[fav_collector]

Especially when it covers non-citizens and people who are illegally in the country.

We could at least have a little compromise by making health care more tiered so that citizens, payers and people with insurance receive better health care than others. Make a list of services that will only be provided to payers and automatically push non-payers to the back of the queue.

[nck4222]

I would view that as a horrible compromise, because it would result in poor people receiving worse health care than wealthy people.

[throwaway5752]

I'm amazed sometimes the things people say here. The idea of withholding medical care based on citizenship comes very close the criteria for evil, with the drawback that it's largely incorrect, too (non-citizen residents, legal and illegal pay taxes at many levels of government for far less in return comparably than citizens).

[ythn]

What is the maximum amount we should spend to save a human? A million? A billion? Should society absorb any cost to save a human even if it gets exponentially more expensive with each subsequent procedure? Or should there be a cutoff where you are basically told "Sorry, you've exceeded the threshold and have to either pay for it yourself or die"

[dv_dt]

It would seem that the cost of being stingy here is that the medical care system is more expensive for less performance in the US. Cut off your nose to spite your face exemplified.

[ryanobjc]

This is a non-sequitur, and not related to the original topic which was: Should non-citizens be disallowed from receiving ER care without paying for it themselves?

Additionally, we already had that system in place, it was called "lifetime limits" and it was typically $1-2m on the best healthcare plans.

[AnthonyMouse]

> I would view that as a horrible compromise, because it would result in poor people receiving worse health care than wealthy people.

It's impossible for that not to be the case. It's even the case in countries with single payer, because rich people who live there and don't want to wait for an appointment or want something that isn't covered will just go to a country that can give them what they want and open their wallet. Even without leaving the country, they can hire private nurses and so on when they aren't covered by the national health system.

Moreover, why is this supposed to be a problem? "Money buys things" is the purpose of money.

There are things a rational national health system wouldn't pay for because they aren't economical, but a rich person would buy for themselves for much the same reasons they buy a Tesla instead of a Dodge. Which means they have a safer car because they have more money. Should we prohibit expensive safer cars because poor people can't afford them?

[panzagl]

As opposed to now?

[okreallywtf]

I think the idea being that generally, two people going to the same ER one being broke and the other being loaded are going to get a similar level of emergency care. Long term maybe not but you aren't going to get the bronze plan of gunshot care while the guy next to you is enjoying platinum.

[ryanobjc]

I think most people believe its morally repugnant that your value as a human being is related to how much money you have. Because choosing to serve one person over another based on money rather than their medical need is exactly that.

Ie: I broke my toe and I have insurance, so I get ER treatment, but that guy who has no insurance and is internally bleeding to death from a street stabbing (and is hispanic, doesn't have insurance and maybe isn't american?) is pushed behind me in line. That is the real life scenario that at least one person is advocating here.

[okreallywtf]

I agree, I think that ER's work more or less like that now (not necessarily the rest of the hospital), I'm concerned for the future this not always being the case.

I think as the governments become more starved (not made more efficient by reducing costs, starved by simply cutting funding without optimizing it logically) that important government services will have to replaced with tiered private companies. As regulations are removed, the same thing occurs.

What if a speed of ambulance was built into your insurance? How do you know what response time is right for you and your family (as it will be framed)?

[chrisbennet]

Is it really fair to let poor people have health services that they didn't pay for? Is keeping poor people healthy/alive really the best allocation of resources?

Shouldn't triage take into account who is the most profitable so wealthy people can go to the front of the line where they deserve to be?

I mean really, why should my undocumented nanny, house keeper and gardeners be entitled to the same health care that I am? [Of course, I don't pay them enough to buy health insurance but that's their problem.]

As @gselevator tweeted "I never give money to homeless people. I can't reward failure in good conscience."

(This is sarcasm in case it isn't obvious.)

[ryanobjc]

Actually it wasn't obvious that this is sarcasm.

It totally reads like the kind of libertarian/dude-bro nonsense that has invaded tech.

I'd be wary of reusing text like this in other areas, because until I skipped ahead to "this is sarcasm" I was like "oh here we go again"

[conanbatt]

There is a case for adverse selection for the ER, and the effects of it being free in comparison to very expensive healthcare.

The next question would be: how many of the people that ended up on the ER could actually afford healthcare? And why didnt they have/use it?

[leejoramo]

Not sure what citizenship has to do with this. As an American traveling in Europe, I received emergency room care. They may have glanced at my passport, but certainly did not ask for any other documents. Nor did they ask for payment.

[conanbatt]

I dont know your experience as an American, but as an Argentinian I am not allowed to enter Europe without health insurance. They dont let you on the plane without it.

[undersuit]

How do they know I'm a citizen? Do they deny care to the unresponsive person in pajammas because they can't be sure if the person isn't a foreigner bilking the US health system?