[sheltiedave]

And why are costs out of control? A large driver is because 40% of the people(those who have insurance, mainly) get to cover the other 50% to 60% who do not have adequate insurance coverage.

Also, most hospitals are in competition with one another in urban areas, so they all line up and get the larger ticket items, like MRIs and CATs, and then they end up with 18 machines in an area that can readily be served with 8 machines. Many modern hospitals are in competition for services and prestige these days, and they end up pushing identical rather than complimentary services.

When you duplicate services, and require the uninsured to be funneled into the most expensive of medical care to treat the most rudimentary of illnesses, you end up with underutilization, and cost tilting.

Please ignore my post here, Whell. I have just as many direct relatives who are intensive consumers of medical treatment as you, plus I have two brothers who are MDs, five first cousins who are MDs, a sister who is a pharmacist, a wife who is an MSN nurse informaticist, seven other first cousins who are regular BSN RNs, another first cousin who is an MSN RN psychiatric nurse manager, a first cousin who is a retired PhD nurse anesthetist(and the President emeritus of her professional society,) and another first cousin MD who runs the largest group doctor's practice in Illinois. And there also are two fathers-in-law who are the medical directors of major metropolitan Level One trauma hospitals, and a now deceased step great aunt who ran the SSM hospital chain here in Missouri for her religious sisters order.

We have been having these discussions about national medical insurance coverage within the family for longer than either of us have been alive, and it is a given that any current evolving system that makes the key stakeholders to be politicians, insurance companies, and actuarials is going to be a bastardized stew of epic proportions.

You may know stuff at the microecon level of medical care, but you don't know squat about macroeconomic medical care models, and it shows.