[ingelein]

[quote=KayMichelle;2662661]

Originally Posted by carolinapooh

I agree that there should be SOME things that are slowly added to a list of care that is basically socialized. There are some deeply divided issues that cannot be resolved, as I mentioned earlier, so we should just start with the primary care, preventative care things.

Our problems are nothing like the mess in some countries. Some type of tort reform/insurance reform would be a great idea too. That would ease the burden on the hospital staff. It would also help to make the industry more competitive financially as well, I think socialized medicine will wreak havoc on our paychecks, if it comes to pass!

When you become a nurse, you can actually put into practice all your strongly held beliefs. Just don't DEMAND the crack addict in the ER to get off of drugs, it might be safer to ask nicely. When do you graduate?

[KayMichelle]

Should the cost for the care for these things come out of the pockets of those who have no choice? Backed up by the power of the police state? Police State......

These issues are true conundrums. They need to be discussed without such emotionalism.I think I may have detected a bit of emotion in the police state comment.


-------------------------


Methinks you missed your government classes in college. In political theory, "police state" just means that you can get thrown in jail if you don't pay the taxes government sets up.

I think you are confusing it with conspiracy theories.

It is the concept of "The Social Contract" which is the basis of sociology.

The contract is that we give our freedom to a government in exchange for social order.

for instance:


"...in his essay No Treason, argues that a supposed social contract (of the Rousseauean sort) cannot be used to justify governmental actions such as taxation, because government will initiate force against anyone who does not wish to enter into such a contract..."

This is the essence of the questioning the fairness of socialism.

Can you force anyone to pay taxes for something they do not believe in?

Is that tyranny?

According to Aristotle, Rousseau, Locke, Hume, among others other, especially our founding fathers, absolutely yes.

[VivaLasViejas]

Originally Posted by KayMichelle

Zippy, in post #208 is who called these patients "victims".

My goodness! How we have become emotional over this issue! I thought this was an academic/intellectual debate about universal heathcare.

First of all, I didn't mean at all to point anything out to you personally. I didn't insult you at all. I'm sure you're a perfectly wonderful person. DMII is only one of many, many sticking points in the overall debate of universal heath care. It is simply one of those watershed items, which are many. Universal healthcare is usually rejected because of these issues.

Let's discuss another watershed issue.... how about AIDS? The drugs needed are very, very expensive cocktails taken by the patients. You know, many in Africa are very upset that the rest of the world won't pay for these hugely expensive drugs. I saw a movie in school not too long ago about AIDS, which showed how, in Africa, men think that if they have sex with a very young virgin, it will cure their affliction. Nothing the NGOs say will change their minds. They just keep spreading this horrible disease. Are we to avoid "judging" these men? Or are we to be true to our profession by promoting good health decisions? Do we enable this risky behavior? Or do we stand firm and persist in demanding that it stop? Back in the '80s, the healthcare professionals tried to shut down the bathhouses in L.A. They were called judgmental, bigoted. After many, many unnecessary deaths, they finallly closed. It was a good movie, it gave much to think about in our tolerant society.

Or how about another issue... drug addiction and costs to rehabilitate drug addicts. Or another... STDs... Gastric band surgery.... or another... abortions... or another, after effects of attempted suicide... or what about high risk athletics? steroid abuse therapy? reckless driving? lung cancer caused by smoking? What about illegal aliens that bring into this country hepatitis and TB?

Should the cost for the care for these things come out of the pockets of those who have no choice? Backed up by the power of the police state?

These issues are true conundrums. They need to be discussed without such emotionalism. By US, the healthcare professionals, in a mature way, without name calling, without calling someone's opinion "disturbing" and such. That is nonsense. If we cannot openly discuss healthcare issues, who can? When you descend to name calling, we will never have healthcare reform, or even a shadow of it.

Discussing thorny issues doesn't make someone a 'bad' nurse. No one is judging you personally. Forums are for discussing issues, not judging anything.

There are many syndromes that will be made worse by making healthcare "free". The state should not become an enabler. If someone is noncompliant in their therapy, how can you justify forcing another citizen to pay for it?

I think a monetary fine at least should be levied for noncompliance if we had universal healthcare. Other wise, it is like someone refusing to work, but still getting a paycheck.

It could be a true nightmare.

Sorry, I'm a little fuzzy sometimes, but I honestly can't recall having called anyone names here.

And FWIW, the post I was referring to IS disturbing, at least to me personally, because it reflects a general shift in societal attitudes that I find objectionable. America used to be about "we're all in this together"; now it's "every man for himself". I was raised by a generation that prided itself on sticking together and seeing things through; it bothers me greatly that so many seem so willing to simply cast their fellow human beings aside when they don't conform to some ideal of right behavior. I don't apologize for that.

I used myself as an example, not because I felt insulted, but because I wanted to put a human face on "lifestyle" diseases. It's much harder to be judgmental toward a group of people when one of 'them' is someone you know, somone who works with you or lives next door to you or goes to the same church with you. Being fairly well-known here at allnurses as a frequent poster and moderator, I thought that speaking of my own struggles might help others see that those of us who have self-induced conditions are not just a bunch of weak-willed losers, we are PEOPLE who deserve health care like everyone else.

As for the scolding on the purpose and function of discussion forums: I've been a member of allnurse for five and a half years, and a moderator for two and a half. I think I may have learned a couple of things in all that time, not the least of which is how to be patient with other posters.

Good-night.

[ingelein]

Never mind, lets rock and roll!

[KayMichelle]

[quote=ingelein;2662672]

Originally Posted by KayMichelle

When you become a nurse, you can actually put into practice all your strongly held beliefs. Just don't DEMAND the crack addict in the ER to get off of drugs, it might be safer to ask nicely. When do you graduate?

Goodness no, I thought we were talking about whether or not to promote universal health care!

As far as the "demand" goes, I was speaking in the context of the rape of virgins in Africa, and yes, I think NGOs surely should demand certain risky practices stop. I promise that if I go to Africa, I will!

In any case, a crack addict in the ER (like the sister I mentioned) isn't going to be concerned about how the healthcare is going to be paid, is he/she?

I would like to have an opinion on universal healthcare, I really don't, which is why I am discussing it here. We are kind of getting off on a tangent talking about noncompliant patients, aren't we?

I already graduated, but I'm older, I'm talking more as a taxpayer than anything else. Honestly, I can't think of anything a government does right so I hate to put our healthcare industry into their hands.

[KayMichelle]

Yes, this discussion is truly going no where.

There are two completely different issues getting confused here.

The topic is "universal health care" but people keep referring to 'denying care' The question is whether or not it should be publicly funded care.

It's not much of a valuable discussion.

[ZippyGBR]

tort reform is irreelvant

thebiggest problem US healthcare faces is the fee for service ethos which has led to a lack of clinicla objectivtiy over investigations - becasue there is no need to justify investigations on a price basis the 'standard of care' soon becomes irradiate everyone after taking an armful of bloods ... that might not actually tell you a great deal more than you'd find by good clinical examination ad the minimum amount if investigations to give a good diagnostic picture.

[VivaLasViejas]

The issues keep getting confused because they are inextricably linked. Start a discussion about universal health care, and within minutes someone will inevitably object to it because a) someone, somewhere, MIGHT receive a service they are not 100% entitled to, and b) people get sick because they have no self-control, and we shouldn't have to pay for their care.

FWIW, I don't want the feds running health care any more than you do. If universal health care ever happens, it needs to be at the state level and managed by medical and legal professionals, not politicians. But that's a thread for another day.

[ingelein]

Originally Posted by KayMichelle

There are two completely different issues getting confused here.

The topic is "universal health care" but people keep referring to 'denying care' The question is whether or not it should be publicly funded care.

post by KayMichelle

I would actually be for universal healthcare if it only provided those services that are the ones that are not self-induced, due to neglectful health personal choices.

post by Kay Michelle

The type of healthcare that should be "free" (or rather on the public dole) should be only those that are not precipiated by poor choices.

Wise Words, by jjoy

Like anything, there's quite a lot gray regarding the personal responsibility, circumstantial conditions, and human foibles that play a role in each of these hot button issues. We certainly don't want to encourage or enable poor choices and behavior, especially when it directly or indirectly affects others in society. But we also don't want go to the other extreme where any deviation from the ideal standards is severely shunned or punished. By defintion, it is impossible to truly achieve our ideals. No one is perfect, life has innumberable variables and we can't control everything nor see the future. Thus, some grace, generosity and humility is also necessary in society

[HM2Viking]

[quote=KayMichelle;2662661]

Originally Posted by carolinapooh

Our problems are nothing like the mess in some countries. Some type of tort reform/insurance reform would be a great idea too. That would ease the burden on the hospital staff. It would also help to make the industry more competitive financially as well, I think socialized medicine will wreak havoc on our paychecks, if it comes to pass!

47 million uninsured? That is a big problem.
Double digit health care inflation? That is a big problem.

If you are serious about fixing health care the first place to go is administrative costs and profits. I encourage you to read "Where is the Mango Princess." It has an excellent discussion about the difference in quality between the US and Canada.

Tort costs have an essentially negligible effect on the cost of health care. See the following from EPI.

No evidence of significant effects on health care costs
The cost of medical malpractice claims and litigation is so small a part of national health care expenditures as to be insignificant—even as calculated by Towers Perrin, which indicates its tort cost estimates (Chimerine and Eisenbrey 2005). According to Towers Perrin, medical malpractice tort costs, broadly defined to include the costs of insurance industry overhead (including profits) and claims handling, as well as all claims paid without litigation, totaled $28.7 billion in 2004, only 1.5% of the nation’s $1.9 trillion bill for health expenditures. The Congressional Budget Office (CBO) concludes that “even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 to 0.5 percent” (CBO 2004, 6). To put the insignificance of this into context, health care inflation in 2004 would have been 7.8% instead of 8.2%.

If, as Towers Perrin has claimed, damages awarded to plaintiffs are 46% of total tort costs (Tillinghast-Towers Perrin 2003, 17), and non-economic damages are about half of all damages awarded to plaintiffs, then fully eliminating noneconomic damages in medical malpractice (and the attorney fees associated with them) would have a negligible effect on U.S. health expenditures, reducing them by 0.5% or less.5 It follows logically that legislative changes like those recently debated in Congress that would cap such damages at $250,000 would have an even smaller effect.

http://www.epi.org/content.cfm/bp174