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  1. #1
    Banned germanyt's Avatar
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    How do unpaid medical bills get "passed on to taxpayers"?

    When u don't pay your hospital bills they get sent to collections. Why do I hear so often that taxpayers fit the bill? If I don't pay my cable bill the taxpayers don't pay it. I could understand the arguement that other policy holders pay higher premiums because of people that don't pay but am confused about the taxpayer claim.
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    Registered User SDMuscleBuddy's Avatar
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    Originally Posted by germanyt View Post
    When u don't pay your hospital bills they get sent to collections. Why do I hear so often that taxpayers fit the bill? If I don't pay my cable bill the taxpayers don't pay it. I could understand the arguement that other policy holders pay higher premiums because of people that don't pay but am confused about the taxpayer claim.
    If you go to the ER, they must treat you by law, regardless of your inability to pay. Most Americans agree with this law. The catch is that only those ER's who receive funds for Medicare patients or other federal funds are in the jurisdiction of this law. The more uninsured patients in the ER, the higher the bills to Medicare, which is paid from the general fund, which is created out of our taxes.

    It is in everyone's best interests to maximize the number of Americans who are insured. Since most Americans, or at least most of our reps in congress, don't want a single-payer system, and the Democrats pulled back into their shells like so many scared turtles over the public option, uninsured Americans will be subjected to a new tax.
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  3. #3
    Banned germanyt's Avatar
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    Originally Posted by SDMuscleBuddy View Post
    If you go to the ER, they must treat you by law, regardless of your inability to pay. Most Americans agree with this law. The catch is that only those ER's who receive funds for Medicare patients or other federal funds are in the jurisdiction of this law. The more uninsured patients in the ER, the higher the bills to Medicare, which is paid from the general fund, which is created out of our taxes.

    It is in everyone's best interests to maximize the number of Americans who are insured. Since most Americans, or at least most of our reps in congress, don't want a single-payer system, and the Democrats pulled back into their shells like so many scared turtles over the public option, uninsured Americans will be subjected to a new tax.
    So if Medicare covers it then why does it wind up in collections? If it's Medicare shouldn't it show up as a tax lein from the government? And not a general collection from an agency that works with the hospital.
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  4. #4
    Damn Yankee frankenstein's Avatar
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    Originally Posted by SDMuscleBuddy View Post
    If you go to the ER, they must treat you by law, regardless of your inability to pay. Most Americans agree with this law. The catch is that only those ER's who receive funds for Medicare patients or other federal funds are in the jurisdiction of this law. The more uninsured patients in the ER, the higher the bills to Medicare, which is paid from the general fund, which is created out of our taxes.
    Medicare is only for the elderly and disabled. It is by far the primary form of insurance for people over age 65. Everyone over 65 is coerced into enrolling. If Medicare patients have supplemental insurance (most do, especially the ones who don't spend 5 years in a nursing home) what Medicare doesn't cover should get picked up by their private insurance. If it doesn't or they don't have supplemental insurance, the patient is billed directly. Many times the hospitals and other providers write off the losses.

    "The more uninsured patients in the ER, the higher the bills to Medicare." What? Are you trying to be misleading? I think you don't understand Medicare firstly. If you or I, or anyone under 65 go into the ER of a hospital without insurance, Medicare cannot be billed a penny. Medicaid cannot be billed a penny either unless the patient has it. Also, Medicare and Medicaid do not simply pay whatever the hospitals feel like charging. Medicare has standard treatment reimbursement rates (aka "the allowable") for almost everything. Most of the reimbursement rates are retarded, but that's another topic.

    Unpaid medical bills do not get passed onto the taxpayer. They do get passed onto people carrying private health insurance though. The only grounds upon one can say unpaid medical bills get passed along to the taxpayer is to claim that Medicare and Medicaid's reimbursement rates are artificially high to make up for the people who won't pay their medical bills. I have yet to see any evidence of that. I can keep going, but I'll stop for now.
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  5. #5
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    Frankenstein,
    I disagree to a limited extent. Unpaid medical bills do get passed on to others...via increased charges.

    If a hospital performs a $100k procedure and does not collect payment...that $100k loss will get passed on to others using the hospital's services...

    it is that way in any business..losses have to be offset by your receivables.
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    The statement is somewhat misleading. The cost for unpaid medical bills gets passed along to clients of the medical system with insurance, who pay their own bills. These tend to be the people that actually pay taxes (net income to the government). A more accurate statement would be that people who actually pay taxes carry the cost of unpaid medical bills. Not true in every case, but gets the point across.


    Originally Posted by frankenstein View Post
    The only grounds upon one can say unpaid medical bills get passed along to the taxpayer is to claim that Medicare and Medicaid's reimbursement rates are artificially high to make up for the people who won't pay their medical bills.
    Everyone I know who works in the medical industry says that the reimbursement rates are too low and not keeping up with inflation and increased costs. People who can pay their bills wind up catching the difference between hospital costs and government checks.
    Disciple of the tire flip and Utilikilt.
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    Originally Posted by markymark69 View Post
    Frankenstein,
    I disagree to a limited extent. Unpaid medical bills do get passed on to others...via increased charges.

    If a hospital performs a $100k procedure and does not collect payment...that $100k loss will get passed on to others using the hospital's services...

    it is that way in any business..losses have to be offset by your receivables.
    ^This is why there's an 800%+ markup on things like aspirin and tylenol.
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  8. #8
    Registered User TimesRoman's Avatar
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    Originally Posted by germanyt View Post
    When u don't pay your hospital bills they get sent to collections. Why do I hear so often that taxpayers fit the bill? If I don't pay my cable bill the taxpayers don't pay it. I could understand the arguement that other policy holders pay higher premiums because of people that don't pay but am confused about the taxpayer claim.
    Years ago, I worked temporarily in a hospital in their accounting department. Did you know that hospitals have about 40% of everything they bill comes back as bad debt? Of course, they recover what they can, then sell the rest to collection agencies for pennies on the dollar. Hospitals know this going in, and they price everything they do understanding 40% will go uncollected. That means all government sponsored health plans are paying 40% more than they would have ordinarily had to pay, if not for the 40% bad debt loss. Taxpayers pay social security taxes, which in turn pays for medicare/medicaid.

    By not paying your hospital bill, this in turn causes everything (healthcare) to be more expensive, which means medicare is more expensive, which means you pay more social security taxes.

    Simple as that.

    So pay your dang bill!

    I'm tired of paying for it.
    --------------------> Roman
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  9. #9
    Damn Yankee frankenstein's Avatar
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    Originally Posted by markymark69 View Post
    Frankenstein,
    I disagree to a limited extent. Unpaid medical bills do get passed on to others...via increased charges.

    If a hospital performs a $100k procedure and does not collect payment...that $100k loss will get passed on to others using the hospital's services...

    it is that way in any business..losses have to be offset by your receivables.
    I wasn't implying otherwise, which is why I said people with insurance end up paying more. Actually, it is everyone who uses the hospitals services indeed, as prices are inflated due to nonpayments in the past. This of course has nothing to do with Medicare and Medicaid, though SDMuscle was saying that it does. As I stated, the taxpayer pays more perhaps in the long term if Medicare and Medicaid reimbursement rates go up with the nonpayment of others built into their pricing structure. But to claim the taxpayer end up footing the bill for people in the hospital right now who don't pay is wrong.

    And yes, Medicare and Medicaid's reimbursement rates are low enough now that medical providers who are allowed to end up charging more to private insurance and the uninsured to offset the low govt reimbursement rates. To give a fuller story, let me explain that it was quite the opposite until about 1998 or 1999. Medicare was reimbursing at outrageously high rates and treatments were almost unlimited, at least compared to now. As time has passed since then, Medicare has swung the other way to make up for its past mistakes and due to the huge number of new Medicare patients coming as the Baby Boomers retire. Now that Medicare has gone from a medical reimbursement treasure chest to barely covering costs, the medical community is trying to make up for the shortfall outside of Medicare. Medicaid has always had crappy reimbursement rates.

    I used to sell medical equipment to rehab centers, etc. Inexpensive stuff, relatively speaking. By the time I left after 6 years, the reimbursement rates from Medicare for most of the equipment had gone down or at best was the same as it was 6 years earlier. Just to keep up with inflation, the rates should have gone up 25% over that 6 year period. Instead, some key products saw rates go down 30-50% or more. When billing private insurance as someone's primary insurance, reimbursement rates were typically much better.
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    Originally Posted by frankenstein View Post
    I wasn't implying otherwise, which is why I said people with insurance end up paying more. Actually, it is everyone who uses the hospitals services indeed, as prices are inflated due to nonpayments in the past. This of course has nothing to do with Medicare and Medicaid, though SDMuscle was saying that it does. As I stated, the taxpayer pays more perhaps in the long term if Medicare and Medicaid reimbursement rates go up with the nonpayment of others built into their pricing structure. But to claim the taxpayer end up footing the bill for people in the hospital right now who don't pay is wrong.

    And yes, Medicare and Medicaid's reimbursement rates are low enough now that medical providers who are allowed to end up charging more to private insurance and the uninsured to offset the low govt reimbursement rates. To give a fuller story, let me explain that it was quite the opposite until about 1998 or 1999. Medicare was reimbursing at outrageously high rates and treatments were almost unlimited, at least compared to now. As time has passed since then, Medicare has swung the other way to make up for its past mistakes and due to the huge number of new Medicare patients coming as the Baby Boomers retire. Now that Medicare has gone from a medical reimbursement treasure chest to barely covering costs, the medical community is trying to make up for the shortfall outside of Medicare. Medicaid has always had crappy reimbursement rates.

    I used to sell medical equipment to rehab centers, etc. Inexpensive stuff, relatively speaking. By the time I left after 6 years, the reimbursement rates from Medicare for most of the equipment had gone down or at best was the same as it was 6 years earlier. Just to keep up with inflation, the rates should have gone up 25% over that 6 year period. Instead, some key products saw rates go down 30-50% or more. When billing private insurance as someone's primary insurance, reimbursement rates were typically much better.
    ^^^That(the part in bold).

    I didn't know about all that other stuff though. Thx for the informational post.
    "...that's the great virtue of the free market, of the private market. It enables people...who hate one another...who don't speak the same language...who would fight one another if they had the chance, to cooperate economically. We were able to deal with China when China was a communist state. Even though we thought that that was a terrible arrangement, we could still cooperate. And that's what markets enable people to do. They bring freedom with them."
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    My wife was born with heart problems and her family took advantage of charity care more than once. No way they were ever going to be able to pay for major surgeries like valve replacements and such, they were doing the best they could just handling meds, cardiologist visits, etc.
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  12. #12
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    Originally Posted by TimesRoman View Post

    So pay your dang bill!

    I'm tired of paying for it.
    Lucky for you I have no medical debt. I have no insurance so I don't go to the doctor.
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    Originally Posted by germanyt View Post
    So if Medicare covers it then why does it wind up in collections? If it's Medicare shouldn't it show up as a tax lein from the government? And not a general collection from an agency that works with the hospital.

    I didn't say that Medicare covers the costs. Health care in general costs more because of the uninsured. Those costs are passed onto everyone who pays for health care, including taxpayers via Medicare. Sorry if this wasn't clear.
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    Originally Posted by markymark69 View Post
    Frankenstein,
    I disagree to a limited extent. Unpaid medical bills do get passed on to others...via increased charges.

    If a hospital performs a $100k procedure and does not collect payment...that $100k loss will get passed on to others using the hospital's services...

    it is that way in any business..losses have to be offset by your receivables.
    Exactly. In my state for every $1.00 in actual services the hospital charges the private insurers $1.77 to make up for the uninsured.
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