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Originally Posted by LWJ
I have heard this practice may be history with the ACA now.
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No, same rules. ACA made no change to that. There may be fewer uninsured out there, but if you are uninsured and cannot pay, the provider often still winds up eating it.
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Originally Posted by Superman
... It sounds like we have a unique system here. A different kind of socialized medicine system, said to be the most expensive of all developed countries. Hmmmm....
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I think a major part of why we have the most expensive system of all hasn't even been touched upon by the discussion so far. It's the public's expectations and demands on the medical system, as if it's a consumer product/service. People want/expect/demand everything, regardless of cost. I think that's a major problem of why medical care is so expensive in America.
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Originally Posted by asphaltgambler
Most Physicians and facilities understand that fully collecting on self-pay cases is a long and tedious process and that some - they will never collect and use that to offset tax liabilities. That portion is sold off for pennies on the $ to collection agencies.
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As a provider, you cannot write off what you didn't get paid (but performed). You (financially) just lose. There's no tax write-off allowed. A provider may euphemistically say, "I'm going to have to write it off." But that just means the provider stops trying to collect from someone with limited financial means (no blood from the proverbial stone). You can't actually tell the IRS that because you didn't get pain for seeing/treating one patient, in return you aren't to be taxed on the money you made for providing the same service to a paying customer. This isn't capital gains and stocks, for example.