When people don't have insurance - how many just don't pay the bill?

[YewNork]

Opponents of reform are trying to take the position that requiring someone to have medical insurance is an unfair tax.

The flip side would be that many people who can afford insurance but who do not choose to buy it are passing their
medical costs along to the insured, because we end up paying higher prices to compensate for the unpaid care that they
receive when they do need medical care.

But, that raises a good question. - Of the people who could afford insurance, but who do not pay for it, how many of them
don't pay their bills and how many do? And what amount is unpaid?

[no_hypocrisy]

1. The unpaid medical bills are passed to a collection agency.

If the collection agency cannot persuade the debtor to pay in full or in installments, it sues. If you lose or don't answer the Complaint, the collection agency gets a default judgment which it files in the state court. In most cases, that puts a lien on the debtor's real estate for a certain amount of time (e.g., 20 years). And the debtor can't sell his/her/their property until that lien has been paid to the collection agency. Or less often, the default judgment can be filed in the county where the debtor resides and have it executed by the sheriff to collect it by going after the debtor's bank account.

[Altoid_Cyclist]

3. We've had so many dealings with collection agencies that we should

probably exchange Christmas cards. My wife and I have had health care insurance, but with all of the health problems that we've had, there's no way to pay all of our medical bills off in full. We send each one five or ten dollars every month and they'll get the rest in full if I kick the bucket and my wife collects my life insurance.

We've had them tell us to cash in our life insurance policies and ask friends or family for the money. No way are we going to do that. As long as we make an attempt to send them something, they usually leave us alone.

It pretty much sucks to have health problems in this country even when you do have coverage.

[Warpy]

8. And when they sue, they get paid

because they will attach your wages, put liens on any property you own, or force the sale of your property outright.

Anybody who thinks he can just beat a hospital bill is a fool, unless he's planning to leave the area without leaving a forwarding address. Even then, he'd better move frequently or they will eventually find him.

[YewNork]

9. Then why do some people claim that the people who do have insurance are paying...

for the people who don't have insurance. If the collection agencies truly go after the people who don't pay their
medical bills, then how is it that some people are saying that our medical bills are higher because there are people who
go to hospitals without insurance and who don't pay.

[Warpy]

11. First, the collection agency buys the debt from the hospital

at a bargain rate. The hospital ends up getting paid what they should have charged in the first place instead of trying to gouge the people who are least able to pay. Then it costs a lot to pursue that debt in terms of leg work, phone harassment, and taking it to court.

The collection agency generally makes something on the debt, although it's far from the whole amount because their expenses are high.

The whole system is insane. There is simply no other word for it.

Insured patients used to subsidize the people who couldn't pay. That simply hasn't been the case for some time now. Hospitals and collection agencies have both gotten too nasty.

[Laelth]

2. Unfair or not, it is a tax.

And the President promised us he would not raise taxes on those making less than $250K/year.

Fair or not, the President will have broken a significant campaign promise if he signs a bill with the individual mandate.

And the Democratic Party will pay for it in 2010. The "individual mandate" is a very bad idea.

:dem:

-Laelth

[mopinko]

4. did he promise that health care reform would be free? np

[Laelth]

5. That argument won't get you anywhere with the people who have to pay this new tax.

And I suspect you know that.

The Democratic Party should heed this warning. We will be punished at the polls if we pass the individual mandate. The only relevant question is whether the reforms we can achieve (the end of pre-existing condition exclusion, the end of rescission, and the end of lifetime caps) are worth the price we will pay.

But let's not pretend that we won't pay a price. The Democratic Party will lose a lot of votes if it forces millions of people to buy health insurance.

:dem:

-Laelth

[mopinko]

6. no doubt there are many who will be disappointed that they cannot get

something for nothing.

[YewNork]

10. Private insurers will say that they can't afford to cover pre-existing conditions unless

they have everyone in the insurance pool. That means that the young healthy people must also contribute.

[Heddi]

7. the last hospital I worked for had a 20% payment rate

granted, it was a level 1 trauma for 5 surrounding states, community hospital whose primary patient population were homeless, incarcerated, uninsured, underinsured, working poor, immigrants, domestic violence, sexual assault...That was about 85% of the people we served. The other 15% were people who had insurance, had medicaid or medicare or some kind of reimbursement. But the number of those were starting to fall when I left.

we were operating at "even" if we had 30% reimbursement. Generally we ran between 20-25% reimbursement. Last year when I left we were at 25% and having to scale back and slice budgets & staff