Actually They Dying On The Streets.
Posted by Chris Martin at 11/16/2009 11:17 AM 
Categories: Health policy
Tags: Laws are attempts to deal with problems
Categories: Health policy
Tags: Laws are attempts to deal with problems
Mr. McPhail feels that Wonks Anonymous caricatures the outcome of consistent market medicine. He also feels that we already have a safety net:
In fact many inner city hospitals are continually on the brink of bankruptcy, largely due to EMTALA requirements. Drew-MLK in Los Angeles is a good example. As things stand now we have had a couple of cases of the indigent dying in an underfunded emergency room.
Please to note that the costs of this "safety net" are not borne by the squeamish, who benefit from its existence, but by people who work hard to provide medical care.
"You want to help people? Here, work for free so that I can pay less in taxes. I will admire your efforts from afar while I watch Gray's Anatomy on my new wide screen TV".
Wonks Anonymous does not mind paying taxes. He could pay more. Wonks Anonymous resents the social expectation that helping professions should work for free. He spent a long time teaching for next to nothing and the topic is sensitive,
But this gets worse because the emergency treatment model is really the most expensive possible way to deal with chronic conditions. People need help, attention and encouragement in order to stay in good health. We ignore them until they get really sick and then - because we would think less of ourselves if we just let them die - we spend large amounts of money to keep them alive, in pain and impaired.
By the way, Wonks Anonymous believes that medical decisions are best left to competent medical professionals. He feels that the rich are no more capable in these matters than the poor. When we try to make the fee for service medical model work we are thinking in the wrong box. Not all economic transactions are best handled by anonymous markets where every good and service becomes a commodity. Other payment relations have prevailed and will continue to prevail.
For a more complete treatment of this see: The Wonks Anonymous Guide to Health Economics
Sure, there is room for a "safety net," which purportedly the EMTALA creates. What's being proposed expands and creates something wholly different. Stupid behavior should not be subsidized—irrespective of politics or economic status. The doomsday rhetoric of the indigent simply dying in the street does not mirror reality.The Emergency Medical Treatment and Active Labor Act was passed because poor people were dying on the streets or in transit between Emergency Rooms that wanted them to pay and County Hospitals that were supposed to take them. EMTALA itself is a poorly crafted safety net because the poor still tend to be concentrated in certain areas and the requirement to provide free emergency care to all comers falls mainly on hospitals that are located near the poor.
In fact many inner city hospitals are continually on the brink of bankruptcy, largely due to EMTALA requirements. Drew-MLK in Los Angeles is a good example. As things stand now we have had a couple of cases of the indigent dying in an underfunded emergency room.
Please to note that the costs of this "safety net" are not borne by the squeamish, who benefit from its existence, but by people who work hard to provide medical care.
"You want to help people? Here, work for free so that I can pay less in taxes. I will admire your efforts from afar while I watch Gray's Anatomy on my new wide screen TV".
Wonks Anonymous does not mind paying taxes. He could pay more. Wonks Anonymous resents the social expectation that helping professions should work for free. He spent a long time teaching for next to nothing and the topic is sensitive,
But this gets worse because the emergency treatment model is really the most expensive possible way to deal with chronic conditions. People need help, attention and encouragement in order to stay in good health. We ignore them until they get really sick and then - because we would think less of ourselves if we just let them die - we spend large amounts of money to keep them alive, in pain and impaired.
By the way, Wonks Anonymous believes that medical decisions are best left to competent medical professionals. He feels that the rich are no more capable in these matters than the poor. When we try to make the fee for service medical model work we are thinking in the wrong box. Not all economic transactions are best handled by anonymous markets where every good and service becomes a commodity. Other payment relations have prevailed and will continue to prevail.
For a more complete treatment of this see: The Wonks Anonymous Guide to Health Economics
Apparently, Wonks Anonymous missed the point: there is no evidence to support the rhetoric that droves of sick, poor people are dying in the streets now and gov't insurance is necessary to reverse the tide.
I don't expect anyone to work for free and I don't expect others to pay for the promise of utopian coverage.
Well, if Wonks Anonymous loves taxes, here are just a few that the Congress is contemplating to pay for its so-called healthcare improvement:
Excise Tax on High-Cost Health Plans. New 40% excise tax on health insurance plans to the extent they exceed $26,000 in cost ($9850 single). Exemptions made for over-55 retirees and “high-risk” professions; high-cost states phased in. The “Cadillac” threshold is indexed to inflation-plus-one percent, but average premium growth has been eight percent annually for the past decade. At that rate, the average family plan will hit the “Cadillac” threshold less than two decades from now. At that point, a majority of health insurance plans in America will face this new 40 percent tax.
Individual Mandate Tax. If someone does not sign up for health insurance, he/she will have to pay a tax in the following range: $750 - $1900.
No rational person would enroll in a health insurance plan if they could pay this tax instead. The average cost of health insurance is about $5,000 per year for an individual, and $11,000 for families. Plus, people would be able to enroll in health insurance even if they wait until they get sick. Many people will simply pay this tax, and then enroll in health insurance when they need it. After they no longer need insurance, they will un-enroll and continue to pay the cheaper mandate excise tax.
Employer Mandate Tax. $400 per employee if health coverage is not offered, which is a huge incentive to drop coverage. A rational employer will drop coverage and simply pay the much lower tax.
Backdoor Death of Health Savings Accounts (HSAs). By requiring that all plans (besides the few that are grandfathered) provide actuarially-generous coverage for most services, there would be no HSA-qualifying plans available from the Massachusetts-like exchanges.
Report Employer Health Spending on W-2. This is clearly a setup for the easy individual taxation of employer-provided health insurance down the road. If everyone receives an estimate of the cost of care on their W-2, it will be very easy for Congress to require that some or all taxpayers pay tax on this compensation.
Cap Flex-Spending Account (FSA) Contributions at $2,500. Currently unlimited. This will have some of the worst side effects for families of special-needs children, who have very high health costs which can be made tax-advantaged with unlimited FSA deferrals.
Eliminate tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D.
Medicine Cabinet Tax. Americans would no longer be able to purchase over-the-counter medicines with their FSA, HSA, or HRA.
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(Sorry for the double entry)
At least one area of agreement can be found in Wonks Anonymous' statement that medical decisions are best left to medical professionals. Unfortunately, the referenced gov't interference exactly prevents this type of result.
When the gov't subsidizes health care, anything you do with that money becomes the taxpayers' business. Typically, the gov't imposes the preferences of the majority — or sometimes, a vocal minority — on everybody with no middle ground.
Last week, the House its version of health care 2.0. However, to appease pro-life members, Speaker Pelosi allowed them to insert an amendment to prohibit taxpayer dollars from touching any health insurance plan that covers abortion.
House leaders are searching for a compromise, but there literally is no way to split the baby here. Either the gov't will force taxpayers to fund abortions, or the restrictions necessary to prevent taxpayer funding will reduce access to abortion coverage.
Welcome to government-run health care.
Do you think chiropractic treatments are a waste? Well, too bad, the gov't forces you to pay for it through Medicare.
Think faith healing seems like quackery? Sorry, Medicare and Medicaid force you to pay for faith healers at prices "comparable with those of real health care providers." Get gov't out of health care, and you'll be able to make choices for yourself.
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