From the other thread...

Archduke Russell John wrote:

danivon wrote:What if they present with the symptoms of a treatable yet virulent communicable disease and can't pay? Do you turn them away and just treat the (insured) people who end up catching it from them? Surely if individual health is not a government responsibility, public health is?

You treat them and bill them.

So, if they cannot afford to pay, what do you do? If they die, what do you do? If they have no dependents you can stick the bill on, what do you do?

What happens to the unpaid bills from such situations? It seems that either the taxpayer pays, or the costs are paid for out of the healthcare system (ultimately, by insurance payers).

danivon wrote:So, if they cannot afford to pay, what do you do? If they die, what do you do? If they have no dependents you can stick the bill on, what do you do?

You follow existing laws in place it recover debt.

Oh, come on...

Are you unable to comprehend that sometimes there will be people who rack up medical bills who just can't pay them off, and the debt won't be recovered?

Frankly, I doubt it very much. I know you are a smart guy. So, let's get to the point - when medical bills can't be paid back (because there's no-one alive liable, or because those liable just do not have the assets), someone will end up paying. Who is it?

Additionally, are you also verging on suggesting that the CDC is a step too far - government involvement in health that may involve more than just advice, but actual intervention?

rickyp wrote:Who benefits most from the status quo in the US health system?

Canadians who can't wait for the red tape.

rickyp wrote:bbauska

Surely you do not advocate the treatment of a non-paying person for the common cold, do you?

Ah, so this is what a mindless drone is?

In real life, every person who comes into an emergency ward takes up time. You can't be certain its a common cold until someone is seen and diagnosed. And thats an expense.
every solution for the uninsured and indigent involves tax payers ultimately paying for their care. People who refuse to carry health insurance and get treatment beyond their means to pay are also depending on the system to subsidize their care as well.
As soon as there is a mandate to guarantee treatment, there is a a socialization of the cost of some who are treated. (thats what medicaide is...)
And as long as there is a public health angle to consider, the taxpayer is again on the hook.

I would think you know what droning is when it comes to a monotonous, unceasing noise. Perhaps you were being witty, it is hard to tell sometimes from you.

If the person needed assistance, they should be on Medicaid/Medicare. That would have them be insured and available for ER visits. I see no situation for a citizen or legal immigrant to not be allowed access to the ER.

But not illegal immigrants?

Again, what if there's a public health risk to turning them away?

bbauska wrote:If the person needed assistance, they should be on Medicaid/Medicare. That would have them be insured and available for ER visits. I see no situation for a citizen or legal immigrant to not be allowed access to the ER.

Besides, it's not your position that raised our questions. It's ARJ's of:

"Well, since I don't consider it government's duty to provide healthcare the difference is without distinction to me."

That seems to rule out Medicaid and Medicare as well, but I'm sure ARJ can ensure his views are clearly expressed if that's not the case.

In the same post that ARJ quote came from was this:

Archduke Russell John wrote:However, if you are using flawed figures to make your argument, it makes your argument flawed. He is trying to say that we spend more money on healthcare for a lesser result. When apples are compared to apples, this is demostrably false. Therefore, his argument is invalid.

I think that the onus is now on ARJ to substantiate this argument. On infant mortality, I've already pointed him to the CDC report that has an explanation for the difference and a clear picture of how many countries are using the same measure as the USA. So far I've not seen any other methodological differences between the USA and other comparator nations on health statistics.

danivon wrote:But not illegal immigrants?

Again, what if there's a public health risk to turning them away?

Deportation.

Gee, that was simple.

I realise that was a flippant remark Brad, but still... The sort of thing Dan had in mind was if an illegal immigrant rocks up at a hospital with a virulently infectious disease. Turning them away is simply sending them out into the community where they can spread that disease to legal citizens. Your alternative would either require hospital staff to act as law enforcement agents or the permanent stationing of law enforcement agents at hospitals just on the off chance that somebody needed to be deported. Both of things would be so inefficient as to end up costing more than providing the treatment would.

Somewhat flippant, but not totally. Secure the area, call ICE, arrange immediate transfer to country of origin. All the while treating the person in question until/during transfer.

That doesn't really address the public health concerns though, because it would only need to happen a few times and word would get around, meaning that illegal immigrants would no longer come to hospital even when they had infectious diseases. Neither would they get their children immunised against common illnesses. Pretty soon you'd find that public health was put at risk as they spread their illnesses to legal citizens, which again would end up costing more money than simply treating them would have done.

It's not a great situation for sure, I do understand the ethical objection to providing free treatment to non-citizens, but there's a case for saying the alternatives are worse.

Just as there is a case for providing more stringent patrols of borders, as well as stiffer deportation; as both would pertain to financial issues also.

I do understand the implications doing too much, as well as the implications of doing nothing.

bbauska wrote:Just as there is a case for providing more stringent patrols of borders, as well as stiffer deportation; as both would pertain to financial issues also.

Are we talking about public health policy, or about immigration policy? (after all, there are alternatives to stricter controls, such as a more efficient means of legal immigration, a less exclusive policy on visas, etc)

I do understand the implications doing too much, as well as the implications of doing nothing.

Is this abaout health policy again? Sure, I can see that providing full health cover as in Medicare and Medicaid to illegal immigrants might be going too far. But my question was about a specific set of concerns - emergency healthcare and public health.

And then we come to another question:

What if John Doe presents, with no ID, is not in a fit state to answer questions etc?

Surely you treat as you find, and determine residency status / level of insurance / ability to pay. i mean, you would not want to refuse a citizen by accident?

Brad, what you fail to understand is that if the official US policy does not provide treatment for everyone with little or no cost, it is unacceptable. They won't say it. They'll keep presenting "what if" scenarios that will begin with the benign and move to the absurd.

Some reasaons why our health care costs more than other western counntries without increasing health measurements vis-a-vis them:

1. The obvious one--high administration costs due to health insurance middle-men
2. Health care does not lend itself to free-market solutions
3. Dan pointed out the large number of premature babies in the U.S. costing a lot of money to take care of. I don't think it is unreasonable to think a country where wealth is more concentrated and health care is not evenly distributed is going to have higher numbers of premature babies Some of the factors the March of Dimes lists for causes of premature babies includes late or no pre-natal care, domestic violence, working long hours, drug use, and lack of social support- I strongly suspect that all of the above are correlated with povery and lack of health care coverage. Also think that uneven health care and more concentrated wealth correlates in general with more health problems (people treating too late, poor people not as healthy)
4. Monte made a good point about excessive spending on end-of-life care. My suspicion is that Americans rely more than Europeans on nursing home care. In other words, as Dan pointed out, of course Europeans do not care less about their elderly, but they may care for them at home rather than taking them to a nursing home.
5. I am thinking that given the competitive nature of our society, a safety net that is not as generous as those in other countries, and middle-class workers facing every more fianancial pressures that we have a higher number of stress-related diseases (raise your hand if you have GERD)
6. U.S. is the king of fast food and soft drinks--this cannot be good for the country's health