Dear inquest,
"I'm on board with what I described at #56."
"And if they incur a bill that they can't pay off because they didn't get insurance but could have, it should be treated no differently from what happens when you can't pay off the mortgage." - from post #56
Well, actually, that's how it's done now. That's how the system works, now.
Believe me, if you have any assets, and are uninsured, and wind up racking up high medical bills, they'll come after you, your income, and your assets.
Unfortunately, plenty of times, folks run up bills that outrun their assets. That's why a significant percentage of bankruptcies are due to medical bills. The problem is not that the doctors, hospitals, etc., won't come after folks' assets. The problem is, even after taking most of their assets, it often doesn't cover the whole bill. Or even a significant part of the bill.
The difficulty is that a mortgage is a secured debt, and the medical bills of an uninsured person are not. Thus, if the mortgage lender lends the buyer $300,000 to buy a house, even if the buyer defaults, the mortgage lender is liable to get near to 100% of his money back, in most cases. When the lender sells the house at foreclosure, every net penny of the sale goes back to the lender, as the secured creditor of the mortgage. And, if the lender has a loan-to-value ratio of under 80%, he even requires the buyer to purchase mortgage insurance, in case of foreclosure, to cover the last little bit that may open up between the amount of the mortgage PLUS all the lender's costs, and the net proceeds from the sale of the house.
But the uninsured person who receives treatment is incurring an unsecured debt, and there is no guarantee that the individual will have substantial assets to cover the debt. Hence, many of these folks go to bankruptcy, and the hospital, doctor, or other healthcare provider, as an unsecured creditor, often gets little or nothing.
In fact, the problem is further exacerbated by two facts. Often, folks who could afford insurance, but don't have it, are nonetheless not terribly high income, and thus have not had enough income to accumulate much by the way of assets. And often, folks who finally accumulate some significant assets often understand that they need health insurance to avoid being wiped out by medical debt. Thus, the uninsured who can nonetheless afford insurance will predominantly come from that part of the population with few assets.
You can run up quite the hospital bill in a short period of time. My mother was in the hospital a mere six days before she died. Ran up a bill of $114,000. Nineteen grand a day. And that's WITH the health insurance company discounts.
No, just saying we'll make folks pay for the bills they incur (and let lots of 'em off the hook through bankruptcy) is what we're doing now. If folks who CAN AFFORD IT BUT OTHERWISE REFUSE IT aren't going to be required to protect the rest of us from their failure to act prudently in this regard, by having health insurance, then they ought to be required to foreswear all medical treatment that they can't pay for upfront.
Whaddaya think?
sitetest