Replying to a message of Bob Klahn to Bob Ackley:

 BA>> Replying to a message of Bob Klahn to John Massey:

 JM>>>> health care system is at risk of an insurance meltdown.

 JM>>>> Not the governments problem.

 BK>>>  Your opinion. When you figure out how we maintain a health care
 BK>>>  system in this country without the insurance industry please let 
 BK>>> us all know.

 BA>> We could start by getting the government *out* of the
 BA>> health care business.

 BK>  No military health care?

Most of it seems to be contracted out, at least in the CONUS.

 BK> No research?

Why is the government involved in medical research at all?

 BK> No nursing homes?

Why is the government running nursing homes?

 BK> No care for the poor?

Didn't say that.

 BK>  All privatized?

Yes.  Perhaps I should have said 'get the government out of
*controlling* the health care business.'

 BA>> Doctors and hospitals somehow managed to care for people
 BA>> regardless of their ability to pay for that care quite
 BA>> nicely before health insurance was invented. I don't recall

 BK>  Not even close. Look at all the treatments we have today, that
 BK>  didn't exist before health insurance was invented. The health
 BK>  care industry didn't develop those treatments for the fun of it,  but
 BK> because somebody was paying for it. No private patient could  afford
 BK> to pay for that research and development.

Most such was and is done in conjunction with university teaching hospitals.

 BK>  If you ever need cataract surgery, thank the govt. Until
 BK>  Medicare started paying for it, it was horrendously expensive.
 BK>  Under medicare it became common enough, and they set prices low
 BK>  enough, almost anyone can have it.

 BK>  Heart bypass surgery may not have been invented by a govt
 BK>  doctor, OTOH, maybe it was. But I do know a good part of the
 BK>  research was done by doctors working at the VA Hospital in
 BK>  Madison Wisc.

 BA>> any horror stories of masses of people dying in the streets.

 BK>  No, they just died at home. Or in the hospital.

They still do.  *Everybody* is going to, you know.

 BA>> Y'see, once upon a time health care providers were allowed
 BA>> to factor the cost
 BA>> of charity care (can't call it charity care any more,
 BA>> that's politically incorrect

 BK>  I never heard that. Where is that?

 BA>> because receiving charity is somehow demeaning to the
 BA>> recipient, it's now called 'uncompensated care') into
 BA>> general overhead; and a portion of that general
 BA>> overhead was allocated into everybody's bills.  All

 BK>  They still do that.

Not for Medicare and the big insurors - which, incidentally, write themselves
big discounts off the stated charges on the bills.  In my particular case Tricare's
discount was 80% off, Tricare paid $9K and change of a bill totalling about $49K.
Where do you suppose the other $40K went?

 BK> That is one of the issues emergency rooms
 BK>  face. And that is an issue counting heavily against companies
 BK>  like Wallmart that don't provide insurance for a lot of their
 BK>  employees. We wind up providing the coverage for their
 BK>  employees. An unfair advantage for them.

 BA>> businesses do that, although
 BA>> they don't have 'uncompensated care' to worry about, they
 BA>> do have shoplifting, employee theft, 'inventory shrinkage,'

 BK>  Mostly insider jobs.

Shoplifting isn't, and theft is theft regardless of who's doing it.  And
that's exactly the same thing as someone being treated for some medical
condition and not paying the bill.  Whether they have the funds to pay or
not is not the issue; after all, some shoplifters only steal enough food to
keep them alive, but it's still stealing.  When one is admitted to a hospital
one signs a lot of paperwork, among which is a promise to pay the bill;
during my internship at St. Mary's Hospital in Nebraska City I processed the
admission for a young couple (she was a maternity patient) who signed
everything and obviously had no intention of paying the bill, they just didn't
care.

 BA>> etc. to worry about.  Health care providers
 BA>> are no longer allowed to do that, first it was Medicare
 BA>> that refused to pay that
 BA>> part of general overhead and the big insurors followed suit.

 BK>  It's still there. The just puff up all the bills. For emergency
 BK>  rooms. They don't have to provide actual curative care if you
 BK>  can't pay for it. Not unless you can get on a govt program.

Providers cannot refuse to provide necessary care, nor can they turn away
emergency patients for financial reasons.  Hospitals cannot transfer patients
for financial reasons (as from a privately owned hospital to a government-owned

--- FleetStreet 1.19+