[Jolie]

Originally Posted by spacenurse

Now the insurance industry , big pharma, consultants, and others control the lack of a system.
With the government WE can have our say.
Both with our votes and with a local citizens committee (led by direct care nurses- I would lobby for that).
I am very glad for the government regulations that exist regarding health facilities and safety. They need to be improved.

I agree that we currently have a number of entities with competing interests that influence our system, including government (in terms of regulation and payment), insurance companies, manufacturers, etc. None of which have the patient's best interest at heart, including the government.

I fear a system where only the government exerts influence, because I believe that the oversight we currently have (flawed and inadequate as it may be) will be completely lost.

But I ask: what good are government regulations when the government will only be regulating itself? Is that not the fox guarding the henhouse?

Far better, IMO to put individuals in charge of their own healthcare by enabling them to purchase services for themselves and by making providers acountable to them, not the government or insurance company.

[pickledpepperRN]

The government regulates law enforcement.
From murder to jaywalking.

I am so very glad our government is charged with water safety and the other public protection laws.

If not government who should make the laws?
Who should make the arrests? Or enforce the laws?
Who should run the courts.
I sure don't trust a for profit corporation to do that.

[mrsportsmedicine]

Originally Posted by Jolie

I agree that we currently have a number of entities with competing interests that influence our system, including government (in terms of regulation and payment), insurance companies, manufacturers, etc. None of which have the patient's best interest at heart, including the government.

I fear a system where only the government exerts influence, because I believe that the oversight we currently have (flawed and inadequate as it may be) will be completely lost.

But I ask: what good are government regulations when the government will only be regulating itself? Is that not the fox guarding the henhouse?

Far better, IMO to put individuals in charge of their own healthcare by enabling them to purchase services for themselves and by making providers acountable to them, not the government or insurance company.

I SECOND THAT ...
Well said.

[pickledpepperRN]

I fail to understand how an individual who is taken by ambulance to the nearest hospital can make that facility accountable to them.

I am for regulations regarding the physical facility, required equipment and staff, sanitary requirements, isolation, pharmacy regulations, and such.
I can't believe anyong is against this. So what am I missing?

[mrsportsmedicine]

Originally Posted by spacenurse

I fail to understand how an individual who is taken by ambulance to the nearest hospital can make that facility accountable to them.

I am for regulations regarding the physical facility, required equipment and staff, sanitary requirements, isolation, pharmacy regulations, and such.
I can't believe anyong is against this. So what am I missing?

Now is this the same standards of care that the government is enforcing in our Veteran Hospitals? How we are treating our veterans?

[HM2Viking]

Single payer is not socialized medicine. Clinics and hospitals are still independent. They compete for patients not insurance contracts. Furthermore the best single payer plans will bring transparncy to the reimbursement process through:

<H3>Who will run the health care system?

There is a myth that, with national health insurance, the government will be making the medical decisions. But in a publicly-financed, universal health care system medical decisions are left to the patient and doctor, as they should be. This is true even in the countries like the UK and Spain that have socialized medicine.
In a public system the public has a say in how it’s run. Cost containment measures are publicly managed at the state level by an elected and appointed body that represents the people of that state. This body decides on the benefit package, negotiates doctor fees and hospital budgets. It also is responsible for health planning and the distribution of expensive technology.
The benefit package people will receive will not be decided upon by the legislature, but by the appointed body that represents all state residents in consultation with medical experts in all fields of medicine.

http://www.pnhp.org/facts/singlepaye...lthcare_system

Instead of:

</H3>

[pickledpepperRN]

There are minimal federal standards, standards for Medicare that include abiding by state and local regulations, and then the actual state and local regulations.
Like our safe staffing regulations in California. - http://www.dhs.ca.gov/lnc/pubnotice/...ation_Text.pdf

When I attend CE programs and seminars the nurses from local VA hospitals say their hospitals are following the ratios. Maybe because otherwise they couldn't recruit nurses.
I've also heard that the VA doesn't have to follow state regulations. Does anyone know?

[HM2Viking]

Originally Posted by mrsportsmedicine

Now is this the same standards of care that the government is enforcing in our Veteran Hospitals? How we are treating our veterans?

The VA is an excellent system.

See:

[The] VHA's complete adoption of electronic health records and performance measures have resulted in high-quality, low-cost health care with high patient satisfaction. A recent RAND study found that VHA outperforms all other sectors of American health care across the spectrum of 294 measures of quality in disease prevention and treatment. For six straight years, VHA has led private-sector health care in the independent American Customer Satisfaction Index.

Indeed, the VHA's lead in care quality isn't disputed. A New England Journal of Medicine study from 2003 compared the VHA with fee-for-service Medicare on 11 measures of quality. The VHA came out "significantly better" on every single one. The Annals of Internal Medicine pitted the VHA against an array of managed-care systems to see which offered the best treatment for diabetics. The VHA triumphed in all seven of the tested metrics. The National Committee for Quality Assurance, meanwhile, ranks health plans on 17 different care metrics, from hypertension treatment to adherence to evidence-based treatments. As Phillip Longman, the author of Best Care Anywhere, a book chronicling the VHA's remarkable transformation, explains: "Winning NCQA's seal of approval is the gold standard in the health-care industry. And who do you suppose is the highest ranking health care system? Johns Hopkins? Mayo Clinic? Massachusetts General? Nope. In every single category, the veterans health care system outperforms the highest-rated non-VHA hospitals."

http://prospect.org/cs/articles?arti...lth_of_nations

VA patients are older and sicker on average. Yet they receive better care at lower cost.

We can certainly do better at cost containment.

[pickledpepperRN]

Originally Posted by mrsportsmedicine

Now is this the same standards of care that the government is enforcing in our Veteran Hospitals? How we are treating our veterans?

I'm afraid we need to elect more competent and honest people to our high offices.
Probably a new admistration will do better than the current one.

That said most VA hospitals provide a high level of care. The problem is access for all veterans.
It seems to vary by location and individual situation.

[Jolie]

Originally Posted by spacenurse

I'm afraid we need to elect more competent and honest people to our high offices.
Probably a new admistration will do better than the current one.

Why place your healthcare in the hands of politicians, many of whom you don't trust?

If you believe the current administration is unfit to manage healthcare, what makes you think the next (and/or Congress) will be any better? Regardless of your political persuasion, it is reasonable to estimate that approximately 1/2 of the time, you will not approve of those who sit in the White House and on Capital Hill. Why would you hand your healthcare over to them? That's a crapshoot I'm not willing to make.