Non-consensual care and capitalism

[Machjo]

I was wondering about views on how non-consensual healthcare fits in with capitalist theory.

In principle, in capitalism no contract is binding unless it's mutually agreed upon by all parties concerned and without undue pressure.

The problem though is that when you're lying on the street unconscious, you may need service immediately yet are in no condition to enter into a binding contract.

So following a strictly capitalist doctrine:

1. no hospital has any obligation to serve an unconscious person unless they are convinced of the likelihood of his ability to pay up. So if you're a rich man with insurance but were wearing old jeans, an old t-shirt and a baseball cap one sunny Sunday when you got hit and no one is around to vouch for you, the hospital, not knowing who you are, would opt to et around to helping you once (if) you've regained consciousness and proven your ability to pay.

2. if a hospital should choose to serve you anyway, then you have no obligation to pay since you'd never agreed to the service.

Looking at it that way, if the government requires hospitals to serve the unconscious, then it must decide whether to make it obligatory for the unconscious to foot the bill. Already it's broken with capitalism an entered the realm of socialism.

Now, if it requires the patient to foot the bill in spite of there not being any contract, then it's delving even further into socialism.

And if it requires the patient to purchase insurance prior to the incident, then it's delving even further into socialism.

Looking at it that way, anyone who proposes anything other than the idea that the hospital has no obligation to serve you without a mutually agreed upon contract, and that you have no obligation to pay back unless you'd agreed to the service to being with, is in support of a socialist system already.

At that stage, we have to conclude that the US system was a socialist system even before Obama came to power. He's just making it more socialist. At that stage, it's no longer a debate between capitalism and socialism, but rather one between varying degrees of socialism.

Honestly, I've come across few Americans who support the truly capitalist system presented above in this OP. In reality, the majority are debating varying degrees of socialism. And my guess is very few Americans would be willing to deregulate the health care system to real capitalist standards, even among Republicans.

Again, with a few libertarians standing as exceptions, the majority of Americans are just debating between degrees of socialized health care.

 

[eh1eh]

I there were universal health care in place your point would be moot.

 

[Machjo]

I there were universal health care in place your point would be moot.

If there were universal healthcare in place, yes it would be a relatively more socialistic system, but to say that the system in place in the US before this bill was passed was a truly capitalist system would be equally false. And again, I doubt many repubicans would support a truly capitalist healthcare system. All but a few libertarians would likely support the idea proposed in the OP, and they'd more likley than not be either independents or members of the US Libertarian Party, not the Republican Party.

My point is simply that many Republicans are either disingenuous or outright deceitful when they try to portray the system before this bill was passed as a capitalist system. It was socialist already by requiring hospitals to provide care and requiring people to pay the bill in spite of the lack of any contract (obviously they can't sign a contract when unconscious).

Looking at it that way then, if the US is not going to have a truly capitalist system to begin with, then it might as well develop a quality socialist one instead of having a socialist one disguised as a capitalist one and thus not functioning well in any sense.

 

[Machjo]

Well, essentially if the government forces a hospital to serve an unconscious person, then it also have the duty to foot the bill for him. If it's not going to foot the bill, then it forfeits the right to force the hospital to serve him.

Since I doubt many would want to accept the risk of hospitals not being obligated to serve them while unconscious, then if they're honest, they'll agree to the idea of universal health care so as to ensure no one goes bankrupt over care he'd never agreed to.

Either the capitalist or the socialist system can work, but the current US ad-hoc system which is really neither is a mess. I don't know the details of the Obama plan, but it's clear that something needs to change in their system.

 

[Zzarchov]

The US system has been socialist for ages. Once the government told me who I could and could not get medical aid from they were socialist. I had to go to state approved doctors. If my cab driver was a medic in Vietnam and I want to pay him $20 to set my broken arm I shouldn't have to drive to the Hospital to pay a doctor several hundred to set it.

the USA has been socialist in medicine for along time. Now its just socialist health insurance, but health care has ALWAYS been socialist.

 

[Machjo]

The US system has been socialist for ages. Once the government told me who I could and could not get medical aid from they were socialist. I had to go to state approved doctors. If my cab driver was a medic in Vietnam and I want to pay him $20 to set my broken arm I shouldn't have to drive to the Hospital to pay a doctor several hundred to set it.

the USA has been socialist in medicine for along time. Now its just socialist health insurance, but health care has ALWAYS been socialist.

Like I said, with the exception of some libertarians in the US, most Americans are not debating between a capitalist and a socialist model, but rather between varying kinds of socialist models.

 

[Machjo]

By the way, I'm not necessarily using the word socialist in a bad way or in a good way. I'm just using it at face value. I'm just pointing out though that when republicans say they want to keep their capitalist model, it's somewhat laughable.

 

[tay]

Non-consensual care costs will always be rampant unless you have a system similar to Canada's in place. Obamacare still leaves the control of costs in the hands of Insurance Companies and Hospitals and Doctors...............








After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know






Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.


He was blindsided, though, by a bill of about $117,000 from an “assistant surgeon,” a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.


“I thought I understood the risks,” Mr. Drier, who lives in New York City, said later. “But this was just so wrong — I had no choice and no negotiating power.”


In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care.


But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.


The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier’s case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.


“The notion is you can make end runs around price controls by increasing the number of things you do and bill for,” said Dr. Darshak Sanghavi, a health policy expert at the Brookings Institution until recently. This contributes to the nation’s $2.8 trillion in annual health costs.


Patricia Kaufman’s bills after a recent back operation at a Long Island hospital were rife with such charges, said her husband, Alan, who spent days sorting them out. Two plastic surgeons billed more than $250,000 to sew up the incision, a task done by a resident during previous operations for Ms. Kaufman’s chronic neurological condition.


In the days after the operation, “a parade of doctors came by saying, ‘How are you,’ and they could be out of network or in network,” Mr. Kaufman said. “And then you get their bills. Who called them? Who are they?”




much more




http://www.nytimes.com/2014/09/21/u...on&region=bottom-well&WT.nav=bottom-well&_r=0

 

[Tecumsehsbones]

That the U.S. economy is not pure capitalism, and never was, is hardly news.