[dalmations202]

Originally Posted by mcsluggo

dalmations, I can see you point to some extent...

however, underlying that point is ALSO the fact that the current system is getting bogged down because SOMEBODY already has to provide care for those that are outside the system. The hodgepodge way we do it now is retarded, and and tries to overtly ignore the situation and instead addresses the problem as an afterthought plugged into the side of the general system.

Clearly that doesn't work very well. It is also clear (to me at least) that we can't just exclude medical services from a large swathe of the population... even if you ignore the humanitarian aspects of that decision, the external and spillover costs of having an uncovered portion of the population are too high.

so you have to divide the question into two parts. One, what is the problem? (which you addressed) and two, What is the best way to solve this problem? (which you didn't)

i don't think ignoring the un-covered is an option.

No argument from me at all.

There is an issue that needs addressing. The question, at least to me, is not if there is a problem, but how to address the issue.

I want the care that private healthcare provides. Being ex-military, I have seen how the military does it, and it isn't pretty. Go visit the VA hospital sometime, and see what you are getting with free service.

I have worked in a county hospital, in a semi-poor county. Everyone with insurance goes to the "other" hospitals in the metroplex because they get better care. This leaves even more indigent care for that hospital, and even less money coming in because they don't get the $$$$ from the insurance. They only get paid by medicare and medicaid or self-pay. They also get paid less by medicaid/medicare for the same services because they are classified as a rural hospital, even though they provide the exact same service ie MRI, and the cost of the machine is the same.

I moved to a better county hospital in the suburbs of the metroplex to get paid. We were and are a better hospital totally due to the money we get and are willing to spend. Then we were bought out and privatized. We now work on profit, but we provide much better service. We have much better scores. We rank up there with Baylor and Harris (better in some things) now that we have even more $$$$ to spend.

The downside is that we don't take indigent care now. If you come to this hospital's ER and don't have insurance, medicaid, medicare, or proof of cash, then we will stabilize and send you to the county clinic. Have the flu, don't come to our ER without ability to pay. Anything not life threatening -- same thing. This has caused many issues with some people. Metal fragment in the eye hurts greatly, but isn't life threatening....see the issue.

Because the hospital gets paid so well, and yes we charge outrageously...then people think it is OK to gouge the hospital. Before I got here one business was charging 9K a server to the hospital -- when I could get the same server off Dells site w/o the HPG discount for $2800. I know we get gouged on lots of products solely because we are a hospital and we have to have certain things.

People also don't realize how many people it takes to take care of a person for 24 hrs a day. 5 shifts minimum in a week for nurses. Nurses, Doctors, Pharmacist, Lab, Computer, Billing, all the Health information coding, Maintenance of the building, Clean-up, Cooks, etc. Not to mention the QC people (to make sure no one screwed up) and the ones that do all the credentialing to make sure you are getting certified people and that they keep their certifications up to date. Add to that the marketing groups to try and drive a little more business this way, the recruiting people who try and get the best talent here, and the accounting people to keep the product coming in the doors, and everyone getting paid. It is a nightmare of people that are involved, just to keep 1 person in one bed for 1 week.

And remember, everyone wants paid, since most positions here require a bachelors degree, just to get interviewed.

** Just a note, I get paid half what I made when working in the business world. I stay working here because it is home, and I feel like I am actually helping people.

With all of this said. Socialized medicine doesn't work. I am interested in someone coming up with a better answer though, if we are to continue to be a society that stays with a free market system.