[Sundown17]

Being both a health care employee and a health care user, I am the first to admit the US health care system needs a major overhaul...but we do have all of the above mentioned categories...private insurance (the kind that employer/employee each contribute or the uber rich pay out of pocket) government insurance (for the qualifying poor, disabled and anyone over 62) and pay as you go (for all the unfortunate people that do not fall under either of the former).

I work in an Intensive Care Unit at a non profit hospital in New Hampshire. The hospital will treat any and every patient that shows up regardless of their ability to pay. Yes, they will be billed and yeah, maybe even get some phone calls down the road looking for money, but they are never turned away even if they already have a large outstanding bill with us. The social workers work with them to figure out a way to get the bill paid, whether it be some government hand out or an agreed upon monthly payment that is doable on the person's income (I've seen as low as $35 a month on a multi thousand dollar bill, if that was all the person could afford to pay each month and as long as they made the $35 payment each month, no harassing phone calls).

Case in point, there was a patient that would be admitted, oh, probably every couple of months or so, to the ICU. He was basically a homeless, alcoholic, drug user. And when he got close to dying, he would call 911 and get an ambulance to take him to the Emergency Room. They would admit him, the ICU would fix him up and then send him home after a week with services to try to improve his living style that he would reject after about two weeks. And then the process would start all over. (Interestingly enough, whenever he was hospitalized, all kinds of family would show up, demanding this or that for him...which made us wonder...where were these people when he was alone drinking, injecting and smoking himself into illness?) Anyway, my point is that, I suspect that by the time he passed away, he had ran up a hospital care bill in the hundreds of thousands with his many admissions, which will never be paid. So in a sense we do already have a universal health care system...it's just not universally available.

Can anyone tell me...I had heard that in universal health care, if someone is habitually ill because of self-abuse or non-compliance (not taking their meds or engaging in activity that will make a diagnosed chronic illness worse) sooner or later they will be turned away from treatment by the doctor, hospital unless they pay for it themselves...is that true? The hospital I work at is not allowed to do that. So needless to say, we see the same patients over and over again because they don't/won't take their meds or care of themselves.

And not every hospital is non profit, but many are and some of them are the biggies that Yuri mentioned. My husband had open heart surgery at Brigham and Womens this past winter. We have wonderful private health insurance through his employer that we pay oh, around $200 a month for. The bill was over $100k, our out of pocket was less than $500. However I met a woman in the waiting room whose daughter was getting a heart transplant. She had no insurance, but the daughter was getting every bit the same high quality care that my husband was. The hospital had set up a cot for her so she didn't have to pay for a hotel room. And a nearby hospital was validating her daily parking so she could keep her car parked in their garage for the duration. Unfortunately this is more the exception than the rule and more available in the high health care cities like Boston.

Sorry, kinda went off on my little personal rant here. Didn't really address Ron's question...but I have been very interested in the replies.

Yes, we do have to do something to make sure affordable health care is available to everyone. But one way or another those that can pay for it, will, whether it be through private insurance or in higher taxes for property, purchases, income and those that can't pay, won't, because they don't/can't own property or work or afford spending sprees. Nothing is truly free. It's just a difference of seeing upclose and personal what it's costing you or have it hidden in taxes and fees. It will be interesting to see if the US does implement a more global health care system, how "smooth" the transition will be. Personally I see a big fat ugly mess with alot of fingers in the pot still trying to get rich from it and sadly alot of people still falling through the cracks because anything involving the government is not a simple line from point A to point B.

But then that's a whole 'nother rant...:P

Diane