Two Years On: Obamacare

The reason people no longer drop dead in emergency waiting rooms is that a Democratic Congress, in 1986, passed a bill -- signed into law by noted socialist and freedom hater Ronald Reagan -- that mandated hospitals treat patients regardless of insurance status or ability to pay. To my knowledge, this bill has never been challenged in court in the subsequent 26 years.

That bill was good law, but it does stand as an unfunded mandate.

The individual mandate serves two key aspects of the ACA -- to motivate people to carry insurance and to recoup some of the money from people treated under that act.

 

I'll wait right here for pictures of all those stacked-up dead in ERs before 1986.

 

If the individual mandate is the main hang-up -- and if the ACA goes into effect except without it -- how does this work in practical terms? Or, not just the ACA, but the utopian world Ron Paul describes.

It's bad enough to tell a 26-year-old who finds out he has testicular cancer, "I'm sorry, we have this incredibly smooth and efficient way to deal with this disease and you can live another 50 years, but since you chose to play Russian roulette with your health, come up with $100,000 or start pricing gravestones."

But, fine. Say you do that. At least it's his choice. What then do you do for the not-inconsiderable amount of people who arrive at the emergency room unconscious and are treated and stabilized, only to wake up and say they don't carry insurance? Does the hospital bill those people for treatments they didn't agree to take responsibility for? Does the hospital unhook the machines right then and there if the person won't agree to pay retroactively? Does the hospital enact a policy of not treating anyone whose identity and insurance status they can't immediately verify, which means they'll end up refusing to treat a whole lot of people who do in fact have insurance? Or does the hospital suck up the costs and try to recoup elsewhere, which is going to keep costs jacked up for the rest of us?

 

If you don't believe it was a real problem, you are free to take that up with Ronald Reagan.

It was a very real problem, particularly with private hospitals simple refusing to take patients without insurance and instead immediately transferring them to public hospitals. Patients often died en route. It was the subject of extensive research and an influential article in the New England Journal of Medicine.

Happy researching.

 

The uninsured weren't denied services before King Barry's soon-to-be-declared-unconstitutional plan was passed.

 

No one said they were.

And it would take a massive failure of the Supreme Court to declare this law unconstitutional.

 

Aw, sure. Walk into any doctor's office and say, "I don't have insurance. I'd like a whole battery of tests and complete treatment for anything you find."

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That depends who's defining "failure."

Why do you think they were appointed? At some point the leashes will be yanked.

 

Hospitals make a habit of turning people away from the emergency room?

 

People die all the time who never get close to an emergency room.

 

It would have to be an opinion on par with Bush v. Gore. That's how bad it would have to be.

They'd have to throw out all of the Commerce Clause precedent to this point.

And they know they'd then have to overturn Medicare, Social Security, the ETAMLA and about 500 other different laws.

I just don't see it happening.

6-3 to affirm on the Commerce Clause, something like 8-1 on the other, even more ridiculous argument.

 

And Obamacare won't stop that.

 

Doctors turn away uninsured people for non-emergency situations that nonetheless should be treated. The situation gets worse until the person has to be treated in the ER. (And in many many cases the ER is the first stop now that word has gotten out that's a guaranteed way of being treated.) The ER gets no reimbursement except maybe something small from Medicaid. To make up the difference, it charges higher rates to insurance companies, which pass it off as higher premiums to keep their profits high.

Lather, rinse, repeat. It's what the whole system is built on now.