I haven't seen it like that. Medicaid sets prices so that even "Cadillac" insurance policies are not bound to pay more.
Yes, Medicaid is insurance. Insurance sets prices. Across private and gov they set them to suit interests, not based on any actual costs.
In other industries, the cost of production, supplies, and labor factors into the cost of the product... not so with medical. Why is it that a standard delivery of a child in the 40s was less than 100, and today it is over 11000... for even a SHORTER STAY at the hospital? Nope, not inflation.
The $70 childbirth bill - CNN.com
This article doesn't speak to the problem, only mentions it in passing. But it gives figures that I wanted to bring forth.
I had an episode last year. I was in the hospital, no exaggeration, for a month. There were other documents, legal ones, that PROVES I was unstable. My husband obtained a private insurance policy in preparation for these bills.
Guess what? "We won't cover it" says insurance "because WE don't deem it medically necessary." WTH? So you're saying that because you don't want to foot a bill or negotiate one that is well over 30000, that you're just not going to cover it at all? Are you more learned than the doctor, than the medical examiner, are you more learned than them to say "yeah, you didn't really NEED to be there, much less it was a MONTH before the doctor decided you were well enough to leave, so we're not paying?"
This same insurance said they could buy me hearing aids. In my instability, I lost the last pair. Hearing aids range from about 4000 to 6000 a pair. This is kinda important for me in WORKING A JOB because then I can HEAR and be more receptive to orders. Guess what? The same insurance that said "yes we cover that" said "no we won't, cause we don't like that doctor (iow, not in the "network").
Now, you tell me: Why should my coverage be affected by who offers the service? Why should my options be limited for the EXACT SAME SERVICE, I mean, for the same product (the aids)? What if I think a doctor is more knowledgeable or likeable, and I don't want to go to another doctor? Why should YOU, oh insurance, decide FOR ME who I can and can't see?
This is why it doesn't work as a free market and allows this monopolistic pricing... you can't say to one hospital "your service is better, I'm going with you" because the INSURANCE has a say in who you can go to.
Oh and btw: Prices are not published. I know because I used to ask the cost of things before a service, and like "oh, you'll get the bill." So, I can't decide FOR MYSELF whether that MRI would be financially worth it to me, that you say I need?" NO OTHER INDUSTRY IN AMERICA gets away with this.
The issue where the Constitution comes in, here, is I shouldn't be forced or coerced into buying a product, and I should be free to choose who I want to reward with my money... Insurance prohibits this, both private and gov. And by forced, I don't just mean Obamacare... I mean, I should be able to decide: "I want to go to this hospital vs this one because of quality of service and price" NOT "well, I have to go to this one even though the service is marginal, they don't listen to me, I feel like a cash cow, BUT if I want this service, insurance says this is the one."
I have that coverage, get a statement of benefits. It says I don't have to pay more than what the government has set for the basis of Medicaid/Medicare. I have neighbors who are excused of all charges due to low income, while I pay the approved maximum.
Then perhaps what the gov needs to address is the limited mobility in our economy.
Now, I agree that many people just don't want to work... but for many, they don't want to work, they refuse to because their "hope is deferred."
You can't climb in this economy by hard work alone. For a fortunate few, this may work. For people from your generation, in a different social/economic climate, this may have worked.
For me personally, when I worked at McDonald's I got to where I worked hard, with precision and speed, and customer/manager alike praised how clean the lobby was... but, I had "resting ____ face" in other words, I didn't make customers feel warm. When I worked register, I wasn't going at sounding both friendly AND genuine. I worked hard on that, even got complimented for doing better on a review... but did I climb the ladder? No. But you bet your bottom dollar that few worked harder in little detail than I did. I would scrub dried ketchup off the floor - I wasn't afraid of getting on my knees, even. You may say "well, appealing to the customers is part of the work, so you didn't work hard."
Well, my point is hard work is a relative term. When multiple customers go out of their way to comment on a clean lobby, go out of their way to tell you personally "you're different, you don't walk mop around, I see you're always working" and one customer even buys you a new pair of work shoes cause they see you work... then that's hard work. Relative to that environment, that's hard work. So be careful when you say to someone "you're not getting anywhere because you don't work hard." It's precisely that mentality that discouraged me personally, like "well, I'm not advancing so I must not be doing anything right" despite clear evidence to the contrary.
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If I had to choose between taking a better job, and yet the gov. assistance puts me 500 dollars in the hole because of a SLIGHTLY better income (like .75 cent raise), then it is not worth it to me to try. Maybe you might criticize me, and say "Do with less so you can have more" but doing with less may mean the difference between scraping by or even getting evicted cos the rent and utilities don't change and I still have to pay them.
Before you criticize people for staying on welfare, LOOK AT THE NUMBERS, and look at the GOV restrictions. For most people, and I certainly understand, the added stress of losing a lot of income to gain a little bit is not worth it. They stay on welfare.
When I started working at McDonald's, I was on gov assistance. I was on disability insurance and food stamps, and both Medicaid and Medicare, because of income. I started working, min wage, for about 30 hours a week. Now, I can't count on a fix set of hours, and they go down in the wintertime due to less demand and cutting labor. So, I may work 30 hours one month, then 10 hours the next. I have to factor that into paying for my stuff if I let go of insurance. I was willing to work, but it is not STABLE and STEADY work - this is why people feel the job is beneath them because it is NOT A SECURE SOURCE OF INCOME.
I sympathize, because I too thought (before I got married) "yeah I want to support myself" THEN I started thinking "how to pay for this and that" and I lost hope.
A natural result in this capitalistic economy of ours, which BTW still works magnificently for people who are willing to work enough to enter it,
Do they have the skills? Do they have the social savvy in interviewing? Many employers won't hire someone because they didn't make the feel good, didn't impress them in the exact way they think they should. I read that many employers take issue with young folks not having manners.
In some cases, it's not about willingness or unwillingness to work... it's about not having the right skills and not even realizing you don't because you weren't taught them.
I can't tell you how many times I've gone in where "help was wanted" but MY help in particular wasn't. Maybe I didn't engage "correctly" in the interview. Maybe they had other applications that looked better. But I WASN'T "unwilling to work." If I may, unless you can read the heart or motivations of a young person, I wouldn't assume "they don't want to work" simply on the fact that they currently don't have a job.
is a growing reaction to medical service price lowering, not increasing.
Um, where has prices decreased? They may be negotiated by insurance with the hospital, but they haven't decreased.
This is the thing: To say to one person "you have insurance, you'll pay less" and to say to another person for the same service "you don't have insurance, you'll pay the full ten times we charge insurance before negotiating amount" is discriminatory.
Gov. insurance is more appealing to people because it really is more comprehensive. And being subsidized, it is cheaper.
Insurance REALLY should be held by people who want to protect themselves from LARGE costs in case of an emergency. I shouldn't need insurance for birth control, I shouldn't need it for my routine meds, I shouldn't need it for maintenance costs that I expect to pay for myself. Insurance, in the beginning, was not intended to be a catch all. Because it is a catch all, it is more expensive, because it covers more.
Maybe focus on bringing down the price fixing and monopolies so people can afford certain things without welfare insurance.
Every doctor's office I've been in the past few years have posters up that if your insurance is young enough to include ACA policies, or you are on Medicaid and even a growing list of Medicare policies, they will not accept new patients.
Well, yeah, they lose money! They charge insurance, insurance negotiates it down, iow, they lose profits they would otherwise have because gov. insurance is more comprehensive. Have people get on with private insurance, there's a good chance they'll pay out of pocket for some services because they have to be "in network."
People with good policies, who pay up their deductibles & copays,
The issue is MANY CAN NOT. Insurance is meant to be a buffer for the unexpected, so some people would rather take their chances than throw hundreds down the toilet every few months on a MAYBE something will happen.
So, a patient is favored for the money they put forth, rather than their need? This is the issue, this is what makes it sooooo corrupt... "buy this pill, for thousands a month, or hundreds in co-pay, IF IT IS COVERED IN THAT NETWORK, OR DIE."
I don't know where I'd be if it weren't for the laws set in place that emergency rooms can not turn you away because you can't pay. For that, I'm thankful, because at one point (and now via marriage) I didn't have a way to pay and I got treatment.
who are providing the funds that allow medical personnel to earn a fair living, considering the price they pay to qualify, and the long hours (12 per shift plus a lot of overtime), even compelled to sleep on a cot a few hours to work another shift, etc..
Really? I'm curious as to how the type of insurance affects the quality of work for these people. I really don't know.
Poor people can't contribute to the welfare of all people, seeing they are unable to support themselves well enough, apparently, to avoid bankruptcy over medical bills.
Yes, apparently. You know what bankruptcy does to your purchasing power? How it looks when you need to draw a loan? Bankruptcy is so common, we hear about it so much that I think we've become desensitized to just how crippling it can be... unless you're facing it yourself, sit down and count the costs, then gov. assistance doesn't look so bad.
A better idea is to reduce the numbers of poor people, favoring small businesses that can prosper near where people are available to work.
I agree.
A way to avoid that calamity
Staying healthy isn't going to prevent that drunk driver from hitting me, that inadvertent fall from a ladder while working, that hospital stay because the vaccine didn't protect me from the flu, and so forth and so on.
is to stay healthy, work steadily, obtain an employer-provided health care plan,
Which excludes MANY jobs, including ones that OFFER benefits but getting around giving them by cutting your hours.
then see those huge bills negotiated down from $200K to your part a mere $400,
400 dollars is mere to you? That's almost a month's rent for us!
plus providers willing to take monthly payments rather than lose all income from bankruptcies.
Not many. Most private clinics want it up front UNLESS YOU HAVE INSURANCE, but what if you don't cos you literally can't afford a monthly payment cos you're being humble and working these "beneath you" jobs?
But way too many people now fear getting off welfare to take a job.
With good reason. Listen, I sympathize with people being so apathetic in these times, and I agree, many people are.
But I speak as someone WHO THOUGHT ABOUT pulling myself up by my bootstraps and letting go of assistance. My conscious convicted me and I started the PASS program. Before I finished, though, I had gotten married and lost it that way.
I am telling you as someone who was actually there, actually looked at the costs, looked at the probabilities, and formulated a plan (which is, btw, only available for those who are eligible for SSI), but I didn't get it fully executed. Even so, I knew just glancing at the numbers that in working for McDonald's, the wee little bit of income I got barred all my foot stamps... so working to gain 150-200 dollars a week, took away the 100 I made in food stamps... that's about a half of a GOOD week's income (25 hours a week, and this is a gross income figure) on summer days, to replace something taken from me for working.
The only people I know who have been damaged from medical bankruptcies are people who lose their jobs,
Yeah, and MANY have lost because of cutting labor... by no direct fault of their own via quality of work.
decline to continue their insurance,
If the money's not there, it's not there. And thus, people descend into welfare.
then get sick (or continue some condition) before qualifying for welfare. Then when a big bill is made there is no negotiator to haggle the prices down.
Medicaid and Medicare ARE forms of insurance... they negotiate prices down as well.
If people could work, then get laid off, they should be able to jump right into at least enough work to keep up basic expenses to avoid financial collapse.
They should... but it depends on how the employer words it. If they can show, someway that you deserved termination (maybe via an unfair write up or something) THEY DO NOT OWE YOU UNEMPLOYMENT. Some employers will harass you in hopes that you will quit if they think you may be entitled to unemployment so they don't have to fire you themselves (cos they have no good reason to yet.)
All it takes often is simply go work out offers to creditors. A man came to me to negotiate a bill, and I hired him until he got his old job back.
But, like my fishing buddy, he refuses to take a low paying job, holding out for his old high paying job.
People don't want them because the hours vary, thus the stability of their income varies. At McDonald's, they cut the hours of people who have been there longer just to train someone new. They systematically hire people they don't just need - this makes getting hours very competitive in this places.
People want security in income from a job, they want steady hours because the bills are steady.
Phone
Internet
Rent/mortgage
Garbage/water/electric
INSURANCE
A man should not even eat if he refuses to work. I can't sympathize with anyone who is capable of doing some job, but refusing to work.
I can sympathize with people who try and try and try to find a job, but for whatever reason, they don't. Maybe they didn't have just the right mannerisms at the interview. Maybe they're "overqualified" or "underqualified." Maybe they can't afford a nice set of clothes that fits just right for that interview, and they get brushed off for wearing their best jeans.
There's a myriad of reasons why people can't find jobs, and unless they're taught in specifics they will continue to have a hard time. Let me put it this way - college textBOOKS, whole books are written, whole classes are given JUST to increase the changes than an employer will like you... it's not about being a hard worker, it's about how you present yourself, which frankly, is one thing I personally struggle with.
Our county has 1,100 unfilled jobs, most good ones, but require exposure to the outside, or on an assembly line, some requiring special skills. The problem is few people are willing to work if it means sweating.
I can sympathize with you on people not wanting to do dirty work. But another thing to consider is where are these jobs? Can people get there - cities or countryside? Will they train you on the job (some won't)? Some people literally can't lift much. And so forth.
There's the Bible answer.
Bible answers usually have a specific context, audience and topic, but that's none of my business.