Healthcare's Crushing Costs

Esme12, ASN, BSN, RN · Jul 12, 2012

So who pays for it when the resource well dries up? It dosen't factor in for most of us because that is our culture and there are resources in this country for those who are not mega wealthy. I think almost everyone wouldn't care as long as there is someone to pay for it. What if we become a country of pay out of pocket or private insurance only? There are places in the world where that is the case. the rich get to try and purchase what they want, the poor don't. some times there are charity hospitals other times it is like other situations : can't afford it than too bad. I think these will become more common situations in years soon to come.

Those people who are in those other countries come here for their care.

Ruby Vee, BSN · Jul 12, 2012

those people who are in those other countries come here for their care.

and we pay for it.

Esme12, ASN, BSN, RN · Jul 12, 2012

and we pay for it.

amen sister!

Stcroix, ASN, PhD, RN · Jul 13, 2012

"

he put the patient's tab at more than $1.5 million. "if we are ever to control rising health costs, we will have to do a better job confronting the realities for patients like this man," he wrote."

all i can say is that at least we are having this conversation. a few years ago anyone who spoke a word about controlling runaway costs was stoned down. it is obvious we cannot continue down the road we are on. like it or not, somewhere in our future there will have to be a 'death panel' (not my term!) that will be called upon to review complex cases and draw the line. someone said "the cost doesn't matter as long as someone else is paying for it", but guys...we are all paying for it, and maybe our kids will be too!

Fiona59 · Jul 13, 2012

I work in a universal healthcare nation. We see it here, probably more than you do in the US. It's a case of we see families who research every last treatment on Dr. Google and then demand it for their family member and threaten to go to the media if the hospital doesn't jump.

One cultural group wants everything done for their family member, doesn't matter the cost, in order not to lose face in their cultural group. One nurse pointed out that the treatments would have stopped months ago "back home". He was the same ethnic group. The reply was we're not back home and the government pays for it so we're entitled to it.

Universal healthcare was set up in a far simpler time. It was to stop people from the losing the homestead when they needed an appi or if they came down with polio. It wasn't set up to provide IVF9not the actual treatments BUT the system bears the cost of the pre and post natal care and any complications that arise), gender reassignment, etc.

Now people feel it's their right to have whatever they feel necessary.

I'm a greater believer in just because we can fix it, doesn't mean we should. I've worked in LTC, where there have been full code, tube fed, comatose patients because the pension ends when the patient dies. So the family wants them to have everything done to keep the cheque coming in. They don't visit. I've cared for one First Nations patient who belongs to a band that gets huge royalty cheques every years from the oil on the reserve. Every adult over 18 is entitled to a cheque. The patient has been in care for over 15 years but the parents have guardianship and the cheque goes to them. Not even a birthday visit. Saddest patient history I've ever read. But hey, they don't do the care and they are entitled to full healthcare.

wooh, BSN, RN · Jul 13, 2012

But who decides that one is not worthy.

Death panels. Run by people who don't have an obligation to the families or the money.

We've already got them, they're called "insurance companies that deny preapproval." Instead of tying it to money, put together an ethics committee type group that can tell families, "No, we're not going to torture your loved one anymore."

Short of that, I'd like to see some physicans grow the testicles to say, "No." to the families.

DoGoodThenGo · Jul 13, 2012

Maybe in a few years it will be pretty much all self pay or charity cases as it is in other places. Who knows. Very interesting and relevent article.

Doesn't have to be that way.

By all accounts France has one of the best healthcare/payment systems in the Western world. It isn't perfect but has outcomes on par and in some areas better than the United States and spends vastly less to reach those goals.

Problems are many in the United States but one is that the system is profit driven. Starting with physicans, to drug companies on down. Healthcare in this country is about *doing* something which begs the question how much should be done and whom is going to pay.

Call it death panels, rationing of care or whatever you like but am willing to bet anywhere else in the world that poor man in the OP wouldn't have been put through all that maddness.

DoGoodThenGo · Jul 13, 2012

Death panels. Run by people who don't have an obligation to the families or the money.
We've already got them, they're called "insurance companies that deny preapproval." Instead of tying it to money, put together an ethics committee type group that can tell families, "No, we're not going to torture your loved one anymore."
Short of that, I'd like to see some physicans grow the testicles to say, "No." to the families.

Well Obamacare is supposed to crack down on those and other practices, it remains to be seen however how "best practices" will work out in situations such as the OP. Insurance companies and the federal government via Medicare & Medicaid will go bankrupt within a few years if that sort of care becomes the standard.

Am not saying they are always correct to deny preapproval, nor the ethics beind such actions but someone sometimes needs to sit down,objectively look at the case and based upon best practices and current science say "yes" or "no".