Also, I don’t know about the rest of you folks, but when you’re ill and don’t feel good at all, you aren’t very productive. If you stay home from work you’re not of much use doing houshold chores and if you don’t have sickpay you’re not of much use in your normal working duties either. Yeah, alot of the times you just “get over it” as our learned colleague Bladefist suggested those of us without daddy’s trust fund do. However, it takes a LOT longer to just “get over it” than it does to go to your doctor and get medications to help you fight off whatever it is you have. With government health insurance everyone can get the meds and get back on their feet and back to work faster making everybody more productive.

    I also love how Bladefist hates paying for others. He seems to have no problem though buying equipment for the Department of Defense that it doesn’t really need. He also doesn’t seem to mind paying the USAF’s fuel bill doing approach/landing exercises that NASA has been doing in simulators for YEARS. But he’ll be goddamned if he has to pay for Little Timmy’s broken leg, or Susies Leukemia treatment.

    I guess that’s where we differ. I got no problem paying for Little Timmy’s third broken bone from a stupid skateboard stunt OR Susies Leukemia treatment now PROVIDED that Timmy and Susie’s parents (or themselves when they grow up) pay for my replacement knee later. Of course I’m paying for someone else’s stupidity/misfortune now, but they may be paying for mine later on.

  161. MrEvil says:

    Oh, and for those saying that corporations will do the right thing in the end forget that to corporations “doing the right thing” is doing whatever it takes to make their stock close higher at the end of trading. You can thank the Michigan Supreme Court and Dodge v Ford Motor Company for that.

    “The Court held that a business corporation is organized primarily for the profit of the stockholders, as opposed to the community or its employees.”

    Henry Ford wanted to “Do the right thing” for his employees and the communities where his employees lived. However the Dodge brothers wanted none of that despite the fact that at the time FoMoCo had a $60 million capital surplus (in 1916).

    Unless you’re a stock holder a business corporation has absolutely NO obligation to you, other than to steal the pennies off your eyes at your funeral (if they could get away with it) since stealing the pennies would amount to positive cash flow on the books.

  162. AlphaWolf says:

    Govt run Universal health care cannot be any worse then the system we have now. What we have now has failed to satisfy anyone and costs a fortune.

    The current system is immoral and discourages people from getting the treatment they need.

    Meanwhile we as taxpayers socialize the costs of airlines, manufacturing, farming, oil and other industries instead of spending money to keep our citizens in good health (unless you can get Medicare.)