[ingelein]

Originally Posted by Jolie

I don't believe anyone indicated that they were against basic safety regulation of healthcare.

The point I was trying to make is that it is preferable to have healthcare institutions be accountable to a number of entities, including the patient him/herself, rather than solely to the government from which 100% of the institutions' funding would come. That appears to create a conflict of interest. For example, would you want to complain about unsafe staffing, unsafe working conditions, unsanitary conditions, etc. (either as a nurse or patient) if you knew there was no where else you could go for employment or healthcare?

If UHC is run in the fashion of Medicare, the care is portable, one can go to whatever doctor they choose or work at whatever hospital they choose, the government does not own the hospitals or pay the nurses and doctors directly. They would still be employees of a private entity.

[pickledpepperRN]

How can we achieve a system that puts 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]

What kind of payment system does the US have now?
Multiple Providers
· Private and public, profit and non-profit hospitals
· Clinics
· nursing homes
· rehab facilities
· doctors
· pharmacies
· laboratories etc.

Multiple Payers
· Individuals (co-pays, premiums and out of pocket)
· Many insurance companies
· Many HMOs
· Medicare
· Medicaid
· SCHIP
· VA
· Military
· Local government (county)


What kind of a system would single-payer be?
Multiple Providers
· Private and public, profit and non-profit hospitals
· nursing homes
· rehab facilities
· clinics
· doctors
· pharmacies
· laboratories etc.
Single-Payer
· Government (National Fund)

[pickledpepperRN]

Two reasons to consider a single payer system:

• Common sense budgeting. The public system sets fair reimbursements applied equally
to all providers while assuring all comprehensive and appropriate health care is delivered,
and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.

• Public oversight. The public sets the policies and administers the system, not high priced
CEOs meeting in secret and making decisions based on what inflates their compensation
packages or stock wealth or company profits.

http://www.guaranteedhealthcare.org/...ayer_top10.pdf

Maybe it comes down to locus of control.
"Yes we can together" or "I can all by myself"

[pickledpepperRN]

Originally Posted by Jolie

I don't believe anyone indicated that they were against basic safety regulation of healthcare.

The point I was trying to make is that it is preferable to have healthcare institutions be accountable to a number of entities, including the patient him/herself, rather than solely to the government from which 100% of the institutions' funding would come. That appears to create a conflict of interest. For example, would you want to complain about unsafe staffing, unsafe working conditions, unsanitary conditions, etc. (either as a nurse or patient) if you knew there was no where else you could go for employment or healthcare?

Along with tens of thousands of others I worked for our comprehensive whistle blower law. The law applies to patients, families, and staff. There is a big fine for both the individual and the facility when retaliation occurs. And the presumption is that any discipline is retaliation. It is not up to the nurse to prove retaliation. They must prove otherwise.

As a patient advocate I must not just leave an unsafe situation without attempting to change conditions which are not in the best interest of patients.
WE can accomplish so much more when we work together than one person alone can hope to do.
WE need to work for a system in which ALL are provided high quality care when needed. At ALL facilities.
That is why I asked about being taken to the nearest facility.

Don't Medicare patients have the same right to choose their provider as you?
To report unsafe conditions?
The Federal government is the payor. The state or county may be the enforcer.
BUT when NURSES have the RIGHT as well as the responsibility to advocate solely in the best interest of the patient I do not believe even the President will get away with claiming so crazy reason the nurse should allow harm to a patient.

I know where I work WE THE NURSES will NOT allow it!
Remember when we followed Arnold until he was sneaking in the alley past the garbage cans?
Because thousands of nurses, teachers, and firefighters were carrying signs on the sidewalk?

[Jolie]

Spacenurse,

I am glad that you are optimistic about the future of healthcare in our country.

I don't share your trust of the government to "get it right".

[pickledpepperRN]

Unfortunately I don't think it will ever be perfect but we can do our best to make it better.
And then continue to improve.

[VivaLasViejas]

Health care is the one area where I don't trust 'the market' to do the right thing.

I would like nothing more than to see all the multimillionaire health-insurance company CEOs and their paper-pushers out of work. This 'system' we have right now is insane.........nobody can keep all the different companies with their difference policies and rules straight. It's a bureaucratic nightmare.

I will admit that my perspective is somewhat prejudiced because I deal with insurance companies all the time on behalf of the residents in my ALF, and it is MOST unpleasant. Not only do they usually deny my residents needed medical equipment and prescriptions, but the bureaucracy one has to go through in order to appeal the denial is too much sometimes for ME, let alone the average patient. And yes, I do believe the insurance industry does things that way on purpose so that people are too intimidated by the volume and the complexity of the paperwork to fight for their benefits.

The sooner we get the insurance industry out of health care, the simpler ALL our jobs will be.

[ingelein]

Originally Posted by Jolie

Spacenurse,

I am glad that you are optimistic about the future of healthcare in our country.

I don't share your trust of the government to "get it right".

If such a dismal and negative outlook was in place when the North decided to go to war to free the slaves, or when we were attacked by the Japanese at Pearl harbor, or when women wanted the vote, how could we have won the war, gave women to right to vote and freed the slaves? Cant do attitude never got any country anywhere except to be overrun by a CAN do country.

[VivaLasViejas]

Originally Posted by Jolie

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.

Neither am I.

That's why I advocate a system of universal coverage that provides a basic package of health services for every US citizen and is administered at the state level. I think the states are in a much better position to decide what their populations need. I also would have this system administered by a panel of experts in the health, financial, and legal fields rather than politicians. All of the monies that are currently paid to the insurance companies, Medicare, and Medicaid would instead go into a fund that would provide every citizen with preventive care and basic health services. Those who are wealthier can always buy more coverage if they want it, and nobody would be allowed to "opt out" (like with auto insurance) so the contributions would come from the entire population---not just those who are employed or who can afford insurance premiums.

I'm sure there are a gazillion things wrong with this idea, but almost nothing can be worse than 40+ million uninsured and underinsured Americans. We need universal health care, and we need it sooner rather than later!