just curious, who pays for detained patients

It is not clear to me what you mean by 'detained.' Do you mean held against that person's will or incarcerated.
Insurance pays for all hospital stays, whether voluntary or not. If a person doesn't have insurance, I am not sure if they get billed. That would be interesting to take it to court, "I didn't even want this, how can they charge me for this?" For the incarcerated, it is our tax dollars that pay. In my training program, the county picks up the tab (the tax payers) for those without insurance.

 

In the US, in my experiece, if somone is committed to a psychiatric hospital, and they don't have insurance, their county of residence ususally picks up the bill. As you note, it would be hard to hold someone liable for unwanted (albeit neccessary) hospitalization. Even in the case you wanted to make their payment a punative measure to discourage future behavior, they would certainly have the germs of a insanity case. It becomes more interesting when the psychiatric hospital tries to collect from said county. Often times they aren't the best payers. I hospitals I worked in before they would't accept pts from certain counties, even with signed letters of payment gurantees from county administrators.

 

These days localities are more aggresive in seeking payment for services considered medically necessary.They are likely to bill the patient for the treatment rendered.If the person has the money or private insurance they will be expected to pay.If not efforts to obtain medicaid coverage will be intiated by social services.It really depends on the particualr facility,the state and the financial situation of the patient.

 

In Ca. we call that taxes.....

 

If the patient has billable insurance, it is billed since it is a medically necessary procedure. A comparison would be the ambulance bill to the hospital after a car accident in which the person loses consciousness. While this is a slightly different concept ("Implied consent"), the result is the same.

If the person has no billable insurance and does not have medicaid (medicaid is NOT insurance....I hate when patients say that ), they'll receive a bill.

Which they generally won't pay.

 

Around here, what I've seen is that the pt is billed first, and then the social services people will step in to try to get coverage through county or federal programs. Often, though, the Feds will require a Share of Cost from the pt, which is based on FEDERAL poverty guidelines. I think pts are allowed up to about $600 dollars a month in income, everything else must go to SOC.

This is one of the most expensive housing markets in the country, which means that no one on these programs can pay rent, since rent is certain to be above $600.

And don't get me started on ambulance companies. Those are billed to the pt around here, with no reduction in cost due to indigence.

So, while taxpayers are paying for a lot of 5150s, the system is already set up in such a way that everyone loses. Except private ambulance companies, of course.

 

If a patient has insurance, we pre-certify the admission (even if involuntary) with the insurance first, so they're agreeing to pay for it ahead of time (usually for ~3 days at a time before you have to call back and review for another 3 days). The uninsured fall into the "uncompensated care pool", for which the hospital gets some money each year, but never enough to cover the care delivered.