[...]

I've been in the hospital twice in the last two months and that isn't the case here. Even my nurse charged seperately.

The last and only time I was in the hospital as a patient was for surgery in 1978. My memory is a bit foggy from that long ago, but I know the nurse didn't
bill me seperately, but the anesthetist did. The only other bill I remember is
the hospital's. Inasmuch as I dislike saying it, this hospital had good food.
My doctor was on staff at the hospital and is the brother of the former DA of New Orleans (Richard Dowling).


Regards,

Roger

... Before you see the light, you must die.
--- D'Bridge 3.43
* Origin: NCS BBS (1:3828/7)

Replying to a message of Roy Witt to Bob Ackley:

Historically, physicians have *not* been employees of a
hospital. They have always billed separately. That
situation, however, is changing as younger physicians now
have no problem with being ordinary wage slaves working
for somebody else - in point of fact,

I've been in the hospital twice in the last two months and
that isn't the case here. Even my nurse charged seperately.

It may be that nurses work for an agency rather than the hospital, and
the agency agrees to supply the nurse required staffing. When I worked
in an Omaha hospital, the hospital had a core of nurse employees and
contracted with local agencies if they needed more; AFAIK the patients
weren't billed separately by the agencies.

That arrangement can cause staffing problems, though. In order to keep
busy many nurses work for multiple agencies and may not be available
if they're already on a job for another agency. The use of 'float' nurses
is to reduce staffing costs, as they don't have to be paid when they're
not working and they don't receive employee benefits. When the patient
census is down this is a good thing, because the hospital doesn't have to
lay anyone off; unfortunately if the census suddenly spikes the hospital
has to scramble to get the help it needs.

Shortly before I left Bergan Mercy there was a short squib in the employee newsletter thanking a couple of dozen Bergan nurses for volunteering to
work overtime one weekend at Immanuel Hospital (Immanuel was in the
process of taking over Bergan Mercy). Seems that Immanuel was 24 nurses
short that weekend, and there hadn't been a catastrophe or epidemic; somebody had screwed up royally WRT nurse staffing that weekend. When I pointed out that apparent screwup I was told I had an attitude problem.

If you recall several years ago when that DC-10 crash landed up in Sioux City, IA; the administrator at Bergan called the administrator of the Catholic hospital
in Sioux City and asked him if he needed help. Answer was yes, Bergan sent
a busload of staff nurses to Sioux City to help out, and they stayed there about
ten days; all paid for by Bergan, including overtime. That wouldn't happen today
because hospitals don't have the funds available to do that sort of thing (plus
the
idea wouldn't occur to Alegent management, Alegent is the name of the outfit that took over Bergan Mercy and they have a monomaniacal fixation of cutting costs, as I noted to the former head of Bergan Mercy: someday that cost
cutting is going to kill somebody - if it hasn't already).

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

Times have changed, Roger. When I was in the hospital in 2003, the bill
was $22,000 and my insurance paid about 1/4 of that and the hospital
wrote off the rest. The only charge I had was from a lab worker who was called into surgery to take a biopsy. He eventually got paid by my insurance. This time, the bill was $18,000 just for 2 days of observation and my total out of pocket was $40 co-pay. Then two weeks later I had to
go back and stayed for 3 days of observation, which cost about $20,000
and
my out of pocket was $65. Best part was they gave me a prescription that will enable me to stay out of the hospital and that prescription is free.

After watching the movie Critical Care, with James Spader, Kyra Sedgwick, Albert Brooks and Helen Mirren, I've made sure that no hospital will touch me.
That may sound foolish to some, but they'd have to see the movie first. Also, I
can buy any Rx I need cheaper online than I'd have to pay for locally (unless the time factor is critical) and that's why I don't have Part D.

BTW, the food wasn't anything to write home about and it certainly wasn't plentiful, but I did manage to lose 3lbs on it.

That was the only hospital I've been in where the food was good. It was Southern Baptist in New Orleans and they also had an excellent medical staff. Nowadays, their food is probably more like I imagine prison food is today and I
have no idea what the medical staff is like. I can only vouch for them when I was a patient there Thirty-one years ago.


Regards,

Roger

... Patience and time do more than strength or passion.
--- D'Bridge 3.43
* Origin: NCS BBS (1:3828/7)

Replying to a message of JIM WELLER to BOB ACKLEY:

Some Hamilton philanthropists booked her as a headliner for
a gala dinner which is a fundraiser for charity. A cancer
clinic and a hospital refused donations from the gala after
getting really angry feedback from their other sponsors and
donors due to her being such a strident critic of public
health care.

Public health care in general

Public health care in general including Canada's
specifically, although the bulk of her wrath was aimed at
Obama.

Once again she was caught out by a political satire comedian
posing as a politician or serious journalist and shot her
mouth off in an embarrassing way.

or the proposed government destruction
of the US health care system?

I honestly don't know enough of your proposed plan to
comment but I gather that the plan you are about to get is
a political compromise and not what was originally
envisioned.

There's a place for public health - at the county level.

In my strictly personal opinion it should be federally
funded but locally delivered. Poor counties and even
states/provinces can't handle the load on their own.

The county public health office here offers limited general
services at reasonable prices. I can get immunizations there
for a nominal fee, and they do sponsor occasional clinics in
the outlying towns for those who can't or don't wish to travel
the 20+ miles to their office in Glenwood.

In the US there are *many* publicly owned free standing
hospitals. 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.

Most of the hospitals in this country, however, are privately owned -
and the overwhelming majority of those are owned by a religious
group, and the majority of those happen to be Catholic (others include Lutheran, Methodist and Jewish). Next in line in terms of numbers
are hospitals run by (usually state government owned) colleges and/or universities, and are affiliated with the respective institutions' medical schools. A tiny minority of the hospitals in this country are 'investor
owned' - IOW 'for profit' operations; these are the ones that seem to get
all the bad press, although their rates/charges are comparable to similar institutions run by government or religious organizations.

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. Seems to be the same thing in the pharmaceutical industry, development of new drugs and treatment doesn't seem to be being done in countries where the prices of drugs are government controlled.

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.
There will be a massive decline in the quantity and quality of medical care available, with long waiting lines for all significant procedures.

As I've noted, providers have for several years been quietly dropping out of the
US Medicare system. Some providers no longer deal with the government plans
or with insurance companies at all; with them it's cash, check or credit card - and payment due within 30 days of treatment (their rates seem to be lower, too).
For at least a decade physicians in this country have been advising their children to *not* go into the medical care field - because of the hassles involved
in dealing with insurors and the government, and some physicians who can afford to do so have either retired or found another line of work.

We may see the opening of new, well equipped hospitals on the Mexican side of the US border and in some Caribbean countries. These hospitals will cater to US
citizens and will operate on a cash, check or credit card basis only; no insurors,
no (US) government regulation or interference. If the host governments in those
countries are smart they'll leave the operations strictly alone and simply collect
tax revenue from them; if the owners of those facilities are smart they'll provide
good care to the citizens of those host countries at very nominal costs.

US citizens are already travelling to other countries for medical care, usually

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

On 12/22/2009 3:45 AM, Bob Ackley wrote:

In the US there are *many* publicly owned free standing
hospitals. 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.

I don't believe there's a single one in the State of Alaska. No, I've
done no research on this. Anchorage is served by 3 major hospitals. Providence is a non-profit, Catholic sisters of providence. Alaska
Regional was a joint venture between physicians and the Presbyterian
church. It appears to be the older and I "Think" it's a for profit,
used to be called Humana. The 3rd is run by the Federal Government for Natives ONLY. Not a single one is state/borough tax supported. The few clinics available are walk-in clinics for simple things like tetanus
shots, when I stepped on a nail while tearing down drywall, or hook
removal for people fishing, which I've never had done. Further out in
the bush they're an extension of the Native hospital for the most part.

Last summer I was hospitalized at Providence. While the facility is non-profit the services are contracted out. I was charged for more than
3 different companies representing doctors just in the ER. That's
separate from the Providence charges. Then there's the imaging
department for X-Ray/MRI/CT/CAT scans. This continued until I was
released after a 3 day stay, and around $35,000 in charges. With no
diagnosis as to what the problem was.

My point? One size doesn't fit all and your situation doesn't for
Alaska. For example, per Wikipedia and the 2000 census it cites, the Northwest Arctic Borough is slightly larger than Indiana. It has about
7,200 people living in it. The largest town is Kotzebue and it's
population is around 3,200.
--- Platinum Xpress/Win/WINServer v3.0pr5a
* Origin: FidoTel & QWK on the Web! www.fidotel.com (1:124/311)

Replying to a message of bill swisher to Bob Ackley:

Last summer I was hospitalized at Providence. While the
facility is non-profit the services are contracted out. I
was charged for more than 3 different companies
representing doctors just in the ER. That's separate from
the Providence charges.

Historically, physicians have *not* been employees of a hospital.
They have always billed separately. That situation, however, is
changing as younger physicians now have no problem with being
ordinary wage slaves working for somebody else - in point of fact,
as hospital employees they work fewer hours and their expenses are
much lower (office space and personnel are furnished, and the hospital
handles their professional liability - malpractice - insurance); and even though the pay scale is lower, employee physicians quite likely net more
than independent physicians (I've not investigated that but it seems likely).

Then there's the imaging department for X-Ray/MRI/CT/CAT scans.

I'm surprised that X-Rays were billed separately, that's usually a hospital department and those charges should have been in the hospital bill. CAT
and MRI scanners are a different story, many hospitals cannot afford to install or operate them (technician training among other reasons) and therefore contract with private companies to provide those services. I've seen big semitrailers that contain portable MRI scanners; they pull up to a hospital and set up shop in the parking lot - they're usually in place for a couple of weeks at a time, then they move on to another hospital.

This continued
until I was released after a 3 day stay, and around
$35,000 in charges. With no diagnosis as to what the
problem was.

That's surprising. In 2004 I spent 3 days in a hospital and the bill
was $49,000 and change, the attending physician added his bill of
around $3,500 and the cardiac specialists also added theirs, which was
around $11,000 - but they knew what was wrong with me and they
fixed it (99% blockage in one coronary artery, I now have a stent in it). Tricare - which I call Medicare for the military - paid a total of about $18,000 of all of that and the providers wrote off the rest (which one
reason why medical bills are so high - they don't get paid).

My point? One size doesn't fit all and your situation
doesn't for Alaska.

I was not intimating it did.

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

On 12/24/2009 2:22 AM, Bob Ackley wrote:

That's surprising. In 2004 I spent 3 days in a hospital and the bill
was $49,000 and change, the attending physician added his bill of
around $3,500 and the cardiac specialists also added theirs, which was
around $11,000 - but they knew what was wrong with me and they
fixed it (99% blockage in one coronary artery, I now have a stent in it).

Oh...now cardiac...when I had my heart attack, 1986 IIRC, I had a 95%
blockage in one of the TWO arteries in my heart. Most people have
three. They did the angioplasty and balooned me, no stents in those
days. Bill was well over $70K, back when a buck was worth a little more
than today. In 2001 I had a single-bypass, that ran another $180K+.
Our share was almost $25K.
--- Platinum Xpress/Win/WINServer v3.0pr5a
* Origin: FidoTel & QWK on the Web! www.fidotel.com (1:124/311)