What happens when a patient with no insurance goes to the ER? ( 2 scenarios )

[chaii]

I've always wondered about this and have never gotten a concrete answer. So what would happen in these cases?

1. Elderly man new to the country comes to live with his child in the states. The man goes to the ER for whatever reason. Who incurs the cost? the man is obviously uninsured and his child cant afford the cost. Who does the cost fall on?

2. Homeless person struck by a car rushed to the ER. Who pays for that?

If anyone could help clear up the confusion I would really appreciate it. Thanks in advance.

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[Beargryllz]

I've always wondered about this and have never gotten a concrete answer. So what would happen in these cases?

1. Elderly man new to the country comes to live with his child in the states. The man goes to the ER for whatever reason. Who incurs the cost? the man is obviously uninsured and his child cant afford the cost. Who does the cost fall on?

2. Homeless person struck by a car rushed to the ER. Who pays for that?

If anyone could help clear up the confusion I would really appreciate it. Thanks in advance.

In both cases they are responsible for the bill, just unlikely to pay it. There are all types of ways this can play out. Neither of these people are likely to be insured at all, even through Medicaid (and this is beside the fact that hospitals don't actually take Medicaid). What happens next is the hospital tries to get some of the money, but they won't so they write it off as a loss. When an insured fellow comes in with a bad ankle, sore throat, headache, etc. the hospital is poised to make many thousands of dollars. It all evens out and if you didn't invest in health insurance before the ACA was passed you are probably kicking yourself because they're making goddamn ridiculous numbers.

 

[chaii]

In both cases they are responsible for the bill, just unlikely to pay it. There are all types of ways this can play out. Neither of these people are likely to be insured at all, even through Medicaid (and this is beside the fact that hospitals don't actually take Medicaid). What happens next is the hospital tries to get some of the money, but they won't so they write it off as a loss. When an insured fellow comes in with a bad ankle, sore throat, headache, etc. the hospital is poised to make many thousands of dollars. It all evens out and if you didn't invest in health insurance before the ACA was passed you are probably kicking yourself because they're making goddamn ridiculous numbers.

Thanks for the reply! a few more questions haha this interest me very much. How aggressive are hospitals in trying to get owed money from uninsured patients? couldn't they take it to court? And in the case of the elderly man why wouldn't they try to get one of his adult children to pay the bill? Im assuming this varies from hospital to hospital as well?

 

[Beargryllz]

Thanks for the reply! a few more questions haha this interest me very much. How aggressive are hospitals in trying to get owed money from uninsured patients? couldn't they take it to court? And in the case of the elderly man why wouldn't they try to get one of his adult children to pay the bill? Im assuming this varies from hospital to hospital as well?

Taking homeless people to small-claims court is probably the single worst way a hospital could go about getting compensated. It would pretty much be a disaster in every way imaginable and in some unimaginable ways as well. Some bills might eventually go to a collections agency, but that would have to be a fairly extraordinary case.

You are never responsible for another person's debt. This won't stop people from *asking* relatives of debt-holders to pay, but that is all they can do: ask. There is no way they can hold a person's kids responsible for their parents' debt. Will their estate have to settle it? Sure, absolutely. But their relatives don't magically assume all debts owed to some jackoff.

 

[chaii]

Taking homeless people to small-claims court is probably the single worst way a hospital could go about getting compensated. It would pretty much be a disaster in every way imaginable and in some unimaginable ways as well. Some bills might eventually go to a collections agency, but that would have to be a fairly extraordinary case.

Definitely understandable. In what cases would a hospital take to court then? Surely if a hospital spent a great deal of resources and money to save an uninsured trauma patients life they might later aggressively pursue the patient to pay? or take them to court?

What about the elderly man's case could/would they sue him?

 

[Beargryllz]

Definitely understandable. In what cases would a hospital take to court then? Surely if a hospital spent a great deal of resources and money to save an uninsured trauma patients life they might later aggressively pursue the patient to pay? or take them to court?

What about the elderly man's case could/would they sue him?

The result is the same in both cases: bankruptcy happens. Something like 60% of personal bankruptcies in America are from medical bills. Interestingly enough, most of those individuals had health insurance. The hospital says you owe them a billion cajillion dollars, you say you can't pay, the court says you can't pay, and then you are bankrupt.

Assets are assessed and liquidated as needed to settle the debt and then that person has a tough bunch of years ahead of them.

As long as healthcare remains profit-driven, it is essential to remain on the right side of this game. Do have good insurance, do avoid debt, do make lots of money, etc. There is a lot more to it, but you really (literally) cannot afford to fall behind in this little game. I don't know how much longer we all have to keep playing, but for now I would plan on it.

 

[chaii]

The result is the same in both cases: bankruptcy happens. Something like 60% of personal bankruptcies in America are from medical bills. Interestingly enough, most of those individuals had health insurance. The hospital says you owe them a billion cajillion dollars, you say you can't pay, the court says you can't pay, and then you are bankrupt.

Assets are assessed and liquidated as needed to settle the debt and then that person has a tough bunch of years ahead of them.

Fascinating system in the US, thanks for the info

 

[Apollyon]

The EMTALA act (of course, that is redundant, as the last A stands for "act") of 1986 makes it federal law that any patient presenting to an ED has to be seen, regardless of the ability to pay. That's why they send a bill, but don't chase it. To make a very incendiary point, we are forced to work for free (and what does that mean, if you are "forced to work for free"?), and patients can thumb their noses at us all day long.

 

[Beargryllz]

we are forced to work for free (and what does that mean, if you are "forced to work for free"?)

Have you ever worked for free?

 

[dynx]

The result is the same in both cases: bankruptcy happens. Something like 60% of personal bankruptcies in America are from medical bills. Interestingly enough, most of those individuals had health insurance. The hospital says you owe them a billion cajillion dollars, you say you can't pay, the court says you can't pay, and then you are bankrupt.

Assets are assessed and liquidated as needed to settle the debt and then that person has a tough bunch of years ahead of them.

As long as healthcare remains profit-driven, it is essential to remain on the right side of this game. Do have good insurance, do avoid debt, do make lots of money, etc. There is a lot more to it, but you really (literally) cannot afford to fall behind in this little game. I don't know how much longer we all have to keep playing, but for now I would plan on it.

blah blah blah. That much quoted study (and it was 50% actually) included those "addicted" to gambling and the cost of having a child that people couldnt afford. It also didn't just look at medical bills but loss of income from an illness and grouped that under one big banner of "healthcare issues" to come to the amazing sounding 50%. Its BS. For insured people the number in the best studies is around 8% and in the uninsured 27%. Moral. Get insurance and save some money. Stop being a loser. Even after the ACA the same people that didnt have insurance before don't have it. Why? They don't care about anything other than getting high or drunk or popping out their 10th kid. The old man worked hard all his life, came here to live with his family in his old age? I've seen that once. I see drug addicted leeches every week. The old guy had social work help him with paperwork and placement. My office wrote off our cost. I assume the hospital did the same. People get care and with rare exception are hounded into bankruptcy for real life threatening issues (MI in this case). Now you want a knee replacement then say f-u when its time to pay the bill then yeah, you should be sued.

 

[dpmd]

Have you ever worked for free?

I have at times, when I am on call and a patient needs their appendix out or whatever I am going to take care of it. If they had Medicaid before I became a provider, Medicaid just told me to **** off and I got nothing (so there was quite a bit of free care I provided). If they are not insured and the patient doesn't pay me a dime, an agreement with the hospital means I will get a percentage of what medicare would have given me for what I did. However, if the patient pays me a few dollars then stops paying, I get nothing unless the collections agency gets me something eventually so at least part of the care I gave the patient is free.