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hospital emergencies in a capitalist society

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The Wrath

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Wow...thanks for clearing up the defintions for us. I think that I would be ok with restitution in this circumstance. The idea of letting unconcious people who forgot or lost their ID tags die because they couldn't agree to a contract, seemed like a heavy price to pay to protect the rights of a supposedly suicidal person. I can think of moral reasons as to why their rights are not relevent(pursuing death and all). If they are trying to die, probably doesn't matter much what debt they leave behind.

It still bothers me, though, that their rights seem to be violated. The individual watching the work be done is making a concious choice, so that example seems somewhat different. I don't know. This is a tough one.

I'm happy to help! <_<

I too feel ambivalent about my position, for just the reason that you highlight - the person cannot consent to the treatment. I'm definitely open to opposing arguments, and would love to have someone demolish my argument for that very reason. This is definitely a topic with broader ramifications for the law in general, which I've been mulling over in my extremely limited spare time.

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Check out the following. I just had a cursory glance at both. So, no idea whether these are really helpful. But these seem relevant here. The first contains smth to the extent that emergencies actually contribute to the bottomline of the hospital and there is a trade-off between the costs and revenue (directly or indirectly) generated by the EDs. The second, I am not sure what it is really about.

http://www.usc.edu/schools/sppd/research/h...ofitability.pdf

http://www.tha.com/pdffiles/Industrial-Imp...resentation.pdf

Well, some thoughts :

It is a capitalist society. So, would it be right to assume

1. There would be no or very less poverty and no individuals with no income either of their own or someone willing to pay for them (eg non-working population like children)?

2. Stretching a little bit, if in general, the ppl are 'accepting' capitalistic society, they are 'accepting' and 'agreeing' to the principles underlying it. So that, in general, the ppl are 'principled' with the right principles in place. So, there are no or very less cases of non-payment or denial to pay on recovery. What I am trying to say is that even if there is a possiblility of non-ability to pay at the given moment, there will be no unwillingness to pay. And so, either there will be immediate payment or smth like a loan or instalment could be worked out.

Also, I think there is a point missing. When anyone takes a decision unilaterally, he is the one responsible for its consequences. In today's situation the hospital is forced legally to treat emergencies. But in a capitalist society it is not. So, if it decides to go ahead without checking on the ability-to-pay, it is a voluntary decision and so it is responsible for it. In effect, what it means is 'I will treat you no matter what'. Now, if the patient refuses to pay saying 'I didn't ask you to treat me', the hospital cannot, at least on moral grounds, ask the patient to pay. So, now the hospital has to bear the costs. But, businessemen (especially in a capitalistic society) are smart. They are not going to allow this to turn into losses. So, they will find out some means to trade these off against revenue from other sources. One of the ways this can be done is pricing the in-patient section in a manner to absorb probable ED losses (this is a complex statistical exercise and am not going into detail here). Or the hospital can be smart to recover it from the said patient albeit without stating it explicitly. Maybe smth like, discontinuing further treatment till the patient agrees to pay once he is conscious. Now, the patient has two alternatives, either agree to pay or shift to some other hospital. In the second case, when he shifts (if that is physically possible in the first place), the other hospital will need the medical reports and documents from the first hospital regarding the treatment it used. Now, the first hospital refuses to furnish these (in a capitalistic society, I don't think it will be forced to furnish without being compensated for it). The second hospital refuses further treatment in absence of history (assuming this is critical for further treatment). And thus this goes on with each hospital the patient shifts to. He suffers. So, he is 'forced' to return to the first hospital and make good the payment. I know I have made many assumptions and I don't know if this is the best way to handle it. Just a suggestion. Or another way is stating that it is not charging for initial treatment, but for further continued one (after the patient is conscious and agrees to it) and it prices the further treatment in a way to absorb the initial treatment costs.

Also, the mentality of -Uncle Sam (consequently the tax-payers)-should-take-care-of-my-medical bills- will not be very prevalent in a capitalistic society. So, the financial model for the EDs will be very different from what it is now. Again, in all probability the ED will be just one part of the hospital whose costs will be traded-off against revenue from other departments. There will be no special emergeny hospitals in absence of a strong financial model (whether for-profit or not-for-profit) which will need to be worked out.

Just my two cents. Open to discussion.

Edited by spadeaspade
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It is a capitalist society. So, would it be right to assume

1. There would be no or very less poverty and no individuals with no income either of their own or someone willing to pay for them (eg non-working population like children)?

I don't know what the definition of poverty is. But I don't see any reason to say that there can be no poverty in a capitalist society. A man is free to pursue his own goals, and that need not include the production of income. Cash is good, but it is not a logical requirement in a free society -- it does mean, however, that it will be difficult for you to find a doctor willing to treat your illness for a goat and a bag of rice. Reality will probably intervene and shorten the life-span of men who chose to live the subsistence lifestyle, but it's certainly permitted under capitalism. If I were running a hospital as a business, I would not tolerate a practice of admitting everybody and spreading the costs to those who seem to have the ability to pay, so my nurses would direct such patients to the Mother Theresa Self-Sacrificial Heart hospital down the road. Actually, the ambulance drivers would not even bring them to my hospital, because they know that would be a waste of time. However, I might allow unconscious, critical patients to be treated and take the risk, because I'm half-compassionate. My accountant would keep me abreast of the bottom line so that I'd know whether this was a bad business decision.
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Our entire country benefits from having lower prices of fruits and vegetables. Are we ethically bound to pay for the health care of this group?

No. While I buy vegatable and fruits, I don't hire/fire the people that pick them. I have no contract with those folks and I didn't make them cross the border to take low paying jobs in illegal situations where they may not receive all that they might happen to need.

But as has been pointed out, this is not the crux of the discussion going on here.

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