[gwenith]

Originally Posted by ArwenEvenstar

I am NO expert on this issue. But I know that some Americans tend to think of socialized medicine as this practically perfect system. "Everyone gets free health care! We need that here!" But as mentioned in the above post from Australia, in socialized systems you can often have long waiting lists! And only those who can afford to pay privately or have a private health insurance policy can get immediate/prompt care. Does this seem fair? The wealthier get better care than the poor. Hey...this sounds similar to the complaints about our US system of private health care! See...there is no perfect system! Socialized medicine and privatized medicine both have problems.

I used to live near the Canadian border and we sometimes had Canadians come to our US hospitals to pay privately for care because they were on a several year long waiting list for the procedure in Canada.

And Americans seem to complain a lot about taxes... But do you know how high the tax rates are in these "cradle to grave" countries?? Most Americans would probably flip their lids. Socialized health care isn't free...they pay for it through high tax rates.

I personally prefer out US private system.

Anyhow...I better stop writing because this topic can easily head off into political issues....

Let me clarify - our waiting lists are for non-urgent and elective procedures - if you are in trouble you get seen right away. Even on elective procedures if the waiting list gets too long there is a public outcry and the politicians will address the issue (kicking a screaming but the will eventually address the issue if we twist thier arms hard enough)

As for paying for it through our taxes that is true but what people do not realise is that will we or nil we somehow we have to pay for health care. If it is not taxes then it is cost shifted to the private sector.

Our system has advantages too and one BIG one is that the drug companies do not like us. That is because of the PBS system which as a fixed list of public subsidised drugs. Which means that unless you get your drug on the PBS forget about marketing it here. Does that mean we do without? Hardly the PBS list is HUGE but it has only a handful of each group of drugs available i.e. there might be only 6 Beta Blockers out of a possible 12 on the market and 4 of those 6 are generic makes and therefor cheaper. It stops the price gouging little trick the drug companies have gotten into of bringing out a "new improved" version every couple of years that is not that new or that improved.

[gwenith]

Originally Posted by CHATSDALE

something i am curious about...we have an extensive charity system here...pay is when you factor in benefits are about on par with private pay hospitals...but i hear horror stories about staffing .. ratios being through the roof etc...one new graduate was put in charge of 3 proeclampic pts...in progress mi on the floor b/c there was no room on cardiac floor or icu.
i wonder if the countries with s med have these problems

Most hospitals here use a patient - nurse ratio system like Terndcare that works out the patient acuity for each patient and assigns the nursing workload so that you might have 7 med surg patients but they are all self -caring and about to be discharged. Or you might be allocated only 2 patients but both of those are high care requirements.

It is our observation that the PRIVATE hospitals have a worse nurse/patient ratio than the public hospitals. Most commonly throughout Australia we have a 1:1 nurse patient ratio in ICU (that is RN's only) for ventilated patients.

[Kyriaka]

[quote=gwenith]Let me clarify - our waiting lists are for non-urgent and elective procedures - if you are in trouble you get seen right away.
_______________
But you can have a gall bladder removal that is elective...that can turn easily non elective.

Does anyone know if in Canada you now have to bring your own pillow to the hospital? Something I heard in passing.

[Ross1]

We already have partial "nationalized healthcare" in the USA in the forms of Medicaid and Medicare. For folks in the USA that are so opposed to national health care......remember, your sweet old grandmother has it in the form of Medicare and possibly Medicaid too.

I'm not an economist but I do know one thing....one of the largest costs of doing business in the USA is health care. I wonder how our economy would be impacted if these costs were shifted away from employers and on to the federal gov't. Yes we would probably pay more in taxes, however, would we pay less for other things? How much would goods and services costs if employers didn't have to pay for health care coverage for its employees.......which is the fastest growing cost of doing business in the USA.

The answer to this question would be very interesting and I'm sure that there must be many studies on this subject.

[Angie O'Plasty, RN]

I'd be concerned about staffing levels. I don't think patient outcomes would improve without better staffing ratios, and I just haven't seen the government as our partner in that goal.

I'm also concerned about wages. We'd suddenly be employees of the government, would we not? From what I've heard of the VA hospital situation, I don't think I'd be very happy there, and that's only a limited example of "socialized medicine" for a specific group of individuals here in the US.

Would socialized medicine really help our patient population? I am beginning to think not.

[SmilingBluEyes]

I am not at all smart on the issue, I readily admit. I have nothing but questions myself:

Like IF we justify spending the bucks to build bigger, better weapons systems, enough to destroy the world- 2000 times over......

And IF we can spend big bucks on charity overseas, foreign worker recruitment, etc.....

And IF we can afford mass bail-outs of failing corporations in the form of "corporate welfare"........

IF we can continue to cover illegal and undocumented immigrant/indigent care......


IF we can spend millions to celebrate the inauguration of a President (not just Bush)......

then why can't we insure the WORKING POOR?????!!!!!!! You know, the poor average sucker who DOES hold a low-paying, unbenefitted job? The ones we are seeing increase in numbers EVERY year that passes as companies just cut these benefits out from under them?????? The one whose working backs on which building a great nation's progress rests????

Anyone????

As I said, I am not too damn smart after all. I just have that BURNING "why" question that I can't seem to get any answers to.

[Fiona59]

No, here in Canada we make our patients sleep on the floor, without blankets.... Don't know what you do in Alabama, have you ever seen a Canadian. We don't live in igloos, mounties dont wear red to work, and I've only ever dated one lumberjack....:hatparty:

Now lets get real. Every bed has a pillow on it before admission. Spares are kept on the linen cart/supply area. Yes there can be pillow shortages especially when certain patients want 5 or 6. Yes, some people bring their own pillow. I've seen them take their pillows on vacation too! Some people will bring in feather ones because they dont like the cleanable covers or whatever.

What else, oh, we supply sanitary pads in maternity and diapers for the babies...Heck, we even provide the drugs in the hospital without a bill at the end of the stay. We don't bill for dressing changes and we don't charge for kleenex....

[Dixielee]

"No, here in Canada we make our patients sleep on the floor, without blankets.... Don't know what you do in Alabama, have you ever seen a Canadian. We don't live in igloos, mounties dont wear red to work, and I've only ever dated one lumberjack"


I was just going to comment that you can tell which patients have been to our hosptal before because they come in with blankets, pillow and a book (for the wait!). We are always out of pillows in our ER. They are too uncomfortable to steal, I don't know where they go!

I do have a question about the 2 tier system though. Since we have EMTALA/COBRA here and have to see anyone who can drag themselves to the doors of the ER, how would that work in the duel system. Do people without ability to pay get stabalized and shipped to the public hospitals? Or do they stay where they started. I agree that the health care system as it is in this country is severely in need of an overhaul. I don't have the answers. My husband had emergency CABG last year and the bill was about $50,000 for an uneventful course and 4 days in the hospital. If we had not had insurance, we would be forever paying that back. We spend countless dollars every day in the ER doing CAT scans, MRI's, labs etc on every belly pain that comes in the door. If we don't do everything that is available and miss something, we are open to huge law suits. So we send someone home with a Rx for vicodin for a belly ache that turned out to be nothing, and a huge bill for someone to absorb.

Another problem is of course patient compliance. We have folks come to the triage window complaining of nausea and vomiting but they are eating a big box of fried rice (true!!). Last week I had a woman complaining of 10/10 abd pain, yet she consumed an entire fried chicken dinner between doses of oral contrast prior to CT. I give up!!!

I don't have answers, but I do know something has to give eventually.

[SMK1]

here is my admittedly uninformed opinion.

We do need a FORM of socialized medicine in the U.S. I don't think you will find a person in the U.S. who is uninsured who wouldn't mind a waiting list if it means they would get care. Seriously, waiting and being treated is better than waiting and not being treated at all. Having said that their should be the private pay option. If you have the resources to pay for "upgrades" shall we say, then I believe it is your right to do so. After all if you want and "upgraded" house you pay for it if you don't want the hassels of flying coach, you pay for first class, if you want the options in a BMW you pay for it etc... However i think that those with money SHOULD NOT be able to bump up spots on a waiting list for necessary procedures, operations, transplants, etc.. I feel they should be able to go to private hospitals much in the way many do now. If people have the option of going to a doctor for their cough or sore throat, i feel we won't see so many in the ER for these types of things either because they have a place to go to be treated. Again though i am talking about BASIC health care annual exams with the recommended tests (breast, pap etc..) urgent care, emergent care, immunizations. Anything above this (except maybe maternity, haven't thought enough about this one though...) can be on the private pay system.

[Lanceman]

I would never picture socialized medecine taking off in the US unless Democrats took control of about 99% of the government and then it would still be a tough passage because it is not a popular topic and even a lot of the Dems don't agree with it. Now some form of a national insurance program would probably have a better chance with the government just paying out money instead of actually employing doctors, nurses, etc and owning hospitals. Of course it could be a payroll deduction like SS or Medicare, but maybe optional if you didn't want to go private or through your employer. Of course you would still have to get it past the people who actually control healthcare in the US: Insurance companies, Pharmaceutical industry, Hospital corporations, AMA, etc. I can give a quick example of the unisured in America though:
My 55 yo uncle had a heart condition. No insurance at the time. Had to have surgery. Total bills = over $200,000. He declared banckruptcy. He now pays the hospital and doctors $5 a week, a piece, as per their settlement. Any medical care he needed until he was eligible for medicare, he just went to the ER.
When you think about it though, you are either going to pay more in insurance premiums, receive lower wages to compensate for higher employer costs, or pay higher taxes if healthcare was "socialized". Either way the costs of the system are absorbed by somebody somewhere, no way around that.