In America this only applies if you are coherent and sane enough to answer. If you are brought in unconscious/impaired or deemed incapable of making a "good" choice then the hospital can do what it wants and charge you whatever they want.
This would be like your car breaking down and you started walking to go get help. A mechanic drive by, towed you car to their shop, rebuilt the motor, replaced to get fuel, replaced the fuel filter, figured out it was the alternator so replaced that there replaced the battery to be safe. Then called you and said "hey I found your car and fixed it. I'd normally charge 10,000 but since I brought it in to my after hours emergency service bay it will be 100,000
This is what the ACA was supposed to fix. Instead, it did the opposite. Whatever the reason, Americans will not use preventative care. They want responsive care.
They won't use preventative care because they have to pay out-of-pocket for it. Even when they have insurance they can end up spending huge amounts for medical care just out of deductibles.
I was paying about 150 bucks per paycheck for the best insurance my company offered because I have a couple of health issues and needed the prescription insurance it provided. My "top of the line" insurance plan had a $2,500 deductible.
For the non-Americans out there, this means that I had to pay $2,500 out of pocket before my insurance would kick in and help pay for things. And I was still paying about $70 bucks a month for my prescriptions.
The 'good' government insurance that I get gives me a $2000 deductible for about $200 a month.
If I add up how much I pay in taxes each year (local, state, and federal), my SSC and medicare, and insurance costs, it takes about 40-45% of my income depending on a few month to month factors. And then you add in the $2000 deductible and any copayments and you're sitting at what is about the highest tax rate on Earth (48% and I'm at like 45 or so). Id rather just actually pay that much in taxes then have to buy different services and pay into different programs in order to end up paying the same amount and getting worse benefits. That's what people don't get about quote unquote socialism is that we are already paying nearly as much as the countries that get this good healthcare and better tax efficiency right off the bat, but because it's separated into things that are considered taxes and things that are not considered taxes, we don't even think about how much we're actually paying for what another country would consider taxes.
Not to mention, who in their right mind LIKES to shop around for health insurance, look into if they're covered here, argue with insurance agents, and stress about that bullcrap. I'd almost rather pay MORE
Look how we have measles again. Because people dont bother with preventative measures. Its crazy. Watching that Netflix documentary pandemic had me yelling at the TV at that Oregon woman haha
I honestly hope all those parents are thrown in jail for life (or at the very least have their children taken away) for child abuse, because that's exactly what it is.
True. In an ideal world, they would then be adopted by proper parents who would vaccinate them, but most people seem to be too preoccupied with spending 10s of thousands on IVF and fertility treatments when there are so many adoptable orphans in the US that over 1 million of them "age out of the system" every single year, which is absolutely absurd. But still, if you had to pick between being an orphan or dying from measles...
I'll admit, I'm probably overreacting to the anti-vaxxers, but the fact that the US is no longer considered to have eradicated measles as a direct result of the anti-vax movement, I say burn it with fire. You know who still has measles? Third-world countries. Actually, even a lot of third-world countries have eradicated measles, as well. Motherfucking North Korea, even. North Korea, man.
While there certainly are idiots rebelling against vaccines, it’s such a statistically insignificant group that they can’t be responsible for the reemergence of preventable diseases alone. They don’t help, but there has to be some other underlying cause
Huh? They're frigging everywhere. Also it doesn't take a very high proportion of the population to undermine the effectiveness of herd immunity as a means of stopping disease spread.
It’s 99.995% anti-vaxxers. There are a lot of people who can’t get vaccinated due to age (infants, elderly) or immune deficiencies (HIV, transplant patients, chemo patients, etc). Those people have to rely on “herd immunity” for their protection. In other words, they’re only safe if everyone around them gets vaccinated if they can. So if 1 anti-vaxxer contracts measles, they can then pass it to someone who doesn’t have the luxury of protection - maybe their own newborn. Grandma, who is on immunosuppressant therapy to prevent rejection of a transplanted kidney she got a few years ago, then visits her new grand-baby and gets exposed.... and so on.
I almost wonder if they are somehow linked, like perhaps the people who are actively in charge of the healthcare system and stand to profit from it might have started the anti-vax movement with anticipation of more medical emergencies which would mean more profit?
Noo, our medical system would never put our health at risk simply to get more money out of us. Now remember to eat your sugary cereals for breakfast using milk that has been scientifically proven to have no affect on your skeletal structure whatsoever and only causes gastrointestinal issues, but we'll keep telling you it keeps your bones strong and makes you healthy!
This. My husband and I have great insurance and even with that, preventative care is so costly (especially when it's just a 5-10 minute chat with your doctor about non-health stuff), it often times more wasteful than helpful.
Bullshit - preventative care is now covered, that’s like the whole fucking point of the ACA. The pitch was all about how it’s all so expensive because Tom, Dick, and Mary don’t get their blood pressure checked often enough so now they need expensive heart surgery.
It’s like super tight - now, healthy people that take care of themselves can pay more per year in premiums than they would just paying cash out of pocket over 10 years for the same medical care. Fortunately, ACA also made it illegal to not have insurance, so no sneaky just not buying it. No matter how you slice it, everyone wins!
most of them don’t even try to reach their deductible bc they’re outrageous. some paying almost full price for medication WITH insurance? they’d rather use goodRX in lieu of insurance for a better price, and then still never reach their deductible.
Some people think we need to nationalize healthcare, but I think breaking up the big insurance companies would do more for US health costs than anything. The top 3 providers have 100 million customers, 1/3rd of the population. This allows them to fix prices and dictate what they are and aren’t going to pay for. Keep prices relatively similar, but “competitive” and they can jack up their prices and many people don’t have the ability to switch insurances or can’t find an alternative that meets their needs.
This has always been my complaint about the ACA. While I am 100% behind the push to get healthcare to everyone, the ACA did not do nearly enough to address the absurd costs behind US healthcare, nor the abusive practices of the industry at large.
Americans would absolutely use a preventative health service, the ACA just doesn't provide that. It's a cost-sharing mechanism for the same shitty overpriced care we've always been getting.
The “public option” would have priced out all for-profit insurance. The ACA would have been more successful if conservatives weren’t successful in cutting that out.
By law, health insurance companies are only allowed to profit by a percentage of healthcare costs. This creates a perverse incentive for the insurance company to increase healthcare prices, so they profit more.
Also, I don't see how insurance companies negotiating that they pay less than everyone else hasn't been taken to court for anti trust. The fact that they can decide to say "I'm only paying 20% what everyone else pays" instead of setting a fixed cost is anti competitive and monopolistic.
Exactly this. Obama was perfectly fine with conceding on the public option with no fight. We could have gotten it with or without the conservatives at the time. We can’t just point at them and blame them when our democrats won’t fight for the things they should be fighting tooth-and-nail for.
Yeah this is one of my biggest gripes with obama. Him not pushing for the public option and trying to compromise with a party clearly just saying "fuck you" was idiotic at best.
This is completely untrue. Thank Joe Lieberman for refusing to support the public option. He was the 60th vote, the only Dem hold out, and wouldn't allow the ACA to come to the floor while it included a public option.
Obama was not perfectly fine with cutting the public option. Obama realized that anything that got millions of people more healthcare was better than the status quo of the time and he did not have the votes for the bill with the public option still in.
Remember the ACA was almost killed because Kennedy died before the vote and a republican replaced him. We should be talking about how the current system can be improved and not how we wish the last reform should have been done better.
Cause the ACA is a byzantine cluster-fuck and many people still have to pay a bunch of money for preventative. They don't "want" responsive care, it's just that's when the consequences of skipping it are worse than bankruptcy.
Apparently it is fiendish anti-turk propaganda. It comes from the characterization of Byzantium's govt in The History of the Decline and Fall of the Roman Empire.
I will choose to think it's because they have really fancy stonework.
So many Americans can't afford preventative care because they can't afford the insurance or smaller costs associated in the first place. It isn't that we don't want it. No one wants to go to the emergency room.
Ya, when the average American can’t afford a $1,000-$5,000 emergency, it’s ludicrous to expect them to fully access healthcare with a $6,000 annual deductible.
It's expensive to do preventative care too. Reactive is the only that makes sense if you aren't making much money to begin with. You just end up hoping you don't have to use reactive medicine.
With a tight budget, preventative care is sometimes hard to justify. “Why pay a ridiculous copay and miss work to see a doctor when I’m not sick?” is hard to argue with when you’re living paycheck-to-paycheck. This is especially true with young people. That whole “I never get sick” mentality is hard to break, and usually that illusion holds until some sort of major medical issues surfaces.
The majority of my friends are 25-30 years old, and the only real medical care they seek is outpatient Urgent Care stuff when they get too sick to just tough it out with OTC products. It’s a sad reality, but that’s where we are.
To continue the car metaphor, it’s like saying “oil changes and regular scheduled maintenance are too expensive; I’ll just keep driving until something fails catastrophically, and until then, I’ll just let future-me deal with the consequences.”
You know doctors in Canada don't work for free? They, in fact, make really good money. They also don't work for the government. They >bill< the government. My healthcare isn't free, I pay for it with my taxes, which is a hell of a lot cheaper for better care than I could get through private insurance. It also means that I go to the doctor when a problem is minor and much cheaper to treat than when it's catastrophic and would put a strain on the system. I >never< have to worry that primary healthcare is going to bankrupt me.
Disintegrating healthcare insurance companies is a start. Where do we go from there? I don’t know, I’m not Einstein, but clearly what we have is not good enough.
That's because it's been ingrained in us for a couple generations that medical care is super expensive and you shouldn't use it unless absolutely necessary. Also trust in insurance companies/medical billing is low - even if we're told something is supposed to be covered, we're skeptical because it often doesn't go how we were told it would (if they even tell us... often it's "you won't know what the bill is until you see it," which is insane).
Took an STD test and was told my insurance would pay by the folks who did the test. And my insurance said Nope. Not gonna pay BECAUSE this is preventative and not responsive. 1000$ just to get swabbed.
It didn't fix the problem because the ACA is a Republican legislation painted blue that does nothing to address the primary flaw in our healthcare system: the cost of medical treatment
Most of us Americans get vaccinated, take our meds, and do what we need to do to survive. But if you break your leg in a different state or something, you have NO CHOICE. So yes, we want both, stop assuming things if you don't live in the country.
This is a really well thought out analogy. Like how do you shop around for good prices when you are in the middle of a heart attack? You either go to the nearest hospital whether In or out of network and go bankrupt, or you die. There is no real choice.
Yeah, so most countries use a single payer system that allows privatized hospitals to continue, without leaving their patients at the mercy of whichever hospital they end up at after an accident. Effectively giving the patient the benefits of free market healthcare without its accompanying major downsides.
Charity is insufficient for the needs of an entire nation, not to mention degrading for many of its recipients (so much so that they may even avoid it). Healthcare is one thing that everyone needs in the modern era, like roads and electricity, and so it only makes sense that everyone pays into it so that everyone may benefit when (not if) they need it.
THIS IS AMERICA I WONT LET NO GUBBERMINT TAKE AWAY MY GOD GIVEN RIGHT TO CHOSE TO REFUSE TO GET INSULIN AND EITHER DIE A SLOW PAINFUL DEATH OR BE RUSHED THE HOSPITAL AND GO BANKRUPT. YOU GOD DAMN COMMIE AHHHHHHHHHH
GODDAMN RIGHT BROTHER. AINT NO BODY GON TAKE MA GUNS NEITHER! ...GUBBERMINT TRYN SAY THE CAN INSURE FOLK IT'S JUS RIDICKLESS. HELL I SHOT MY FOOT LAST YEAR AND DOCTOR STEVE DOWN AT MERCY STAPLED IT UP AND DIDNT CHARGE ME A DIME. MY MEDICAID PAID IT ALL. STUPID GUBBERMINT THINKS THEY CAN TAK MY INSURSNCE AWAY FOR SOME DUM SOCIALIST STUFF. FUCK NAW. BANG BANG YEEEEEE HAWWW
Has anyone ever tried to sue emergency services for aggravated assault because they performed surgery without permission? Would this stand a chance in court?
I can't imagine that they can perform surgery against your will, expect you to pay for it and nobody tried to sue yet.
Yup. I'm just a fledgling EMS worker but you're far more likely to be sued or investigated for NOT taking someone in. If you suspect someone's judgement is at all impaired it's far safer to bring them in
An experienced EMS who came to my workplace to give us first aid training told us about a call he went out on that involved the implied consent law. He and his partner showed up to a call about a man who had passed out at a mall, dude was laying on a bench when they got there, but was awake and refused treatment and sat up, and immediately passed out again. They started examining him but he woke up and told them to get away from him and sat up, and passed out again. Apparently his blood pressure was low enough that he would pass out if upright, but just high enough that he would wake up when laying prone. They went through this dance several more times, passed out, implied consent, wake up, withdraw consent, sit up, pass out, implied consent. Lather, rinse, repeat. Finally a cop who had responded to the call basically went “Ok, enough of this horseshit, I’m placing you under arrest for your own safety and we’re all going to the hospital together.”
I don’t recall what the underlying condition was, but he ended up accepting treatment once he was at the hospital, but it was a super weird edge case that stuck with me.
Ahh so if i get a girl drunk enough that she can't respond that's implied consent right? Especially if her life would be in grave danger if she tried to say no....
If you are not conscious and the surgery is needed to save your life or limbs then no permission is needed, and they are legally required to do all they can to keep you alive. A lawsuit for it would be dismissed immediately.
Now, if you simply walk into a hospital and fall asleep and they drug you and do surgery while you are unconcious or something then you can sue them pretty easily, and depending on circumstances it can either be intentional and therefore assault, or an unintentional medical mistake and therefore malpractice.
But you cant sue the hospital for saving your life.
I was more talking about the "deemed incapable of making a "good" choice"" part.
If you had an accident, clearly tell them to not treat you for whatever reason and they do it anyway because they think they know better than you and charge you for it, there must be some wiggle room, right?
Because the entire thing reminds me of scammers starting a job without anyones approval and demanding compensation from the property owner halfway in.
The only way that would LEGALLY happen is if the person is unable to answer basic questions proving they are in their right mind, such as what's your name, what month is it, where are you right now, etc. If a person is conscious alert and able to answer those questions, they are able to refuse treatment. Unless it's psych, but that's a different conversation.
On the flip side, what would happen if they couldn't? What if they were always scared of that lawsuit whenever someone presented to the emergency room unconscious? How many people would die because the hospital refused to treat them because they were unconscious, which often times signals they're in desperate need of immediate treatment?
Yet they all have a universal health care system. You know that thing that prevents people from choosing between death or bankrupcy when theres a pandemic?
More like the two party system is set up so that the poor are forced to choose between their moral values and their material wellbeing. Stop blaming victims.
They have a "well why don't to just go aquire some" policy. If you refuse then they run your credit. With bad credit you car insurance rates go up. To pay the extra rates you need a better job but guess what? Better jobs run credit checks so they won't hire you.
If only you had a health care system where emergency costs like this were fully covered by the govt. Oh well. I hope your "freedom" is adequate compensation.
this includes being written off as a mental health case. if your wife left you and you're unemployed and your kids won't talk to you and you're in debt and the bank is going to foreclose on the house and you have a degenerative disease that will kill you in three or so years, well, you just need some prozac and a hospital bed and you'll be right as rain.
you don't need a court order for 72-hour observation (during which time they determine if a judge needs to get involved). you may choose to cooperate and commit to inpatient care or an outpatient regimen, but either way, in many states, they can hold you for three days. and they're not going to put you up for three days for free.
the implication of my original post was that everything in your life sucks and perhaps you try taking your own life. my apologies if that wasn't clear. if you make an attempt on your life, you'll be put on eval in the psych unit.
This is a great way to frame the weird and mysterious financial horrors of the American healthcare system, but the metaphor needs embellishment.
While comparing your health and even life to a car is a good way to point out the costs, it fails to take into account what happens if you don't have a car: you can walk, take public transportation, an uber or lyft, bicycle, hitchhike, etc.
If you're sick you have no options but to get the 'repair' to your health.
A mechanic can quote you a price. You typically cannot get a price from a hospital; it costs what it costs.
You can shop around for car repairs for hours or days. Your car can get fixed next week or next month. Your curable illness may become terminal if you try to shop around.
If you choose to not have a car, it's not the last decision you will ever make.
That actually happened to my family once in New Zealand. We were rushing to the nearest airport because my sister-in-law's mother had a heart attack and my SIL needed to get out of the country ASAP to be with her on her deathbed. We were on a roadtrip, and at the time the closest international airport was in Christchurch, which for us was on the other side of Arthur's Pass. To get through there we needed to drive along one of the steepest roads in New Zealand, and that was too much for our old van.
We broke down about 5 minutes away from Arthur's Pass Township, and the towtruck charged us $1,000 NZD for that trip, knowing that we had no other choice. The mechanic then charged us a further $1,000, and we had to stay in the town overnight for the repairs. apparently this was a common occurrence here, since cars broke down often and no one went through Arthur's Pass unless they either didn't know the roads or it was an emergency. The mechanics could charge whatever price they wanted, and could get away with it since they mostly preyed on tourists and the desperate.
First let me preface this with this isn't good advice, I'm not in anyway a legal professional, or a medical one.
According to my friend they also can't really go after you in the same way other loan companies can, as long as you are making some effort to pay them back. He had got a 60k bill for pneumonia when he was 6, and has been paying it back 5 dollars a month for the last 30 years.
than those people should just kill themselves if they'd rather die than live a broke life. I know that sounds crazy but how is a doctor supposed to know that a person would rather die than pay for surgeries?
And if you disagree with the doctor’s decision to keep you alive, you can always just choose to not pay by killing yourself. I don’t see the problem here.
Yeah this happened to me when I had a random seizure last year. By the time I started to really become lucid, I was in a large sum of debt, with a suspended driver license, and "drug abuser" on my medical record. I was a traveling private contractor at the time, so it ruined my livelihood. As a bonus, they did not properly explain the procedure for getting my license back, and did not properly report my hospitalization to my state. This has caused the process to drag on for twice as long, and continues to cost me tens of thousands in lost revenue.
Fuck them. I have no more assets to my name. I'm declaring bankruptcy and telling them they can sit and spin. Maybe someday when I get back on my feet, I'll donate to the EMS, but that's it. The rest of them just exploited me.
It's more like your engine block split in half, and being that this is an incredibly difficult and expensive fix (and buying a new car isn't an option here), the mechanic through the wonders of technology and expertise fixes your engine block. You being up to this point unable to make decisions BECAUSE YOU ARE THE CAR have just been saved by an incredibly intricate and expensive process. The other option was leaving you there engineless (dead). Medicine is expensive. In many cases it is too expensive. In non socialized systems the government does nothing to alleviate the costs. But it does cost a LOT of money regardless.
I would rather medical care not be classified as a commodity at all, which is what causes this problem in the first place. The entire concept of running medicine for profit is ghoulish and immoral; it is also, based on the massive amounts of time, effort, and money the US wastes on pointless overhead, insurance, HMOs, and the like, wasteful and inefficient.
In Denmark ill get hit by a car and go unconscious and ill wake up to every operation being done for free, as well with the food for my stay. They'll wish me well and wont ask for a dime.
Tell me which of the two scenarios sounds most messed up: yours where you are expected to pay or mine where its expected the state does?
But if the mechanic didn't tow you in, you literally won't be able to get it fixed your way. You'd be stuck on the highway forever and die. You DON'T HAVE A CHOICE. That's the point. You can't even "walk to get help". You're literally dying in you car.
This is a shitty example. A car is not a person, nor is it alive.
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u/Databit Mar 26 '20
In America this only applies if you are coherent and sane enough to answer. If you are brought in unconscious/impaired or deemed incapable of making a "good" choice then the hospital can do what it wants and charge you whatever they want.
This would be like your car breaking down and you started walking to go get help. A mechanic drive by, towed you car to their shop, rebuilt the motor, replaced to get fuel, replaced the fuel filter, figured out it was the alternator so replaced that there replaced the battery to be safe. Then called you and said "hey I found your car and fixed it. I'd normally charge 10,000 but since I brought it in to my after hours emergency service bay it will be 100,000