[RN4MERCY]

Originally Posted by ZASHAGALKA

And THAT was at the height of the progressive movement. How on earth do socialists, I mean, er, progressives intend to pass such a thing TODAY when even FDR knew it was doomed to fail?

First off, Medicare doesn't work. It will be out of money within a decade. 2nd, to the extent that it IS viable it is because it piggybacks off the private system to such an extent that the private system dictates or at least checks the abuses of Medicare. Even then, Medicare funding is a constant issue; when Medicare is ALL the funding a hospital can get, look out! If you were to universalize Medicare so that the gov't had a monopoly on dictating prices and/or services, the restrictions would be such that the AARP alone would engineer the defeat of every single Congressman.

Of course, they don't have to do that. All they need do is prove that they can.

Gov't restricted healthcare will never pass. It's the tragedy of the commons combined with the free rider problem of economics. A double economic disaster. Unlimited access must equal unlimited supply or - restricting said access. It's the law of supply and demand. That's unmutable by political desire.

Look at the problem with our ERs. EMTALA equals unlimited access. The results are as plain as day. Now, this is EXACTLY what gov't restricted healthcare will do to the entire system. Not just the ER. Not just the hospitals. Not just the nursing homes. Not just home health. Not just DME supplies. Not just medications. Not just doctor visits. The whole system. Until.

Until the gov't must, beyond choice, restrict access to the system. That means longer waits. That means elective procedures takes a far back seat to emergent ones. That means gov't restricted healthcare.

The public will never buy it.

Ask Harry and Louise. They'll tell you.

You want to help the less fortunate. The American People are a generous lot; I'm sure you could find a way to do so. You just will not be able to accomplish it by demanding that the average citizen must give up what they already have in order to do so. It will never sell. Being generous is one thing. Taking from me to give to another is something else. In fact, it's called theft.

Gov't restricted healthcare is a morally bankrupt idea that cannot sell in a basically moral nation.

http://en.wikipedia.org/wiki/Tragedy_of_the_commons
http://en.wikipedia.org/wiki/Free_rider_problem

~faith,
Timothy.

According to a poll by the New York Times/CBS News in February, 64% of Americans think that "the federal government should guarantee healthcare for all Americans," and 76% believe that universal access to healthcare is more important than recent tax cuts. The survey also found that 60% of those polled are "willing to pay higher taxes so that all Americans have health insurance they can't lose no matter what." Public support ("Harry and Louise") for comprehensive health reform is at it's highest level in over a decade!

Speaking of a restrictive and morally bankrupt bureaucracy, what about the insurer's and HMOs that profit by denying care and restricting access to care? (Now THAT'S what I call THEFT!) Think about this: Co-pays and deductibles, caps, gaps, pre-existing conditions, pre-authorizations, PPO/HMO in-network, out-of-network exclusions and denials are a form of RATIONING...to maximize profits for their shareholders! An insurance-based approach is discriminatory; the private insurance industry is rank with onerous multiple intrusive and restrictive regulations imposed on patients and providers. This despicable "system" punishes the sick, leaves millions vulnerable and violates our basic social principals of decency and fairness.

A single-payer, publicly financed and publicly administered program, like Medicare (efficient: YES!...3% administrative overhead, compared to over 30% waste of the private plans!), everyone in, no one out, is the only way to eliminate the enormous disparities and inequalities in our healthcare system. No exclusions based on ability to pay, health status, or prior conditions. If you move travel, or lose your job, your healthcare coverage always goes with you. We should remember that the government is elected by the public and we are responsible for it. The so-called conservative values and practices, ("every man for himself"), when they lead to people getting hurt and undermining our democracy, has to be confronted overtly. As nurses, the most trusted professionals in the country, we have empathy for others and we must act responsibly on that empathy, being both responsible for ourselves and socially responsible as well. We're all in this together.

Do you really believe that the wealthiest nation of all is not financially equipped to do what all the other progressive, industrialized nations have done? According to Marcia Angell, M.D. of Physicians for a National Healthplan, (former Editor-in-Chief, NEJM), "We live in a country that tolerates enormous disparities in income, material possessions, and social privilege. Those disparities should not extend to denying some of our citizens certain essential services because of their income or social status. One of those services is healthcare. Others are education, clean water and air, equal justice, and protection from crime and fire, all of which we already acknowledge are public responsibilities. We need to acknowledge the same thing for health care." At some point in our lives all of us, without exception have needed or will need some level of health care.

BY the way, yesterday, on June 12th in Sacramento, California, I was privileged to watch a special preview of Michael Moore's new documentary, "SiCKO", with over 1,000 other RNs from across the country, including several representatives of the Canadian Nurses Federation. I hope you'll make a commitment to watching it the first weekend it opens to the general public, on June 29. It was a sad and truthful documentary, that exposes the festering wounds of our broken health care system, the pain and suffering that cannot heal until we become the social advocates the public trusts us to be.

Some people believe that a single-payer system is politically unrealistic and it seems to me that you have inadvertently bought into that idea. Once the facts are known and the myths are dispelled many of us believe that the public will be even more enthusiastic about a single payer system! As Ralph Nader's father said to him after school, "Did they teach you to believe, or did they teach you to think?" With courageous ethical and principled political leadership, such as that provided by Rep. Conyers of Michigan, (HR 676), State Sen. Kuehl of California, (SB840), and the responsible moral professional advocacy of physicians and nurses, the evidence is pretty overwhelming that there is nothing unrealistic about a National Health Plan.

"Health Care Security = MediCare for All"
www.SinglePayer.com
Support Ca. SB 840 (Kuehl) - USA HR 676 (Conyers)

"...the call to the nurse is not only for the bedside care of the sick, but to help in seeking out the deep-lying basic causes of illness and misery, that in the future there may be less sickness to nurse and to cure."
Lillian Wald, Founder of Public Health Nursing

[ZASHAGALKA]

Originally Posted by RN4MERCY

According to a poll by the New York Times/CBS News in February, 64% of Americans thing that 'the federal government should guarantee healthcare for all Americans,' and 76% believe that universal access to healthcare is more important than recent tax cuts. The survey also found that 60% of those polled are 'willing to pay higher taxes so that all Americans have health insurance they can't lose no matter what.' Public support ("Harry and Louise") for comprehensive health reform is at it's highest level in over a decade!

Ask those same Americans if they want to restrict their own coverage in order to do all this, and your polling takes a serious tank.

Yes, I understand that pollyanna polls will always favor the concept of Americans being generous. Americans ARE generous. But, the 85% with good health coverage isn't going to tolerate month long waiting lists to see a doc or get a CT scan in order to accomodate the 15% that doesn't have coverage.

Higher taxes is one thing.

A fair share is a dismal healthcare system is another. Especially when combined with the unfair share of those higher taxes.

The insurers and HMOs might be morally bankrupt, but only because they are neo-mercantilists in bed with the gov't. So your solution with the gov't tainting the healthcare market is for the gov't to take it over? Your solution is more of the same. Much more. Whatever you choose to call it, it is not compassionate.

Gov't restricted healthcare cannot save costs. No amount of administration savings can account for a sudden increase in unlimited demand, because of course, it's free. Look at any Emergency Dept in this nation that must deal with the unlimited demand that is EMTALA. Now, expand that to every aspect of healthcare.

You want to defy economic laws: supply and demand, free rider problem, and tragedy of the commons. Of course, the laws of economics don't care a twit about your compassion. The result will be that the system you create will be incredibly uncompassionate as it meets the unmovable barrier of economic reality.

The result is rationed, limited, care. Gov't care. "Close enough for gov't work" should never have to apply to your health . . .

I haven't inadvertently been sold the idea that gov't restricted, socialist healthcare is unworkable. I'm an advocate of the idea that it is unworkable. It IS unworkable, in reality as well as concept. Socialism is a failure. It has always been a failure, everywhere it's been tried.

History is on my side.

Even the current nations with universal healthcare are either buckling under the strain, or moving to some level of privatization in order to deal with the strain.

~faith,
Timothy.

[ZASHAGALKA]

http://www.cbsnews.com/stories/2007/...n2528357.shtml

Let's look at the CBS poll, quoted above:

41% of Americans are very satisfied with their healthcare coverage.

The majority are at least generally satisfied.

Less than 1 in 3 Americans believe the gov't could do a better job than private insurance.

The above is a telling number of the level of support for when the debate moves beyond the gov't covering someone else and TO the gov't covering the average American, 2/3rd of which don't trust the gov't to do so.

Only 36% of Americans favor a complete overhaul of the system on the scale of socialist, gov't restricted healthcare.

~faith,
Timothy.

[DarrenWright]

Originally Posted by RN4MERCY

According to a poll by the New York Times/CBS News in February, 64% of Americans thing that 'the federal government should guarantee healthcare for all Americans,' and 76% believe that universal access to healthcare is more important than recent tax cuts. The survey also found that 60% of those polled are 'willing to pay higher taxes so that all Americans have health insurance they can't lose no matter what.' Public support ("Harry and Louise") for comprehensive health reform is at it's highest level in over a decade!

Speaking of a restrictive and morally bankrupt bureaucracy, what about the insurer's and HMOs that profit by denying care and restricting access to care? (Now THAT'S what I call THEFT!) Think about this: Co-pays and deductibles, caps, gaps, pre-existing conditions, pre-authorizations, PPO/HMO in-network, out-of-network exclusions and denials are a form of RATIONING...to maximize profits for their shareholders! An insurance-based approach is discriminatory; the private insurance industry is rank with onerous multiple intrusive and restrictive regulations imposed on patients and providers. This despicable "system" punishes the sick, leaves millions vulnerable and violates our basic social principals of decency and fairness.

A single-payer, publicly financed and publicly administered program, like Medicare (efficient: YES!...3% administrative overhead, compared to over 30% waste of the private plans!), everyone in, no one out, is the only way to eliminate the enormous disparities and inequalities in our healthcare system. No exclusions based on ability to pay, health status, or prior conditions. If you move travel, or lose your job, your healthcare coverage always goes with you. We should remember that the government is elected by the public and we are responsible for it. The so-called conservative values and practices, ("every man for himself"), when they lead to people getting hurt and undermining our democracy, has to be confronted overtly. As nurses, the most trusted professionals in the country, we have empathy for others and we must act responsibly on that empathy, being both responsible for ourselves and socially responsible as well. We're all in this together.

Do you really believe that the wealthiest nation of all is not financially equipped to do what all the other progressive, industrialized nations have done? According to Marcia Angell, M.D. of Physicians for a National Healthplan, (former Editor-in-Chief, NEJM), "We live in a country that tolerates enormous disparities in income, material possessions, and social privilege. Those disparities should not extend to denying some of our citizens certain essential services because of their income or social status. One of those services is healthcare. Others are education, clean water and air, equal justice, and protection from crime and fire, all of which we already acknowledge are public responsibilities. We need to acknowledge the same thing for health care." At some point in our lives all of us, without exception have needed or will need some level of health care.

BY the way, yesterday, on June 12th in Sacramento, California, I was privileged to watch a special preview of Michael Moore's new documentary, "SiCKO", with over 1,000 other RNs from across the country, including several representatives of the Canadian Nurses Federation. I hope you'll make a commitment to watching it the first weekend it opens to the general public, on June 29. It was a sad and truthful documentary, that exposes the festering wounds of our broken health care system, the pain and suffering that cannot heal until we become the social advocates the public trusts us to be.

Some people believe that a single-payer system is politically unrealistic and it seems to me that you have inadvertently bought into that idea. Once the facts are known and the myths are dispelled many of us believe that the public will be even more enthusiastic about a single payer system! As Ralph Nader's father said to him after school, "Did they teach you to believe, or did they teach you to think?" With courageous ethical and principled political leadership, such as that provided by Rep. Conyers of Michigan, (HR 676), State Sen. Kuehl of California, (SB840), and the responsible moral professional advocacy of physicians and nurses, the evidence is pretty overwhelming that there is nothing unrealistic about a National Health Plan.

"Health Care Security = MediCare for All"
www.SinglePayer.com
Support Ca. SB 840 (Kuehl) - USA HR 676 (Conyers)

Fortunately for us, access to universal healthcare is already guaranteed to all Americans. Noone is restricted by legislation from pursuing all approved available therapies. There may be financial restrictions, but these are not legislatively imposed, and socialist/single-payer systems do not somehow magically bypass the financial limitations of providing health care.

Having a single-payer system does not improve delivery, or improve access. It reduces the number of available providers, reduces the wages for nurses who already claim to be underpaid and look to unions for help, and creates circumstances where people will now be put on lists. One of our colleagues pointed out that Canada recognizes it's problem with wait times; they forgot to mention that one of the key resolutions has been loosening the restrictions on private insurance and private provision of health care.

And while private insurance was portrayed as a big bad meanie, is one to believe that a single-payer (gov't) program is going to function with unfettered altruism and a seamless lack of beaurocracy? Not in this lifetime! The gov't will operated with an even stronger lack of regard for the victimized patient because they will be harder to sue, and many providers will opt out (because private insurance will never go away). Few physicians will be willing to accept the substandard reimbursements that a single-payer will provide with the rampant John Edwardian multi-million dollar litigation that will go on with the approval of single-payer advocates; it doesn't function anywhere near like this in the comparative countries (Europeans think we are insanely sue-happy), so I'm not sure what poorly thought-through process led anyone to think a single-payer/litigatory combination will improve US health care delivery. And off-hand comparisons to other single-payer countries simply doesn't distract the 'thinker.' There are blistering problems with their systems, and people are not counting on the gov't to fix them; they are taking matters into their own hands and paying their own way.

Since I already know that M.Moore uses significant creative liberties in "exposing" issues, he has no credibility in this truthfulness that is so important in this discussion, this truthfulness you speak of that M. Moore is not inclined to respect.

There is nothing unrealistic about a national health plan; there is simply nothing realistic about the plans offered by Clinton, Kuehl, Kucinich, and others, and nothing realistic or truthful about a M. Moore documentary.

[ZASHAGALKA]

http://www.opinionjournal.com/editor...l?id=110010071
A recent effort, by a popular Gov, to bring universal healthcare to Ill.

The vote?

107-0, against the measure. THAT, btw, was a Democrat controlled house.

Why?

Because, this wasn't just some pollyanna idea absent cost. It actually was a design for a system, costs and all. After considering the true costs of such a system, even the Gov came out against his own plan.

From the article:

"Universal" government health care has once again returned as a political cause, with many Democrats believing it's the key to White House victory in 2008. They might want to study last week's news from Illinois, where Democratic Governor Rod Blagojevich's tax increase to finance health care became the political rout of the year.

The Democratic House in Springfield killed the proposal, 107-0, after Mr. Blagojevich came out against his own idea when it became clear he was going to be humiliated."

"One lesson here is that it is far easier to talk about "progressive" political causes than to pay for them without doing larger economic harm. In today's global economy, the margin for policy mistakes is smaller, even for individual states."

107-0. THAT is why I'm confident that gov't restricted healthcare cannot pass, even if some have inadvertently bought into the idea that it could pass.

~faith,
Timothy.

[pickledpepperRN]

Naomi Lakritz, Calgary Herald

It's been said that during the 12 or so years they spend in medical school, doctors learn to think of themselves as gods.

Well, the gods must be crazy. Or greedy. Or both. How else to explain the Canadian Medical Association's ridiculous support for physicians' right to work simultaneously in both a public and private system, including the introduction of private health insurance -- and the gall to label this as standing up for their patients?

It is patently obvious they are standing up for their bank accounts, not their patients.

That they are so eager to place patients at the mercy of insurance companies, whose subterfuges for skipping out on claims are well-documented in the U.S., shows their patients' best interests are the last priority….

… A recent New York Times article profiled Gordon Hendrickson, 66, of Albuquerque, whose best bet to beat pancreatic cancer was risky surgery performed by a Houston specialist. His insurance company refused to pay for the surgery. Hendrickson had it done anyway. Today, he is cured, but owes $80,000 in medical bills.

Is this what the CMA wants to inflict on Canadians?...

http://www.canada.com/calgaryherald/...e-ad46de9db0a3

From part 2:
… Economist Paul Krugman, also writing in the New York Times, shatters one of the cherished myths of Canada's proponents of private health, when he discusses hip replacements. This surgery is always seized upon by the private-health cheerleaders as something for which there is no waiting in the U.S. system:

"There's a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

"That's right: the hip-replacement gap is actually a comparison of two government health insurance systems….

http://www.canada.com/calgaryherald/...46de9db0a3&p=2

[pickledpepperRN]

Health minister rebuffs doctors' call for two-tier health care

Health Minister Tony Clement has rebuffed the Canadian Medical Association in its call for greater privatization of medicare.
Clement said the federal government will not allow so-called dual practice, which allows doctors to work in both the public and private health systems. In an interview, he referred to such an arrangement as a two-tier system….

… The minister was responding to a letter from the Registered Nurses Association of Ontario, which called on Prime Minister Stephen Harper to uphold the single-tier system.

http://www.cbc.ca/cp/health/070801/x080121A.html

[herring_RN]

Canada's Medicare System:
It's all about equality for Canadians with disabilities

The preservation and strengthening of Canada's Medicare system is very much an equality issue for people with disabilities.
One of the most important roles of the public sector is to promote equality. And there is no one-single public policy instrument in Canada that promotes equality more so than our public Medicare system.
Since the inception of Medicare, Canadian society has become much more inclusive of, accessible to and accepting of people with various types of disabilities….

http://www.trudeausociety.com/home/Health/2008/03/25/01121.html

[Onyx1]

but falls short with tertiary care. As an example, I just treated a Canadian citizen that came to the US for a Whipple procedure. It cost him about $110k but it was worth it for him. He said in Canada it would have been months before he was considered for treatment and even then his post treatment outcome would have been well below US standards of care.

Probably because they do the same crap the U.S. does. Why isn't there more doctors there? Is it because they can't afford equipment and there's not enough doctors? Graduate more and shave off useless government jobs. Why not consolidate middle/high school? Make the classes bigger (teachers unions keep them small to claim shortage) and require less subjects for graduation. You do the same old classes in college. There's some money that could be used for funding for more resources into the medical field. It's all about allocation of resources. You find that in any economics book. Some bad ones are school (as I've mentioned), government administrative bs, lawyering, and marketing (big waste)

[HM2Viking]

Small class sizes are positively correlated with increased student achievement. (See American Teacher May/June 2008 p. 7) It is not the only answer but it is a big piece of the puzzle.

Others include:

High quality curriculum (more than memorization of facts...)
Intensive assistance to high poverty schools
Focus on developing quality teachers
Emphasis on early reading instruction and intervention
safe/orderly schools

Decreased class sizes are a strategy that helps achieve these goals.