I see we've returned to the form of government where Ray DiPerna determines whether a person deserves sympathy.

Huh? Don't we all determine whether a person deserves sympathy? I mean, I assume that there's no Federal Bureau of Sympathy Entitlement yet, is there? So how else does it happen except for us each to make that determination?

I mean, look at this very thread: an awful lot of people decided that Lenny Dykstra didn't/doesn't deserve sympathy for his current plight, didn't they?

Most people, having made inferior choices compared to Ray DiPerna, shall be judged deficient and sent away.

It's really striking to me the insane hubris of libertarians in this thread - they really seem to believe that they know, if they were born in a different body to different parents in a different situation, exactly what they would choose to do, be able to do, and so on.

Libertarians do not believe anything of the kind. It's possible that if I were an entirely different person, I'd have entirely different beliefs. So what? If I were born in 1920 in Germany to non-Jewish parents, I might be a Nazi. Does that mean that I shouldn't judge Nazis harshly?

Basic human compassion runs only so far as the other person made choices directly symmetrical to a libertarian's notion of right. Hell isn't other people, hell is libertarians.

Spread your own compassion as far and wide afield as you choose. Just don't demand at gunpoint that I make the same choice as you.

It's really striking to me the insane hubris of libertarians in this thread - they really seem to believe that they know, if they were born in a different body to different parents in a different situation, exactly what they would choose to do, be able to do, and so on. Basic human compassion runs only so far as the other person made choices directly symmetrical to a libertarian's notion of right. Hell isn't other people, hell is libertarians.

Pot, kettle. Who are you to make assumptions about the lives of the libertarians here? You know nothing of where we've come from, what challenges we've met, what obstacles we've overcome. You're making assumptions based on your own prejudices.

The debate over whether folks in tough situations actually are to blame for their situation is deeply ugly, and needs to stop.

Why? Because you said so? The decisions made by people should, do, and always will influence how they are treated.

The debate over whether folks in tough situations actually are to blame for their situation is deeply ugly, and needs to stop.

I see. So the problem isn't discussing the situation, it's just holding a view on the wrong side of that discussion that calls out for censorship. You have no problem with those claiming that people aren't to blame for their respective situations; it's only when someone says, "Hey, wait a minute, maybe that's not true" that it "needs to stop." Convenient.

If Dave and Ray want to defend this line of thinking, I'd like to see them actually lay out with precision how the line of thinking works.

Is the notion that only a person whose choices have been impeccable deserves the "takings" of the government? That is, if someone existed who had made perfectly correct choices to maximize her own welfare and benefit her fellows, but through absolutely no fault of her own found herself poor and without health care, then you would support government agents in jackboots stealing money from everyone to support this unlucky but perfectly virtuous person?

Or is there some level of quality of choice that you have in your mind, above which government may justly redistribute wealth, and below which people should receive nothing? If so, what is this level?

Is the notion that if people in financial distress as a group do not surpass the level of good decision-making at which they would be worthy of redistributive government action? If so, what is the general level of good decision-making that would justify redistributive government action?

If there is no level at which such government intervention is justified, then what is the value of seeking to sit in judgment? You could simply say, "your situation sucks, but redistributive government action would be worse." That would be something I disagreed with, but it would bespeak basic compassion.

I think what libertarians really want is for guns to be illegal. Every post ends with this fear of being forced to do something at gunpoint. I have this vision of you all on April 15th, furiously filling out your TurboTax forms while wearing bulletproof vests.

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

Pol Pot killed a lot of people, but he didn't do it with a whole zany backstory and mythology, it was just kinda arbitrary.

Well it wasn't entirely arbitrary he did have this urban=evil thing going on in his mind, there was also his obsession with barring foreign influences, even things like food, but he himself preferred Chinese and French Food to Cambodian...

Then there is the other category, the guys who definitely aspired to be upper tier tyrants if given the chance, Abimael Guzmán for instance clearly aspired to be Pol Pot.

Spread your own compassion as far and wide afield as you choose. Just don't demand at gunpoint that I make the same choice as you.

Man, that must make every voter who's ever cast a ballot a willing accomplice to a potential bloodbath. Including you and me, of course. But then we were only following orders.

it's only when someone says, "Hey, wait a minute, maybe that's not true" that it "needs to stop." Convenient.

Don't forget that it is "deeply ugly."

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

They either don't, or they're willing to go along as long as their taxes are only spent on the goals they find acceptable, which vary according to taste.

If there is no level at which such government intervention is justified, then what is the value of seeking to sit in judgment? You could simply say, "your situation sucks, but redistributive government action would be worse." That would be something I disagreed with, but it would bespeak basic compassion.

You're almost there with this option, but you're kind of omitting something important: compassion does not need to be expressed through government. These are two separate questions, that you're compressing into one and conflating with each other:

(1) When is government assistance justified?
(2) When is compassion justified?

The "value of seeking to sit in judgment" is to answer the second question, not the first. I need to answer the second question so I can decide where to direct my personal efforts.

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

Selling subscriptions to Grit. Rendered oil from beached whales. Coins thrown in the Reflecting Pool.

A young person who is just starting out and is barely scraping by unexpectably gets sick and runs up $10,000 of medical debt. What should that person person do? What options does that person really have?

Even if they had some cheap medical insurance just paying off the deductibles could be a major enough set back to ruin their credit for several years and unlike other purchases medical treatment isn't something people can reasonably go without if they can't afford it.

The "value of seeking to sit in judgment" is to answer the second question, not the first. I need to answer the second question so I can decide where to direct my personal efforts.

This is precisely my point.

These discussions of the quality of people's choices are irrelevant to the question of redistributive government action. Redistributive government action is bad, under the general libertarian philosophy most of the libs who were sitting in judgment here follow, regardless of whether folks who might receive its benefits have made good choices.

What was being debated, on the previous pages, was not whether governmental redistributive action was justified - because the quality of the choices made by folks who would benefit from that action is irrelevant to the debate. Instead, we were debating whether those people deserved basic human compassion, and people were finding them wanting. That's precisely the thing I find morally ugly.

Not the opposition to redistributive government action - I know lots of people who disagree with me who I don't have a problem on this level with. The problem is the insanely restricted area to which people will direct their compassion - as DMN said, the debates on the previous pages weren't about policy, they were about compassion. That's my point, that's what's ugly, that's what I object to.

What should that person person do?

not get sick?
oops, too late,
not get treated?

forgo cable TV and a Cellphone, find one more roomie to share costs with?
Take on a second job

die?

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

Selling subscriptions to Grit. Rendered oil from beached whales. Coins thrown in the Reflecting Pool.

Going door-to-door selling photo enlargements, and donating your chihuahua in a teacup commissions to the Govt. rendering plant.

ALL of the plans. ALL of them simply fine you if you don't have insurance. As I understand them, the fines just be tacked on to your tax liability.

And if you don't pay that, they put a tax lien on your property or garnish your wages. And if you get around that, they do something else or throw you in jail for tax evasion. Or if you don't show up for a court date, they arrest you. If you resist arrest, they throw you in jail. And so on and so forth.

The very basis of every last shred of governmental power is that every possible path either ends with:

- You complying with what the government wants, whether voluntarily or involuntarily.
- You being dead.
- You leaving the country

This is no different.

...and presumably, you don't support any of the FICA deductions or the programs they fund. Presumably, too -- you haven't taken any radical actions to eliminate those deductions.

Sooo... you're issue -- what... that it's likely to be line item'ed on your 1040 rather than auto-deducted from your paycheck?

Would it be more acceptable if any automatic upping of your FICA deductions just happened?

I'm just failing to see why enforcement of an insurance mandate is any different than other of the sundry programs that are supported/enforced via taxes in various forms... I mean, I presume you're not one of those "the IRS is illegal!" types.

We all pay taxes for things we don't want to pay taxes for.

In this case, however, you're only going to be 'paying' if you either 1)are not carrying insurance already, 2)aren't getting subsidized insurance, and 3)utterly and completely refuse to put forth the effort for 1) or 2).

Again, I just shake my head...

"I don't like this program/policy, so I shouldn't be forced to be a party to it"...

Cripes... why didn't I think of that in 2003 after the AUMF passed or when the FISA abuses came to light or DOMA passed or any one of a 1000 other things have happened.

This makes me not unlike virtually every other American, in some way, shape, or form.

A young person who is just starting out and is barely scraping by unexpectably gets sick and runs up $10,000 of medical debt. What should that person person do? What options does that person really have?

There have been several excellent suggestions right here in the last few posts. It's up to you to follow through on them and stop your whining.

A young person who is just starting out and is barely scraping by unexpectably gets sick and runs up $10,000 of medical debt. What should that person person do? What options does that person really have?

With a high deductible policy, the point is the person would only be out $5 grand or so (per year). Add an HSA, and it reduces it somewhat.

The options are to slowly pay it off or go bankrupt.

...and presumably, you don't support any of the FICA deductions or the programs they fund. Presumably, too -- you haven't taken any radical actions to eliminate those deductions.


I am less powerful than the government and I desire to remain alive, so I have chosen to comply instead of die.

By Andy's typical logic or lack thereof, anybody who didn't attempt to forcibly overthrow the government over the Iraq War is personally responsible for anything that happened over there.

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

print more money?

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

War? I hear that the invasion of other countries can pay for itself.

How else does anyone expect a government to raise revenue?

Force retired baseball players to sell their World Series rings (at gunpoint, natch).

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?

Taxes are obviously the easiest way for a government to raise revenue.

But the fact that all laws stem from the physical power of the government should be a good reason for people not to want government to pass laws faster than osmosis for every damn thing they want or makes themself feel "caring" (quotes intended).

"Yep, I'd also complain if a lefty compared George W to Hitler, what's your point?"

Hitler had much better facial hair.

You couldn't make a movie like Inglorious Basterds about W. I mean, who would be the villians? Crazed neo-cons in the Pentagon?

"A has money. A lacks "compassion" and doesn't want to give his money to B. C comes along and forces A to give it to B.

And -- presto -- we have compassion.

But who has been compassionate in this scenario? A, who never wanted to give his money forcedly to B? B, who supported the notion of taking A's money? C, who forced A to give to B?

I don't see where the magical compassion presents itself."

Seems to me like C was pretty compassionate. He cared enough about B that he was willing to take time out of his schedule to deal with a selfish ####### (and possible sociopath) like A.

Hitler also had a Kaiser-moustache earlier in this picture under the x. Zach Wheat also grew a badass moustache after he retired.

"The options are to slowly pay it off or go bankrupt."

So, wait. Choosing between bankruptcy and a lifetime of grinding penury is (and should be) Plan A?

"Hitler also had a Kaiser-moustache earlier in this picture under the x."

I think he made the right call, going with the smaller 'stache. It's less overwhelming on his rather-thin face.

Muttonchops might have been an interesting look on him.

Choosing between bankruptcy and a lifetime of grinding penury is Plan A?

For someone who doesn't have 10K, bankruptcy essentially amounts to a couple quick drives to the courthouse and a year of mild inconvenience.

The debate about taxes just seem so odd. How else does anyone expect a government to raise revenue?
Governments can borrow, tax, or print money. No one will lend them the money if they don't tax though.

I guess they can sell commissions and sell monopolies, but I don't think that that would satisfy libertarians.

He was able to kill off 1/3 of the Cambodian population, that's pretty damn good.

I'm adding this to my list of reasons for wasting way too much time here. As far as Pol Pot, I think he's inner circle. Just as you have ballpark adjustments, I think you need country adjustments. For the Potter to wipe out as many people as he did, in the short time he had to do it- I think with proper adjustments the guy's practically the Willie Mays of dictators.

For someone who doesn't have 10K, bankruptcy essentially amounts to a couple quick drives to the courthouse and a year of mild inconvenience.

Several hundred dollars, 1-2 meetings with a trustee, 2 meetings (by phone or internet) with a credit counselor and bad credit for 10 years.

These discussions of the quality of people's choices are irrelevant to the question of redistributive government action. Redistributive government action is bad, under the general libertarian philosophy most of the libs who were sitting in judgment here follow, regardless of whether folks who might receive its benefits have made good choices.

The fact that I believe the government shouldn't be in the redistribution business is just that: my belief. But that's the debate on my terms. The debate on liberal terms is that the government ought to help these people because we feel sorry for them, and if we're going to debate on those terms, then it's legitimate to explore whether we should actually feel sorry for them.

There's a big difference between helping someone because he got hit by a car and helping someone because he wanted to major in Bulgarian opera in college and now he can't find a job in his field.

Several hundred dollars, 1-2 meetings with a trustee, 2 meetings (by phone or internet) with a credit counselor and bad credit for 10 years.

It shows up on your credit report for 10 years, but you can pretty easily get credit with bankruptcy on there after a year or two. Someone that broke won't exactly have a complex bankruptcy case, either.

I thought this whole debate was about not "leaving people to die on the street." Have we moved down to "not leaving people to be inconvenienced for the sake of their health?"

Seems to me like C was pretty compassionate. He cared enough about B that he was willing to take time out of his schedule to deal with a selfish ####### (and possible sociopath) like A.

So is compassion merely a function of time, then?

If I take time out of my schedule to go up to A with a gun and demand that he give money to B, have I been compassionate? After all, I've given my time.

Or is there something more that goes into compassion?

A young person who is just starting out and is barely scraping by unexpectably gets sick and runs up $10,000 of medical debt. What should that person person do? What options does that person really have?

I thought this was already asked-and-answered. To repeat: Get a better job. Work more hours. Ask for help from a charity. Walk up to the Kennedy compound at Hyannisport, knock on the front gate, and demand that the Kennedy family pay their <strike>premiums</strike>bills for them, since we know the Kennedys believe that rich people have an obligation to provide health care to the poor.

Now I'll add: work out a payment plan, and pay back the money over time.

"The debate on liberal terms is that the government ought to help these people because we feel sorry for them, and if we're going to debate on those terms, then it's legitimate to explore whether we should actually feel sorry for them."

The debate on liberal terms is that government's responsibilities include "promot[ing] the general welfare", and that keeping people from unnecessary, easily-avoidable suffering and death through injury or illness falls under that heading.

Feeling sorry for them is optional, but probably a good idea if you don't want to come across as a huge dick.

The debate on liberal terms is that the government ought to help these people because we feel sorry for them
Also that we (as a society) are 'better' off for having done so (be it from the enabled being able to make other choices or from the 'good feelings' we get or whatever).

For someone who doesn't have 10K, bankruptcy essentially amounts to a couple quick drives to the courthouse and a year of mild inconvenience.

Is bankruptcy really that easy? I partly asked what I asked because I friend for mine is in this sort of situation and didn't really know their options. I think one problem as a lot of people in this situation don't really what they can do.

Regarding the more philosphical side of this discuss, are bankruptcies really the best way for society to deal with medical expenses for people that can't afford to pay? Ultimately those debts need to paid back somehow and if its not the debtor then its through losses by creditors or medical service providers which is could lead back to inflated costs.

Is bankruptcy really that easy?
Have you seen the US version of The Office?

A young person who is just starting out and is barely scraping by runs up $100,000 of education debt. What should that person person do? What options does that person really have?

"So is compassion merely a function of time, then?

If I take time out of my schedule to go up to A with a gun and demand that he give money to B, have I been compassionate? After all, I've given my time.

Or is there something more that goes into compassion?"

Brain chemicals and basic human decency, if you want to look at it on a more granular level.

Or is there something more that goes into compassion?

You have to also have an anecdote about how you heard about this guy who knew this other guy that died because his mean old insurance company didn't understand that the second guy simply forgot to mention his metastatic brain cancer on his application for benefits. And a either a slogan to illustrate how awesome the guy with a D next to his name is.

Then, you've displayed compassion.

Is bankruptcy really that easy? I partly asked what I asked because I friend for mine is in this sort of situation and didn't really know their options. I think one problem as a lot of people in this situation don't really what they can do.

The forms are very long and complicated (the wording can be confusing), but yes.

A young person who is just starting out and is barely scraping by runs up $100,000 of education debt

Worst case, they'll repossess your education.

A young person who is just starting out and is barely scraping by unexpectably gets sick and runs up $10,000 of medical debt. What should that person person do? What options does that person really have?

I thought this was already asked-and-answered. To repeat:

what's amazing is he doesn't seem to realize that people have already proposed those answers as a parody of the Libertarian position...

We don't need a Libertarian Strawman when we have Dave.

Regarding the more philosphical side of this discuss, are bankruptcies really the best way for society to deal with medical expenses for people that can't afford to pay? Ultimately those debts need to paid back somehow and if its not the debtor then its through losses by creditors or medical service providers which is could lead back to inflated costs.

It's not the best way, obviously, but the sob stories of bankruptcy being like getting the plague are ridiculous.

I thought this whole debate was about not "leaving people to die on the street." Have we moved down to "not leaving people to be inconvenienced for the sake of their health?"

Exactly. Just as the debate is no longer, "Feel sorry for some people who are in bad situations for no fault of their own," but instead, "Never make judgments about anybody's decisions or behavior, ever."

It's not the best way, obviously, but the sob stories of bankruptcy being like getting the plague are ridiculous.

Bankruptcies are pretty easy if you have nothing. But when you do have some things and you lose them (your house say) plus add the bad credit, it can be pretty harsh. In addition, most people are raised to pay off their debts, work hard, and it can be quite traumatic. The social stigma is pretty harsh.

Is bankruptcy really that easy? I partly asked what I asked because I friend for mine is in this sort of situation and didn't really know their options. I think one problem as a lot of people in this situation don't really what they can do.

Well, it depends on the assets involved.

For someone like the person in the example with no assets and a low income and can file chapter 7, it's pretty easy. You can even keep your mortgage and car if you agree to keep paying it.

My girlfriend filed for bankruptcy in 2000. I've had trips to the DMV that were longer and more complicated.

A young person who is just starting out and is barely scraping by runs up $100,000 of education debt. What should that person person do? What options does that person really have?

Presumably use that $100,000 dollar degree they chose to acquire to get a job and pay off his/her debt. Slightly different.

The last 50 to 100 posts in one quick lesson.

so your saying i should just file bankruptcy and ill my debts will go away?

Anyone who files BK because of medical debt generally isn't making much of an effort to avoid BK (which is hardly an uncommon event.) I'm fortunate to do quite a bit of pro bono work and if you have someone who gets a "bill" from the hospital that they legitimately can't pay, remember- hospitals don't send you a bill, they send you an offer. I've negotiated as much as 50K worth of hospital bills down to less than 6K, with a five-year payment plan. Hospitals are incredibly flexible on their invoices for a myriad of reasons. Most importantly, particularly with hospital debt (although also true of most debt) if the debtor sends in a payment a month, they will almost never end up dealing with a collection agency (this is critical.) Even if the payment is $10.00 on a 6 figure bill- as long as a check keeps coming in- you're still revenue and they'll work with you.

Obviously there are exceptions, particularly as to how much debt you can run up if you're in a serious accident without coverage, and I'd be happy to see a proposal that addresses that and makes sense for everybody involved. That said, most medical debt is extremely easy to work with and I'm always a bit skeptical (based on my own experiences) as to the notion that people are being pushed into BK because of medical debt. I was familiar with the Andy link, and with the various rebuttals, but if anyone has any other info on this topic- I'd appreciate a pointer.

Or is there something more that goes into compassion?"

Brain chemicals and basic human decency, if you want to look at it on a more granular level.

But now we're just down to you and MCoA defining "basic human decency" for us.

Presumably use that $100,000 dollar degree they chose to acquire to get a job and pay off his/her debt. Slightly different.

Not to the person with the debt. Actually, the student debt is worse. If I have lots of medical debt, I can file bankruptcy and rid myself of it. I cannot get rid of student loan debt.

My point is that things happen. If we limit their impact to $5 grand, it is difficult at the beginning but you can work it. Hopefully, you can advance in your life and pay it off in a few years. I was not trying to be flippant, but when medical bills are $100,000, then it is impossible to get from under. $5-$10,000 is doable.

so your saying i should just file bankruptcy and ill my debts will go away?

Pretty much.

Or you could get a better job.

Anyone who files BK because of medical debt generally isn't making much of an effort to avoid BK (which is hardly an uncommon event.) I'm fortunate to do quite a bit of pro bono work and if you have someone who gets a "bill" from the hospital that they legitimately can't pay, remember- hospitals don't send you a bill, they send you an offer. I've negotiated as much as 50K worth of hospital bills down to less than 6K, with a five-year payment plan. Hospitals are incredibly flexible on their invoices for a myriad of reasons.


That, too. Anyone who thinks hospitals simply send you a bill for all services and send it to a collection agency for eventual lawsuit, doesn't know #### from shinola.

I'm given to understand that some employers use bad credit as a reason not to hire applicants. That makes going bankrupt a pretty bad deal in an economic climate like this one.

so your saying i should just file bankruptcy and ill my debts will go away?

If you don't have anything that's worth a lot and don't plan to buy a house for a couple of years, then pretty much.

I'm given to understand that some employers use bad credit as a reason not to hire applicants. That makes going bankrupt a pretty bad deal in an economic climate like this one.

Then that person should just apply for an even better job.

like what bernal, washing your car?

What constitutes "worth a lot"? Would they take my computer? Where do I store my files, which I need to continue writing my dissertation?

I will pay you $5 and a ham sandwich to wash my car.

I'm given to understand that some employers use bad credit as a reason not to hire applicants. That makes going bankrupt a pretty bad deal in an economic climate like this one.

That's mostly in financial industries (because of the risk of fraud).

But if you're contemplating bankruptcy, in most cases you won't have good credit anyway. Most employers are pulling your credit report for identity verification as part of a background check.

Hospitals are incredibly flexible on their invoices for a myriad of reasons.

No kidding:

A hospital will "charge", $17,000 for staying in a room
$650 for aspirin
$300 for some service or another

have an itemized list with 8 or 89 more entries like that

some will have "waived" next to them
then there will be a credit for insurance reimbursement...
then there will be the "Due from patient" column , with one or two entries discounted for no apparent reason "Compassion"?

and then at the very bottom, balance due: $896.41

1: That $896.41 may or may not be an accurate total of the preceding debits and credits
2: Who cares, the preceding debits and credits, being just plugged in made up nonsense, with the possible exception of "insurance reimbursements"

I used to, long ago, work fro a collection mill, I saw thousands of bills and invoices
generally speaking an invoice lists items purchased/ services rendered, tie spent, taxes, shipping, the cost of such item (which is usually an agreed cost, per contract or something- 6 widgets, $12.50 each, tot: $75.00 etc.

We all know this, but Hospital Bills are, well, just nuts, the numbers are all made up when the bill is printed out, there is no relationship between that bill and any "price" agreed to previously, any "price" posted on a wall, any costs actually borne by the Hospital in administering care to you.

No other business in the US works that way

No other business in the US works that way

You ever get body work done on your car?

Or use a lawyer?

Well, it took until September, but I've finally found something I agree with Obama about:

TMZ has obtained the audiotape of President Barack Obama calling Kanye West a "jackass" for hijacking Taylor Swift's acceptance speech during the VMAs.

The audio was recorded just before Obama went on camera to do an interview with CNBC. Before the interview began, Obama -- referring to Kanye's antics on stage -- said "I thought that was really inappropriate," then adding, "He's a jackass."

What constitutes "worth a lot"? Would they take my computer? Where do I store my files, which I need to continue writing my dissertation?

In MD, you can keep appliances, furnishings, goods, and clothing to $1,000. Nobody wants your couches, this is mainly for people that have extremely valuable furniture. Anything you use for work (clothing, books, tools, computers) up to $5,000. MD has a wild card as well, allowing you to keep an additional $11,000 worth of stuff (no more than $6,000 in cash). There's a whole bunch of other stuff (disability benefits, your 401k and so on).

States have all sorts of things. For example, in quite a few states, you have an unlimited homestead exemption.

In my girlfriend's case, she used her wild cards for her Camry and had nothing else of real value and she was able to get a car loan 2 years later for her new car at 6%.

yes and yes

Would someone like to mow my lawn?

My prescription allergy nasal spray costs me $15 for a 3 month supply, which is 3 seventeen gram dispensers. According to the EOB, my insurance paid $252 and change for that amount. That comes to $89 per dispenser, or $11 dollars and change per gram, for allergy spray.

The swine flu vaccine has been passed by the FDA. DAMN THE LONG REACH OF THE GOVERNMENT!!!!

What is the Libertarian party line on the FDA? How about the EPA?

Anyone who files BK because of medical debt generally isn't making much of an effort to avoid BK (which is hardly an uncommon event.) I'm fortunate to do quite a bit of pro bono work and if you have someone who gets a "bill" from the hospital that they legitimately can't pay, remember- hospitals don't send you a bill, they send you an offer. I've negotiated as much as 50K worth of hospital bills down to less than 6K, with a five-year payment plan. Hospitals are incredibly flexible on their invoices for a myriad of reasons.


That, too. Anyone who thinks hospitals simply send you a bill for all services and send it to a collection agency for eventual lawsuit, doesn't know #### from shinola.

My guess quite a lot of people don't actually know any of this or even where to look to find it out.

What is the Libertarian party line on the FDA? How about the EPA?

It depends on what aspect.

For example, you don't have a right to pollute someone else's property, so an enforcement mechanism there is warranted.

Not to the person with the debt. Actually, the student debt is worse. If I have lots of medical debt, I can file bankruptcy and rid myself of it. I cannot get rid of student loan debt.

My point is that things happen. If we limit their impact to $5 grand, it is difficult at the beginning but you can work it. Hopefully, you can advance in your life and pay it off in a few years. I was not trying to be flippant, but when medical bills are $100,000, then it is impossible to get from under. $5-$10,000 is doable.

While I obviously agree with the contents of the second paragraph, as a person who has significant student loans remaining to be paid, I am fairly confident that I freely asked for that onus and that I have received a product that will help me pay it off. That situation has little in common with another gentleman getting hit by a bus and having to pay for his care.

Manny- I'm sorry to hear about your friend. I can't offer any legal advice, but if you want to send me a bit of the backstory/particulars- I'd be happy to offer you some suggestions that might be of help.

The debate on liberal terms is that government's responsibilities include "promot[ing] the general welfare", and that keeping people from unnecessary, easily-avoidable suffering and death through injury or illness falls under that heading.

That's not the "general" welfare; that's one guy's welfare.

what's amazing is he doesn't seem to realize that people have already proposed those answers as a parody of the Libertarian position...

Yes, but sarcasm isn't an argument. You haven't explained why these are a "parody" of anything, as opposed to a perfectly legitimate set of options.

You ever get body work done on your car?

Or use a lawyer?

well you know their "rates" ahead of time, only the "labor" hours later applied against those rates are fictitious

except those of my firm of course

EDIT: FAIL

Ray and I are different people, Lassus. Our names are spelled and pronounced differently.

That's not the "general" welfare; that's one guy's welfare.

What is the cutoff number for General Welfare? 51%? 76%? 99%?

Manny- I'm sorry to hear about your friend. I can't offer any legal advice, but if you want to send me a bit of the backstory/particulars- I'd be happy to offer you some suggestions that might be of help.

Thanks for the offer. I've spent some of the afternoon looking at local groups that offer pro bono legal advice/services and will probably send that his way, so that should be fine for now.

Eep. Sorry, Dan.

My general idiocy - on occasion - derails my utter hilarity.

687...Of course your sock puppet wouldn't have the same name as you.

Here's how someone who wanted to know about hospital bills could research it.

Best of luck to your friend. Bankruptcy does offer someone a good way to start over if he/she needs to go that route.

I'd have to be pretty dedicated to maintain a sockpuppet for 15 years.

Manny's friend should just get a better job.

Maybe we could hire Manny's friend to delete all the useless crap that people clutter this board with- I got five on it.

Dan, I could probably have found a better post of mine to advertise.

I do like the .sig I had then:

"I know several peglegs who would give Blowers a run for his money at third."
-- David Pease on rec.sport.baseball 12/2/95

We all know this, but Hospital Bills are, well, just nuts, the numbers are all made up when the bill is printed out, there is no relationship between that bill and any "price" agreed to previously, any "price" posted on a wall, any costs actually borne by the Hospital in administering care to you.

No other business in the US works that way

And this is an area that I would like to see in a health care reform plan, but it's a fight to be had with the AMA... and with the insurance lobby squarely aligned against reform of virtually any type, probably not something feasible in a single bill.

Virtually all medical bills are based on the CPT (-CPT®Codes, descriptions, and material only are copyright 2008 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT®. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. CPT®is a trademark of the American Medical Association. better include that so the AMA doesn't file suit against BTF) coding system. Medicare's HCPCS system is built directly on the CPT(-CPT®Codes, descriptions, and material only are copyright 2008 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT®. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. CPT®is a trademark of the American Medical Association.) system. All procedures, tests, and medical procedures are in some way or another, tied directly to the CPT (-CPT®Codes, descriptions, and material only are copyright 2008 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT®. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein. CPT®is a trademark of the American Medical Association.) system.

If you wanted to see exactly what is being billed to Medicare for a procedure - I could show you how to figure it out... It's not pretty, it's not easy -- but the information is basically freely available.

Not so with the AMA's set. When it comes to protecting their 'intellectual property' - the AMA makes the RIA look like a perpetually stoned hippie at a Grateful Dead show.

So... the AMA updates its set every quarter... CMS then bases its HCPCS updates on the CPT updates (as well as caluclating its RVUs, DRGs, geographic factors, etc).... then private insurance uses Medicare's rates as a baseline in negotiating its own rates with networks.

Simplifying that -- and making it more efficient for everyone (Medicare, private insurers, out-of-pocket payers) --- has to start with that first domino. I'm not suggesting that the government (be it CMS or the VA or HHS or whomever) should build the base codeset - let the AMA's board continue to maintain it (though... even within the medical profession - there are complaints about that).

But dispersal of the base set is best left to the government who has no interest in maintaining some licensed control over it.

That alone won't solve the billing complexity problem -- but it's a necessary first step.

dear manny and donde

i am one of the many iggnerint people who did not know that about hosp bills. who do you go to for getting it fixed? how much do you have to pay the people who know how to fix it?

going to the people inside the hosp only get you put on a payment plan to pay the whole thing

-----------

and anyone who thinks that a whole lot of people can just pay 15% of their entire income just for the health "insurance" premium is nuts. there is absolutely NO way we could do that

as for this "get a better job" stuff DMN,

the way things are with the health insurance sstuff right now, my husband can't never get another plan because he has asthma (pre-condition) so he really can't do real too much

as for me, well, there is only one "job" i could get that is not minimum wage and it isn't something YOU would want to be "stuck" doing - so to speak. and getting minimum wage menial jobs that start AFTER your husband get home from work and lets you get home BEFORE he has to leave so as your kids are not all alone - well are not real too many of those and a whole lot of the ones that there are use illegals

but hey, i would appreciate any ideas because i got no idea where we gonna come up with all that $$$

But it really sucks not to have if everyone else does

Being poor is supposed to suck. If it was cushy more people would do it.

I'm making no value judgment on the person who posted this or their reasoning, truly. I don't think I'm morally right and they're wrong or anything of the sort. I would just like to point out that this is why I consider myself a fairly extreme social liberal (because that's the term for feeling the way I do about this statement.) I think that this comes too close to presumption that those who are poor choose to be so because they're lazy or they value free time over money or whatever, when one really looks at why those who are below the poverty line are in that place. Further, even if you told me (and it were truth) that 70% of the poor were totally there out of direct choice to work "easy" low-paying jobs for 30 hours a week, it would still be important enough to me to give at least some modicum of enjoyment and happiness to the other 30% that I'd be okay with my tax money going towards giving all 100% something relatively frivolous like cable.

I hate when money is wasted through inefficiency or stupid decisions made in the face of overwhelming pre-decision evidence that it will be stupid, but government, our form, is pretty good at capitalizing on people's basic, innate tendencies to actually and truly want to do the humanitarian thing (the "right" thing, no value judging again), say they want to do it when they're asked and it's easy to say so, but then forget all about it when it comes down to brass tacks. People hit the ballot box, and the system gives them a brief window of time to honestly and without fear of judgment, make their decision tovote for this guy who will slash taxes and that guy who will give hobos money to buy lap dances with. If six months later the voter is in a foul mood that day or selfishness takes over and they'd at that moment revoke Medicaid and take away free school lunches for poor kids, that's not their decision anymore. I like this. So even though government is inefficient, it still gets my vote, because I think it is good where a profit seeking actor would (rightfully) be more efficient but less humanitarian and more subject to the fleeting whims and mores of the populace.

bbchick, at the hospital my wife works at there is a Financial Counselor in the Patient Access department whose sole job it is to negotiate payments and payment plans with patients. Sometimes the hospital will even eat the cost. What hospital? I can maybe help you navigate and figure out who to talk to. You know how to reach me privately.

i am one of the many iggnerint people who did not know that about hosp bills. who do you go to for getting it fixed? how much do you have to pay the people who know how to fix it?

going to the people inside the hosp only get you put on a payment plan to pay the whole thing

Private insurance, out of pocket, or state/federal program?

If private insurance, your carrier should be having that fight.

If Medicaid/Medicare - most states have help lines, as does Medicare.

If out of pocket... well... that's more difficult. There are private firms that will help - costs vary and some are legitimate, but many of them are charlatans. Your state's dept of health - most likely under whatever agency licenses hospitals - might have some assistance to offer.

bernal darling boy

things are ok right NOW, but i didn't know that hosp bills are negotiable. make me have a lil hope that if something bad happen to me maybe i won't be dead after all

Gotcha. Everything is negotiable. They just don't want you to know that.