You Can Thank Private Equity for That Enormous Doctor's Bill 157
Private-equity investors have poured billions into healthcare but often game the system, hurting both doctors and patients. From a report: Consolidation is as American as apple pie. When a business gets bigger, it forces mom-and-pop players out of the market, but it can boost profits and bring down costs, too. Think about the pros and cons of Walmart and "Every Day Low Prices." In a complex, multitrillion-dollar system like America's healthcare market, though, that principle has turned into a harmful arms race that has helped drive prices increasingly higher without improving care. Years of dealmaking has led to sprawling hospital systems, vertically integrated health insurance companies, and highly concentrated private equity-owned practices resulting in diminished competition and even the closure of vital health facilities. As this three-part Heard on the Street series will show, the rich rewards and lax oversight ultimately create pain for both patients and the doctors who treat them. Belatedly, state and federal regulators and lawmakers are zeroing in on consolidation, creating uncertainty for the investors who have long profited from the healthcare merger boom.
Consider the impact of massive private-equity investment in medical practices. When a patient with employer-based insurance goes under for surgery, the anesthesiologist's fee is supposed to be determined by market forces. But what happens if one firm quietly buys out several anesthesiologists in the same city and then hikes the price of the procedure? Such a scheme was allegedly implemented by the private-equity firm Welsh, Carson, Anderson & Stowe and the company it created in 2012, U.S. Anesthesia Partners, according to a Federal Trade Commission lawsuit filed last year. It started by buying the largest practice in Houston and then making three further acquisitions, eventually expanding into other cities throughout the state of Texas. In each location, the lawsuit alleges, USAP pursued an aggressive strategy of eliminating competitors by either acquiring them or conspiring with them to weaken competition. As one insurance executive put it in the FTC lawsuit, USAP and Welsh Carson used acquisitions to "take the highest rate of all ... and then peanut butter spread that across the entire state of Texas." In May, U.S. District Judge Kenneth Hoyt dismissed the FTC's unusual step of charging the private-equity investor, Welsh Carson, but allowed the case against USAP to proceed.
Consider the impact of massive private-equity investment in medical practices. When a patient with employer-based insurance goes under for surgery, the anesthesiologist's fee is supposed to be determined by market forces. But what happens if one firm quietly buys out several anesthesiologists in the same city and then hikes the price of the procedure? Such a scheme was allegedly implemented by the private-equity firm Welsh, Carson, Anderson & Stowe and the company it created in 2012, U.S. Anesthesia Partners, according to a Federal Trade Commission lawsuit filed last year. It started by buying the largest practice in Houston and then making three further acquisitions, eventually expanding into other cities throughout the state of Texas. In each location, the lawsuit alleges, USAP pursued an aggressive strategy of eliminating competitors by either acquiring them or conspiring with them to weaken competition. As one insurance executive put it in the FTC lawsuit, USAP and Welsh Carson used acquisitions to "take the highest rate of all ... and then peanut butter spread that across the entire state of Texas." In May, U.S. District Judge Kenneth Hoyt dismissed the FTC's unusual step of charging the private-equity investor, Welsh Carson, but allowed the case against USAP to proceed.
need to remove profit from healthcare and maybe fo (Score:3, Insightful)
need to remove profit from healthcare and maybe force estimate to be the max price that you are to pay if if then under estimated the bill.
Re: (Score:2)
My area has a pseudo-municipal-owned not-for-profit hospital and a hospital owned by a for-profit company. It's the not-for-profit hospital that has turned into the monster, buying up all the not-for-profit hospitals in a 70 mile radius (including into the next state), buying the ambulance systems, signing doctors to exclusive network agreements, and continually trying to block the for-profit hospital from adding services or even beds to compete.
Re: (Score:2)
It is indeed amazing that none of these mergers and other behaviors aren't smashed by antitrust litigation.
Amazing in that it perpetuates, not amazing in the standpoint that it's likely because of regulatory capture.
That said, it's a very tough situation to remedy. Even single-payer has its downsides, because of the issues someone else mentioned that basically emergency health care doesn't afford any concept of "competition" because you can't really shop around for emergency care.
One solution might be to re
Re: (Score:2)
I load sixteen tonnes (Score:2)
Re:need to remove profit from healthcare and maybe (Score:5, Informative)
You may be surprised that many participants in US healthcare are NONPROFIT, take Arizona Blue Cross Blue Shield, which operates as a non profit
I have had both BCBS and UHC (united health care, a for profit insurance company) and BCBS provides far superior benefits and services that UHC ever did
There are plenty of non-profit options in America, and We the Consumers can demand more by moving our business away from for-profit companies that provide less to consumers while maximizing their profits
Re: (Score:2, Insightful)
Good thing that insurance is so easy to purchase, because there are no regional restrictions on where and when you can buy insurance plans, nor are most of the great insurance plans locked into being offered by certain employers at a reasonable price.
Re:need to remove profit from healthcare and maybe (Score:4, Interesting)
locked into being offered by certain employers at a reasonable price.
In Maoist China, each factory ran a school for the children of its employees. So, if you changed jobs, your kids had to change schools.
Obviously, that's stupid. Companies should not be responsible for educating the children of their employees.
But companies being responsible for their employees' health insurance is just as stupid. We only accept it because we're used to it and think that's "the way it's supposed to be."
Breaking the link between employment and health insurance and moving instead to a single-payer system is the first step to fixing America's dysfunctional healthcare industry.
Re: (Score:2)
locked into being offered by certain employers at a reasonable price.
In Maoist China, each factory ran a school for the children of its employees. So, if you changed jobs, your kids had to change schools.
Obviously, that's stupid. Companies should not be responsible for educating the children of their employees.
But companies being responsible for their employees' health insurance is just as stupid. We only accept it because we're used to it and think that's "the way it's supposed to be."
Breaking the link between employment and health insurance and moving instead to a single-payer system is the first step to fixing America's dysfunctional healthcare industry.
Yep, last year I spent 5 months off of work. I decided one day I couldn't stand working where I was any more and handed in my notice. I could afford it, that meant I could also afford to be picky about my next employer, it took me 5 months to find a job I liked... Entirely self funded, I did not claim a penny of benefit money. I would never have been able to do that if I were beholden to my employer for health care.
The hardest part was trying to explain to some HR flunkie that I wasn't on benefits (welfa
Re: (Score:2)
We only accept it because we're used to it and think that's "the way it's supposed to be."
Ummmm, no. We accept it because there is no other choice. Nobody ever asked the American people if they would like to have health insurance tied to their employer. If they had, we know how that vote would have turned out. The lie is that this is in any way a Democracy.
Re: (Score:2)
Re: (Score:2)
Wow, where did I ever suggest
>>Non profit doesn't mean they don't have to make expenses
Non-profits have to pay all the same operating costs as for-profits, but do not issue stock, so they are not beholden to "increasing shareholder value" and can keep their focus on the work they are doing. They are also tax-exempt because they do not generate profits. However, their employees do have to pay income tax on what they are paid.
You can read more about non-profits here [delawareinc.com]
I have worked for non-profits that pro
Re: (Score:2)
Re: (Score:2)
I can see why you did not include a link, since this all happened in 1992, to a CHARITY, which does not really reflect on the application of non-profits to HEALTHCARE
But, keep trying, I am sure you will pull a gem out of your ass... eventually
Re: (Score:2)
Re: (Score:2)
I have had both BCBS and UHC (united health care, a for profit insurance company) and BCBS provides far superior benefits and services that UHC ever did
I have had both as well. I am not surprised about your experiences with UHC, but... BCBS is an amazingly greedy company that denied almost every procedure doctors had ordered for me. Maybe they have changed recently, but my experiences with BCBS were about on par with UHC.
Re: (Score:2)
Speak for yourself.
Re: (Score:2)
It's more accurate to say the concept is to remove profit from health insurance.
Re: (Score:2, Insightful)
It's more accurate to say the concept is to remove profit from health insurance.
Or better, remove insurance from health care.
Re: (Score:2)
I think it's just a bit politically unfeasible in the US
A majority of Americans believe that the government should be responsible for healthcare, and 36% support a single-payer system. So, it's well within the Overton Window.
Increasing share of Americans favor government provided healthcare [pewresearch.org]
Re: (Score:2)
Nice! From your lips to God's ears those numbers will move ahead more.
Single payer, multi payer, lots of setups would be an improvement.
Re: (Score:2)
How does health spending in the U.S. compare to other countries? [healthsystemtracker.org]
America, by a pretty wide margin, pays the most for medical care, per capita.
but where the majority of people except the poorest take out private insurance or go see private doctors?
Most countries still have private doctors regardless of the insurance system. Also you pretty accurately described America right now
Re: (Score:2, Insightful)
Wrong. I, for one, want to nationalize the whole damn thing.
Re:need to remove profit from healthcare and maybe (Score:5, Insightful)
As the USA has been demonstrating for the past few decades, privatised healthcare has far too many risks of perverse incentives that adversely affect the vast majority for the profits of the very few. Ask the Sackler family; it couldn't have happened without the US ill-heathcare system! & how much for a Salbutamol inhaler or an emergency epinephrine injector in the USA? Seriously?
Re: (Score:3)
Re: (Score:2)
Re: (Score:2)
Meanwhile, in most of the rest of the developed world, we understand that universal healthcare is an investment in public stability that benefits citizens & their families, employers, hospitals, & doctors alike.
America doesn't even think about that. It is what can benefit 'me', the richest person in this country. This "public" thing... what is it and why should I care about it?
Re: (Score:2)
Re: (Score:2)
Even the most ardent US leftists are not proposing to eliminate profit from healthcare.
I live in the SF Bay area, so I know plenty of leftists.
They all want to eliminate profit from healthcare.
Re: (Score:2)
No, that's the job of non-Americans to show the damaging effect of the theft of service from users, by profiteers.
Doesn't America still have paws on the books for sticking war profiteers against a wall and shooting them?
And isn't America some 50 years into losing it's "war on cancer" (that was Tricky Dicky, an un-convicted felon President, if ever there was one)?
So, will the executions be public, or behind closed doors
Re: need to remove profit from healthcare and mayb (Score:2)
NHS style does not mean copy one flawed implementation.
Perhaps look at Canada or Australia for examples of highly successful nationalised healthcare systems.
Re: (Score:2)
See, you people are so brainwashed that you think that this is "socialism". There are plenty of countries around the world with single-payer healthcare systems, and they all work pretty well for the most part. Not flawlessly, but pretty well. It's not like the USA is some utopic place where everyone gets access to top notch care. For all but about 10% of the USA population, it's actually better to have a heart attack in Bolivia. What's the point
Re: (Score:2)
Having a heart attack isn't a bad decision. Health issues affect the population largely randomly and the whole point of living in a civilized society is that we acknowledge the vicissitudes of live and agree to help one another. Although, I guess that's the key. Today's USA is not a "civilized society" by any reasonable definition.
In Austra
Re:need to remove profit from healthcare and maybe (Score:5, Insightful)
This is a classic incorrect line of thinking. Try sticking with it whilst simultaneously explaining why the following areas should _not_ have profit motives in them:
- Road infrastructure
- Water infrastructure
- Energy infrastructure
- Defense (army, navy, air force, etc.)
- Law enforcement
- Fire departments
- The entire judicial system, including imprisonment
- Politics
You may succeed in convincing yourself that a bunch of free market capitalism would work great for one or perhaps a few of those areas, but definitely not all of them. The logic you presented with regard to the health care system would however seem to apply to all of them, which means it must be absurd (in the logical sense).
Re: (Score:2)
Re: (Score:3)
Prisons as a profit center is a truly terrible idea. That we're doing it doesn't make it any better.
That various other examples exist doesn't mean their existence is a social benefit. I'm not assuming that they *could* only be communal operations, but that many of the *should* only be communal operations.
OTOH, public institutions have their definite problems. They are different problems, but sometimes they are serious enough that the private alternative is better.
The difference isn't really public vs. pr
Re: (Score:2)
I don't claim that they have to be better, but that they can be. There are and have been examples. But if their goal is to make people unhappy at the lowest cost, then they have an equivalently low purpose.
FWIW, I think that prisons *should* try to rehabilitate people more than try to punish them. I'll admit, though, that while we know how to punish people, we don't really know how to rehabilitate them.
Re: (Score:2)
You dodged the question. Note that I was countering based on the role of the profit motive and that you haven't mentioned it in your reply.
The fact that there are private entities operating in those areas is not at all an argument that the area should be mainly governed by financial incentives. Do you think stating that private defense exists is in any way a good argument that national defense should be driven by profit?
There is nothing that magically enables [governments] to ignore the laws of supply and demand or other types of market forces.
Of course there is. They're called taxes and actual laws (protip: macro-economics is not
Re: (Score:2)
It's not clear that the work should be contracted out rather than civil service. There are probably instances of both. OTOH, private road maintenance is a long history of abuse. The public system isn't necessarily good, but it's got different problems. (Ask San Francisco about it's relationship with the California Dept. of Highways re freeway building.)
Re: (Score:2)
I remember the result was that neither one is necessarily more efficient than the other, but switching from one to the other would often make them more efficient for a while (until nepotism/the manager class crept in and made things sclerotic. Then you need another switch to shake things up).
Re: (Score:2)
Then, as you explained, it's no longer capitalism: It's a profit-driven oligarchy. "vivian" was correct: The problem is US government obeying the whims of insurance and telecommunication corporations. It's why they are not accountable and they do not compete with each other. The USA has a built-in malady of corporatism: Protecting the power of corporations at the expense of everything else: People, the environment, the government itself, the practice of capitalism and culture.
One of the lessons of co
Re: (Score:3)
I'm presuming that you do have money left over from your paycheck after expenses. That's profit!
This is not "profit" as commonly used. You, as an individual, are in charge of your own profits. Medical professionals still get paid.
Treating it as a special case because it's medically related isn't necessary
It is though, medical care doesn't really follow the usual laws of economics we subscribe by because the elements for a "rational" market don't exist.
Massive lack of knowledge between consumer and providers.
Limited ability to "shop around"
Demand is functionally limitless (how much would you pay to not die?)
No real alternative options for people when purchasing products incl
Re:need to remove profit from healthcare and maybe (Score:5, Insightful)
How willing to do your job would you be if someone else decided to remove all profit from it?
Dunno, how about I ask my local doctor who is powered by socialism. Or maybe I'll ask the guys who invented the COVID vaccine who sold it at cost (oh and they were in Germany so again powered by socialism). Or I'll ask my local fire department, and the ambulance that never sent me a bill.
Your view is typical of modern discourse. Everything is all or nothing. You either have free market capitalism, or a complete meltdown because no one gets paid for anything. It's just an absurd point of view. The reality is there is a long sliding scale between the two. The rest of the world has shown healthcare functions as well, if not better, when the absurd profit motive present in America is removed, and when it is brought back down to a reasonable level.
Re: (Score:2)
My salary would triple if I were int he USA after tax. But I don't want to come over there. You seem to think the only thing about life is money. It's probably why every one of your Slashdot posts makes you seem jaded and bitter.
The US paid for the COVID vaccine
They paid for production. Development ended up happening at cost. Some production happened at cost too. Yet those producing them at cost (and this is true) still produced them.
We can thank private equity for a lot of evil (Score:4, Interesting)
Re: (Score:2)
Re: (Score:2)
Because those clowns taste funny.
Re: (Score:2)
That's a lot more widely spread that just certain X sects. I've seen analogous things attributed to Aristotle, Voltaire, and Cardinal Richelieu.
Spread vs used (Score:2)
Google the phrase (Score:2)
Hospitals-R-us (Score:3)
Wait while they saddle your local clinics with huge debt burdens
if their sole purpose is to extract money from the system then they should be regulated because they are regressing from improving the lives of practitioners and patients. It's not just the patients being shaken down for more for the same or worse service, the doctors are being squeezed too. How does that help recruitment into the healthcare profession ? I get that proper management and accounting is important and a specialist skill, but it doesn't merit being rewarded with ALL the money
Certificate of Need (Score:3)
This is the lynchpin of the whole scheme. In many regions, to open a new hospital or certain types of health care facilities, you have to obtain a certificate of need from the local health board. To get one, all the existing hospitals and health care facilities have to agree to give one to you. That is, if there is only one hospital that charges high rates, if you want to open a second hospital to compete, the existing hospital has to OK it.
Sounds fair, right?
true story (Score:5, Interesting)
I got to the emergency room at Mary Washington Hospital ( I was living in Virginia then) . I waited until just after 11 pm to be seen (much more seriously injured people were being seen before me, and all I had was pain, deep, dark red urine and vomitting. When seen, the took urine and blood and did an x-ray. the doc told me I had a kidney stone and discharged me at about 12:30 am with some anti nausea pills (chewable) and some pain pills (hydrocodone) and he had injected me with some morphine derivative. I drove home, and took the pills as directed, facetimed my brother and mom to tell them about this development, and the morphine kicked in. How did I know, because my first generation iPhone started growing hair. So I went to bed, only awoke to take meds as prescribed...
6 months later I got a bill from the hospital, a little over $8000, the insurance had paid 80% of that. the documentation said I had been being seen for two days and assigned a private room to me, when the reality was I had been seen for 1.5 hours, had one X-Ray and one blood test and one Urinalysis, been prescribed anti-nausea meds and pain killers.
I called my insurance and told them this and the lady on the other end of the phone basically didn't care and told me they had already paid it.
I called the hospital billing and tried to explain to them, but they just presumed I was lying and told me so.
So, if I am ever in that part of Virginia again and need medical care, please do not take me to Mary Washington Hospital, there are a couple of newer hospitals that have been put up in the area.
Re: true story (Score:3)
Re: (Score:2)
.
Studies have shown that holding the newborn after birth (specifically placing the newborn on the mother's naked belly if she didn't have a c-section so there is skin to skin contact if I remember correctly) speeds up the recovery of the mother, so it is a best practice, or used to be before these assholes got in charge!
Re: true story (Score:3)
Re: (Score:2)
Or am I misunderstanding and the extra cost in the UK for the mother to be allowed to hold her baby after the birth the equivalent in British Pounds Sterling $30, the cost for a normal birth in the US, $30K, and that the NHS pays the doctors, nurses and all the others involved in the
Re: true story (Score:2)
Re: (Score:2)
Every Day Low Prices (Score:2)
Think about the pros and cons of Walmart and "Every Day Low Prices."
Sure, but I'm not sure Walmart is the model here as 70-80% of their merchandise comes from China.
Pretty sure we can't get our local healthcare there.
From Walmart’s Open Call Continues To Support Products Made in the USA [retailwire.com]
In America, estimates say that Chinese suppliers make up 70-80 percent of Walmart’s merchandise, leaving less than 20 percent for American-made products,” according to the Alliance for American Manufacturing.
Also not sure how that's going to play out in the future if ... Donald Trump’s 60% Tariff on Chinese Imports [crfb.org]:
Former President and current Republican presidential candidate Donald Trump recently proposed implementing a tariff of 60 percent or higher on imports from China.
Noting that tariffs are paid by the importers *not* the exporters (ie: China) and those costs are often (usually?) passed along to the consumer.
You can also thank deregulation (Score:5, Insightful)
Why should a doctor be allowed to gouge patients, but a grocery store can't gouge shoppers? Why should a drug maker get to dictate the price they charge Medicare, without any ability for the government to negotiate those prices (except for 10 drugs)?
When there are no boundaries, there is no one to say "no" when abusers come along, and they always will.
I'm all for free enterprise, to a point. It's way past time for healthcare to experience heavier government regulation.
Re: (Score:3)
Or the opposite. Arguably, much of what is wrong with medicine today is due to government policy:
* Monopolies on medical services, pharmaceuticals, and devices.
* Tax incentives for employer-provided insurance, pushing other models out of the market, limiting choice, and requiring portability regulations to try to fix it.
* Medicare and Medicaid distorting the market and imposing burdensome administration.
* etc.
The only thing worse that I can think of would be direct government health care, which would end up
Re: You can also thank deregulation (Score:2)
I'll vote with my dollars. I've told my wife to shop around and pick the hospital with the best value if I ever have a stroke or heart attack. There will be no overpaying for us.
Re: (Score:2)
Good luck with that research! It's NOT easy to figure out in advance what you will pay for healthcare. And a hospital that charges less in one area, might well charge more in another, so you can't just pick a hospital and stick with it.
Re:You can also thank deregulation (Score:5, Insightful)
* Monopolies are allows because of *lax* government policy.
* Employer-provided insurance helps bring *down* the cost due to bargaining power.
* Medicare and Medicaid also bring *down* healthcare costs, because many insurers limit their payouts to some percentage, like 150%, of what Medicare pays. Those without insurance, pay even more, but often those costs are also tied to a percentage above what Medicare pays.
Re: (Score:2)
* Monopolies are allows because of *lax* government policy.
The government artificially creates monopolies for pharmaceutical companies (patent law), for doctors (illegal to practice medicine without the doctor monopoly granting you permission), in some places it's illegal to build a hospital without the local hospitals granting you permission. The vast, vast majority of monopolies are artificially created by the government, and most of the rest are allowed by the government despite being illegal. Maybe for good reasons, but that's how it is.
Re: (Score:2)
The things you are describing, are not monopolies.
A monopoly is "a market structure with a single seller or producer that assumes a dominant position in an industry or a sector." https://www.investopedia.com/t... [investopedia.com].
Having a patent gives one company the exclusive right to sell a specific drug, but does not enable the company to control the entire pharmaceuticals market.
Physician licensing does not give a physician or group of physicians, the ability to control the entire industry or sector.
Some places require
Re: (Score:2)
You're basically claiming that monopolies are impossible. Maybe you can read your own link, where it goes on to say that a monopoly can be in a single product.
Re: (Score:2)
I did go back to the article, and it does not say that a monopoly can exist around a single product, except when there is "no similar substitutes for the product being sold." There are very few drugs that fall into this category. Just because a drug has a patent locking out competitors, doesn't mean there are no good substitutes. Even for those few cases that are truly unique (hmmm...not sure I can think of a single example), patent law has a built-in expiration date, after which competitors can jump into t
Switch to single bill. (Score:3)
First step is to have one itemized bill. ONE. Any other bills for that procedure are not legally binding. This isn't hard, just greed. The current design is to overwhelm the patient such that it's just a wall of money requests. If you have insurance they too should get ONE FUCKING BILL PER PROCEDURE or DAY.
Corporate legal shield (Score:2)
"In May, U.S. District Judge Kenneth Hoyt dismissed the FTC's unusual step of charging the private-equity investor, Welsh Carson, but allowed the case against USAP to proceed."
One of the benefits of the US corporate system is the whitewashing of legal liability. A private equity firm (or any investor) can gain control of a corporation, force that corporation to act illegally to benefit the investor, and only the corporation can be punished. It's a great system ... for some people.
Only going to get worse... (Score:3)
And it will affect the counties that consistently vote for people that would never even consider the idea that health care is fundamental right that every single person should have access to without fear of cost.
Basically, they will ring as much as they can out of rural and community hospitals, but that is short lived. The doctors can't even come in and stop it, because regulations allow a vulture equity firm to buy up hospitals, but they can't be employee or doctor owned.
The doctors will burn out and move to urban areas where there is still demand and actual non-profit systems that are trying like hell to stave off for-profit acquisition.
It's either single payer or a health system that is completely collapsed under mismanagement for profit.
But, no, we need to spend trillions on weapons programs that don't work, prop up defense contractors that just leech off our taxes to maintain stock pricing.
You could cut 4 trillion of defense spending over 10 years and you get nothing but a more efficient and nimble defense force. Sure, we can't spend trillions trying to install democracies in random countries.
But, I'll take that over nobody ever going into bankruptcy over medical bills by a system where insurance and equity take up 33% of very cent spent to just deny care.
It's due to excessively cheap debt (Score:2)
When debt is cheap, people use more of it. And they use it to do the things people do with debt - buy assets. And do leveraged buyouts (private equity companies used to be known as leveraged buyout investment firms and their business model is use relatively small portion of equity and a relatively large portion of outside debt financing [aeaweb.org]).
The perniciousness of cheap debt, and debt where risk is transferred away from the lender (e.g. "privatize profits, socialize losses") has led to these dysfunctions.
Privat
Re:Partially (Score:5, Insightful)
Millions of illegal immigrants don't help... My coworker's wife was an account for a major local hospital where the migrant population has exploded. She said that 80% of the ER visitors had no way to pay their bill, not Medicare, Medicaid, insurance nor cash. So how does that affect everyone else's bill.
I like how you conflate poor people with immigration, and then throw the word "illegal" in there just for shits and giggles while ignoring the absolutely absurd notion that an ER visit should result in a bill for anyone.
Re: (Score:2)
Re:Partially (Score:5, Informative)
Blaming "illegal immigrants" is a convenient political foil, but the data doesn't support that contention. US citizens make up 78% of the country's uninsured patients. https://www.kff.org/wp-content... [kff.org] Further, illegal immigrants are less likely to show up at the ER in the first place, than citizens. So the percentage of uninsured ER visits that are illegal immigrants is less than 5%.
If we really want to reduce the impacts of illegal immigration on the healthcare system, we should make it easier to become a *legal*, tax-paying immigrant, so that their income (and the tax) can help offset the costs of uninsured care.
However, those who point fingers at illegal immigrants, actually are just looking for excuses to blame illegal immigrants. They don't *actually* care about the legality of their status. This can be clearly seen by pointing out that the same people that oppose illegal immigration, refuse to back measures to make it easier to become *legal.*
Re: (Score:3)
I personally have no problems with legal immigration. However, I acknowledge that unfettered immigration can be equally problematic: The country has been "built". The country needs to shrink in size, not increase. We require less and less low-skill folks overall as automation continues its pace.
Re:Partially (Score:4, Informative)
I live in Houston, you know, where a lot of those buses come from. Houston has almost half a million undocumented immigrants, by recent estimates. I don't think your location likely has that many. And yet, Houston is thriving, and is known worldwide for its healthcare. I don't view Houston as being damaged somehow by the level of immigration, I believe it is enriched by it.
The idea that "we require less and less low skill folks" is an assumption not backed up by data. While teen unemployment is trending up, it's still at historically low levels. https://www.spglobal.com/marke... [spglobal.com] There's certainly no evidence of a "major shift" in teen (unskilled) employment.
Re: (Score:2)
Re: (Score:2)
First you blamed immigrants for high healthcare costs, but the data didn't support that notion.
Now you are blaming crime on immigrants. The data also doesn't support that notion.
Immigrants, documented or not, are significantly less likely to commit crime, or become incarcerated, than US Citizens.
Relative to undocumented immigrants, US-born citizens are over 2 times more likely to be arrested for violent crimes, 2.5 times more likely to be arrested for drug crimes, and over 4 times more likely to be arrested for property crimes.
https://www.pnas.org/doi/pdf/1... [pnas.org]
Since 1870, it has never been the case that immigrants as a group have been more incarcerated than the U.S.-born.
https://news.northwestern.edu/... [northwestern.edu]
Your assumption that these Hispanic people are undocumented, is also unfounded. There are more than 60 million US Citizens of Hispanic origin, com
Re: (Score:2)
Most of my best friends throughout life have been Hispanic, not that that matters, nor do you believe it. It's easier to assume and call me names.
And by the way, your defense reminds me of the people who deny global
Re: (Score:2)
Immigrants who sneak across the border, do it not because they are criminals, but because they are desperate. They aren't coming here to commit crimes, but to get jobs and a better life. Yes, they should come legally. But due to our insane process, which includes a lottery and high costs, many don't have a legal option.
Christians have been known to sneak Bibles across borders into countries that don't allow Bibles to be brought into their countries. Are these Christians committing crimes when they do so? Th
Re: (Score:2)
Yes, they should come legally. But due to our insane process, which includes a lottery and high costs, many don't have a legal option.
For someone I know it's been:
1 year to get a K1 visa.
1.5 years to get a green card.
Now, with the expiration of that green card approaching, it's another 4 years to get an unrestricted green card.
Green card = "permanent resident", where "permanent" means anything from 2 to 10 years.
The kicker for this, most people going through this route never get their unrestricted green card now, because they become eligible to become citizens while the green card process is still running.
Even worse, though, are the India
Re: (Score:2)
Your friend was lucky. My friend, who was Canadian and married a US citizen, applied for legal residency based on her marriage. After more than a year, INS *lost* her paperwork, and she had to start over. After many more months, they lost her paperwork *again.* And then a third time.
I happen to coordinate the immigration process for employees of my company. These people are doing everything by the book, and it takes *years.*
I think these people who say immigrants should just enter legally, actually do have
Re: (Score:2)
I have plenty of other horror stories. One friend got such bad service that his lawyer was suggesting suing the INS (as it was at the time).
Re: (Score:2)
Obviously the Christians
Re: (Score:2)
Yes, your stance is indeed harsh, denying the humanity of people less fortunate than you. You have a nice cushy life, and you want to deny the same for others who haven't been as blessed as you. There's nothing admirable about that.
Just because rules exist, doesn't make them right. Houston has a rule against providing food to homeless people without authorization from the city (an authorization that's hard to get). That's not right, I support those who break it.
You have zero basis to assume these crimes wer
Re: (Score:2)
MY experience, after watching our region shift to the Hispanic (assumed Mexican) immigration, is that its become a burden on the citizenry, local policing/justice and social welfar
Re: (Score:2)
Your experience tells you that no harm comes from ignoring the illegal migration
Nope, you're either still not understanding, or intentionally distorting what I said. What I said was, that it's wrong to have a law that is extremely difficult or impossible to obey. If we want immigrants to enter legally (as opposed to illegally), we should make it possible for them to enter legally.
YOUR personal experience isn't really very important, when it comes to the larger scheme of things. What *is* important, is to back up your laws and policies with data. I supplied you with data from reputable
Re: (Score:2)
What I said was, that it's wrong to have a law that is extremely difficult or impossible to obey. If we want immigrants to enter legally (as opposed to illegally), we should make it possible for them to enter legally.
Of course it would be nicer if it were easier, but surely quantity is the big issue here. If we closed the gates after 5 million people, the next one would complain that he has to wait until next year.
It is very common for people to assume that their personal experiences are a reflection on the larger population, a fallacy in most cases.
Exactly. Houston is NOT a template for everything else that's going on elsewhere. I'm telling you it's not like that here, but you're not listening. I guess that starts with you being unable to stop considering me a racist.
What makes your stance racist, is that you assume because of the color of someone's skin (someone who "looks" Hispanic), or the language that they speak, that the person is undocumented.
Someone who has no ID has no documentation, the definition of being undocumented. A
Re: (Score:2)
Yes, if we closed the gates after 5 million people, the rest who were trying to enter, would be facing a law that is impossible to comply with. That would make it an unjust law. ANY zero-tolerance law is inherently unjust, because there are always exceptions that should be taken into account.
I only brought Houston into the discussion because you were bringing your location into the discussion, I was showing that there are differences in people's experiences from different places. Just because things aren't
Re: (Score:2)
Yes, if we closed the gates after 5 million people, the rest who were trying to enter, would be facing a law that is impossible to comply with. That would make it an unjust law.
What makes a law unjust? Clearly that's a matter of perspective. Laws are for protection. You want to protect the desperate people coming here (admirable). But our laws in America are to protect Americans, firstly. You don't see any problem, any negative impact to Americans (our budgets, our welfare programs, etc.), if an infinite number of poor people migrated here. I don't see how you are unable to predict that.
ANY zero-tolerance law is inherently unjust, because there are always exceptions that should be taken into account.
I assume that's what seeking asylum is for.
I only brought Houston into the discussion because you were bringing your location into the discussion, I was showing that there are differences in people's experiences from different places. Just because things aren't going well in your location, doesn't mean we should enact laws that keep people from finding a better life in every place in the US.
Why not? It's clear to me this brings problem
Re: (Score:2)
I never said there are "no issues" with immigration. We create many of those issues by giving immigrants no practical way to legally enter. If they were allowed to come in and find jobs, support themselves, and pay taxes, we wouldn't have to rely so heavily on the welfare state. They *want* to work, that's why they're here. They have no wish to sit around and be fed by the government system. We have jobs that are going unfilled, that Americans don't want to do. Seems like an ideal match to me!
Yes, asylum is
Re: (Score:2)
When the demand for workers dries up, they will stop coming.
If that were true, I'd believe much of what you've said. SOME are here to work, for sure. X% merely want an easier life (then again who doesn't?). I can't imagine the single women carrying infants seen in the border TV clips will be able to support themselves, ever, as day care is expensive, natal care is expensive, raising kids is expensive. ("Hand the check to Tony, he's paying.")
We don't have millions and millions of low-skill/high-pay jobs left, especially with the fervent pace of automation.
Re: (Score:2)
You keep going back to your talking points, which I've already disproven, and provided links to data to prove it. Teenage unemployment is at historic lows. There is no shortage of low-skilled jobs for those who want them. You even admitted that American's don't want these jobs. And yet, there's no shortage of jobs Americans *do* want, unemployment is at historic lows all the way up and down the economic scale. Automation has *not* taken away our jobs, you just fear, without evidence, that it will.
You keep h
Re: (Score:2)
Re: (Score:2)
You keep going back to your talking points, which I've already disproven, and provided links to data to prove it.
Your Northwestern study on crime was based on "Using incarceration rates as a proxy for crime". So only those who got caught were counted. Those who could freely flee to anywhere else (no mortgage, rooted family, ATM/bank accounts, cellular phone nor identification trail) had a better chance of avoiding being caught and wouldn't be counted by the study. Wouldn't you say that's flawed?
Your Kaiser report is ~ 20 years old; things have clearly changed at our southern border very recently. Regardless, it
Re: (Score:2)
The solution is simple. Anybody who believes the roads should be funded by everyone because everyone benefits from them, must also believe that healthcare should be funded by everyone because everyone benefits from it.
Single payer roads and single payer healthcare. Both or neither, because anything else is hypocritical.
Re: (Score:3)
In an actual EMERGENCY situation, though (as often happens in an Emergency Room), I don't want the doctors/staff taking any extra time to make sure the patient can pay before doing what they need to keep them alive, because that patient can be me. Doing it that way would be silly. I suppose someone could set up a hospital that does that (in jurisdictions that would allow it), and maybe their bills would be a lot lower, but would you go there in an emergency when seconds/minutes count?
You have to step back
Re: (Score:2)
Google doesn't seem to find that quote. Who are you quoting? (I have my doubts about his wisdom.)