Wal-Mart suing family of brain-damaged employee.

[Frankie's Market]

Read all about it.

http://www.cnn.com/2008/US/03/25/walmart.insurance.battle/

Yes, Walmart would be within their legal rights to collect the $277,000 that remains in that lady's family's trust. Yes, the company needs to think about being fair to all of its other employees. But considering the family's extraordinary circumstances, you would think that the executives at Walmart would want to avoid this kind of negative publicity. A company with $90 billion in net sales suing an embattled family for their last $200,000 or so? That poor woman may be brain injured after her terrible accident, but at least she's not brain dead like the powers-that-be at Walmart. Incredible!

What, does Walmart think that helping out this family will cause their other "associates" to think up schemes to defraud the company? Oh yeah, I'm sure that a whole bunch of them will conspire to put themselves in a nursing home, have their spouse be diagnosed with cancer, and plot to have their child killed in an overseas war. Total idiots!

[timkona]

Boo Hoo....can't send my kid to college....and my other died in a war that I don't agree with.

First of all, my parents couldn't afford college, but I went anyway. And worked my friggin butt off in two jobs while eating baloney, before I realized, after 4 tortuous years, that there were no wealthy professors, so if I want to be successful, perhaps I should pick other mentors. DUH!! It's a no brainer. Reading books, and learning, is truly one of the only free things left in America. Problem is that we are raising generations of ignoramuses who believe that they are entitled to something without any hard work. Check Molokai if you don't believe me.

Second, there is no draft. Military is a choice. Live with the choice. Perhaps you will get educated on the realities of life. Perhaps you will die. But remember, it's a choice. And I support the military, and all they do to protect me and mine. So FO you liberal panzy.

Lastly, I am truly sorry for the lady who is hurt. God Bless her and keep her, and give her mate, and offspring, the strength to follow the basic message I have tried to convey.

[Adri]

CNN is reporting that Wal-Mart has relented and is changing its policy to allow the woman to keep the money. Wal-Mart mentioned being given perspective by outside views (I read that as them caving to bad publicity). It would be one thing if they offered to let the woman keep the money from the start and on their own, before any bad publicity. Now they're in a no-win situation of being unfair to the other health plan participants (based on Wal-Mart's earlier arguments) and making the injured woman go through all that stress and litigation only to give her what she wanted after all after Wal-Mart won (thus making it look like they're just concerned about publicity rather than with doing whatever they think the right thing may be).

[joshuatree]

If Wal-Mart is creative, they can dig themselves out of this one. Like maybe hold a one day sale where all the proceeds go to paying off that amount the family owes. I know that's just working the books but at least on paper, all the other health plan participants have recovered the expenses, the family isn't chased for the amount, and the company gains some positive PR. And because it's a charity event, I'm sure they can get some sort of tax write-off too. :D

[Adri]

If Wal-Mart is creative, they can dig themselves out of this one. Like maybe hold a one day sale where all the proceeds go to paying off that amount the family owes. I know that's just working the books but at least on paper, all the other health plan participants have recovered the expenses, the family isn't chased for the amount, and the company gains some positive PR. And because it's a charity event, I'm sure they can get some sort of tax write-off too. :D

They should hire you to do their PR :D

[Frankie's Market]

CNN is reporting that Wal-Mart has relented and is changing its policy to allow the woman to keep the money. Wal-Mart mentioned being given perspective by outside views (I read that as them caving to bad publicity). It would be one thing if they offered to let the woman keep the money from the start and on their own, before any bad publicity. Now they're in a no-win situation of being unfair to the other health plan participants (based on Wal-Mart's earlier arguments) and making the injured woman go through all that stress and litigation only to give her what she wanted after all after Wal-Mart won (thus making it look like they're just concerned about publicity rather than with doing whatever they think the right thing may be).

As much sympathy as I may have for Debbie Shank, believe it or not, I can understand Wal-Mart going through the legal process of establishing the company's right to enforce the clause in their employee's medical plans. And in fact, the courts backed them on this. Fine, mission accomplished.

Having won the court's backing, what I didn't agree with was the idea that Wal-Mart had to sue the Shanks and to recover the $470,000 that it earlier gave the family to pay for Debbie's medical expenses. There is such a thing as excercising discretion and making exceptions for unusual cases. I mean, if you're not going to display any compassion for a family like the Shanks (brain-damaged mother who will live in a nursing home for the rest of her life, father who is recovering from prostate cancer, a son who died for his country in Iraq), then I guess you never ever will for anyone, period.

As far as other Wal-Mart employees howling and complaining about fairness (something I don't anticipate happening),.... how many other families of Wal-Mart associates do you think will ever run into the kind of bad luck that the Shanks have gone through? I don't think the odds are even one in a million. That is why the fairness argument that Wal-Mart execs earlier gave sounded hollow and news media outlets weren't buying it.

And for those who think that the Shanks pulled a fast one on Wal-Mart and are now living it up on Easy Street,.... all that Wal-Mart's decision did was to allow the family to keep the $200K or so remaining in Debbie's trust fund. That's not a whole lot of money when you're talking about nursing care expenses. Her husband is going to have to keep working his two jobs in order to make ends meet. Wal-Mart's decision to not sue just makes the rest of their lives a little more tolerable and bearable. It's not going to lead to a life of leisure and luxury for the Shanks, as some critics might imagine for themselves in their own deluded minds.

[GeckoGeek]

The original article just raises more questions in my mind

- How common is this clause in the health plan? Is this unique to Wal-Mart?
- What did the $100,000 of the award the family got represent? Was it the family out of pocket expenses? The limit of what they could get from the trucker's insurance? Did the family lawyer blow it by not adding what the health insurance would be asking for in the award?

About the only thing I'm sure of is that the health insurance should keep it's hands off the portion of the award that represents future care of the woman. Not unless the insurance is willing to take on that responsibility.

I'm unsure if the insurance should be able to get a portion of the pain and suffering part as I'm not sure what the purpose of the award is in the first place.

[Bobinator]

Boo Hoo....can't send my kid to college....and my other died in a war that I don't agree with.

First of all, my parents couldn't afford college, but I went anyway. And worked my friggin butt off in two jobs while eating baloney, before I realized, after 4 tortuous years, that there were no wealthy professors, so if I want to be successful, perhaps I should pick other mentors. DUH!! It's a no brainer. Reading books, and learning, is truly one of the only free things left in America. Problem is that we are raising generations of ignoramuses who believe that they are entitled to something without any hard work. Check Molokai if you don't believe me.

Second, there is no draft. Military is a choice. Live with the choice. Perhaps you will get educated on the realities of life. Perhaps you will die. But remember, it's a choice. And I support the military, and all they do to protect me and mine. So FO you liberal panzy.

Lastly, I am truly sorry for the lady who is hurt. God Bless her and keep her, and give her mate, and offspring, the strength to follow the basic message I have tried to convey.

Makes sense to me.

[GeckoGeek]

Yeah, there's a lot of emotional bait in this story.

Brain damaged, mother who lost a son in the war, and Wal-Mart.

[Adri]

And for those who think that the Shanks pulled a fast one on Wal-Mart and are now living it up on Easy Street,.... all that Wal-Mart's decision did was to allow the family to keep the $200K or so remaining in Debbie's trust fund. That's not a whole lot of money when you're talking about nursing care expenses. Her husband is going to have to keep working his two jobs in order to make ends meet. Wal-Mart's decision to not sue just makes the rest of their lives a little more tolerable and bearable. It's not going to lead to a life of leisure and luxury for the Shanks, as some critics might imagine for themselves in their own deluded minds.

I deeply suspect the trust that is holding the funds is a "Special Needs Trust". If it is, then the Shanks family would not be able to use the money in it for anything other than Debbie's medical expenses and care. If Debbie is using Medicaid for long term care (which she probably is if the description of the family's financial circumstances is accurate), then whatever is left in the trust when Debbie dies, if there is anything left, would go to the government to reimburse the government for the part of her care paid for by the government. So, no, I don't think the Shanks are now going to be living in the lap of luxury.

Apparently Wal-Mart's existing policy didn't give them the discretion to opt not to try to collect back what was paid to the Shanks from the lawsuit the Shanks won regarding her accident. It's commonly and colloquially called "double dipping" if insurance pays for certain costs and then someone else pays for the same costs (as a result of a lawsuit, usually) and the injured person keeps both the insurance payment and the lawsuit payment. So Wal-Mart is going to change their policy to give them some discretion to not recover payments in cases like Debbie Shanks' case. Although I am glad Wal-Mart is going to let Debbie keep the money, I can understand Wal-Mart's hesitation because it sets a precedence. From now on, any participant in Wal-Mart's insurance plan can argue that they should receive the same treatment Debbie did or it would not be fair to them.

[Frankie's Market]

Although I am glad Wal-Mart is going to let Debbie keep the money, I can understand Wal-Mart's hesitation because it sets a precedence. From now on, any participant in Wal-Mart's insurance plan can argue that they should receive the same treatment Debbie did or it would not be fair to them.

No, it's the opposite way around. Wal-Mart's victory in federal court sets the legal *precedent* that it has the right to enforce the terms of its employee medical plans, including the clause that the company has the right to recoup any money earlier paid out in the event of any monetary award coming through litigation or settlement. It is still up to Wal-Mart to decide if they want to exercise that right in certain unusual/special cases.

People, the Shanks got the nod from Wal-Mart to keep the money because of pressure applied to the company by a multitude of media organizations, including MSNBC and CNN. And the Shanks got such overwhelming media support because of their special situation. Not every Tom, Dick, and Jane working for Wal-Mart can expect the same kind of media support/publicity if they are undeserving. So once again, those that justify sticking it to the Shanks out of a "fairness to all" argument don't have anything to stand on.

[Adri]

No, it's the opposite way around. Wal-Mart's victory in federal court sets the legal *precedent* that it has the right to enforce the terms of its employee medical plans, including the clause that the company has the right to recoup any money earlier paid out in the event of any monetary award coming through litigation or settlement. It is still up to Wal-Mart to decide if they want to exercise that right in certain unusual/special cases.

They won in court and then they waived their right (with respect to the Shanks). Waiving their right sets the precedent that they can waive the right if they wanna. That opens the door to every other plan participant to demand that that right be waived with respect to them since it was waived with respect to someone else and to argue that it is unfair if it was waived for someone else and not waived for them.

But that's all moot now since Wal-Mart is revising its policy.

[craigwatanabe]

Rules typically are set into place because of a prior incident.

Right now where I work at (The Home Depot) we have a pretty fair return policy on merchandise purchased here.

But if more and more people abuse our return policies, HD will have to adjust and make returning products that much more difficult. The real losers are those who were honest but bought the wrong item and then having to deal with a rule that was put into place to protect HD.

It's all about abuse and unfortunately WalMart has probably seen enough fraud on medical claims to be that stone cold. We as individuals may look at WalMart as evil but when having to deal with thousands of issues, it's easy for us to only see one and ask WalMart to make an exception. But when you're on the receiving end of thousands of claims you have to develop a plan to address the entire process.

[Frankie's Market]

They won in court and then they waived their right (with respect to the Shanks). Waiving their right sets the precedent that they can waive the right if they wanna. That opens the door to every other plan participant to demand that that right be waived with respect to them since it was waived with respect to someone else and to argue that it is unfair if it was waived for someone else and not waived for them.

No, it doesn't. The 8th Circuit Court of Appeal upheld Wal-Mart's right to enforce the terms of its medical plan, and the Supreme Court refused to hear the case. Wal-Mart's decision to forego collecting from the Shanks does not change that fact. If any other employee of Wal-Mart tries to do the same thing that the Shanks did, they would run into the same judicial roadblock.

Just because a party (in this instance, Wal-Mart) decides to voluntarily forego a lawsuit in one particular case, that doesn't mean that they have given up their right to sue in every other case. Do you not understand?

Let me put it this way, if you still haven't grasped this concept: Suppose you own a piece of land next to a public road and you built a fence on the property line. One day, a driver who happens to be an old family friend veers off the road and crashes through your fence. You have the right to sue the driver. But because you know him, you decide not to. You rebuild your fence at your own expense and then a year later, another driver veers off the road and crashes through the fence again. Just because you decided not to sue your friend, does that mean that you have given up your right to sue anyone else for doing the same thing?

Do you still not see the flaw in your reasoning?

[Adri]

The reason the court upheld Wal-Mart's right to recover the costs is because Wal-Mart did not previously undermine its contractual rights under the insurance plan. If Wal-Mart undermined its rights under the contract that is the insurance policy without sufficient protection against being considered to have waived Wal-Mart's rights under the insurance policy (by making an exception to allow Shanks to keep the money without the contract allowing such an exception) , there is no guarantee that a subsequent court case would continue to uphold Wal-Mart's rights under the insurance policy.

Scroll for "Non-Waiver" in this link http://www.expertlaw.com/library/business/contract_clauses.html#9. The difference in the example you cite and the Wal-Mart case is that in the example you cite there is no contract between the property owner and the driver stating that the property owner will sue the driver and recover the costs of the repairing the damage caused by the driver if the driver crashes into the owner's property with the driver agreeing to be responsible for repaying the cost of such repairs if the driver crashes into the owner's property. If in fact there was such a contract and the driver crashed into the owner's property and the owner did not enforce the contract terms requiring the driver to pay for the damage caused by the driver, then the owner may in fact have waived the owner's right under the contract to sue the driver for the damage caused by the driver. In the Wal-Mart case, the insurance plan provided by Wal-Mart and accepted by Shanks was a contract between Wal-Mart and the plan participants. Based upon what I have seen from Wal-Mart's comments, it appears that said contract did not contain a "non-waiver provision" stating that Wal-Mart's failure to require the fulfillment of the contract terms would not be a waiver or a breach of the contract and would not become a waiver of any subsequent breach or default on the contract terms (would not make Wal-Mart vulnerable to *having* to waive that same term for any other participants in the contract who want that terms waived). It seems that Wal-Mart is amending its policy to include such a term to allow themselves some leeway in deciding whether to enforce the contractual requirement that monies recovered be used to pay back what was spent for the health care of the plan participant who recovered the money.

[Frankie's Market]

The reason the court upheld Wal-Mart's right to recover the costs is because Wal-Mart did not previously undermine its contractual rights under the insurance plan. If Wal-Mart undermined its rights under the contract that is the insurance policy without sufficient protection against being considered to have waived Wal-Mart's rights under the insurance policy (by making an exception to allow Shanks to keep the money without the contract allowing such an exception) , there is no guarantee that a subsequent court case would continue to uphold Wal-Mart's rights under the insurance policy.

How? The only way that the Circuit Court of Appeals decision can be overturned is via a ruling by a higher court. So in this case, that means one court only. The US Supreme Court. And the Supreme Court refused to even hear the case. That's a pretty strong indication that no similar cases will ever get through. At least, not as long as you have the same nine justices presiding over the Supreme Court. And since they have lifetime appointments, it could take many years before an ideological shift in the Supreme Court occurs on this issue (assuming it ever does, no guarantee).

[Adri]

How? The only way that the Circuit Court of Appeals decision can be overturned is via a ruling by a higher court. So in this case, that means one court only. The US Supreme Court. And the Supreme Court refused to even hear the case. That's a pretty strong indication that no similar cases will ever get through. At least, not as long as you have the same nine justices presiding over the Supreme Court. And since they have lifetime appointments, it could take many years before an ideological shift in the Supreme Court occurs on this issue (assuming it ever does, no guarantee).

*sigh* It's basic contract law. The rights and obligations that exist between Wal-Mart and the insurance plan participants are governed by the contract (the insurance policy) they voluntarily entered into between them. The court enforced the terms of the contract because the contract was not breached and none of the provisions (at least at the time) were waived, presumably. If the contract were breached or there was deemed to be a waiver of one or more of the contract provisions, that would be a material change in the facts of the case and thus the court ruling may be different if another case were brought. The court ruling you keep referring to was specifically regarding the facts and circumstances existing in the Shanks case and Wal-Marts' rights and obligations under the insurance policy that then existed between Wal-Mart and the plan participants. If Wal-Mart had insisted on not allowing the Shanks to keep the money, then yes, there is no other way the court ruling saying Wal-Mart had a right to demand the Shanks' money be used to reimburse Wal-Mart for the insurance payments would be overturned by another court. But if Wal-Mart says regardless of the court ruling Wal-Mart will allow the Shanks to keep the money and if there is no provision in the insurance policy saying that making such an exception is not a waiver of Wal-Mart's rights under the insurance plan, then it might be construed to be a waiver of that contract term in subsequent cases.

[Adri]

I imagine the Wal-Mart/Shanks suit went something like this:

WM: This is the written agreement between Wal-Mart and the plan participants. All of the terms regarding payment of medical expenses and repayment of medical expenses if the same expenses are recovered from another source are contained in this contract. All of the plan participants agreed that Wal-Mart will pay for certain medical expenses but if the patient recovers money from a lawsuit pertaining to the patient's same expenses, the patient will pay back the money provided by Wal-Mart's insurance plan.

Shanks family: Yup, that's the agreement but it sure would be nice if Wal-Mart let us keep the money regardless of the terms of the contract because we really really need the money and Ms. Shanks is going to need life-long medical care.

WM: But the contract voluntarily agreed to by all plan participants does not give Wal-Mart leeway to make exceptions to the provision requiring repayment. If we make an exception for Ms. Shanks as the contract currently exists, we may be liable for breaching the terms of the contract to the other plan participants. It would not be fair to all the plan participants because not recovering the cost of the money spent on Ms. Shanks' care would mean not only did she not have to pay for all of the covered medical care but she didn't have to pay and on top of that got paid for the same costs and because that's not the agreement accepted by all plan participants. Not recovering the money from the Shanks may drive up the cost of the insurance for the other plan participants because the insurance plan may be short the money that it could have recovered and the other plan participants may have to make up that shortfall if they are paying insurance premiums or in any event, the other plan participants may be adversely affected if the plan runs out of money. Further, Wal-Mart may be deemed to have waived the right to enforce that provision requiring repayment for all plan participants if it waives that provision without a non-waiver clause in the existing contract. If Wal-Mart is deemed to have waived its right to enforce that contract provision because it made an exception for Ms. Shanks where such an exception was not provided for in the insurance contract and Wal-Mart is unable to recover the costs spent even where there is money to recover, then the plan may run out of money and fall apart depending upon how many plan participants have big costs for health care.

Court: Wal-Mart wins because the contract between Wal-Mart and the plan participants is clear that plan participants all agreed that participants who use the insurance and then recover money from lawsuits pertaining to the same medical expenses covered by the insurance must reimburse the insurance plan and because the contract is a valid contract that has been enforced in the same way for all plan participants.

If Wal-Mart made an exception for Ms. Shanks without a non-waiver provision in the insurance policy, then I imagine a subsequent suit on whether another plan participant has to pay back money might go something like this:

WM: This is the written agreement between Wal-Mart and the plan participants. All of the terms regarding payment of medical expenses and repayment of medical expenses if the same expenses are recovered from another source are contained in this contract. All of the plan participants agreed that Wal-Mart will pay for certain medical expenses but if the patient recovers money from a lawsuit pertaining to the patient's same expenses, the patient will pay back the money provided by Wal-Mart's insurance plan.

Other patient trying to avoid repaying ("OP"): Yup, but Wal-Mart doesn't really follow the terms of the contract. Why just the other day, Wal-Mart decided to let another plan participant under the same contract keep money that was recovered for the same costs paid by Wal-Mart insurance. So, why shouldn't I be allowed to do the same as the other plan participant?

WM: Well, ok, the contract doesn't allow for us allowing that other plan participant to not reimburse Wal-Mart insurance even if the other participant recovered money in a lawsuit for the same expenses. We did it because the woman was in such need and will need life-long medical care. But we don't want to have to do that in every case.

OP: Hey, wait a minute! I will also need life-long medical care and I'm poor too! If she didn't have to repay, then why do I have to repay? Not fair! Wal-Mart violated the terms of the contract because our contract does not allow Wal-Mart to do what it did. Wal-Mart wrongfully benefitted one plan participant over all the other plan participants and now the other plan participants don't even have the same right to receive the same benefit?

WM: Well, your case isn't as dire as her case. It's different. Because...well, it's just different.

Court: Wal-Mart should not be unfair to the plan participants who have a right to expect equal treatment under the contract everyone entered into voluntarily. Since Wal-Mart doesn't always abide by the terms of the insurance policy, maybe Wal-Mart did waive its right to enforce that provision of the contract. Maybe Wal-Mart is liable to the other plan participants for the lack of money recovered and for not being treated fairly and equally under the plan. Hmmmmm...



Sooo, the long of the short of it is that Wal-Mart has apparently decided to change the insurance policy (which is not a simple process) so that all of the plan participants would agree that under certain circumstances, Wal-Mart insurance company has a right to decide not to seek reimbursement for costs covered when the same costs are also paid for by another source. To avoid the second scenario i described above.

[Frankie's Market]

But if Wal-Mart says regardless of the court ruling Wal-Mart will allow the Shanks to keep the money and if there is no provision in the insurance policy saying that making such an exception is not a waiver of Wal-Mart's rights under the insurance plan, then it might be construed to be a waiver of that contract term in subsequent cases.

That's not how it works. Plain and simple. And if you're going to be fixated on this, then there's nothing more for me to say on this.

[Adri]

This is not to say that the Shanks haven't suffered terribly but another part of the story that isn't being well covered is this: Every state in the United States has a medicaid system that is basically a welfare system that would provide health care for poor people and long term care for people who meet the asset requirements. The long term care portion would require that the Shanks family spend their own assets for Ms. Shanks' health care to a certain level (I haven't checked the requirements for the state in which the Shanks live but I believe it should be $2,000 for Mrs. Shanks and somewhere around $100,000 for the spouse ~ outside of "exempt" assets such as the home as long as the spouse is living in the home). Mr. Shanks divorced Ms. Shanks (which is why I've been calling her Ms. Shanks instead of Mrs. Shanks) to divest her of some assets, to impoverish her so that she meets the asset requirements to qualify for governmental assistance and so that Mr. Shanks would not be legally responsible for the cost of her care and would not have to spend down the family's money to reach the asset requirements. By family's money I mean the family's money, not the money recovered in the lawsuit which is probably held in a special needs trust for the benefit of Ms. Shanks and which would have its own rules and restrictions. Medicaid is basically our safety net to provide for people who cannot afford health care or long term care. I understand Mr. Shanks wanting to keep as much money as possible for the rest of the family (and to cover any costs that may not be covered by Medicaid for Ms. Shanks) and wanting someone else to pay for Ms. Shanks' care as much as possible but it does rankle me a little that the Shanks didn't want to use their own money to pay for her care as far as possible to meet the requirements of Medicaid as they were intended to be met but went so far as to deliberate divest her of assets so that the government would pay for her care. Part of the reason our Medicaid programs are in financial trouble is that people who do not truly need to use medicaid (or who do not need to use it as soon as they use it) manipulate the system and deliberately plan to shield their assets so that they can use it even if they could pay for their own care or part of their own care. Medicaid is not an entitlement program, it's a welfare program. If people who can afford to pay for part or all of their own care use medicaid instead, then it means there's less money to be used for people who honestly cannot afford their own care right now.

[joshuatree]

This is not to say that the Shanks haven't suffered terribly but another part of the story that isn't being well covered is this: Every state in the United States has a medicaid system that is basically a welfare system that would provide health care for poor people and long term care for people who meet the asset requirements. The long term care portion would require that the Shanks family spend their own assets for Ms. Shanks' health care to a certain level (I haven't checked the requirements for the state in which the Shanks live but I believe it should be $2,000 for Mrs. Shanks and somewhere around $100,000 for the spouse ~ outside of "exempt" assets such as the home as long as the spouse is living in the home). Mr. Shanks divorced Ms. Shanks (which is why I've been calling her Ms. Shanks instead of Mrs. Shanks) to divest her of some assets, to impoverish her so that she meets the asset requirements to qualify for governmental assistance and so that Mr. Shanks would not be legally responsible for the cost of her care and would not have to spend down the family's money to reach the asset requirements. By family's money I mean the family's money, not the money recovered in the lawsuit which is probably held in a special needs trust for the benefit of Ms. Shanks and which would have its own rules and restrictions. Medicaid is basically our safety net to provide for people who cannot afford health care or long term care. I understand Mr. Shanks wanting to keep as much money as possible for the rest of the family (and to cover any costs that may not be covered by Medicaid for Ms. Shanks) and wanting someone else to pay for Ms. Shanks' care as much as possible but it does rankle me a little that the Shanks didn't want to use their own money to pay for her care as far as possible to meet the requirements of Medicaid as they were intended to be met but went so far as to deliberate divest her of assets so that the government would pay for her care. Part of the reason our Medicaid programs are in financial trouble is that people who do not truly need to use medicaid (or who do not need to use it as soon as they use it) manipulate the system and deliberately plan to shield their assets so that they can use it even if they could pay for their own care or part of their own care. Medicaid is not an entitlement program, it's a welfare program. If people who can afford to pay for part or all of their own care use medicaid instead, then it means there's less money to be used for people who honestly cannot afford their own care right now.

This is a very good reason why we need to overhaul our health care system. Maybe what Canada or Australia has in terms of universal health care ain't all that bad. The Scandinavian countries have some of the highest taxes in the world but everything is set up in a more fair and equal manner there with less loopholes.

[craigwatanabe]

One of my friends is from Edmonton Alberta, Canada and he tells me the lines are long and the quality of healthcare marginal at best.

Hawaii has Quest. One doctor I know in Honolulu told me he once filled out a Quest reimbursement form wrong (it ain't easy to fill one out correctly) and he was accused of defrauding the government. He hates doing quest patients because some (not all) demand the best since they don't have to pay a dime, and become arrogant. And when he does fill out the forms for reimbursement, it takes a long time so he has to float those medical bills until then.

Now take that on a national level. I don't think our heathcare facilities could handle the influx of "free medical services" to those on a subsidized program nor handle the waiting period for reimbursement. Ultimately those paying for their medical insurance would bear the brunt of these delays.

And what about places such as the Big Island where medical facilities are rare to begin with. It's already taxed with Quest and traditional insured patients already. Add another layer of subsidized healthcare and our healthcare facilities probably won't be able to handle it. They can't handle it right now.

[joshuatree]

One of my friends is from Edmonton Alberta, Canada and he tells me the lines are long and the quality of healthcare marginal at best.

While that is a concern, how does it compare to our system in terms of fiscal sustainability?

[craigwatanabe]

While that is a concern, how does it compare to our system in terms of fiscal sustainability?

Well the difference between Canada and the United States is that Canada doesn't spend 1/3 of its budget on the military cuz it's neighbor protects pretty much all of Canada.

If the United States didn't have to defend the world we'd probably have decent Government Subsidy programs, better schools and most importantly, better roads!

But that's the cost of freedom, an impressive war machine.;)