[BBFRN]

http://thomas.loc.gov/cgi-bin/query/z?c109:H.R.676:

Here is the the bill that lies before the Senate. It does address quality and methods of payment.

[Jolie]

Originally Posted by spacenurse

Should patients just be customers? Should they choose what care they want?
As a patient advocate I am concerned about this.

Patients already are customers with the right to refuse any intervention they don't want. Our current system allows that choice, and any future system should also. Regardless of the method of payment, no one has the right to force unwanted care on anyone.

I think the opposite is more of a problem in our current healthcare system: patients demanding care they don't need (largely because they are not directly responsible for payment.)

[Nurse4years]

The current 'health plans' are exactly as said: pre-paid health care. (Most people cannot afford actual health insurance.)
With these plans, non-emergent surgery requires thousands of dollars prior to the surgery. Doctor visits requires large co-pays, as does testing and medication. Requirements are very stringent, imposing additional monies by refusing payment when subscribers fall into loopholes. Many people do not buy these plans because they cannot afford it, and it is not worth the large percentage of their paycheck to pay for a healthcare plan that doesn't provide healthcare.
Millions upon millions of people buy these plans in good faith, only to find themselves using the same form of healthcare used by the uninsured: ER visits, putting off essential surgeries or procedures, doing without medications, and wondering why.
These are the 'responsible' people. But it isn't working.

Universal healthcare for all will someday be in the same pages of history as child labor laws, women's sufferage, free public education, civil rights, and many other societal issues. Change is inevitable, and it must change for the good of all.
20, 30, or 50 years from now we will be telling our grandchildren how tough times were when we couldn't go to a Doctor and (as my mother always said-) "we did without".
Nope, it is time to progress. It won't be easy, and it will take multiple lifetimes to work out the kinks, but it is time to start the process and continue the growth of this country.
IMHO
Mschrisco

[ZASHAGALKA]

Originally Posted by Mschrisco

Universal healthcare for all will someday be in the same pages of history as child labor laws, women's sufferage, free public education, civil rights, and many other societal issues.

I disagree.

To expect that you can expropriate from ME to give to somebody else, unearned, is a form of slavery. My earnings are the result of MY labor. However much you determine should belong to someone else, unearned and ungiven by me, as their 'right', THAT quotient is how much of a slave you believe that you can legally make me out to be. So, the goal becomes, not what is right, but rather, how much can you get away with before I rightly refuse and rebel at the concept being made a slave to a mob's rule and whims? The ash heap of history is filled with such failures and evils.

THAT is where stealing my production at the point of a gov't gun and giving it unearned as a 'right' to those that did not produce it - THAT is where such ideas will be associated, with like horrors, such as the tyranny and slavery that it is.

A social policy that embraces sloth as a human right and penalized production as a selfish creed is an unspeakable evil. A social policy that believes that it is the rightful role of gov't to determine how much production should be redistributed from the producers and given, unearned, to willful non-producers is nothing short of tyrannical.

To think that you will get the same amount of production from me and the rest of the producers, no matter how much you steal - that is simply wishful thinking. The world doesn't work that way. To think that you will reduce the number of the 'needy' by rewarding their self-induced need with the fulfillment of their every whim as a 'right' - that is simply wishful thinking. You will create legions of people that learn the lesson you wish to teach: that being productive is somehow morally questionable and being needy is morally superior.

It is not moral to grant, as a human right, sloth and inactivity. It is not moral to protect 'the people' from themselves and their need to work. It is not moral to steal in the name of 'the greater good'. The ends do NOT justify the means. Good doesn't work that way.

NOBODY is entitled to my earnings but me. NOBODY has a 'right' to my earnings but me. Not even if you vote it. Our Constitution absolutely FORBIDS such votes, if you care to read it. Why?

BECAUSE IT IS IMMORAL.

And, worse, uncompassionate, for everybody involved.

NOBODY has a 'right' that involves making unearned demands upon my labor and my life. Nobody. If this is such a great idea, then do it without my inclusion. IF my inclusion is required to make it so, then you are properly suggesting that I am to consider it nobility to be your slave to 'the greater good'. But, what if I do not find nobility in the role of the slave that you would vote for me? What IF - - - I - - - REFUSE?

What if I refuse? What would you do? What could you do? In THAT event, I could rightly assume the role YOU created as the noble needy. How could you deny me? You'd HAVE to help me, or you'd be dishonest to your own moral code: my need is paramount to the cause. It doesn't matter WHY I'm in need; just that I am. What happens when you so penalize production that ALL OF US choose to become needy and nobody produces? If it's a dirty crime to make money, then shouldn't we all stop trying? Shouldn't we ALL go on welfare? It's my right, isn't it?

Aren't I thusly entitled, by your own moral code?

"As a basic step of self-esteem, treat it as the mark of a cannibal any man's DEMAND for your help. To demand it is to claim that your life is HIS property." - Ayn Rand, "Atlas Shrugged" page 970.

~faith,
Timothy.

[Nurse4years]

We do all agree that something needs to be done, and soon. It will be an emotional journey toward that something, lots of ups and downs.

Mschrisco

"I am the wisest man alive, for I know one thing, and that is that I know nothing." Socrates

[ZASHAGALKA]

What if I refuse? Don't you think this happens, daily, in smaller ways?

Have you ever not worked overtime, because that extra shift would change your tax status and you'd end up paying more than it was worth to earn the production of your work?

Have you ever outright cheated on your taxes? No? Ever push the boundaries? A little?

Have you ever changed the way you do things: have babies, buy houses, sell items, because of the tax advantages or disadvantages to be had. For example, I have chastised my wife that we really, truly, didn't need the tax break of a child born this year; the baby could have waited, for tax purposes, until her due date next year. But that doesn't mean I won't claim the deduction and the credit to be had. Right?

Have you ever not changed jobs because of the implications of losing/changing your health insurance? Did you know that insurance is provided by your employers at the bribe of a gov't tax break?

Isn't your maximum production shaped and changed, everyday, by the pointed gun of the government? Don't you comply to those demands, effectively limiting your potential economic output?

Don't you, in a variety of ways, REFUSE to be the gov't stooge; it's slave. Don't you resist?

How much can the gov't get away with?

How much?

Or, to sum this up in an easily recognized axiom: you cannot tax yourself into prosperity.

Too bad, it sounds like so neat of an idea - everything, for nothing.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by Mschrisco

"I am the wisest man alive, for I know one thing, and that is that I know nothing." Socrates

"(The mystics) agreed that morality demands the surrender of your self-interest and of your mind, that the moral and the practical are opposites. . . (They) agreed that no rational morality is possible, that there is no right or wrong in reason - that in reason there's no reason to be moral. Whatever else they fought about, it was against man's mind that all your moralists have stood united." Ayn Rand, Atlas Shrugged., page 926

Your quote is exactly on point and frankly, I was shocked and surprised that you would use it. But, it makes so much sense. In order to get people to willfully neglect their own self-interest in favor of granting it unearned to the undeserved, you must first convince them that there is no use in using their brain. If you think about it, this view of morality is what makes no sense.

And so, the counter-argument is easy: Think!

I'm not trying to be rude or violate TOS. This, however, is a crucial premise to the concept that you don't own your own labor and that you should feel morally guilty about not wanting to be enslaved into the forced service of others. Such a concept depends on the premise of: Use your FEELINGS; not your MIND. Or, as ably put by our former President: "I feel your pain!" Don't think; act. That is a concept relevant to the discussion.

~faith,
Timothy.

[Nurse4years]

Perhaps this one:

"Be thankful we're not getting all the government we're paying for."
Will Rogers

(Gotta love Will Rogers)

Mschrisco

[pickledpepperRN]

Originally Posted by spacenurse
A man came to the ER after cleaning a garage with rat droppings. The next day he was diaphoretic and SOB. He wanted to be tested for the Hanta Virus.

He tried to refuse and EKG.
Loudly he said, "I did not come here for expensive tests. I am the customer. I will not pay for the EKG!"

He was in CHF with ST elevation.
He never believed the ER doc until his physician came and explained to him that he was having a heart attack.
Should patients just be customers? Should they choose what care they want?
As a patient advocate I am concerned about this

Originally Posted by ukstudent

Are you saying that under the system you advocate that patients would no longer have any choice in medical care. At the moment patients have the right to refuse any med or treatment. Would this be gone?

Of course not.

I think what the ER nurse did was correct. She persuaded the patient to allow her to attach a cardiac monitor. She persuaded the patients own doctor to come in to the ER. She spent the time to explain to the man that his symptoms seemed like they could be a cardiac problem.

She advocated for the life of that man by allowing him to make an INFORMED decision about his healthcare.

She didn't just say, "The customer is always right." and get the AMA paperwork.
That nurse probably saved his life.

[ukstudent]

Originally Posted by spacenurse

Of course not.

I think what the ER nurse did was correct. She persuaded the patient to allow her to attach a cardiac monitor. She persuaded the patients own doctor to come in to the ER. She spent the time to explain to the man that his symptoms seemed like they could be a cardiac problem.

She advocated for the life of that man by allowing him to make an INFORMED decision about his healthcare.

She didn't just say, "The customer is always right." and get the AMA paperwork.
That nurse probably saved his life.

Yes she advocated for the patient under the CURRENT system. Nurses are still nurses under the CURRENT system. Unless you think this would somehow change under your system I do not understand the point of your story. If Timothy's idea of health care started tomorrow would YOU stop being a patient advocate. Because I don't think you would any more than any other nurse here at allnurses.

If hospitals could actually bill for the cost of the treatment then I think they would try and push more tests, not less in order to make more money. However, if they can only receive what some government committee has decided to pay, possibly a lot less than actual cost, then they are more likely to not push those tests but to hide them.