Mandated Health Care For Retail Employees

[Terry Tate]

Yeah but if you have that accident, they will treat you and some one will have to pay for it.

Likely that someone has car insurance with medical liability coverage.

As a society, we long ago made the decision that we are not going to withhold needed medical care because the patient can't afford it.  We are just having trouble accepting that we have to pay for it.  Human nature.

I wasn't in on that meeting. Can we vote again? Because I have a different interpretation of "needed", and it doesn't include a poison oak infection on your johnson.

[gmac17]

that this happens in America is unconscionable given our resources.

 

A friend's father died in Canada waiting 5 months for bypass surgery. That something like that happens in Canada is unconscionable given their resources.

 

 

A few other points -

 

- you could walk into any emergency room in new york state with the sniffles and get free treatment just about no questions asked.

 

- any parent can purchase insurance for their child in NYS for $100 per month. Granted, if you have 4 kids and work at walmart that probably isn't a great option, but it is available.

[Bill from NYC]

Yet I bet folks who have no health insurance, do have a TV, cable, probably drink or smoke, dvd players, video game consoles, all kind of DVD's and VHS tapes, etc.... 

 

Choices.

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I am willing to bet that some of those foolish greedy bastards also buy Christmas gifts for their families. Some nerve!

[Mickey]

Likely that someone has car insurance with medical liability coverage.

I wasn't in on that meeting. Can we vote again? Because I have a different interpretation of "needed", and it doesn't include a poison oak infection on your johnson.

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What is and is not needed is a detail. Principal remains the same, we do not turn down needed medical treatment to patients because they can't pay for it. That is why hospital ER's are so full. If the point is that if we were just tighter in what we will and will not pay for, the whole problem would go away, then it is not a point, it is a fantasy.

 

Routine care like a case of poison oak is not the kind of expense we are choking on. Try about 5 or 10 years of intensive on-off care for a kid with leukemia or some rare, chronic, eventually fatal disease like Krabbe's Disease. Try a liver transplant or traumatic amputation. Uninsured people are just as susceptible to those kinds of tragedies as anyone else. The costs for that kind of treatment is mind boggling.

 

If your answer to the problem, since you weren't at the meetings, is to authorize hospitals to let kids die in the emergency room parking lot from treatable diseases simply because they can't pay and have no insurance, fine, run for office on that platform and see how many votes you get.

 

As for the car insurance thing, sometimes peopel lose legs in non-car accidents. Sometimes they lose a leg in a car accident and the other driver has no insurance or inadequate insurance. Often the victims own insurance limits are insufficient to cover such a huge hospital bill. You may answer, "tough, should have bought more insurance". Problem is, you still have the same issue, a person needs medical care beyond their financial abilities (which is why they didn't buy more insurance) and we have to decide, are we going to pay for it or let them rot?

 

It keeps coming back to that core question, not every one can afford the treatment they need or to pay for sufficient inusrance. Do we deny them treatment or do we pay for it? It is a really, really, really crappy choice but the answer isn't to pretend that we can avoid it by simply letting care givers worry how to pay for the treatment we mandate they give or by just letting people suffer and die for lack of cash.

 

If we want to not pay for this stuff, fine, cancel medicaid and tell hospitals that they can treat or not treat whoever they want based on ability to pay. The result will absolutely be lots and lots of untreated sick people suffering and dying. If there is anybody out there who wants that, raise your hands. As for the rest, accept that we have to pay for it and find a way to do just that.

[Mickey]

A friend's father died in Canada waiting 5 months for bypass surgery. That something like that happens in Canada is unconscionable given their resources.

A few other points -

 

- you could walk into any emergency room in new york state with the sniffles and get free treatment just about no questions asked.

 

- any parent can purchase insurance for their child in NYS for $100 per month. Granted, if you have 4 kids and work at walmart that probably isn't a great option, but it is available.

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That is why NY doesn't have nearly as many problems on this front as others with no such program do. Fact is though that the $100 (I think it is much higher, more like $250 according to one of my clients) is not enough to cover the costs. The program, I'm sure is paid for mostly by tax payers which is really the issue I keep repeating. We have to either deny treatment or find a way to pay for it. For kids in the Health Plus system in NY, we pay for it with a combo of money from the recipient and tax payer money. It may not be the best way but it does at least address the problem that you have to either deny it or pay for it, we pay for it. It is at least rational.

 

*Edit: I checked the Child Health Plus costs and if you are poor enough, that is very, very poor, the plan is practically free or close to it but if you make much at all, you have to pay the full premium for the managed care plan just like anyone else. For example, a single mother with 2 kids making over 2,600 per month would pay the full shot and she would not be on the plan, just the kids.

[Terry Tate]

What is and is not needed is a detail.  Principal remains the same, we do not turn down needed medical treatment to patients because they can't pay for it.  That is why hospital ER's are so full.  If the point is that if we were just tighter in what we will and will not pay for, the whole problem would go away, then it is not a point, it is a fantasy.

 

Routine care like a case of poison oak is not the kind of expense we are choking on.  Try about 5 or 10 years of intensive on-off care for a kid with leukemia or some rare, chronic, eventually fatal disease like Krabbe's Disease.  Try a liver transplant or traumatic amputation.  Uninsured people are just as susceptible to those kinds of tragedies as anyone else.  The costs for that kind of treatment is mind boggling. 

 

If your answer to the problem, since you weren't at the meetings, is to authorize hospitals to let kids die in the emergency room parking lot from treatable diseases simply because they can't pay and have no insurance, fine, run for office on that platform and see how many votes you get.

 

As for the car insurance thing, sometimes peopel lose legs in non-car accidents.  Sometimes they lose a leg in a car accident and the other driver has no insurance or inadequate insurance.  Often the victims own insurance limits are insufficient to cover such a huge hospital bill.  You may answer, "tough, should have bought more insurance".  Problem is, you still have the same issue, a person needs medical care beyond their financial abilities (which is why they didn't buy more insurance) and we have to decide, are we going to pay for it or let them rot?

 

It keeps coming back to that core question, not every one can afford the treatment they need or to pay for sufficient inusrance.  Do we deny them treatment or do we pay for it?  It is a really, really, really crappy choice but the answer isn't to pretend that we can avoid it by simply letting care givers worry how to pay for the treatment we mandate they give or by just letting people suffer and die for lack of cash.

 

If we want to not pay for this stuff, fine, cancel medicaid and tell hospitals that they can treat or not treat whoever they want based on ability to pay.  The result will absolutely be lots and lots of untreated sick people suffering and dying.  If there is anybody out there who wants that, raise your hands.  As for the rest, accept that we have to pay for it and find a way to do just that.

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Yes, I am all for killing children Mickey. Nice objective look at it.

 

Perhaps you should run for office, and your campaign can be "People have problems. Government should fix them. If you disagree, you're killing children." The only difficulty you will have is there are already two major parties full of demagogues, so competition will be fierce.

 

I only have one basic driving principle or core belief that I want to try to adhere to in as many cases and as often as I can, and that is liberty, or freedom, if you will. Your solution (which you admit is crappy) concentrates more power in Washington DC, so I respectfully submit it is crappy enough to end consideration.

[Alaska Darin]

Hard to find a government solution when the problem has been caused by same. Health care is expensive BECAUSE of government.

[Chef Jim]

- any parent can purchase insurance for their child in NYS for $100 per month. Granted, if you have 4 kids and work at walmart that probably isn't a great option, but it is available.

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Here's the major problem with America today. People who work at WalMart should not be having 4 kids. If you can'f afford children, guess what....DON'T EFFING HAVE ANY!!!!!!!!!

[KD in CA]

Here's the major problem with America today.  People who work at WalMart should not be having 4 kids.  If you can'f afford children, guess what....DON'T EFFING HAVE ANY!!!!!!!!!

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but...but...but...I have a right to have all the illegitimate kids I can't afford to raise that I want!!!

[UConn James]

Hard to find a government solution when the problem has been caused by same.  Health care is expensive BECAUSE of government.

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Exactly. Insurance companies/HMOs have nothing to do with it. </sarcasm>

 

Here's the major problem with America today.  People who work at WalMart should not be having 4 kids.  If you can'f afford children, guess what....DON'T EFFING HAVE ANY!!!!!!!!!

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I want to agree with you in principle. When you can't afford something, you shouldn't buy it. But to have the dollar outcome of human institutions of economics determine whether you get to procreate.... I'd rather live in a cave and be able to live unobstructed by any social rule than wear a McDonald's shirt & tie and essentially be a slave to the system. And I don't think I'd be alone in that.

[Chef Jim]

Exactly. Insurance companies/HMOs have nothing to do with it. </sarcasm>

I want to agree with you in principle. When you can't afford something, you shouldn't buy it. But to have the dollar outcome of human institutions of economics determine whether you get to procreate.... I'd rather live in a cave and be able to live unobstructed by any social rule than wear a McDonald's shirt & tie and essentially be a slave to the system. And I don't think I'd be alone in that.

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What I'm saying is I am not going to feel sorry for someone who says I can't raise my x number of children on the salary I get from doing y.

 

What should be done is everyone is temporarily sterilized at birth. In order to procreate you would need to pass a test to prove you're not a dumbass and show a financial statement to prove you can raise that child properly. Trust me in two generations vee vould have zee master race. Where the hell did that German accent come from?

[Alaska Darin]

Exactly. Insurance companies/HMOs have nothing to do with it. </sarcasm>

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Of course they do. However, much of what they end up doing is reactionary to poor government policy/attempt at control. Virtually everything the government does starts out with excellent intentions but morphs into something unrecognizable and ridiculously expensive.

[Crap Throwing Monkey]

What I'm saying is I am not going to feel sorry for someone who says I can't raise my x number of children on the salary I get from doing y. 

 

What should be done is everyone is temporarily sterilized at birth.  In order to procreate you would need to pass a test to prove you're not a dumbass and show a financial statement to prove you can raise that child properly.  Trust me in two generations vee vould have zee master race.  Where the hell did that German accent come from? 

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Plus, if we didn't reverse the sterilization in blacks we'd lower the crime rate...

 

[Mickey]

Yes, I am all for killing children Mickey. Nice objective look at it.

 

Perhaps you should run for office, and your campaign can be "People have problems. Government should fix them. If you disagree, you're killing children." The only difficulty you will have is there are already two major parties full of demagogues, so competition will be fierce.

 

I only have one basic driving principle or core belief that I want to try to adhere to in as many cases and as often as I can, and that is liberty, or freedom, if you will. Your solution (which you admit is crappy) concentrates more power in Washington DC, so I respectfully submit it is crappy enough to end consideration.

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I know you are not, that isn't what I was trying to say. What I am trying to focus on is that ultimatey we have a choice, either pay for the treatment some people can't afford or deny them treatment. If your answer is to pay for it, then you have to figure out a way. I am not saying anything at all about how that should be done or arguing for government involvment. You are automatically converting "if we are not going to deny treatment we must find a way to pay for it" into an argument for national health care or some other massive government involvement.

 

If on the other hand you are going to deny treatment rather than find a way to pay for it then whether it is what you favor or not, the end result is that people will suffer and die for lack of treatment.

 

If I am asking you to do anything here it is simply to make it clear what your choice is, do we deny treatment to people who can't afford treatment or adequate insurance or do we provide them treatment and find a way to pay for it?

 

Once you make that choice, the argument shifts to discussing the best way to accomplish that goal. If you want to provide treatment then we should discuss not just what you think won't work (government) but what you think will work. If you want to deny treatment, then tell me how, from a political perspective, you convince enough voters to support denying treatment to people who have treatable conditions, even those that are potentially fatal.

 

My own view based on political realism is that the notion that we will deny treatment would last about as long as the first front page story of some poor person who died from a treatable illness due to lack of insurance. A handful of such stories and the public would demand that something be done. Thus, I just don't see denying treatment as a realistic option in the current political landscape. Fact is, though I haven't researched it extensively, I believe that hospitals receiving federal and state funds have to provide treatment to the uninsured. To a large extent, the political decision to provide the treatment appears to have been made. The question is whether we have the political will to pay for the cost of our convictions and compassion. Will we pay for the treatment we mandate or simply push the costs off to hospitals who then raise the cost of everything else to cover it? The result being spiraling health care costs with more and more patients being priced right out of their insurance.

 

Step by step this situation is getting worse and worse and the party that has no answer for constituents who have good jobs but no insurance is going to be in big trouble. Hell hath no fury like a soccer mom with no health insurance. New York has a child health plus plan that addresses the issue in its most compelling form, uninsured children. Most states, I'm guessing most red states anyway, do not. Those are the states where this issue could explode.

[Live&DieBillsFootball]

Mickey, I agree with you that the majority of people want to see the underinsured treated but they don't want to think about how much it is costing us. Medicaid is killing state budgets in blue and red states.

 

You're right that everyone knows that there is a problem but nobody wants to offer a solution that will improve the situation.

 

One of the solutions from the right is for companies to stop covering their employees and put the responsibility on the employee to buy their own insurance using Medical Savings accounts. IMO, this will just make the problem much worse.

 

If employees have the option of buying their own insurance or going without, you will see many more uninsured people. IMO, if a company offers medical insurance, it should be mandatory for all employees to accept the coverage unless they already have similar coverage through a spouse or other family member.

 

Walmart offers medical insurance to their employees, but most employees decline it due to the high cost. I don't think that they should have the option to decline unless they have other coverage. This would cause Walmart workers to either find other employment or force Walmart to pay more of the costs.

 

We need to get the working poor off Medicaid. The only way to do this is to force employers to offer coverage and force employees to accept it. This will lead to higher prices as companies pass on their costs, but it will also lead to a lower burden on hospitals and Medicaid.

 

We are going to pay for it one way or the other, but I would rather keep the insurance with private companies rather than government programs.

[VABills]

Mickey, I agree with you that the majority of people want to see the underinsured treated but they don't want to think about how much it is costing us.  Medicaid is killing state budgets in blue and red states.

 

You're right that everyone knows that there is a problem but nobody wants to offer a solution that will improve the situation.

 

One of the solutions from the right is for companies to stop covering their employees and put the responsibility on the employee to buy their own insurance using Medical Savings accounts.  IMO, this will just make the problem much worse.

 

If employees have the option of buying their own insurance or going without, you will see many more uninsured people.  IMO, if a company offers medical insurance, it should be mandatory for all employees to accept the coverage unless they already have similar coverage through a spouse or other family member.

 

Walmart offers medical insurance to their employees, but most employees decline it due to the high cost.  I don't think that they should have the option to decline unless they have other coverage.  This would cause Walmart workers to either find other employment or force Walmart to pay more of the costs. 

 

We need to get the working poor off Medicaid.  The only way to do this is to force employers to offer coverage and force employees to accept it.  This will lead to higher prices as companies pass on their costs, but it will also lead to a lower burden on hospitals and Medicaid.

 

We are going to pay for it one way or the other, but I would rather keep the insurance with private companies rather than government programs.

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Or better yet. If your employer offers insurance and you refuse it, you go into a national database, and all free medical service priviledges are denied to you.

[Mickey]

Mickey, I agree with you that the majority of people want to see the underinsured treated but they don't want to think about how much it is costing us.  Medicaid is killing state budgets in blue and red states.

 

You're right that everyone knows that there is a problem but nobody wants to offer a solution that will improve the situation.

 

One of the solutions from the right is for companies to stop covering their employees and put the responsibility on the employee to buy their own insurance using Medical Savings accounts.  IMO, this will just make the problem much worse.

 

If employees have the option of buying their own insurance or going without, you will see many more uninsured people.  IMO, if a company offers medical insurance, it should be mandatory for all employees to accept the coverage unless they already have similar coverage through a spouse or other family member.

 

Walmart offers medical insurance to their employees, but most employees decline it due to the high cost.  I don't think that they should have the option to decline unless they have other coverage.  This would cause Walmart workers to either find other employment or force Walmart to pay more of the costs. 

 

We need to get the working poor off Medicaid.  The only way to do this is to force employers to offer coverage and force employees to accept it.  This will lead to higher prices as companies pass on their costs, but it will also lead to a lower burden on hospitals and Medicaid.

 

We are going to pay for it one way or the other, but I would rather keep the insurance with private companies rather than government programs.

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I have no idea if this idea is workable or not but I do recongize that it is a legitimate attempt at addressing the problem rather than just pushing it off on to someone else or pretending that we can go on this way idefinitely.

 

Frankly, as much as people carp about government, we really dump this problem in their laps leaving little choice but for government to step in. We don't want to endure any pain in trying to address the problem which means we don't want to pay for it nor do we want to read stories of people dying in ER parking lots because they had no insurance.

 

With that reality, what in the world do people think will be the result? Either magic rabbits with medical degrees will pop out of holes to treat the uninsured for a handful of carrots or the only entity in the country with the ability to do something about it will do just that. I don't see any rabbits. Surprise, surprise, surprise, the government is paying for treatment of the uinsured and to protect us from the true cost, tax a little and borrow a lot. I use the phrase "tax a little" as a relative term.

 

It always makes me laugh to see people claim to be against big government who adopt policies that make big government inevitable or, alternatively, adopt a policy that in theory would mean less government but that they know full well is a political impossibility.

[Crap Throwing Monkey]

Or better yet.  If your employer offers insurance and you refuse it, you go into a national database, and all free medical service priviledges are denied to you.

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My employer offers insurance. I refused it. But I'm on my wife's.

 

So do I go into your database or not?

[Mickey]

Or better yet.  If your employer offers insurance and you refuse it, you go into a national database, and all free medical service priviledges are denied to you.

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Won't work. You have the patient dying in the parking lot for lack of insurance scenario again which ultimately, voters won't tolerate, especially if the guy who refused the coverage has a sick kid. You might think or hope that people would not crumble and instead reason that he got what he deserved but what if he had to make a choice between rent and coverage? What if it was a choice between food and insurance? This idea depends on people having free choices so that if they make a bad one, tough on them. However, depending on the numbers, there may not really be a choice for the low wage earner to make. Choosing between getting evicted today and maybe getting sick tommorow, is not exactly a free choice. The sympathy factor will still come down in favor of providing treatment which we then have to find a way to pay for.

[VABills]

My employer offers insurance.  I refused it.  But I'm on my wife's.

 

So do I go into your database or not? 

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I do the same as you. The answer would be yes. However since you have an insurance card they would not need to check it as long as the insurance covers you, wouldn't they?