Healthcare for victims of violent criminal acts (1 Viewer)

[Henry Ford]

I certainly understand that many people don't support Medicare for All or Single Payer Healthcare. There are other threads for that, and it's a big topic.  I'd like to know whether people support the following:

When people are victims of crimes and have no health insurance or poor health insurance, it can lead to a complete disruption and/or destruction of their lives.  For example - one of the kids from Marjory Stoneman Douglas High School, Anthony Borges, was shot five times while shielding classmates from gunfire, has had extensive surgery and wears a colostomy bag.  That's not just a huge life disruption, it's a massive financial disruption, likely for life.

Worker's compensation gives us a model wherein an insurance company can pay for medical treatment related only to a specific injury.  The injury at work gets taken care of by worker's compensation insurance, everything else is the responsibility of the worker by private payment or other insurance.  The insurance company can challenge whether an injury or treatment is related to work, and similarly, a fund could challenge whether an injury or treatment is related to a crime.

Using that model, would you support a government-funded and government-run "compensation for victims of crimes" healthcare "insurance" to pay for the medical treatment of victims of violent crimes?

 

[adonis]

System likely could be gamed, but I'd be supportive of it, 100% for folks under 18, but with more questions for adults.

 

[Henry Ford]

System likely could be gamed, but I'd be supportive of it, 100% for folks under 18, but with more questions for adults.

What sort of questions?

 

[adonis]

System likely could be gamed, but I'd be supportive of it, 100% for folks under 18, but with more questions for adults.

What sort of questions?

Does it only apply to victims who don't have private insurance?

 

[Henry Ford]

Does it only apply to victims who don't have private insurance?

It can be a secondary payer - so it just picks up the costs that private insurance doesn't.

 

[adonis]

It can be a secondary payer - so it just picks up the costs that private insurance doesn't.

Would it just address the initial injury, or would there be funding for ongoing support like physical therapy, or counseling in the event of PTSD or other lingering trauma?

 

[supermike80]

So someone couldn't pay someone else to beat them up to get free health care? 

What happens if it is in the family?  

What defines a violent criminal act? Or are we just going with the definition as of today?

Fundamentally, people are liars and thieves so this would most likely be taken advantage of seriously and ridiculously abused.  I would have to vote no

 

[Bottomfeeder Sports]

Sure the government should fund such a plan, but  as an interim to such a system that would superseded the need for such coverage.  This is with the understanding that it would still create nightmares for the victim as various third parties fight over what is in and what is out of scope of coverage.   And it should be setup such that regular "qualifying" health plans cannot carve out this category of claims.

 

[adonis]

Fundamentally, people are liars and thieves so this would most likely be taken advantage of seriously and ridiculously abused.  I would have to vote no

This isn't correct.

 

[supermike80]

This isn't correct.

Which part?

 

[Bottomfeeder Sports]

Fundamentally, people are liars and thieves so this would most likely be taken advantage of seriously and ridiculously abused.

Until recently I though "Projector Guys" had something to do with audio-video setups.

 

[adonis]

Which part?

All of it except for you saying you'd vote no.

Fundamentally people aren't liars and thieves. 

Also, it has the same likelihood of being taken advantage of as workers comp, which seems to be pretty low - about 1-2% of claims.

 

[supermike80]

All of it except for you saying you'd vote no.

Fundamentally people aren't liars and thieves. 

Also, it has the same likelihood of being taken advantage of as workers comp, which seems to be pretty low - about 1-2% of claims.

I believe fundamentally enough people are liars and thieves to ruin a program like this.  So again, I would vote no.   It's too vague.  Too many questions.  I don't like it.  

 

[adonis]

I doubt I'd have much of an issue with it, so long as it was implemented reasonably in our current situation where its overlap with private insurance made sense, and it covered a reasonable amount of services for the victim.

I think it's only a step further from saying that folks should have medical care covered if they're victims of violent crimes, to saying folks should have medical care covered for being victims of chance, which is really a vast majority of folks who are sick or injured in general.  Just because you're in an unfortunate position due to circumstances arising from an unnamed source, doesn't make your situation any less worthy of empathy or compassion or help from society.

 

[Henry Ford]

Would it just address the initial injury, or would there be funding for ongoing support like physical therapy, or counseling in the event of PTSD or other lingering trauma?

I certainly envision it for any medical conditions caused by the original crime - that would likely include trauma issues.  Like it does with comp.

 

[supermike80]

I misread the OP>>>i was thinking you meant for LIFE...Oops...I've been in a react first, read later mindset today.

Actually, I'm not totally against this.    We do it a lot already and pay for it due to the reasonable care provisions of the medical field.  I just worry it would be misused.  

 

[matttyl]

I certainly understand that many people don't support Medicare for All or Single Payer Healthcare. There are other threads for that, and it's a big topic.  I'd like to know whether people support the following:

When people are victims of crimes and have no health insurance or poor health insurance, it can lead to a complete disruption and/or destruction of their lives.  For example - one of the kids from Marjory Stoneman Douglas High School, Anthony Borges, was shot five times while shielding classmates from gunfire, has had extensive surgery and wears a colostomy bag.  That's not just a huge life disruption, it's a massive financial disruption, likely for life.

Worker's compensation gives us a model wherein an insurance company can pay for medical treatment related only to a specific injury.  The injury at work gets taken care of by worker's compensation insurance, everything else is the responsibility of the worker by private payment or other insurance.  The insurance company can challenge whether an injury or treatment is related to work, and similarly, a fund could challenge whether an injury or treatment is related to a crime.

Using that model, would you support a government-funded and government-run "compensation for victims of crimes" healthcare "insurance" to pay for the medical treatment of victims of violent crimes?

I understanding you're using an extreme example here - kid getting shot, multiple times, while being a hero - but for most of these type of cases, why can't the injured go after the individual or group that caused the injuries?

I think we should also define a violent crime, here.  Sure, kid get shot 5 times is one thing - but what if I'm waiting at a light and get rear ended by a guy trying to run from the cops. 

Then do I get to decide where I receive my treatment?  If so, I want to go to the best place possible.  Also - and this is likely a biggie - what are the reimbursement rates to the health care providers here?  You don't have insurance, so there is no contractual rate for them to charge - they can charge whatever they want, to be paid by taxpayers?

 

[Henry Ford]

I understanding you're using an extreme example here - kid getting shot, multiple times, while being a hero - but for most of these type of cases, why can't the injured go after the individual or group that caused the injuries?

I think we should also define a violent crime, here.  Sure, kid get shot 5 times is one thing - but what if I'm waiting at a light and get rear ended by a guy trying to run from the cops. 

Then do I get to decide where I receive my treatment?  If so, I want to go to the best place possible.  Also - and this is likely a biggie - what are the reimbursement rates to the health care providers here?  You don't have insurance, so there is no contractual rate for them to charge - they can charge whatever they want, to be paid by taxpayers?

They can, but most people who cause these injuries don't have sufficient assets to pay for the medical care of their victims.  That question, like the rest of the questions, can be answered the same way about worker's compensation.  The point is to have a scheme in place that acts like insurance - just like a WC schedule.

 

[matttyl]

That question, like the rest of the questions, can be answered the same way about worker's compensation.  The point is to have a scheme in place that acts like insurance - just like a WC schedule.

But workers comp can have HUGE reimbursement rates - multiples higher than a standard health insurance reimbursement rate.  If a health claim is being run through WC rather than though traditional health insurance (or if the provider is out of network with the insurance), they can be charged whatever the provider wants to charge.  My point of bringing up payment schedules is just to show how quickly the costs of this could run into super crazy amounts.  If we're tying the charges to Medicare or Medicaid rates, I'd be much more for it.

 

[jonessed]

Perhaps if there is a conviction.  I don’t want a program like this to pay the bills for two meatheads that punch each other out.

 

[Henry Ford]

Perhaps if there is a conviction.  I don’t want a program like this to pay the bills for two meatheads that punch each other out.

So if they never catch the guy, no healthcare?

 

[roadkill1292]

I think this hypothetical is demonstrating a mindset among some number of Americans that prevents us from getting some of the good stuff that more advanced nations have. We can't do things that would benefit almost everyone because some number (small imo, others believe large) of awful people will try to game the system.

 

[matttyl]

So if they never catch the guy, no healthcare?

Yeah.  People can just make stuff up and get free healthcare.  Maybe a police report being filed is the key.

Hey, I'm all for your original example - kid gets shot 5 times.  But there has to be some line somewhere.

 

[Henry Ford]

Yeah.  People can just make stuff up and get free healthcare.  Maybe a police report being filed is the key.

Hey, I'm all for your original example - kid gets shot 5 times.  But there has to be some line somewhere.

There are already procedures in most states for victim compensation for crimes that don't require convictions.

Edit: Generally it involves the police signing off on there being evidence of a crime being committed.

 

[Henry Ford]

@matttyl Does this seem like a reasonable line?

http://www.lcle.state.la.us/programs/cvr.asp

Basic Qualification Requirements

Residency

The crime must occur in Louisiana or the crime must involve a Louisiana resident who becomes a victim in another state that does not have a crime victim compensation program for which the victim would be eligible.

Reporting the Crime

The crime must be reported to a law enforcement agency within 72 hours after the incident unless there is a good reason why the crime was not reported within this time period.  

Filing for Compensation

The application must be filed within a year of the crime unless there is a good reason why the application was not submitted within this time period.  

Cooperation

The victim and/or claimant must cooperate fully with law enforcement officials in the investigation and prosecution of the case.

Who May Qualify

An innocent victim of a violent crime who suffers physical and/or emotional harm or death or catastrophic property loss.

A person who legally assumes the obligations or voluntarily pays certain expenses related to the crime on behalf of the victim.

Immediate family members needing counseling as a result of the consequence of death of the victim

Who is Not Eligible

A victim whose own behavior contributed to the crime (in those cases, benefits may be reduced or denied).

A victim or claimant who was engaged in illegal activity at the time of crime.

An offender or an accomplice of the offender.

A victim who has/had a felony conviction(s) within five years of the date of the crime,, or was serving a sentence or probation in the five years preceding/subsequent to the crime (except for victims of a sexual related offense.)

 A victim was serving a sentence or on probation .  

Anyone who was incarcerated in a penal institution when the crime occurred. ..

Victims of motor vehicle accidents except those listed below ("What Crimes are Covered").

What Crimes Are Covered

Crimes that involve the use of force or the threat of the use of force and result in personal injury, death or catastrophic property loss, and those victims of human trafficking.

Only these motor vehicle related crimes: DWI, Hit and Run, victim of a driver who is fleeing apprehension by law enforcement, or a victim whose injuries were intentionally inflicted with a vehicle.

 

[matttyl]

@matttyl Does this seem like a reasonable line?

http://www.lcle.state.la.us/programs/cvr.asp

For the most part, yes.  You above mentioned that this would be a "secondary payer" - I'd be ok with it being primary, especially in the case where the reimbursement would be lower to the health care provider.  Why should I have to hit my (possibly large) deductible when the injury was the fault of another who was in the act of a crime?  Having it being a primary payer, at least in theory, would lower my health insurance premiums. 

Also, just for clarification sake - this would potentially cover rape?  How about abortion from that rape (you know that question would be raised)?

 

[Henry Ford]

For the most part, yes.  You above mentioned that this would be a "secondary payer" - I'd be ok with it being primary, especially in the case where the reimbursement would be lower to the health care provider.  Why should I have to hit my (possibly large) deductible when the injury was the fault of another who was in the act of a crime?  Having it being a primary payer, at least in theory, would lower my health insurance premiums. 

Also, just for clarification sake - this would potentially cover rape?  How about abortion from that rape (you know that question would be raised)?

I am sure that in Louisiana it does not cover abortion from rape.

 

[matttyl]

I am sure that in Louisiana it does not cover abortion from rape.

But would cover rape?  Just seeing what qualifies and what doesn't. 

 

[Henry Ford]

But would cover rape?

Current victim compensation does.

 

[matttyl]

Current victim compensation does.

So that's a current program in LA, and you're asking why we shouldn't have that at a federal level?

 

[Henry Ford]

I think this hypothetical is demonstrating a mindset among some number of Americans that prevents us from getting some of the good stuff that more advanced nations have. We can't do things that would benefit almost everyone because some number (small imo, others believe large) of awful people will try to game the system.

I think it also demonstrates that people have no idea what the laws currently are (and have been for a long time) when they scream "SOCIALISM!!"

48 states and the District of Columbia currently have in place (limited) compensation for victims of violent crimes, which include the ability to get at least some medical bills paid.

 

[Henry Ford]

So that's a current program in LA, and you're asking why we shouldn't have that at a federal level?

No, I'm asking if it should be expanded to a workers' compensation level program for all victims of violent crimes in all states and on the federal level, for just medical.  The current programs in various states generally allow various types of application for reimbursement.  I'm asking about just medical, but all medical - not "up to $10,000.00" as it currently is in Louisiana.

 

[OrtonToOlsen]

Is Mexico going to pay for it?

 

[matttyl]

I'm torn here, honestly.  For the example above that you gave - kid gets shot 5 times, it's easy to say that all of his medical bills should be paid.  That's the easy answer.  But we know who caused it, Cruz - first go after them.  For everything they, or their family has - for as long as is needed and legally allowed.  Then, depending on the situation (not saying it's warranted here, specifically), the school system or some other potentially at fault party (which, by the way, is what this particular family is doing).

Next, and maybe most importantly, the individual should have their own health insurance.  I mean, we are living in a time in which we still have a mandate in place to have health insurance.  That would have picked up all the costs of the a situation - it wouldn't matter if the injuries were caused by a violent act or not.  Say the same kid had some similarly horrible injuries because they were riding their bike and they wrecked with no one at fault - they'd have to rely on whatever health insurance they have.  You can still go after an at fault party for the deductibles and out of pocket costs, sure - but that's what the health insurance is actually there to do, protect you from unexpected health care costs. 

 

[Henry Ford]

I'm torn here, honestly.  For the example above that you gave - kid gets shot 5 times, it's easy to say that all of his medical bills should be paid.  That's the easy answer.  But we know who caused it, Cruz - first go after them.  For everything they, or their family has - for as long as is needed and legally allowed.  Then, depending on the situation (not saying it's warranted here, specifically), the school system or some other potentially at fault party (which, by the way, is what this particular family is doing).

Next, and maybe most importantly, the individual should have their own health insurance.  I mean, we are living in a time in which we still have a mandate in place to have health insurance.  That would have picked up all the costs of the a situation - it wouldn't matter if the injuries were caused by a violent act or not.  Say the same kid had some similarly horrible injuries because they were riding their bike and they wrecked with no one at fault - they'd have to rely on whatever health insurance they have.  You can still go after an at fault party for the deductibles and out of pocket costs, sure - but that's what the health insurance is actually there to do, protect you from unexpected health care costs. 

That's not how things work.  When someone shoots and kills another person, you don't get to go take their family's stuff.  You're talking about a 19 year old who has no real assets and shot dozens of people.  He'll never have a salary to take.

And, correct me if I'm wrong, you've spent quite some time explaining in a very long thread how much worse health insurance benefits are these days than one would like.

But I think I hear you saying "they should have health insurance."  Which is a response I honestly expected from more people.  I appreciate your response.

 

[matttyl]

That's not how things work.  When someone shoots and kills another person, you don't get to go take their family's stuff.  You're talking about a 19 year old who has no real assets and shot dozens of people.  He'll never have a salary to take.

And, correct me if I'm wrong, you've spent quite some time explaining in a very long thread how much worse health insurance benefits are these days than one would like.

But I think I hear you saying "they should have health insurance."  Which is a response I honestly expected from more people.  I appreciate your response.

You're the lawyer - if it's found that the family was negligent, why couldn't you go after them?  If they knew their 19 year old wasn't well, and had an arsenal of weaponry and did nothing - and then this happened, why couldn't you go after them?  The family of Borges (your victim) is apparently going after the shooters former "carers" from a story I read this morning - isn't that his family?

I understand that this particular shooter doesn't have any real assets, but in my mind that's at least the first place you go in these situations.  Once exhausted, you move onto the next step.

Individual health insurance benefits (ACA policies) are generally worse today than they were pre-ACA.  Not all health insurance benefits.  My 3 year old son spent 22 nights in 3 different hospitals last year - with a total of 6 different ER visits.  Numerous drugs, countless doctors, likely a total of 10 MRI/MRA/MRVs and various other tests - culminating with what was technically brain surgery.  He's covered under my wife's employer plan - you know how many "out of network" or "not covered" bills we got?  Zero.  We hit his max OOP and everything else was covered in full.  Now, if I had a newer ACA individual policy - I'd be broke.  Literally bankrupt. 

In thinking about your example - I remembered a question that I was told/taught to ask prospects when I first got into selling life insurance in the early 2000s.  You ask a wife (with the husband sitting there) if he didn't come home last night because he was "hit by a Coke truck", how much would you go after Coca-cola for?  The answer you'd get would generally be "everything they got", or "millions."  You'd ask why they'd want that amount and they'd say they want their kids to still be ok without a dad, and she'd want all the bills paid for and his future income to be taken into account and so forth.  Then you ask, "lets say there was no Coke truck, he instead lost control of his car on a patch of ice - would you want any less." 

I'm applying that ideology here, but in reverse.  If you have health coverage for breaking a leg stepping off a curb, or getting cancer or (fill in the blank with anything) subject to your deductible and so forth.....then you have the same amount of coverage here when someone else is technically at fault.  The difference is you can go after them for your out of pocket medical costs if you wanted to, as well as for non-medical stuff. 

 

[Ilov80s]

So someone couldn't pay someone else to beat them up to get free health care? 

What happens if it is in the family?  

What defines a violent criminal act? Or are we just going with the definition as of today?

Fundamentally, people are liars and thieves so this would most likely be taken advantage of seriously and ridiculously abused.  I would have to vote no

So let me get this straight. I pay someone to break my leg so that I can get the government to pay for my broken leg? 

 

[Ilov80s]

I support it but it just seems like why not just create a single payer national healthcare and be done with it? The way healthcare costs are going, in another decade  people and their employers are going to be paying $20,000 a year for health care plans that are half as good as their plans were 10 years ago. 

 

[roadkill1292]

So let me get this straight. I pay someone to break my leg so that I can get the government to pay for my broken leg? 

See, somebody's always gaming the system.

 

[matttyl]

I support it but it just seems like why not just create a single payer national healthcare and be done with it? The way healthcare costs are going, in another decade  people and their employers are going to be paying $20,000 a year for health care plans that are half as good as their plans were 10 years ago. 

I thought the ACA was going to fix all of that.

 

[Ilov80s]

I thought the ACA was going to fix all of that.

It didn't. It provided health care access to more people but costs are out of control. That trend has been in place before ACA and continues. I am not a health care expert so I can't speak exactly to how any of it funcitons. All I can say is we have a major problem. 

 

[Henry Ford]

You're the lawyer - if it's found that the family was negligent, why couldn't you go after them?  If they knew their 19 year old wasn't well, and had an arsenal of weaponry and did nothing - and then this happened, why couldn't you go after them?  The family of Borges (your victim) is apparently going after the shooters former "carers" from a story I read this morning - isn't that his family?

I understand that this particular shooter doesn't have any real assets, but in my mind that's at least the first place you go in these situations.  Once exhausted, you move onto the next step.

Individual health insurance benefits (ACA policies) are generally worse today than they were pre-ACA.  Not all health insurance benefits.  My 3 year old son spent 22 nights in 3 different hospitals last year - with a total of 6 different ER visits.  Numerous drugs, countless doctors, likely a total of 10 MRI/MRA/MRVs and various other tests - culminating with what was technically brain surgery.  He's covered under my wife's employer plan - you know how many "out of network" or "not covered" bills we got?  Zero.  We hit his max OOP and everything else was covered in full.  Now, if I had a newer ACA individual policy - I'd be broke.  Literally bankrupt. 

In thinking about your example - I remembered a question that I was told/taught to ask prospects when I first got into selling life insurance in the early 2000s.  You ask a wife (with the husband sitting there) if he didn't come home last night because he was "hit by a Coke truck", how much would you go after Coca-cola for?  The answer you'd get would generally be "everything they got", or "millions."  You'd ask why they'd want that amount and they'd say they want their kids to still be ok without a dad, and she'd want all the bills paid for and his future income to be taken into account and so forth.  Then you ask, "lets say there was no Coke truck, he instead lost control of his car on a patch of ice - would you want any less." 

I'm applying that ideology here, but in reverse.  If you have health coverage for breaking a leg stepping off a curb, or getting cancer or (fill in the blank with anything) subject to your deductible and so forth.....then you have the same amount of coverage here when someone else is technically at fault.  The difference is you can go after them for your out of pocket medical costs if you wanted to, as well as for non-medical stuff. 

Subrogation makes that more difficult.  When you go after them for your "out of pockets" your insurance company is going to show up with a lien.

Regardless, do you believe Nikolas Cruz and his parents are able to satisfy 34 multi-million-dollar judgments?  Plus the suits by all the survivors for emotional distress damages?  

 

[matttyl]

It didn't. It provided health care access to more people but costs are out of control. That trend has been in place before ACA and continues. I am not a health care expert so I can't speak exactly to how any of it funcitons. All I can say is we have a major problem. 

Yes, I'm a health insurance agent.  My comment was "tongue and cheek". 

 

[matttyl]

Subrogation makes that more difficult.  When you go after them for your "out of pockets" your insurance company is going to show up with a lien.

Regardless, do you believe Nikolas Cruz and his parents are able to satisfy 34 multi-million-dollar judgments?  Plus the suits by all the survivors for emotional distress damages?  

Not in my state, as far as I know.

Of course they don't.  But like I said, that's just step one - once he's wiped out you go onto the next (if there is a next in who is liable - potentially in this case the school, litigation will tell us).  These multi million dollar judgements, though - those are for more than just medical claims, correct?  Your idea here is just to cover the medical costs of the victims, not for "pain and suffering", lost wages, and the rest of it. 

 

[Ilov80s]

Yes, I'm a health insurance agent.  My comment was "tongue and cheek". 

Oh yeah I knew that, just wasn't sure you were an anti-Obama poster looking for a partisan debate. Do you have any thoughts on health care given your experience and insight?

 

[matttyl]

Oh yeah I knew that, just wasn't sure you were an anti-Obama poster looking for a partisan debate. Do you have any thoughts on health care given your experience and insight?

Lots, but likely for another thread. 

One thing I did bring up here, though, concerning health care costs - when someone goes to the hospital and a claim is covered by workers' comp (even if the person has private medical insurance), generally the providers can charge whatever they want as there is no "in network discount/rate" (aka allowable charge) when it comes to WC.  Meaning the WC carrier could be charged 2-10x what a private insurance carrier would be charged for the same amount of care.  That's one reason I wouldn't like a system like how Henry describes it as "using WC as a model."  I know that's getting into the nuts and bolts of insurance, though.

 

[Henry Ford]

Lots, but likely for another thread. 

One thing I did bring up here, though, concerning health care costs - when someone goes to the hospital and a claim is covered by workers' comp (even if the person has private medical insurance), generally the providers can charge whatever they want as there is no "in network discount/rate" (aka allowable charge) when it comes to WC.  Meaning the WC carrier could be charged 2-10x what a private insurance carrier would be charged for the same amount of care.  That's one reason I wouldn't like a system like how Henry describes it as "using WC as a model."  I know that's getting into the nuts and bolts of insurance, though.

That may be the circumstance in your state.  It isn’t everywhere. 

 

[Henry Ford]

Not in my state, as far as I know.

Of course they don't.  But like I said, that's just step one - once he's wiped out you go onto the next (if there is a next in who is liable - potentially in this case the school, litigation will tell us).  These multi million dollar judgements, though - those are for more than just medical claims, correct?  Your idea here is just to cover the medical costs of the victims, not for "pain and suffering", lost wages, and the rest of it. 

Virginia is either unique or very rare with its anti-subrogation statute. 

 

[matttyl]

That may be the circumstance in your state.  It isn’t everywhere. 

Where is it not?  I've never heard of a WC carrier having any type of "allowable charges".  They aren't health carriers, so what "in network rates" (allowable charges) are used?

 

[Henry Ford]

Where is it not?  I've never heard of a WC carrier having any type of "allowable charges".  They aren't health carriers, so what "in network rates" (allowable charges) are used?

Louisiana, for one:

https://www.lwcc.com/Portals/0/Forms_Documents/Title-40v01-(April-2014).pdf?ver=2014-10-30-133343-277

There are statutory maximum reimbursement rates based on average charges plus a modifier for location.