Health Care: The Ticking Time Bomb

[Joe V]

Our health care system hurts everyone. Premiums are expensive and increasing every year. Doing nothing today will cost taxpayers 2-3 times more in the next few years.

Currently, the "public option" is the biggest obstacle when it comes to health care reform. Many believe that it will be the end of health care as we know it today - others think that it is long overdue.

Would you support a public health care option?

[live4today, RN]

I absolutely would support a public health care option. We should have always had one for those who could not afford healthcare. The working class have always had healthcare options/plans with their place of employment, so those who cannot afford healthcare in that manner should have the same options. Healthcare is a necessity for every human being. Depriving anyone of that care is just plain wrong.

[PostOpPrincess, BSN, RN]

I will support as long as I don't have to have it--or am forced to have it, that is. I want a choice and I'm not willing to be put on a "list" to for tests. No way.

My personal friends (docs of different specialties) say that they won't participate if it causes them problems. Some of them don't take medicare or medicaid now; and if my GP gets overwhelmed by it, well then I look for a GP who takes only private insurance.

I'm not willing to compromise my family nor me for the government's mandates.

[Bormio]

There is so much misinformation being disseminated regarding healthcare reform and a single payer solution. Over the last 30 years, various measures have been instituted to try and reduce healthcare costs, but these efforts have only served to further complicate the process of care and have provided incentives which produced the very opposite of their intended purpose. The result is a system buried in bureaucracy, with an uninformed consumer whose purchase of healthcare is controlled by a third party with a profit motive to limit access to services.

No system is perfect, however, the U.S. has a long way to go, being number 37 in morbidity and mortality among countries in the world, yet first in the amount of health care expense per capita and as a percent of GDP. Countries including France, Sweden, Australia, Brazil and Panama all have single payer health care systems which provide exceptional care at a reasonable cost and citizens are happy with both access and quality. It can be done!

I believe healthcare is a right - our government should provide for the health, safety and education of its citizenry. The ANA and other nursing lobbies should be actively and aggressively pushing for a single payer system, which will provide basic health care for all citizens, regardless of race, creed, gender or economic status.

It is impossible to expect a fair market system in healthcare to thrive, given that patients as consumers are unable to make informed choices, and a market system where "caveat emptor" prevails is immoral and unethical. In addition, the intervention of a third party, the insurance companies, with the goal of reducing access and services for pursuit of a profit is wholly unacceptable and will always be an obstacle to fair, accessible quality health care.

We as healthcare providers are responsible for being informed about this issue and influencing others to help further the goals of our profession and to advocate for those we serve.

[UM Review RN, ASN, RN]

I'm for it. The system is already in place to do this. What people do not realize is that without a system such as this, in which hospitals are guaranteed payment, hospitals will be forced to close and even private pay folks will lose options for care. Hospitals have always been left out of the money loop -- they have to treat, yet cannot be guaranteed payment.

We already have DRG's and criteria for determining the level of appropriate care, so asking how the system will work is really a moot point.

[TheCommuter, BSN, RN]

I'd certainly support a public healthcare option. The people who have excellent insurance through their places of employment should be allowed to keep their plans, but the rest of us who have substandard plans (or none at all) should have the option for publicly funded insurance.

Although I have been continuously insured, I have also incurred over $10,000 in medical bills over the past 4 years that I have been paying out of pocket because the insurance companies will not pay.

[cursedandblessed]

i agree there should be options for those who cannot pay and don't have coverage, but the keyword is options. people with diabetes and htn need to get regular treatment to prevent problems, like neuropathy and renal failure, there should be an availability of clinics and free medication for these conditions, just like there are family planning clinics at the health department. if the government provided care for these patients on an outpatient basis, many of the problems we see (i've had 10 different renal failure patients in 2 days of clinical; they all had a history of untreated hypertension. ) could possibly be avoided.

however, i don't want to be stuck under a system that does not allow me treatment when i need it, and by the doctor of my choice. i do not want employers thinking that just because there is a government option, they no longer need to cover their employees. that is my biggest fear in government healthcare. just because the government states that nothing will change, does not mean that the employer's won't see this as an opportunity to save money.

[Bormio]

I don't think anyone has "excellent" insurance any more. Employers providing primary insurance for their employees was initially meant as a means to spread risk across larger groups. It has evolved into something else entirely. From an economic standpoint, I don't see how employers bearing the burden for healthcare is sustainable. The government, as a primary insurer, can spread risk across the entire citizenry. In addition, the government can initiate a large scale wellness program either as a requirement for obtaining coverage or provide discounts on premiums to those who participate in wellness programs. There isn't any reason that under a single payer, citizens can not choose their physician or provider. Medicare is an extremely successful program providing coverage for all seniors, ensuring access to care and it allows those insured to choose any provider. The amount of money saved in eliminating the paperwork required for each separate insurance administrator alone should cut costs by at least 25%.

Why do people equate government sponsored insurance with limited access and choice? There isn't any evidence for this at all - it is a fear tactic being perpetuated by those who do not have all the facts. The government has shown that it can administrate a successful insurance program which provides for the needs of all. An expansion of the Medicare program is the logical means for extension of insurance to everyone. The structure is already there. Every other country in the civilized world provides health care for its citizens.

[PostOpPrincess, BSN, RN]

.

"Why do people equate government sponsored insurance with limited access and choice? There isn't any evidence for this at all - it is a fear tactic being perpetuated by those who do not have all the facts."

Wrong. Tell me which docs are willing to "jump" through government hoops (and I mean the ones that are seriously good and seriously busy practices--who TURN AWAY patients). I know those docs are already saying, "I don't have to participate, therefore I won't." THOSE are MY docs. I don't want someone who is going to see me as "#7370303000403020030403--you can go in now." I DON'T THINK SO.

I will not--and I mean WILL NOT--be on anyone's waiting list.

My fave ortho surgeon has his PICK of patients--he's that damn good and I know two IM docs who don't take ANY insurance. AT ALL.

They have minimal overhead and explain to their patients that they are responsible for paying out of pocket. These two docs make house calls too.

Yes, I admit I live in a region where this exists.

But I tell you again, I am NOT going to wait because I've never had to and I'm not starting now.

[anonymurse]

It's all smoke blown by administrators. The real fix is for the doctors and nurses to take back the system. I don't give a rat's how efficient administrators are--efficient at cutting nursing hours and instituting valet parking and quality awards--they plain don't "get" the patient-practitioner relationship. All they understand is the consumer-junkseller relationship. And that's all they'll ever grasp.

[elkpark]

however, i don't want to be stuck under a system that does not allow me treatment when i need it, and by the doctor of my choice. i do not want employers thinking that just because there is a government option, they no longer need to cover their employees. that is my biggest fear in government healthcare. just because the government states that nothing will change, does not mean that the employer's won't see this as an opportunity to save money.

in my experience, it's the private insurance companies who limit treatment and choice of physicians.

we are the only country that links insurance coverage to employment, and it makes no sense. i think one of the best things we could do (short of going to a true, universal, single-payer system) would be to break the tie between insurance and employment. a lot of people are unaware of the history -- employers first started offering health insurance to employees during ww ii, when wage freezes were in put in place by the government and employers were looking for other ways to attract good employees, other enticements they could offer besides more money. that made sense, i guess, at the time, but we've been stuck with this system ever since and it's a dumb system, imho. especially in this current economy -- when so many people are getting laid off from their jobs, not only do they suffer the economic blow of losing the income, but they also lose their health insurance at the same time!

plus, speaking of "choice" -- as it stands now, we're at the mercy of our employers and whether they choose to offer good insurance or sucky insurance. i currently work prn at an inpatient psych facility -- and, as a prn rn, i don't have benefits, so it doesn't affect me -- but a frequent topic of discussion at work is how ironic and frustrating it is that our big-healthcare-"system" employer apparently feels that mental health treatment is important and worthwhile enough to operate a "full service" inpatient/outpatient mental health program, and they sure want local people to come there for treatment -- but the health insurance our (cheap) employer provides offers no psychiatric coverage; if any of the facility's employees needed psychiatric treatment, that's just too darned bad.

[Bormio]

Well, Jopacurn, you are very special indeed and must have lots of resources to be able to afford the best doctors on a self-pay basis.

Docs that do not want to participate in a government insurance progam don't have to now, and won't have to under healthcare reform.

As a PACU nurse, you have limited exposure to patients and don't have an opportunity to listen to patient's stories about paying for their healthcare; insurance premiums, copays, co-insurance, denials, bankruptcies, etc.