Can anyone explain why an uninsured medical services receiver is charged three (3) times what an insured medical service receiver is charged for the same service?

Within the last two years I underwent a major medical procedure. The bill was for nearly $30,000, which, if uninsured, I would have been responsible to pay in full. My medical insurance paid approximately $10,000 as the full costs of that medical procedure.

This gouging of non-insured medical services receivers is the major reason that a national medical insurance program is really needed in the USA.
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:-)

I suppose there is no evidence that the insurance companies target those who decline the "protection", all alleged 47M of them. You might compare to the legally sanctioned protection racket called "auto insurance", where you can run afoul of the law if you don't buy at least the minimum "protection" and then get pulled over while driving... if you want to discuss mob parallels.

his is just silly. I mean they've known this was coming... the could have started making changes but they never did or would.

I'd like to see good data on that, the distributions of fractions of premiums.

It's not different, except they operate under cover of the law from the outset. In most cases, they wrote the laws that are applicable to their industry.

Perhaps the health insurance industry would then have to go into the private military contracting business to pursue its agenda of raping the taxpayer.

Alain Enthoven arguing that several health providers, including the Mayo Clinics, have been able to organize in such a way as to provide superior health care at a cost below Medicare

You have an important point there wrong, it's not at a cost below Medicare, it's that the Medicare spending figures are comparatively low there. It's
detailed in
The New Yorker article that "beltwayskeptic" links to upthread, and which several of us recommended, I will quote a couple of the relevant parts of Dr. Atul Gawande's "The Cost Conundrum":

Rochester, Minnesota, where the Mayo Clinic dominates the scene, has fantastically high levels of technological capability and quality, but its Medicare spending is in the lowest fifteen per cent of the country—$6,688 per enrollee in 2006, which is eight thousand dollars less than the figure for McAllen. Two economists working at Dartmouth, Katherine Baicker and Amitabh Chandra, found that the more money Medicare spent per person in a given state the lower that state’s quality ranking tended to be. In fact, the four states with the highest levels of spending—Louisiana, Texas, California, and Florida—were near the bottom of the national rankings on the quality of patient care.

The Mayo Clinic is not an aberration. One of the lowest-cost markets in the country is Grand Junction, Colorado, a community of a hundred and twenty thousand that nonetheless has achieved some of Medicare’s highest quality-of-care scores. Michael Pramenko is a family physician and a local medical leader there. Unlike doctors at the Mayo Clinic, he told me, those in Grand Junction get piecework fees from insurers. But years ago the doctors agreed among themselves to a system that paid them a similar fee whether they saw Medicare, Medicaid, or private-insurance patients, so that there would be little incentive to cherry-pick patients. They also agreed, at the behest of the main health plan in town, an H.M.O., to meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up. Then, in 2004, the doctors’ group and the local H.M.O. jointly created a regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up. And costs ended up lower than just about anywhere else in the United States.

Grand Junction’s medical community was not following anyone else’s recipe. But, like Mayo, it created what Elliott Fisher, of Dartmouth, calls an accountable-care organization. The leading doctors and the hospital system adopted measures to blunt harmful financial incentives, and they took collective responsibility for improving the sum total of patient care.

This approach has been adopted in other places, too: the Geisinger Health System, in Danville, Pennsylvania; the Marshfield Clinic, in Marshfield, Wisconsin; Intermountain Healthcare, in Salt Lake City; Kaiser Permanente, in Northern California. All of them function on similar principles. All are not-for-profit institutions. And all have produced enviably higher quality and lower costs than the average American town enjoys.

In my opinion, it's crucial to get the facts in the studies referenced in that article across correctly. Really, it's a highly recommended read. They don't say that who is paying matters so much, it's more that that it's important for providers to be working as a team with the correct incentives, and for there to be a lot of time with the patient. If you read that article, you will see that the correct incentives are not built into the way most of our system is, and Medicare just like everyone else in the biz offers no incentives to change it, really, as it fee for service controlled by the patient. After reading it, I see where Obama's push for things like solving the problem of more primary care doctors and getting electronic records is coming from. He sees that skyrocketing costs and dissatisfaction with results are going to continue no matter who is paying until we change the bigger system. Basically, what's going to happen without such reforms happening, is many "customers" being unhappy as they always were, or worse, and many will blame whatever Congress does. Especially as the boomers age and access a lot more treatments.

Medicare by itself as it currently is is not the solution, it has a lot of problems, as it sets low pay reimbursement without anyone requiring reform of how care is delivered. The current setup guarantees failure, in a way--low pay scales are set and then providers figure out a way to make profit in other ways. It's a churning Ponzi scheme of treatments and time. If they can't, they drop out. It's already happening, see New York Times' Doctors Are Opting Out of Medicare of April 2 for one example.

Until we have a system where more doctors are on salary and work as teams, and more doctors are in primary care in order to provide sufficient time to follow patients, we will just be spinning wheels. This requires big reforms of medical education and probably funding of medical education so that so many don't go into it borrowing big and expecting a big payoff down the line for that somehow. Simply having a public payment plan doesn't solve this, you get the scenario of the public plan cutting payments to the bone and caregivers opting out and going for those who can pay. Then you have fewer caregivers in the public plan tending to more and more patients and they either have to cut time with patients and churn them, or figure out a different way to make more money at it, i.e., order more tests that the public plan does pay for and get a cut from it. The Mayo Clinic, the Marshfield Clinic, Kaiser Permanente, et. al., only can do what they can do because they have pretty total control of the whole distribution system. Allowing patients. or even worse, patients grouped into plans, to "shop" for what they want is not the answer, it is what introduces wierd profit incentives....

It's almost as if the baby steps of reform are intended to cause a lot of pain for people to get used to the massive reform that is really needed. I think Obama knows this, that is why he seems more concerned with other reforms rather than who is the payer in the current system.

Maybe nobody is listening to such sensible parody around here...

I read that a week ago. I still don't get it.