[HM2Viking]

The case for a social Insurance model of Health Care finance:

Social insurance was a wise admission on the part of supporters of competitive economies that citizens would take the risks such economies require only if they are provided with a degree of security against old age, unemployment, the sudden death of a spouse and the vicissitudes of health. Social insurance arises from the understanding that competitive economies sometimes break down. Competition has benefits and costs, and both are shared unequally.… Risk is tolerable, even desirable, as long as every one of life’s risks is not an all-or-nothing game. That is especially true when one’s family is put at risk. Protecting citizens against risk is a fundamental role of government. As FDR noted after passage of the Social Security Act, the first Americans to seek government protections against risks beyond their own control were not the poor and the lowly but the rich and the strong. They sought protective laws to give security to property owners, industrialists, merchants and bankers. He did not blame the wealthy for seeking these protections. Instead, he saw these as models for comparable protections for workers and families.

http://www.sharedprosperity.org/bp208.html

[ZippyGBR]

Originally Posted by ZASHAGALKA

The gov't, BY DEFINTION, is amoral.

IT MAKES NO SENSE to say that, in order to avoid an amoral method of rationing, we must turn the whole process over to a purposely amoral gov't entity.

You can't have it both ways: 'Separation of Church and State' AND the gov't doing your 'moral' bidding.

With the free market, both parties have a choice. Morality is preserved by either party, at their discretion and only with the approval of the other party to the trade.

~faith,
Timothy.

says a man from a contury which despite being alledgedly disestablished puts 'in god we trust' on bank notes ....

the UK has the excuse of having an official statereligion withthe sovereign as head for putting 'dieu et mon droit' on some of the currency...

[Katie91]

I happened upon this thread with the desire to do more research on socialized medicine after watching Michal Moore's "Sicko" yesterday.

All I can say is WOW-WOW-WOW!!! I am honestly and *VERY* seriously contemplating moving overseas so that my family may reap the benefits of basic healthcare. My husband and I are un-insured (I work in a private practice environment and simply cannot afford the premiums) but we made sure that our daughter has insurance.

[Katie91]

Sorry for the double reply, but I just wanted share that I posted a new thread related to this topic.

Here's the link to it:
http://allnurses.com/forums/f8/has-a...rk-287357.html

Thank You!!

[ingelein]

Originally Posted by Katie91

I happened upon this thread with the desire to do more research on socialized medicine after watching Michal Moore's "Sicko" yesterday.

All I can say is WOW-WOW-WOW!!! I am honestly and *VERY* seriously contemplating moving overseas so that my family may reap the benefits of basic healthcare. My husband and I are un-insured (I work in a private practice environment and simply cannot afford the premiums) but we made sure that our daughter has insurance.

Why not wait, there WILL be an improvement in our own health care access here in our own country.

[BlueRidgeHomeRN]

Originally Posted by Jolie

You don't spend much time here, do you?

[Katie91]

Originally Posted by HM2Viking

...For that matter I wouldn't even oppose bonuses for meeting certain population health targets for members of the group. (Eg mean hgba1c at <7 for diabetics yields one bonus...decrease of mean group BMI over time yields another bonus.) The organizations need to be competing on the basis of giving results based quality care NOT denial of care.

Doc's and nurses should get the bonuses instead of insurance companies getting the bonuses, after all, it is we who are on the front lines. In working with high risk pts, teaching, treatments, etc. get the LDL, A1C's, BMI and the like WNL, this obviously benefits the pt and the ins cos saves on payouts of benefits. But this is not how it works, as you all know...

A few years ago, I went for my yearly PAP (preventative, non-diagnostic). When I got the EOB from CIGNA, I noticed that the claim was denied. I called and was told by the represtentative (no doubt, non-clinical) that preventative testing was not covered under my plan. I asked her if they would pay for the treatment of cervical CA, and she said, "yes ma'am, 100%".

[Jolie]

Originally Posted by Katie91

A few years ago, I went for my yearly PAP (preventative, non-diagnostic). When I got the EOB from CIGNA, I noticed that the claim was denied. I called and was told by the represtentative (no doubt, non-clinical) that preventative testing was not covered under my plan. I asked her if they would pay for the treatment of cervical CA, and she said, "yes ma'am, 100%".

Your post highlights a common problem: individuals who don't know the coverage and limitations of their plan(s).

I'm not trying to defend your insurer for failing to cover preventive care. I agree that it's usually more efficient, desirable and cost-effective to do so. But I don't understand employees who register for coverage without knowing what they are getting, especially when they have more than one plan from which to choose, and/or pay a portion of premiums out of pocket.

I have worked for 2 employers who changed insurance plans in response to staff members' requests. One added dental and vision. One offered a second option which provided more preventive care as opposed to the "traditional" insurance they had always provided which (like your plan) was focused on illness care, rather than wellness.

Changes can be made, but it won't happen if employees don't know what their coverage is, and how it can be improved.

[HM2Viking]

Originally Posted by Katie91

Doc's and nurses should get the bonuses instead of insurance companies getting the bonuses, after all, it is we who are on the front lines. In working with high risk pts, teaching, treatments, etc. get the LDL, A1C's, BMI and the like WNL, this obviously benefits the pt and the ins cos saves on payouts of benefits. But this is not how it works, as you all know...

A few years ago, I went for my yearly PAP (preventative, non-diagnostic). When I got the EOB from CIGNA, I noticed that the claim was denied. I called and was told by the represtentative (no doubt, non-clinical) that preventative testing was not covered under my plan. I asked her if they would pay for the treatment of cervical CA, and she said, "yes ma'am, 100%".

And this illustrates exactly how we reinforce insurance companies for denial of care rather than quality of care. It also illustrates how a uniformly consistent level of benefits and coverages for all patients can improve levels of care for all. Denial of coverage for a pap smear is the classic example of "Penny wise Pound foolish."

My point about health targets was made in the sense that to get reform through it may well need to include ways for the "efficient" private sector to earn more money since real reform will cut their administration/profits from the obscene 30% ratio to 5%. The contingencies need to be reordered to delivering high quality care instead of denial of care.

I agree that nurses and doctors deserve the credit for the success not the benefit denial specialists.

[ZASHAGALKA]

http://www.rockymountainnews.com/new...r-health-care/

"Those may be the points of emphasis, but McCain wants expanded access, too, while Barack Obama and Hillary Clinton claim they can rein in health-care costs. One thing we've learned from state-based experiments in universal coverage: It's not cheap. In Massachusetts, taxpayer subsidies for its two-year-old program of mandated coverage will rise from $158 million in 2007 to $600 million this year and $870 million in 2009. Lawmakers are now scrambling to impose new cost controls. On the menu: lower payments to doctors, hospitals and drug companies.

Meantime, a similar plan proposed in California died in January when the independent Legislative Analyst projected the program would cost at least $4 billion more in its first five years than proponents first suggested."

Very chilling. First, the program after 2 yrs, costs more than three times its original outlay moving towards four times original cost by year three of the program.

More chilling: the solution - cost controls (rationed care) to include lower payments to providers. THAT'S YOU.

Hillary's plan is very similar to Massachusetts plan: mandatory insurance.

~faith,
Timothy.