My wife had to do a resident rotation at Boston City Hospital (remember 
the show St. Elsewhere?).  A lot of their patients were walk(or 
transport)-ins, and they got excellent care, in some cases better than 
private payers, because Unkie was footing the bill and there was not a 
lot of oversight on what was ordered, billed, etc.  The hospital made 
money off that and everyone knew it and acted accordingly.  Need a cat 
scan for that bellyache?  Of course, their patients were often less 
"well" than private payers, because of lifestyles, behaviors, inability 
(for whatever reasons) to take any responsibility for their own 
care/situation, etc., but they got excellent care. 

Oh, and they could not test anyone for AIDS without explicit written 
permission (the very active and powerful gay lobby in MA at that time 
was agitating hard on that subject), so whenever anyone got a needle 
stick the docs were playing craps with their (and their family's) 
lives.  And BCH being what it was/is, a good portion of their patients 
came in with positive AIDS.

Then she had to do a rotation at the Manchester NH VA hospital ("The 
Manch") and that was *quite* an experience -- her concept of Hillarycare 
(which at that time was a prominent topic) that she uses to calibrate 
the politicians.

A buddy, an excellent doctor, now works at the Houston VA and while they 
provide good care to their patients, the stories about the bureaucracy 
can fill hours.  I mention "Hillarycare" and he just smiles.  That seems 
to be the case (or they start ranting) with every doc I know and talk 
to, and that is quite a few.  Many of them are no fans of the ins cos 
either, but given the choice...

--R

Sunil Hari wrote:
> Not pay it.  it's really that simple.  Public hospitals are specifically NOT
> allowed to send their bills to collection agencies so they have to eat the
> cost.
>
> Of course, if you try this at a private hospital, they'll stabilize you in
> the ER and then boot you.
>
>   
>

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