The state legislature of Missibama

Legislature's, both at state and federal levels, sometimes require actions for which they do not pay. These are called 'unfunded mandates'.

Missibama is not a state, by the way. It looks like a combination of Mississippi and Alabama, which are not noted for being extremely progressive. I do not know why the author did this.

Hi,
Thanks for your time.
I am sorry I could not understand your explanation . 'unfunded mandates' ?? how its related to hospital benefit packages ?
I am in the dark.

Need a very simple explanation .

They told the hospitals what to do. They didn't give them any money to do it with.

They want the hospital to provide benefit packages to employees. They don't pay the hospitals to do this.

what ? but I assumed public hospitals are funded by government !

In fact , in our country government pays the salary of doctors , staffs in public hospitals . is there different system in USA ?

Yes, there is a different system in the United States. Most hospitals are owned by private corporations which intend to make a profit running the hospitals. At the same time, state legislatures often require hospitals to provide services to people who are indigent (too poor to pay their own bills). Hospitals which receive funds from state and federally funded programs such as Medicaid (support for health care costs for poor people) and Medicare (the federal government's health care program for people who are retired and receiving Social Security payments) are considered public hospitals because they take public money, even if they are privately owned and operated for a profit.

So the expression "public hospitals" does not mean hospitals owned by governments, it means hospitals which accept funds from governments. Missibama is a nonsensical name, and i suspect that the author is telling a story to illustrate his or her point about the health care system.

who pays the doctors / staffs in these type hospitals ? private body ? or salaries are given from the fund received from the government ?
I would like to know how they use funds ? is it just they use these funds to serve poor people with free of cost ? here we are talking about employee benefit packages . I am worried whether the salaries/packages are given from this "fund"...thats my concern

any comments

imagine a hospital treats 20,000 patients per year. many of these patients have private health insurance. some patients do not have health insurance insurance.

The goverment require that those patients without health insurance are treated according to their need.

The hospital treats the patients without health insurance and sends an account to the government for that treatment.
so the doctors and nurses salaries and the hospitals operating costs are paid partly by the government and partly by the private patients who have health insurance.

However the government also says we will only pay a certain amount for each particular treatment (different amounts for different treatments of course) usually this amount is substantially less than what the hospital usually charges (in order to make a profit) so there is a lot less incentive for hospitals to treat the patients without health insurance. Sometimes the hospitals try to recover any shortfall in revenue recieved by billing the patients who do not have health insurance.

If the hospital makes a profit it will pay a dividend to its share holders.

Actually, around here, they always try to collect from those without insurance. To get a tax expense for unpaid bills, the creditor must "diligently" attempt to collect the bill. This can include garnishing wages and bankruptcy.

The hospitals are privately owned, and they are owned for a profit, usually by large corporations which provide health care services with the intention of making a profit. It is just like any other business, the employees are paid by the business, by the corporation. Health care packages are provided, and oftentimes negotiated, as they would with any other privately owned business.

Government funds are received on the basis of services rendered. Governments pay a certain amount for specified services, for medications, for specific items such as prosthetic or prophylactic devices. How the corporation uses the money the receive from government is no one else's business. I can't think why this is matter about which you would be worried. The private business gets paid by government for services which have already been provided to the patient.