The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an immense bill.
What this means is that in the USA it's common for people to have to allow earlier-stage, less expensive to treat problems develop into serious problems before finally going into the ED to seek treatment. Which increases all of our health care costs overall. Not only does the problem that eventually gets treated end up being more expensive than it needed to be, but the place where the care is provided is also the most expensive option. And since they don't pay, health care providers are forced to raise everyone else's rates to cover the cost of this unnecessarily expensive care that they had to provide.
Long story short, the range of things that health care providers have to treat is much wider in countries with more socialized systems than it is in the USA. And that is yet another reason why the USA has such enormously high health care costs despite providing poorer quality of care.
Let's not play with words like that. People in the US get treatment—you even say so later, despite your ominous lead sentence. They just get it later, via the ED, after prevention goes un-performed. That's abominable enough, and that's what we should talk about, not the (false) specter of non-treatment.
You two aren't disagreeing.
You say we should talk about the epidemic of people unable to afford primary care, pushing treatment later and later, eventually into the ER where they may not even be able to be saved - and even if they do, suffer long-term health effects due to the delay in treatment.
And he's saying that this is because the system does refuse to treat people - especially at the primary care level.
These two topics seem to line up just fine.
My primary point was that while most things can be debated, it's absurd to claim that people don't get treated in the US.
This isn't actually accurate at all. Hospitals with emergency departments must stabilize patients in an emergency. Thats it. The emergency room has no responsibility to treat the underlying cause. It isn't a loophole that people take advantage of because you still don't get treatment. I suppose you could show up to multiple emergency rooms and hope one treats you but that isn't something you do if you are chronically hurt.
People who can't afford to get treatment or aren't on medicaid or charity care don't get treated period. You can test this by just comparing the emergency room rates in Massachusetts before and after coverage expansion. More people went to the emergency room once they had coverage than previously.
There's a hospital in the town where I grew up which managed to shave millions off of the cost of operating their emergency department in a rather instructive way: They identified their most expensive repeat patients, and started just paying to send them in for regular medical care for whatever health problems it was they had. Yeah it meant that they were giving out free health care to these folks, but that turned out to be nothing compared to the cost of having them show up in an ambulance every other week.
I have a friend (Canadian) who had an internship in the US. He got a major (and quite serious) bout of the flu, and although he was insured (by a Canadian company) absolutely refused to see him until he coughed up a hefty (multi-hundred) deposit - evidently they didn't find the Canadian firm trustworthy enough.
This is a pretty core issue in US healthcare - early-stage care is routinely denied to people, either economically before they walk through the door, or at the door itself. This pushes a lot of health issues to ERs where costs are high and effectiveness reduced.
The thing that gets me is the attitude is that some people don't deserve free(-at-point-of-use) healthcare. For whatever reason; they haven't paid their taxes, or they've made mistakes in life. It seems unspeakably sad to me. Surely a civilised society should help everyone, regardless? It's the humane thing to do. It's as simple as that.
I agree that a civilized society should help everyone, but don't agree that the USA is a civilized society. There is definitely an attitude that poor people don't "deserve" stuff. That's been an American notion since the first settlers arrived and won't change anytime in the near future.
True, but what if it's something less serious? Some people would rather be ill than bankrupt. And then what if it gets worse, and then it's too late? People shouldn't have to make that choice, especially because most people--not being doctors--are going to make bad decisions about when something is serious enough to get checked out.
A major issue with the american health care system is there is a severe shortage of front line care outside of the ER. This is a side effect of the way doctors are compensated. There is no financial incentive to be a GP, so there aren't enough GPs.
Yes there is. It's called a "primary care provider", and many of them have their offices right there in the hospital. Though the ones who operate out of separate clinics can often be less expensive, if not more conveniently located.
If you don't already have one, you really should. The emergency department really hates it when people clog up their waiting rooms by going there with non-emergency issues instead of seeing a PCP. And your health insurance (assuming you have it) really hates it when you drive up their costs by going to the ED instead of seeing a PCP. And, if there were any price transparency in the American system, then your fellow citizens would also really hate it when you force the health insurance company to drive up their costs by going to the ED instead of seeing a PCP.
If you do not have effective access to care until all they can do is give you a bunch of pain killers, they are effectively "refusing to treat people".
Implying the NHS refuses to treat people?