We have parishes in Louisiana, not counties. (-:

Hey I knew that! [g] And northern Canada has "Municipal Districts",
a totally soulless label. I once lived in Alberta MD #56... what a
drab name.

Does everything up there operate like the MNR? (-:


Regards,

Roger

... Yeah, but what's the speed of darkness...
--- D'Bridge 3.43
* Origin: NCS BBS (1:3828/7)

Replying to a message of JIM WELLER to BOB ACKLEY:

Generally, they are operated by a 'hospital authority'
at the county level. That authority has the power to tax
and that tax appears as a line item on the property tax
statements in that authority's service area.

Ah, I'm beginning to understand how your system works a bit
better. I had the impression most of your hospitals were
privately owned, for-profit institutions that billed
people.

Most hospitals - the vast majority in fact - are privately owned. A
tiny minority of those privately owned hospitals are investor owned
(i.e. "for profit") and the vast majority are owned by religious
institutions (most of which are Catholic). Some hospitals are owned
by a local hospital authority, but most government owned hospitals
are run by state colleges or universities as an adjunct to their respective medical schools. The federal government owns the VA hospitals, the
hospitals run by the Bureau of Indian Affairs and the military's health
system - but all of those are open only to a selected population.

I note that there doesn't seem to be much in the way of
medical research or development of new methods and
procedures in any of those 'industrialized countries' that
have 'universal' health care.

Not by hospitals, but by universities and governments.

What's going to happen in the US is that the congress will
pass its health care reform abomination, and the executive
will sign it. Within ten years there will be no privately
run hospitals in this country, and there will be a
significant shortage of physicians and other medical
personnel. Medical research will grind to a near
standstill, as will development of pharmaceuticals.

I do hope you are being overly pessimistic.

I doubt it.

---
* Origin: Bob's Boneyard, Emerson, Iowa (1:300/3)

Replying to a message of JIM WELLER to BOB ACKLEY:

In countries that have socialized health care (aka
'universal' health care) the actual costs of providing
that care are hidden

How is it hidden? The federal budget is a public document.

The true costs of providing the care don't appear on the
bills.

I tend to disagree with that point. I will concede though
that the health budget which is supported by insurance
permiums, often runs a deficit and the shortfall is covered
by general revenue. But that is also true of Unemployment
Insurance, most years until recently, which is supposed to
be self-supporting too.

There are a lot of costs that can be buried in other departments.
For instance, the cost of utilities, the cost of common supplies
such as paper towels and office supplies, the cost of computers
and the people that run them, the cost of the HR department, the
cost of maintaining the building and grounds, security, laundry etc.
In fact the cost of just about anything not directly related to patient
care can be buried someplace else.

You can also contract out a lot of services - laboratory and imaging,
for instance, and list those costs as ordinary contractual expenses
and put them anyplace in the budget.

Bureaucrooks and politicians can get very inventive when their goal
is to hide the actual cost of something.

---
* Origin: Bob's Boneyard, Emerson, Iowa (1:300/3)

Does everything up there operate like the MNR?

MNR? Ministry of Renewable resources?

I'm shocked! (-: It's the acronym for Ministry of Natural Resources.


Regards,

Roger

... QUICK! Hand me the cat; the cherry bomb's lit!
--- D'Bridge 3.43
* Origin: NCS BBS (1:3828/7)

[...]

I would hate to be living in a poor rural county in Missiippi or
Louisiana though.

We have parishes in Louisiana, not counties. (-:


Regards,

Roger

... Dumb luck beats sound planning every time. Trust me.
--- D'Bridge 3.43
* Origin: NCS BBS (1:3828/7)

Replying to a message of JIM WELLER to BOB ACKLEY:

Quoting Bob Ackley to Jim Weller <=-

In countries that have socialized health care (aka
'universal' health care) the actual costs of providing
that care are hidden

How is it hidden? The federal budget is a public document.

The true costs of providing the care don't appear on the bills. While
the government's budget is a public document, for all practical purposers
it's indecipherable - especially to non-experts. Canada's budget process
may differ from that of the US government but I'm inclined to doubt it.
Shucks, when I worked for an Omaha hospital I about went nuts trying to
figure out their account structure (and was not successful); that's in one not-very-large institution; note that I have a BS in Health Care Administration with 3 semesters of accounting plus one of financial management and one
more of each at the graduate level (I didn't finish my master's).

In the US, government sponsored health care (IOW Medicare)
does *not* pay the costs of providing health care to the
elderly.

Medicare has for decades been notorious for (1) slow pay
(90 days after submission of the bill is not unusual, most
industries require payment within 30 days), (2)
disallowing charges it doesn't like and (3) writing itself
huge discounts (sometimes more than half of the amount) on
the bills presented.

Canada has caps which are negogiated between the federal
government and the CMA. Perhaps that is one reason are
costs are less. Doctors in the NWT are on salary with the
Dept. of Health. GPs make $80 per hour, most specialists
around $160. I suspect many American doctors make far more.

And their expenses are far higher. Your salaried doctors don't have
to pay for office space, office help, computers, equipment and
professional liability insurance. I would expect that your salaried
doctors net more income - and work fewer hours.

And your drugs cost more too. We got the whole country
vacinated ( or at least the 90% of the population who
wanted it) against swine flu before Dec. 1 at $8 a pop.

Drugs are expensive because pharmaceutical research is very
expensive. When you figure that less than ten percent of the
drugs that are developed ever see the public market you can see
why. The cost of developing all of those drugs that never make it
to market has to be factored into the price of those that do; further,
in the US, patents on drugs run out fairly quickly so those costs have
to be recovered fairly quickly. Yes, the price of drugs in Canada -
and in other countries - is capped by the government; and I note that
there seems to be very little pharmaceutical research being done in
countries where the prices of drugs are government controlled.

congress routinely underfunds those programs because
they are expen$ive

I agree with that statement, both halves.

There's no reason to expect that anything devised by those
537 pompous, preening, posturing gasbags (I include the
executive along with congress) will accomplish anything
other than the destruction of the US health care system -
and the US economy.

Did you know there are 6 times as many registered lobbyists
trying to influence your politicians instead of leaving
them alone to study the matter and thik things through?

I'm certainly not surprised. IMO in the United States there is
no such thing as an honest politician; at the national level we
have 537 specific examples.

Alaska - like Texas - might be able to escape some of the
damage because of its oil revenues. Texas built a
terrific public health system using revenues from its oil
industry

I would hate to be living in a poor rural county in
Missiippi or Louisiana though.

I'd hate to be living in Canada other than, maybe, in southern BC near
the coast. It's just too d*mn cold up there. Right now it's a whopping
ten degrees F and we've had blizzard conditions here since Wednesday
afternoon, and they'll continue until sometime Saturday. Canada is
about 300 miles farther north.

---
* Origin: Bob's Boneyard, Emerson, Iowa (1:300/3)