Medicare for all

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SSdoc33 said:
if we dont make billy bob buy his own insurance, you are sure as sh$t going to pay when he gets lung cancer. somebody has to, and it might as be his medical insurance.
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No else actually "has" to....we could just make everyone handle their own business. If billy wants to roll the dice and not have insurance, that's on billy. If they choose wrong, the consequences are theirs.
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SSdoc33 said:
if we dont make billy bob buy his own insurance, you are sure as sh$t going to pay when he gets lung cancer. somebody has to, and it might as be his medical insurance.
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No we don't have to buy him anything. Your feelings assume we have to. Does not mean that is true.
 
sb247 said:
No else actually "has" to....we could just make everyone handle their own business. If billy wants to roll the dice and not have insurance, that's on billy. If they choose wrong, the consequences are theirs.
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The problem with this concept is that we as Americans are not so uncaring morally bankrupt so as to not provide some modicum of care to our fellow human beings who are suffering, if they make the "wrong" choices. "We" will end up paying for some of Billy's care, even if it is in the ER.

And yes, I have seen patients with no insurance who get all of their cancer and end of life care through the ER...




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Ducttape said:
The problem with this concept is that we as Americans are not so uncaring morally bankrupt so as to not provide some modicum of care to our fellow human beings who are suffering, if they make the "wrong" choices. "We" will end up paying for some of Billy's care, even if it is in the ER.

And yes, I have seen patients with no insurance who get all of their cancer and end of life care through the ER...




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It's not morally bankrupt to not buy something for someone.

Again, we don't actually have to do that
 
I'm for healthcare for all. I am not ok with subsidizing the cost. A national sales tax for healthcare is a good start. I have a lot of patients working under the table on Medicaid with $2 detuctibles. One just got back from vacation to Cuba. She's not Cuban.
 
Does one payor make docs employees of govt? I would think sovereign immunity could be argued for in this system. Then the ATLA would strongly lobby againt it.
 
sb247 said:
It's not morally bankrupt to not buy something for someone.

Again, we don't actually have to do that
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a minimalistic argument, but the fact of the matter is that we still pay, because these people will access expensive emergency and critical care departments.

(and personally, I feel it is morally bankrupt to deny treatment to prevent imminent death, if such treatment is readily available.)
 
Ducttape said:
a minimalistic argument, but the fact of the matter is that we still pay, because these people will access expensive emergency and critical care departments.

(and personally, I feel it is morally bankrupt to deny treatment to prevent imminent death, if such treatment is readily available.)
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I'm not saying anyone "has to" be denied. I'm saying that if a particular case shows up that you or I feel charitable about, we don't get to outsource our emotion with govt force. If a case walks into your clinic or ED and they can't pay, it's up to you and your office to decide if "free" to them makes sense. If you say yes, you eat it. I donate money all the time, I don't have a right to replace by stealing from my neighbors

There is no moral highground in donating services that you then pay for with theft.
 
sb247 said:
No else actually "has" to....we could just make everyone handle their own business. If billy wants to roll the dice and not have insurance, that's on billy. If they choose wrong, the consequences are theirs.
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ok.

you let me know how that goes for you when you dont pay your taxes.

fantasyland exists only in your mind, not in the real world.
 
SSdoc33 said:
ok.

you let me know how that goes for you when you dont pay your taxes.

fantasyland exists only in your mind, not in the real world.
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"Shutup unless you want to go to jail" is a poor argument
 
sb247 said:
"Shutup unless you want to go to jail" is a poor argument
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thats not my argument.

what i am saying is that it you may believe that an individual should be responsible for his own health care from a financial perspective. but, when that individual invariably gets cancer, or a heart attack, or crashes his motorcycle, both you and I are covering the 100K hospital bills. he cant pay. he may have made the decision to not buy insurance, but the hospital will recoup the debt by charging more, writing it off, lobbying for increased facility fees, etc. that trickles down to you and me.

if you accept that this scenario plays out (which it does all the time, btw), then you should also acknowledge that a better way to save money and improve care is to either "force" payment from him in one way or another, or provide universal basic care.

as much as the ayn rand disciples out there (hello, galt's gulch) would like us to live in a objectivist, libertarian utopia... that is not where we are today.
 
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SSdoc33 said:
thats not my argument.

what i am saying is that it you may believe that an individual should be responsible for his own health care from a financial perspective. but, when that individual invariably gets cancer, or a heart attack, or crashes his motorcycle, both you and I are covering the 100K hospital bills. he cant pay. he may have made the decision to not buy insurance, but the hospital will recoup the debt by charging more, writing it off, lobbying for increased facility fees, etc. that trickles down to you and me.

if you accept that this scenario plays out (which it does all the time, btw), then you should also acknowledge that a better way to save money and improve care is to either "force" payment from him in one way or another, or provide universal basic care.

as much as the ayn rand disciples out there (hello, galt's gulch) would like us to live in a objectivist, libertarian utopia... that is not where we are today.
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No.

You are saying the response to current reality is to force the person to buy insurance (which let's be honest here, what you are really saying, due to subsidies, is that you and I should buy them insurance).......I'm saying, don't make anyone provide those services in the first place unless they can get payment from the patient
 
drusso said:
What if Nelson Mandela had thought way? Only by continuous steady dialogue can we hope for an epiphany of reason to shoot insight into the brains of intellectual adversaries...
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Well ideally yes but, has anyone changed their mind on this forum the last 5 threads this topic has been brought up....same characters same beliefs.
 
Can we have a govt run safety net program with govt doctors that covers XYZ (minimalist care)? Sovereign immunity, no elective surgery, no brand name meds.
Covers mental health, nutrition counseling, emergency surgery. Formulary limited to maybe 100 drugs. Must be FP, IM, Psych. No routine care with specialists.
Meaning for us: No injections, no narcs, no BZD. No monthly visits. Just consult and go back to PCP.

Possible?
 
sb247 said:
No.

You are saying the response to current reality is to force the person to buy insurance (which let's be honest here, what you are really saying, due to subsidies, is that you and I should buy them insurance).......I'm saying, don't make anyone provide those services in the first place unless they can get payment from the patient
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"doctor, i am shooting blood out of an artery in my neck. if you dont stop it i will die in 1 minute"

"sorry, dude, you didnt buy insurance"
 
lobelsteve said:
Can we have a govt run safety net program with govt doctors that covers XYZ (minimalist care)? Sovereign immunity, no elective surgery, no brand name meds.
Covers mental health, nutrition counseling, emergency surgery. Formulary limited to maybe 100 drugs. Must be FP, IM, Psych. No routine care with specialists.
Meaning for us: No injections, no narcs, no BZD. No monthly visits. Just consult and go back to PCP.

Possible?
Click to expand...

i love it.

bare bones crappy universal care. we definitely could make that work

you want better care, you have to pay for it.
 
SSdoc33 said:
"doctor, i am shooting blood out of an artery in my neck. if you dont stop it i will die in 1 minute"

"sorry, dude, you didnt buy insurance"
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"hey man, you owe me $40,000. "

"why?"

"well, some other dude didn't buy insurance and I'm so nice that I'm going to make you pay for the treatment he got"

"but I don't know that guy, why do I have to...."

"shut up and give me the money or you go to jail"
 
SSdoc33 said:
i love it.

bare bones crappy universal care. we definitely could make that work

you want better care, you have to pay for it.
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The problem is we can't make that work. There's no way that you could get a crappy Universal Health Care coverage bill passed. You get every liberal congressperson saying things like "we should cover all maternity care including monthly ultrasounds because think of the children" or "we should cover every medication for asthma because it's not these people's fault that they have asthma, even though it's worse than usual because they smoke" and so on.

If I thought we could actually get a bare-bones plan like you just agreed to, even I could get behind that.
 
sb247 said:
I'm not saying anyone "has to" be denied. I'm saying that if a particular case shows up that you or I feel charitable about, we don't get to outsource our emotion with govt force. If a case walks into your clinic or ED and they can't pay, it's up to you and your office to decide if "free" to them makes sense. If you say yes, you eat it. I donate money all the time, I don't have a right to replace by stealing from my neighbors

There is no moral highground in donating services that you then pay for with theft.
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sb247 said:
"hey man, you owe me $40,000. "

"why?"

"well, some other dude didn't buy insurance and I'm so nice that I'm going to make you pay for the treatment he got"

"but I don't know that guy, why do I have to...."

"shut up and give me the money or you go to jail"
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1. actually, no.
ERs are not allow to refuse care.

2. your arguments again miss the point. we are paying for this care, but the more expensive version because these non-insured are going to ER or are just declaring medical bankruptcy.

3. lobelsteve's recommendation is exactly what I would prefer, but would add in base maternity coverage (prenatal care to prevent complications later, and midwifery deliveries) and covers simple primary care only. no specialist care.
 
Ducttape said:
1. actually, no.
ERs are not allow to refuse care.

2. your arguments again miss the point. we are paying for this care, but the more expensive version because these non-insured are going to ER or are just declaring medical bankruptcy.

3. lobelsteve's recommendation is exactly what I would prefer, but would add in base maternity coverage (prenatal care to prevent complications later, and midwifery deliveries) and covers simple primary care only. no specialist care.
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you aren't listening......EDs should be able to refuse care
 
VA Hopeful Dr said:
The problem is we can't make that work. There's no way that you could get a crappy Universal Health Care coverage bill passed. You get every liberal congressperson saying things like "we should cover all maternity care including monthly ultrasounds because think of the children" or "we should cover every medication for asthma because it's not these people's fault that they have asthma, even though it's worse than usual because they smoke" and so on.

If I thought we could actually get a bare-bones plan like you just agreed to, even I could get behind that.
Click to expand...

excellent points.

but something's got to give.

IMHO, first thing that should "give" is big pharma, device companies, and commercial insurances should take a hit. quality doesnt really decrease if these monsters get put in their place
 
no, EDs should not be able to refuse care.

just like police should not be able to refuse to maintain public order, fire departments should not be able to refuse to respond to a fire (of course, barring safety issues to personnel), 911 operators should not be able to refuse to answer emergency calls, etc.

that would be moral bankruptcy.

(I wonder what would have happened if the first responders of 9/11 had thought the same way...)
 
VA Hopeful Dr said:
The problem is we can't make that work. There's no way that you could get a crappy Universal Health Care coverage bill passed. You get every liberal congressperson saying things like "we should cover all maternity care including monthly ultrasounds because think of the children" or "we should cover every medication for asthma because it's not these people's fault that they have asthma, even though it's worse than usual because they smoke" and so on.

If I thought we could actually get a bare-bones plan like you just agreed to, even I could get behind that.
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Fine, The law will be written such that only MD/DO can decide what is covered, when it is covered. Govt employee docs are salaried and cannot profit from anything in the healthcare sector.
 
lobelsteve said:
Fine, The law will be written such that only MD/DO can decide what is covered, when it is covered. Govt employee docs are salaried and cannot profit from anything in the healthcare sector.
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I think you misunderstand. I absolutely love your idea. I think that is exactly what should happen. The problem is our current crop of politicians would never allow it to happen.
 
lobelsteve said:
Can we have a govt run safety net program with govt doctors that covers XYZ (minimalist care)? Sovereign immunity, no elective surgery, no brand name meds.
Covers mental health, nutrition counseling, emergency surgery. Formulary limited to maybe 100 drugs. Must be FP, IM, Psych. No routine care with specialists.
Meaning for us: No injections, no narcs, no BZD. No monthly visits. Just consult and go back to PCP.

Possible?
Click to expand...
I think it's the right idea. Much better than "single payer". Having employed docs, in house labs, etc at least encapsulates the program and you can predict and contain costs. It "quarantines" govt healthcare so the free market can thrive, unlike "single payer", which I think will strangle the free market like monopolies do. You could also get the govt out of its codependency with health insurance...

You will probably have to offer this IN ADDITION to Medicare otherwise you will be destroyed by AARP.
 
 
 
sb247 said:
you aren't listening......EDs should be able to refuse care
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You seem to be the most ruthless libertarian on SDN. PGG has nothing on you. Just kidding... he's at least 75% of the way there.

Where do you draw the line between services that should be paid for collectively and guaranteed to all, vs those that should be paid for individually?

I think the majority of us on this board believe that having a civil society requires certain basic services that are there for everyone, billionaires and bums. Having these services helps to ensure that society remains civil and secure- the foundation for a robust economy and worldwide influence. Examples would be national defense and law enforcement. Many of us would extend that to fire services, public works, roads/highways, public school, certain utilities etc. Some on this board extend that to emergency medical care, which you clearly disagree with. Do you disagree with this concept, and all of these examples? If so, how would you ensure society remains civil and secure? Please take into account that human nature guarantees that there will always be bad apples who don't think ahead, don't obey laws, are negligent, don't pull their weight, and who, in some fashion will always require the resources of others. Remember, even imprisoning people costs taxpayers money. Do you believe that if we enforce libertarian principles for a long enough period of time, there will be no more bad apples because we will have effectively taught them that being bad and not pulling your weight doesn't pay?
 
powermd said:
You seem to be the most ruthless libertarian on SDN. PGG has nothing on you. Just kidding... he's at least 75% of the way there.

Where do you draw the line between services that should be paid for collectively and guaranteed to all, vs those that should be paid for individually?

I think the majority of us on this board believe that having a civil society requires certain basic services that are there for everyone, billionaires and bums. Having these services helps to ensure that society remains civil and secure- the foundation for a robust economy and worldwide influence. Examples would be national defense and law enforcement. Many of us would extend that to fire services, public works, roads/highways, public school, certain utilities etc. Some on this board extend that to emergency medical care, which you clearly disagree with. Do you disagree with this concept, and all of these examples? If so, how would you ensure society remains civil and secure? Please take into account that human nature guarantees that there will always be bad apples who don't think ahead, don't obey laws, are negligent, don't pull their weight, and who, in some fashion will always require the resources of others. Remember, even imprisoning people costs taxpayers money. Do you believe that if we enforce libertarian principles for a long enough period of time, there will be no more bad apples because we will have effectively taught them that being bad and not pulling your weight doesn't pay?
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Not at all. Bad apples still happen. Particularly as we're talking about health, some folks will still smoke and never buy health insurance. I'm just saying that doesn't mean they get to demand home oxygen from their neighbors.

Police should be generally funded because implicit in the existence pf police is that I'm not allowed to around exacting my own justice if I'm wronged. If I don't get to go across town to take back my stolen property (with force if necessary) then the cops have to do it.

Fire should be user fee/insurance and not required by govt. if you own your property outright and want to risk it, that's on you. I can understand arguments for a liability if your house is within certain distance of neighboring property.
 
I would guess that the majority of your neighbors would view this very problematic, since if your property caught on fire and you did not have fire insurance, it would put their properties at high risk.

That's the problem for me with a strict libertarian viewpoint. Pretty much no one lives in a vacuum. Unless one is living off the grid in rural, say, Montana, what each person does invariably influences or affects someone else.


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The downside to a single payer system is that those electing to work to make a living are paying for those that elect to not work, and those who are industrious are penalized for their labors by escalation of health insurance cost. Our disability system in the US encourages feigned impairment even when none exists.
 
Ducttape said:
I would guess that the majority of your neighbors would view this very problematic, since if your property caught on fire and you did not have fire insurance, it would put their properties at high risk.

That's the problem for me with a strict libertarian viewpoint. Pretty much no one lives in a vacuum. Unless one is living off the grid in rural, say, Montana, what each person does invariably influences or affects someone else.


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which is why I addressed the notion of some liability required with certain proximities.....but I do know of a small town where the local tribe refuses to chip in for the american fire dept. They have a policy to roll up to fires in tribal owned property and douse down the surrounding american houses
 
Here is an area of common ground- I agree with you people should pay for the risks they take whenever possible. This helps prevent moral hazard.

One place where I run into difficulty is how we go about arbitrating these situations. Who decides who is worthy and unworthy, and do we want them to be biased by having skin ($$) in the game? There are going to be unintended consequences to deal with.

Not all people who smoke and use home oxygen are responsible for their oxygen need. What if there are other factors beyond their control? Who decides "we will pay for 50% of your home oxygen because you have alpha-1-antitrypsin deficiency, but you also smoked, so you're responsible for the other 50%. Oh, you can't afford that? I guess you're SOL. Let go of my pant leg. Bill.. taser please."

You are willing to stand up and defend the employed ED doc who looks over a dying patient, begging for help, and is willing to say to that person "no, I won't help you, you didn't buy insurance." Realistically, is that ever going to happen? Not if the doctor has a conscience. So one of the unintended consequences of putting ED docs in this situation is they need to agree to be personally liable for the expenses incurred should they decide to care for the uninsured. Do you think that might impact medical students choosing the field of emergency medicine? I know I would never choose to be put in that situation.

This is a pretty complicated discussion, so I'll try to keep the scope narrow for easy digestion.

sb247 said:
Not at all. Bad apples still happen. Particularly as we're talking about health, some folks will still smoke and never buy health insurance. I'm just saying that doesn't mean they get to demand home oxygen from their neighbors.

Police should be generally funded because implicit in the existence pf police is that I'm not allowed to around exacting my own justice if I'm wronged. If I don't get to go across town to take back my stolen property (with force if necessary) then the cops have to do it.

Fire should be user fee/insurance and not required by govt. if you own your property outright and want to risk it, that's on you. I can understand arguments for a liability if your house is within certain distance of neighboring property.
Click to expand...
 
powermd said:
Here is an area of common ground- I agree with you people should pay for the risks they take whenever possible. This helps prevent moral hazard.

One place where I run into difficulty is how we go about arbitrating these situations. Who decides who is worthy and unworthy, and do we want them to be biased by having skin ($$) in the game? There are going to be unintended consequences to deal with.

Not all people who smoke and use home oxygen are responsible for their oxygen need. What if there are other factors beyond their control? Who decides "we will pay for 50% of your home oxygen because you have alpha-1-antitrypsin deficiency, but you also smoked, so you're responsible for the other 50%. Oh, you can't afford that? I guess you're SOL. Let go of my pant leg. Bill.. taser please."

You are willing to stand up and defend the employed ED doc who looks over a dying patient, begging for help, and is willing to say to that person "no, I won't help you, you didn't buy insurance." Realistically, is that ever going to happen? Not if the doctor has a conscience. So one of the unintended consequences of putting ED docs in this situation is they need to agree to be personally liable for the expenses incurred should they decide to care for the uninsured. Do you think that might impact medical students choosing the field of emergency medicine? I know I would never choose to be put in that situation.

This is a pretty complicated discussion, so I'll try to keep the scope narrow for easy digestion.
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It's cool....it's nice to have a reasonable discussion. The premise of our individual needs not being paid for via taxes is that no one has to decide if we're "worthy" or not. It doesn't matter if I have a sad story or if I'm a jerk who actually caused my problems....I don't have a right to make anyone else pay for me. It solves that quandry of figuring out who is "worthy".

I also get the question about the ED doc making the decision about if someone gets a certain treatment they can't pay for.....but that already happens. docs already change meds to get them stuff they'll actually fill. docs already change plans based on what can be paid for....."sorry, your walking o2 sat was 90 so you don't get oxygen even though everyone pretty much agrees you need oxygen". And in "libertarian land" maybe it's the doc that decides some of those things and maybe it's hospital admin, likely a combination. But what isn't ok, is a doc/admin making a ton of decisions with the entire populations money for one patient. The decision should be between the doc/hospital/patient/insurance and only their pockets should be involved.
 
I think most libertarians are fine with community fire departments, just like they are fine with community health clinics. These are local, self-contained, budgeted priorities for each community. Where the community members actually take accountability for their services.

It's the reflex among liberals to "outsource" programs and their financial liabilities that galvanizes libertarians. If you want to join with your fellow community members to develop and maintain a solid fire department and community health clinics to take care of the poor, you're "heartless". But if you want to impose an proven-unsustainable, cost-prohibitive, quality-suspect program on the entire nation, managed in Washington DC, with nebulous budgetary constraints and minimal local accountability, you are a "progressive", selfless individual. Okaaaay... You guys only have the moral high ground in your own minds...
 
algosdoc said:
The downside to a single payer system is that those electing to work to make a living are paying for those that elect to not work, and those who are industrious are penalized for their labors by escalation of health insurance cost. Our disability system in the US encourages feigned impairment even when none exists.
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but we are already paying for the emergency care of those who refuse to pay already.


hyperalgesia said:
I think most libertarians are fine with community fire departments, just like they are fine with community health clinics. These are local, self-contained, budgeted priorities for each community. Where the community members actually take accountability for their services.

It's the reflex among liberals to "outsource" programs and their financial liabilities that galvanizes libertarians. If you want to join with your fellow community members to develop and maintain a solid fire department and community health clinics to take care of the poor, you're "heartless". But if you want to impose an proven-unsustainable, cost-prohibitive, quality-suspect program on the entire nation, managed in Washington DC, with nebulous budgetary constraints and minimal local accountability, you are a "progressive", selfless individual. Okaaaay... You guys only have the moral high ground in your own minds...
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it would be wonderful if local communities could determine and maintain cost containment. where i live had a very successful community based program that did quite well in health care cost containments... until various forces realized the amount of money they were leaving on the table. ( http://content.healthaffairs.org/content/12/1/58.full.pdf ) from personal experience, relying on local communities is not a realistic sustainable model


drusso said:
http://thefederalist.com/2017/09/15/health-care-expensive-dont-pay/#.WbyJhhL0pDw.twitter

No, the Rest of the World Doesn't Use "Single Payer" | Eli Lehrer
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it would be wonderful if we could get a system that got rid of 3rd party insurance, as they are a major part of the problem.

i just dont see it happening. i dont see BCBS/Aetna/Anthem/UHS/Wellcare/Tricare/Excellus etc. going quietly in to the night, not if they can afford to spend $40 million lobbying in 2017...

and i balk at the image of an ER secretary requesting a 20% downpayment prior to registering a patient for some life-threatening illness (MVA/accident/gunshot/MI/CVA etc.)
 
So much for "bare-bones crappy universal care".

Obamacare benefits (plus), except free for the beneficiary, and paid for by the middle-class and up.
 
Last edited:
algosdoc said:
The downside to a single payer system is that those electing to work to make a living are paying for those that elect to not work, and those who are industrious are penalized for their labors by escalation of health insurance cost.
Click to expand...

That's the crux of the political argument right there. Elect not to work vs. can't work.
 
VA Hopeful Dr said:
The problem is we can't make that work. There's no way that you could get a crappy Universal Health Care coverage bill passed. You get every liberal congressperson saying things like "we should cover all maternity care including monthly ultrasounds because think of the children" or "we should cover every medication for asthma because it's not these people's fault that they have asthma, even though it's worse than usual because they smoke" and so on.

If I thought we could actually get a bare-bones plan like you just agreed to, even I could get behind that.
Click to expand...


SSdoc33 said:
excellent points.

but something's got to give.

IMHO, first thing that should "give" is big pharma, device companies, and commercial insurances should take a hit. quality doesnt really decrease if these monsters get put in their place
Click to expand...


And since that's not going to happen either, let's not do the wrong thing and increase everybody's taxes by a ton.
 
SSdoc33 said:
excellent points.

but something's got to give.

IMHO, first thing that should "give" is big pharma, device companies, and commercial insurances should take a hit. quality doesnt really decrease if these monsters get put in their place
Click to expand...
Government forces are also monsters. They are the reason the stage is tilted in the first place.
 
hyperalgesia said:
Government forces are also monsters. They are the reason the stage is tilted in the first place.
Click to expand...

i dont trust big government. i dont trust the private sector.

that being said, i inherently "trust" the feds with my health more than the CEO of Aetna or Pfizer or Medtronic. there is a layer of insulation between a member of congress who doesnt DIRECTLY make money off of overcharging me for a pill or denying an epidural. congress doesnt exist SOLELY to make money off of my health, but the same cant be said for the other entities above
 
lonelobo said:
Do we have to rehash this tired argument, nobody is going to change their minds.

Some believe that the richest country in world can and morally should provide basic care for all citizens like many poorer and less developed countries around the world.
Click to expand...

The richest country in the world already spends the most on it's citizens. Perhaps, the answer is not spending MORE, but WISER.

750px-Health_care_cost_rise.svg.png
 
Ducttape said:
no, EDs should not be able to refuse care.

just like police should not be able to refuse to maintain public order, fire departments should not be able to refuse to respond to a fire (of course, barring safety issues to personnel), 911 operators should not be able to refuse to answer emergency calls, etc.

that would be moral bankruptcy.

(I wonder what would have happened if the first responders of 9/11 had thought the same way...)
Click to expand...


there are fire departments that will not answer calls if you do not pay your taxes. Do not remember details but read about it awhile back.

as an aside had another medicaid patient regaling me today with the details of vacation last month to turks and cacos.
 
NOS, that's because so much money in the US is being "granted" to admin, Big Pharma and non-clinicians.

second, if anyone hasn't been to Turks and Caicos, I strongly recommend it. it is only a couple hour flight direct from Miami, and very affordable - if you don't stay at the high end resorts. the flight itself is only about $250 round trip.

third: Fire department did not respond to deadly fire because FN 3 months behind on fire bill - APTN News

which prompted this: Children killed in fire prompts Loon Lake Fire Department to improve its operation - APTN News
 
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