Oh, I agree! Self-pay patients are ridiculously hard to get ahold of and are always give false information. And we have an indigent care program also, where we DO write off large sums. Today alone I wrote off nearly $100,000 in four qualifying patients. I thought you meant they just wrote off amounts that were unpaid because they were unpaid, without collections process. I wasn't thinking on the self-pay level!

Labs and x-rays can be part of emergency treatment.

Obviously so! By current laws, however, we can (and do) turn away patients that do not have insurance for outpatient services (we have an outpatient clinic where people bring their orders for radiology services, lab work, etc.) and cannot pay the self-pay price. (Our self-pay prices are greatly reduced, yet still large. A mammogram is $75, MRI's range from $600-$800, labs anywhere from $50-120 per test, etc.)

But to get labs or x-rays a doctor must have asked for the test. Labs and x-rays are often a part of emergency treatment. How do you know the reason for the test being requested??

I was referring to out patient testing, not emergency care, when I mentioned the labs, xrays, etc. Of course that can be a part of emergency testing as well. Obviously the tests are ordered by a doctor, but there's still hosptial fees obviously. As far as knowing the reason, the doctors must include a diagnosis on the slip.

Well, outpatient testing should not be happening if the patient is illegal. That is an abuse of the system. But also one which could be prevented under a properly run public healthcare system (and from the sounds of it, IS prevented in other parts of the country, so it doesn't sound like a widespread problem).

Yes, well emergencies usually require hospital admission. If you have a heart attack you don't turn up to the ER, get treated and go home. :P You get admitted, get your emergency life saving drugs, spend a few days there and THEN go home. That IS emergency lifesaving treatment. It is NOT the same as chronic longterm treatment.

Completely agree with you!!

It's fine to say you're happy to take the responsibility, when you have the means to pay the bill (even if things are going to be a bit tighter as a result). And as you said $2000 is very little relative to what your bill could have been. You had a fairly straightforward delivery. What if you'd needed an epidural? Or a caesarian? What if your bill had been much much higher. How would you have paid it? What if your husband lost his job and you couldn't afford your insurance?

This is an even bigger issue now than ever before, because the vast majority of people without access to healthcare are not the poorest of the poor (who qualify for medicaid)... they're people leaving just above the poverty line, who do not qualify for medicaid, but who do not have the means for pay for insurance or health care bills. The vast majority of these people are legal Americans, and many of them have worked most of their adults lives in low paid jobs, or have been unlucky enough to end up unemployed or on a lower income as a result of the recession.

And as Transit already pointed out... when you pay your insurance company fees... unless you have reason to require a payout from them, that money just goes out to pay for OTHER people registered with the insurance company. So you already do pay for others health care.

So your issue is really about paying for healthcare for people who aren't paying into the system, no? But what about people who just can't pay? Should they suffer just because they've been a little less lucky in life... not fortunate enough to be born into a family who can afford them a good education for example... forced to work in minimum wage jobs... are they less worthy of healthcare because of that?

I'm not trying to attack you, but I'm genuinely curious as to people's reasons for feeling this way.

Thank you, exactly! The biggest problem to me is how we let people just fall between the cracks. Chris and I are a great example-when we got married, we no longer had health insurance , because we were not under our parents anymore, and at the time, had both graduated from college. I was without for a month before an individual policy kicked in, and Chris was without any for two months until his coverage began ( that was free with his doctoral program). Since then, I have been without a job for the last 3 months-but luckily for us, we can still afford on one income to pay for my coverage. There are a lot of people out there so dependent on their paychecks that cannot do that-but they aren't technically under the poverty line.

Also, and this has become very obvious to me as of late-Dental is NOT included in health insurance. Chris had to have an emergency root canal, and we did not have coverage at that time-my parents offered to help with the unexpected bill, which they certainly didn't have to do-but I was grateful, because it was so expensive! So many people don't have help or anyone to turn to without getting into major debt with things like that.

After that treatment, we learned what other work Chris needs done and he has an insurance plan now, which helps.
And now, sadly, I believe one of my new fillings is cracked or needs repair- as I have a toothache today.
I can't imagine living with this or him living with the pain he was in just because of a lack of income/insurance. That's awful.

Nicely put.

Or you could look at tort reform. Malpractice insurance is what drives up health care premiums. By allowing individuals in this country to sue for every frivolous issue, many doctors must pad their bills with costs just to afford the malpractice insurance premiums.

For instance, in Pennsylvania (where I'm from), many OB/Gyn specialists had to leave the state to continue their careers because after taxes and malpractice insurance, they had no money, or even owed money.

The suing culture in the US is ridiculous. When I was a medical student I remember being told that if I was ever in holiday in the US when I was a doctor, I should think very hard before trying to resuscitate someone if they were to collapse in the street infront of me... because even if we save the person's life they'd probable sue for the broken ribs!

It's increasing in the UK too, thanks to private claims companies, but it's nowhere near as bad as you guys have it (and our indemnity insurance is nowhere near as high as that of American doctors).

As I posted on my Twitter: 'The NHS has its faults (namely too much bureaucracy, but Labour are to thank for that), but I'd rather be given care based on the state of my health and not my bank balance. #welovetheNHS'

To me, paying for healthcare is just... bizarre. I like that over here you can pick and choose. Last year, I became convinced I'd contracted HIV. I had a blood test done at my local NHS clinic and the results would take two weeks to get back. Now, if you're a worrier like me, that would have put my life on hold for two weeks.
So, my mom paid for me to get it done privately (it was round about £150). Although they gave me a bit of counseling at the NHS clinic, I found that the private one was so much nicer. He was more thorough and knew more facts, and greatly put my mind at rest. I got the results back in under ten minutes.
So, you can always pick and choose. The NHS also tested me for Hep B and syphilis which I can say I am free from too :-)

My family couldn't afford health insurance. No fucking way. I'd love to be able to go private, and maybe one day I will have the chance too. But the NHS is fabulous in that it doesn't discriminate. Yes, the waiting times are hell. Yes, there is too much bureaucracy interfering, and yes, they squander a lot of their money (my mom works for the NHS so I hear some stories), but I wouldn't swap it for the world.

Oh and I read a great article by an American the other day, about how when his wife went into labour he prayed she didn't need a cesarian, because of the cost! Can you imagine? Worrying about the cost of having your baby delivered? Until recently I didn't even know people had to pay for it!

It also said 70% of all bankruptcies in the US are down to medical bills. That makes me sick. I'm sorry, I'm of the system of thought where I think your access to health care is a right.

Oops. I rearranged my words and made a mess!

I meant to say...

I agree that there's too much bureaucracy, and labour have made some mistakes, but lets not forget that labour put far more money into the NHS than the Tories did. And it's Labour who've reduced waiting list times and rates of MRSA. And at least they're united in their support for the NHS.

Access to health care is indeed a right. However, "free" healthcare is very much not. Demanding payment for treatment from the pockets of others violates their rights.

Not if you're all paying for it.

Why shouldn't free healthcare be a right? Life is a right, and denying healthcare may indeed be denying your life.

What about the right for one to spend one's income as one sees fit, instead of being told how to spend it?

Suppose I demand that I should receive free food, clothing, and shelter for my entire life? I would certainly die without them, so therefore, to disagree would therefore be deny my right to life.

So you're telling me you wouldn't spend it on health insurance?! You can't spend your income how you see fit anyway. You still have taxes.

Which is exactly how the system should not be. Rather than increasing government intrusion into personal autonomy, the people should be moving away from "big government." There are many problems with society, and increasing government has never fixed a single one.

An NHS is not free, everyone pays for it out of their wages at an affordable rate. In a lot of countries you can easily get free food, clothes and housing if you go on benefits, but your point is still completely pointless as I've already pointed out an NHS is not free.

... you're failing to make sense. I was making the point that all this social program and benefits comes at cost -- and to question precisely whose cost is the important thing. The fact of the matter is that moving toward a socialist system encourages laziness and discourages ambition and success.

You're failing to make sense, you complain about your money being spent in a way you cannot control then you seem to believe medical treatment is free with NHS's as you hypothetically wish for free clothes.

The NHS is not a social program, in the UK we all pay health insurance which is completely separate to income tax and compulsory to those working who are over 18 and under 65, only there is one company per country.

The UK isn't a bundle of lazy countries, if we are so lazy and lack ambition then why do we have one of the best education systems in the world with some of the best results in the world, which leads to people from all over the world moving here, even Americans to take advantage of a British education.

To be fair, I'm pretty sure the gvt massages the exam results of this country. I lived with am American in my first year if uni and she couldn't believe how easy her courses were here.