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Published: Monday, Oct. 22 2012 12:00 a.m. MDT

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Mike Richards
South Jordan, Utah

A few years ago, I nearly sliced of the tip of a finger on my bandsaw. My wife took me to the doctor who advised me to go to the emergency room at the hospital because the saw had cut through the bone. The emergency room doctor sewed up the finger. It took twelve stitches. I was there fifteen minutes. The bill was just over $3,000 for those twelve stitches and that fifteen minutes. My insurance deductible for hospital care was $3,000. Do the math. That visit showed that either the emergency room rate was $12,000 per hour or that the rate was $250 per stitch.

When my doctor heard how much I had been charged, he was appalled and he apologized for not sewing my up. In his office, it would have cost $100 for the visit.

Don't cry for emergency rooms. They may give "free" service to some, but they make it up on people like me who pay for services rendered.

one old man
Ogden, UT

And Mike, that is exactly why ACA is needed. Your medical bills and insurance premiums would be much lower if every American was required to provide insurance for themselves.

It's disgusting that so many conservatives scream that the 47% should be taking "personal responsibility," and then cry loudly when "Obamacare" tries to require exactly that.

But unquestioning loyalty to party ideology will always trump good sense, won't it? And what is the first tenant of GOP ideology?

Make Obama a one-term president no matter how much harm that may do to the nation.

J Thompson
SPRINGVILLE, UT

@ One old man,

Huh?

Mike paid out of his own pocket for medical services. His insurance paid nothing. He should have paid the actual cost for the stitches and for the time. He was charged by the ER doctor and the ER room for services that he did not receive.

If you buy a gallon of milk at the grocery store, are you charged for all the milk that was "given" to those on welfare?

It's the same principle. Mike was charged for services that he did not receive. Your answer is that if everybody paid for insurance that the cost would not be so high. HIS cost was not $3,000 to the ER. His cost was valued at $100 by his doctor. The ER charged him $2,900 above the VALUE of the services rendered.

Obama's solution is to dictate to doctors what they can charge. The better plan would be to sue any doctor that charges one patient more than another for the same service.

Makid
Kearns, UT

Mike had to pay out of pocket because more insurance companies don't have good emergency care coverage, they are designed to be preventative in nature.

Emergency rooms charge so much because the majority in there won't pay their bill. The last study I read said that 75% of people in the emergency room will fail to pay the costs of their care.

That means the cost of those failing to pay are being pushed to everyone else. These costs increase insurance premiums because hospitals still have to pay for the emergency care given, so they move some of the costs to other areas that insurance plans do cover well.

This is the reason ACA (Obamacare, Republican Health Plan) however you want to label it is good for the country. It ensures that more people are in the insurance pool. Getting preventative care early, lowers costs to hospitals and this lowers insurance premiums which lowers the cost of emergency care which allows more people to pay their bills.

It is a cycle, think of it as car repairs, if 75% of repairs weren't paid for, the costs for those that pay would need to be raised.

J Thompson
SPRINGVILLE, UT

Isn't it just a little ridiculous to have a 2,000 page bill that essentially tells us that everyone has to pay for their own health care?

The simple way is to deny service when people will not pay for it. You may complain that doing that would kill people. Okay, then change the law. Require people who receive ER care without insurance to sign a note payable to the government where they promise to work at a government provided job in the private sector until they have paid 100% of the cost of the "free" ER service.

Instead of making everyone pay 18% of their income to the government to fund non-healthcare programs (when Congress "borrows" against those funds as it has done with Social Security and Medicare), everybody would only be responsible for their own health care costs. If they chose to NOT buy insurance, they would pay the government, or their children would pay the government, by working off the bill.

It doesn't take a 2,000 page bill to make that change. It doesn't let government stick its hand into our pocket, but it pays the ER bill fairly.

The Real Maverick
Orem, UT

Want to know what Obamacare was just a little more than 10 years ago?

The GOP's health care reform bill...

It's amazing how far the right has moved in just a few years. They're turning their backs on bills that they even drafted! On ideas that they sponsored! Amazing!

Hutterite
American Fork, UT

This is why we need a single payer system. It would support the ER and eliminate those who go to emergency rather than their own physician.

one old man
Ogden, UT

Ms. Thompson, Makid did an excellent job of explaining why Mike paid so much out of pocket. If conservatives would just remove their heads from the snow drifts created by conservative snow jobs, and would actually THINK, you might begin to understand.

ugottabkidn
Sandy, UT

@J Thompson from Springville, #..The better plan would be to sue any doctor that charges one patient more than another for the same service" What is this? The consevative view is to limit law suits and all you can spew is take em to court? I dare say I would suggest you investigate how a single payer healthcare system would cover all these issues. Try googling PNHP.org. The US citizen is getting gouged from a vulturistic capitalist system that profits from people like Mr Richards and myself because they can because we treat healthcare like we do TV's and automobiles, not to mention insurance companies cost you 30% before you even see the receptionist. You and I are already subsidizing 60% of the healthcare for others so why not go all the way? The ACA is a good start but it is only a first step.

Fitness Freak
Salt Lake City, UT

Just think if we had real COMPREHENSIVE immigration enforcement; how much of the e.r. problem alluded to here would be solved!

@Mike Richards - I had a similar situation occur a few years ago with one of my sons. The bill seemed outrageous for what they did at the e.r. I called my insurance co. and told them (in laymans terms) what they did at the hospital. The insurance co. called me back to say that the hospital had "adjusted" the payment downwards. My insurance co. tells me that hospitals do this all the time to try to "fleece" the insurance customers as much as possible. Even though very little of the amount came out of my own pocket, I had a strong feeling that the e.r. doc had "claimed" to have done things he didn't!
I was right.

L White
Springville, UT

My, my, don't we have a problem. We've got people telling us that forcing everyone to pay health insurance will solve the ER problem. How? When 13,000,000 or more people can't afford to pay health-insurance now, how will "forcing" them to buy it from the government suddenly make them rich enough to buy a policy? Oh sure, you'll just say that the government will pay for those who can't afford it. Yeah, right. YOU and I will pay for it. The government pays for nothing. WE pay for all those freebies that you keep telling us comes from the government.

The solution is what Mr. Thompson recommended. Make the uninsured sign a promise to pay note that is backed by the government. Make the government provide a job in the private sector (so that taxes will not be used to subsidize that job), and require that person to pay his medical bills. That still gives everyone the option to either buy insurance or to pay the full cost without insurance.

Obamacare is not the solution. Price fixing is illegal - even when the government does it.

one old man
Ogden, UT

L. White says: " Make the government provide a job in the private sector (so that taxes will not be used to subsidize that job), and require that person to pay his medical bills."

Huh?

Isn't one of the loudest and most frequent howls from conservatives "Get government out of business!"

So now, we're going to force private sector employers to provide jobs?

I guess that makes about as much sense as the rest of the conservative shouting.

What is so hard about understanding that Obamacare opens a wider pool of AFFORDABLE insurance to everyone?

The conservative arguments like this would be laughable if it weren't so serious.

L White
Springville, UT

Mr. One Old Man,

We have only two choices. We (you or I) can pay for the ER care of those who won't be required to pay for their own insurance under Obamacare or we can require them to pay for their health care, either by buying their own policy or by paying for the services. The second option solves the problem. It doesn't require you or me to pay for the service. It doesn't require anyone to buy anything from the government. It doesn't allow anyone to pass his personal healthcare costs to anyone else. It requires responsibility from everyone who is treated by a doctor.

Obama does not require responsibility. He has the insane idea that some rich guy is supposed to support you and me and every other American who decides to drop out and be irresponsible.

Work is required in life. Either YOU work to pay the price for someone else or you provide them with the opportunity to work things off by the sweat of their own brow. Let THEM pay. Let the government guarantee that the bill will be paid. Let private enterprise be the employer.

micawber
Centerville, UT

@LWhite
How do you propose that government provide a job in the private sector? Will the government force me to hire someone?

I would guess that many of the people receiving unpaid emergency services are people who would have difficulty in the workforce.

one old man
Ogden, UT

Ms. White -- your comments make absolutely no sense at all. You simply do not understand what ACA really is and what it will do.

Perhaps you would be wise to turn the radio off and spend a bit of time doing some actual, honest research. Don't rely on other conservatives to tell you what to think. They don't know what's going on, either.

No wonder our country is such a mess!

Mad Hatter
Provo, UT

J Thompson SPRINGVILLE, UT

" . . . change the law. Require people who receive ER care without insurance to sign a note payable to the government where they promise to work at a government provided job in the private sector until they have paid 100% of the cost of the "free" ER service."

Talk about expanding the role of government. Now a true believer recommends the creation of a new government agency to monitor and enforce ER payments by indigent patients. Can you believe the costs this new agency would have for the American people.

And they say government doesn't create jobs but J Thompson wants government to provide a job (in the private sector?) for those people without insurance receiving care.

Somewhere in this is a statement of support for Obamacare.

Mike Richards South Jordan, Utah

Hospitals charge more from those available to pay (i.e. having health insurance) to cover costs incurred where they cannot collect (i.e. indigent or needy patients). Hospitals (i.e. ER) don't provide services for free. Mitt Romney recognized this problem in Massachusetts. The Heritage Foundation recognized this problem. Now, Barack Obama is also doing something about this problem.

Ali'ikai 'A'amakualenalena
Provo, UT

L White Springville, UT

"Price fixing is illegal . . . "

Ever look at the price of oil? However, American-produced oil benefits from the prices set by the oil cartels.

" . . . even when the government does it."

Hospitals are private as are the emergency rooms associated with them.

So, if insurance companies knowingly pay more for services than they should, but they know that can get it on the backend by charging more in premiums (kind of a built-in profit re-adjustment calculator), why bother changing the business model? Everyone makes money. The only one left in the cold in the guy buying insurance from a private insurance provider.

Also, while hospitals charge more to insurance companies to help cover unexpected costs, insurance companies charge more to customers to help cover unexpected claim's costs. Remember, they're in business to make money, not just provide a service. And the higher the profits, the happier they are.

Conservatives in congress will protect this business practice because it's money for the next campaign.

Kent C. DeForrest
Provo, UT

Amazing that none of the comments directly addresses the original letter. Oh well, I won't either. What we really need is to pick any of twenty to forty health-care systems in the world and simply copy it. We would spend half as much per capita on health care, everyone would be covered, and in many respects the quality of our care would improve. What a ridiculous mess American exceptionalism has landed us in. We're so special we can't learn anything from other nations. Pathetic.

Ying Fah
Provo, UT

J Thompson
SPRINGVILLE, UT

"Mike was charged for services that he did not receive. Your answer is that if everybody paid for insurance that the cost would not be so high. HIS cost was not $3,000 to the ER. His cost was valued at $100 by his doctor. The ER charged him $2,900 above the VALUE of the services rendered.

First you say that the patient was charged for services he did not receive and then you say he was over-charged for the service. A couple of items jump out at any reader when they see the contradiction. Apparently, the patient received services for the injury. However, there is nothing to indicate additional payment for services not received.

Payment is determined by two factors: services rendered and insurance coverage. Nonetheless, the patient said "the doctor who advised me to go to the emergency room at the hospital because the saw had cut through the bone" which suggests that the service provided was much more complex than could be handled as an out-patient service.

Cutting through bone? Sounds very complicated.

Mike Richards
South Jordan, Utah

I get a real kick from posts from people who try to insert facts that were not in evidence.

My primary care doctor sent me to ER because he knew that I needed micro-surgery to reattach the veins and arteries and nerves that had been cut. He did not have that expertise, but he knew that there were people at the hospital who had that expertise.

The ER doctor simple sewed me up and told me that my finger-tip might slough off if blood flow was not adequate. When I questioned the doctor and asked if something could be done to save the finger, he told me that everything had been done that was necessary.

My primary-care doctor was appalled when he heard that the ER doctor had simply stitched me up. He told me that the ER doctor had performed a $100 service and offered to write a letter of condemnation of that doctor and of that ER. I declined.

Those are the facts. It had nothing to do with insurance. It had everything to do with honesty and integrity. The ER charged for services not rendered - because they could get away with it.

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