Quote:
Originally Posted by Nate the great
The purpose of government is to be a government, not a nanny.
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That is absolutely perfect, and may I use it in my signature line?
Medical care in the US is a combination of public and private funding, with HMO's tossed in for the sake of confusion. Private practice physicians must operate their businesses and practice medicine. For the most part, they see patients who either pay out-of-pocket or bill the patient's insurance.
Large medical centers, such as where I work, receive funding from out-of-pocket, private insurance, and mostly govt monies. The majority of the money for my particular division comes from state and federal funding. Each year, the state allocates (fewer and fewer) dollars specifically to my medical center to cover many costs.
Our massive medical research is mostly funded by the federal govt via VERY competitive grant applications, with plenty of money from pharmaceutical companies tossed into the pile from our med testing research. People who volunteer to become research subjects receive free medical care related to the illness that the medicine is being tested for, and quite often the pharm company pays the subjects.
Pay attention now, this is what I've been getting to: Those pts who are poor and don't have insurance are covered under a govt program called Medicaid. Medicaid only pays us a fraction of the cost of the medical care, and we are forbidden to try to collect the remainder. This is a contractually binding agreement. We take a large loss on these pts versus pts who have insurance. Nobody makes up the difference. It is mutually agreed upon by us and Medicaid that we will take whatever pittance they give us and be satisfied. We understand that we can not count on our majority population of poor urban pts to support us and that the excellent care they receive from us will be free to them.
However, the working lower middle class often fall through the cracks. They are often working jobs that pay too much to qualify for Medicaid, but not enough to have medical insurance. That remains an unsolved problem.
What differentiates the US med care system from NHS is competitiveness. The better the care that you deliver, the more your reputation grows, and the more research dollars you are awarded. The more research experience you gain, the more pharmaceutical money you are offered. Competition drives the medical field as much as it drive retail. Sure, you can call us greedy, but that drive to acquire the most has driven medicine to the heights it now occupies.
I believe our American way of wanting the mostest biggest flashiest of everything is what made us rich. Why would we want to change that? There's no reason to feel guilty, and I am proud of the fact that anyone who wants to compete be rich in the US can be. Like RSE said, it's a big country, and if you fail, then it's easy to move and start fresh again.