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Well spoken, good points. I do take exception to:
and
You are going into emergency care. You are doing gods work. For your sanity, I think you have the best outlook to take on what you are about to take on. That said...
An ER is always going to cost orders of magnitude more than a private practice. When the hospital "writes off" bills, they aren't waving a magic wand and making that expenditure of resources disappear. The hospital is making the call that collections activities cost money and will never see a return, so they roll the debt into pricing.
That is precisely why hospital care is so cripplingly expensive today.
Insurance or not, hospital care will bankrupt you. That is because poor uneducated people are misinformed and are exploiting the system, causing MASSIVE damage to the system as a whole.
Again, great compassionate mindset for when you are in the ER seeing the patients, but very damaging rhetoric to be preaching to the open internet.
I'm aware that those costs do not magically disappear and are absorbed into other billing/passed on to society. However that is not why healthcare is so ludicrously expensive in the United States. It is the substantial and unnecessary administrative costs, predominantly driven by for-profit insurance companies, for-profit hospital systems, and pharmacy benefits managers. The continued exploitation of the ill for shareholder benefit is a uniquely American take on health care, and coupled with our incredibly individualistic tendencies bring about a huge fraction of the poor health outcomes we have in comparison to other developed nations, despite spending generally more than double per person.
Some of this is certainly driven by system inefficiencies such as forcing people into a situation where they have to use the ER for primary care. Or where they cannot afford their blood pressure or cholesterol medicine, and instead of our society helping provide these very affordable interventions, we pass the buck. So when those individuals inevitably have a heart attack, we then pay many times more for care that they may not have needed had they simply gotten good preventative care.
I will happily stand up and bash the current US healthcare system. I despise its insistence that human lives and suffering are secondary to wealth-extraction. But as much as I hate it I can't change it, and while I will advocate for policy to change things, for now all I can do is continue to provide care to the patients presenting as a symptom of an ill society.
I hope others can see that these patients presenting to the ER are simply doing the best they can to take care of themselves and their families, and that the real blame and consternation should be placed on the government, hospital, insurance, and pharmaceutical officials and lobbyists who continue to exploit their illness for profits.
But noone is forcing them to use ER as primary care.
You are you so fervently spreading that misinformation?
Obama passed a bill to get EMERGENCY care to those who need it and people like you have exploited that legislation to scam hospitals.
15 dollars a month gets you insurance.
If you didn't bother to go through the process, you can still see a doctor for 200 dollars, which can be held as debt and paid back in however small installments you need. You do need to pay it though.
There is literally no reason for an uninsured person to run up a 2000 at the ER for primary care. Absolutely no reason.
You are telling people in a bad place to do the thing that will make their situation, and all of our situation, worse to the maximum degree.
As I said previously, the process needed to get insurance under these programs can be too complicated for individuals with low literacy or for whom English is a second language, limiting their access to these resources. And believe it or not, there are individuals for whom $15 a month is still not affordable for something they may or may not use that month, like medical insurance.
So those people need to put in effort, learn, and be functional members of society.
Bullshit that you can't pay 15 dollars a month and 15 dollars to your medical debt a month.
If you can't do that, you need to figure your shit out... until we implement single payer Healthcare. Which we should.