How Will Universal Health Care Change Nursing? - page 10

How will universal health care change the Nursing profession? Will we finally get ratios? Will our pay go up, or down? What about benefits? Will the quality of care improve, slide, or stay the... Read More

  1. by   dotherightthing
    Quote from ljeffe
    just trying to add to the discussion in a postive way:
    for all who are spouting statistics, one thing i learned in completing my phd (stats can show you anything you want them to show you, so i rather put my stock in people and not statistics).
    i agree with many that our current healthcare system is not working. for those who can afford to pay and want your own insurance i say, yes do it (i do not want your choice taken away), but for those who cannot there must be an option that does not bankrupt the individual/family or the country.
    let's be a bit realistic at this time, what is your personal experience in healthcare and has it worked for you?
    the answer for me is no, a couple of years ago i had a lump removed (benign thankfully) from my breast and my out of pocket expenses were over $5000 (with health insurance). i did pay that fee but for many who have basic expenses with families (which is only me) that would be unaffordable. my personal experience is that insurance is the biggest racket on earth but we all need it (i personally have health insurance, disability insurance (long/short), long term care insurance, and three life insurance policies, not to mention auto and home, but how many times have i accessed them and when i do, do i really need a hassel to get money i have put in the system for this very event?).
    the bigggest areas of need are:
    1. prescription drugs (cost are way too high)
    2. hospitalization costs (again way too high, look at an itemized bill, everything is charged but nursing services, why are we not worth anything?)
    3. need to change the belief that illness is a good thing (insurance companies, drug companies) because wellness is much better and focus on that (and stop building nursing curriculas on the medical model- which is illness focused)
    as far as how it will affect nursing, most nurses i know are not in it for the money they are in it for the experience of helping others (including myself) so it can affect us in a positive way if we take ownership of this issue as our policy piece that we want to work on.
    my final thoughts:
    1. we do need an affordable healthcare system (change is needed).
    2. we need to be realistic about what kind of change we can afford and who will be responsible.
    3. nursing has an opportunity to take charge of this issue (not the drug companies, not the doctors, not the insurance companies) because all of these entities have gotten us in this mess right now!
    4. but where is the nursing leadership on this, we need to stop fighting among each other, bsn vs adn vs lpn vs cna vs (whoever) and refocus on helping patients.
    5. because i have four degrees i am not better than you, it just means i have spent more time in school, we all can contribute in a positive manner so let's respect each other and get the job done (we have 15 minutes left in our shift and there is much work to be done)!
    i've commented about health insurance. so, i'll respond to your comment about nurses working together. nurses, all combined, make one of the largest worker populations in the us. there are more nurses than all medical areas of practice. fact of the matter, we work in all areas of practice. i think there are more nurses than lawyers (we are lawyers, too) and many other professions. if we were together, we could contol the healthcare arena, based on sheer numbers alone. we wouldn't do that, just for control's sake but if we stuck together and quit the in-fighting, we could be a major participant in determining standards of care. sure, we participate but somehow though we know the numbers that are good for the patient, his care and safety, we don't seem to control that.

    we, like physicians, work in every area of healthcare, not just on the hospital floors but in radiology, research, pharmacology...all of the name it...even the insurance companies...except there are more of us. our numbers should control healthcare, we should be hospital administrators, along side the physicians. we should write policy along with the physcian. we should be up there with the docs, drug sellers, researchers and insurance companies, we're there to some degree, but we should be equals. healthcare would not the wreck that it is now if that were so. i may sound like an ego maniac but we're the ones who touch the patients with our hands and our hearts...
  2. by   leshi
    Quote from maritesa
    this might work in other states ( but you are talking about specifics of a system -universal or socialized,) that is not in place yet, but will be because our current health system is not working....a change is a must !! These are things to hurdle as we go thru the new health changes, and just like everything else , it is not going to be perfect , but definitely not disabled as the current health system. As for the State being in charge----this is not going to work for California! We are so broke (God knows where that money went? ) , and the governor is trying to get some money from the bottom of the pot , such as the family and childrens health insurance. Don't you think this is worth trying something new from the current system? With the way the rate is going now, everybody will be broke !!!! Please let us try to look at the bigger picture not be afraid to try something different, specially when the current health system is so cancerous !!!! Let us change the system now , and a lot of other changes will follow as we go through the process. Unless you are one of those rich ones who have a lot of money to spend for your health care.
    We need a solution that will give the poor the access to healthcare they need but at the same time not screw rich people just for being rich. That kind of society limits incentive because it's like if you exceed a certain income bracket, the government automatically starts taking a third of your income.

    It's really tempting to say "They have more money than anyone even NEEDS so it doesn't matter how much they're taxed!" and try to play Robin Hood, but while the government may have a social obligation to help people to a minimum quality of life, drawing a line to set a maximum quality of life isn't ethical. We can say that nobody really needs a 24 room mansion, but a lot of middle class families can technically GET BY with just one car instead of three.

    The government (even state) needs to clean up its act and reevaluate its priorities so that we can give people healthcare coverage without raising the tax rate. Corporate welfare is a giant waste of money. It's ridiculous for companies to buy jets and fill their offices with designer furniture and then go to the government wanting money. Bailouts are in the tune of BILLIONS of dollars. I say let corporations live and die with the market - it may create a less stable economy, but will save money.

    I stand by the fact that state-based socialist healthcare is best because it has a good chance of eliminating problems with queuing and bottleneck effect.
  3. by   darrell
    Ask me where I rate my health compared to highway development, education, crime prevention, air traffic control.

    I'm not working right now. My wife has RA and a compromised immune system. Yesterday she began coughing, c/o lethargy, sore throat. No coverage because it went with the job. We are poised to visit the doctor out of pocket if it gets worse. We are in our 50's - it is a scary thought that we may face this again in our 70's!

    I don't care where the coverage comes from, but it's pretty darn stupid that healthcare is a personal responsibility and not a social one, while my taxes are used to monitor TV bandwidth and develop new ways to kill people.

    Is there something more basic to human life and happiness than individual health? In absolutely no world I can conceive up should nourishment, shelter and other basics not include both preventative and acute healthcare.

  4. by   Fiona59
    Quote from Sade

    This is a normal government funded hospital in Recife, Brazil. UHC... Thinking out of the box... Please... Private pay hospitals in Brazil are very good and in many ways comparable to American hospitals. Take care.

    I work in what Americans would call "an inner city" hospital. Even on our worst nights, we've never had scenes like that. My first though was natural disaster or huge MVA?
  5. by   Sade
    Why is it inconceivable for a average salary earning individual to pay for their own medical expenses? I hear a lot of people talking about solutions to our current healthcare mess. But I rarely hear people talking specifics on how the healthcare mess started in the first place. Does anyone have expertise on how and when this mess first started?

    IMO - HMO's and managed care systems are the culprits of the escalating costs of medical care. Both these systems take the responsibility of paying out of the hands of the person receiving the care. This is very important to understand because it removes the market incentive and results in incremental and artificial rises in healthcare costs. I think there is an obvious correlation between the government and corporations paying for medical bills and the rise we've seen in medical costs.

    IMO - The current proposals to remedy our healthcare mess are not much different than the remedies that caused the mess in the first place. The only difference is that the current proposed rememdies are on steroids and are gift wrapped in beautiful colors.

    I was curious what folks thought of the idea of changing our tax codes to allow individuals to deduct ALL healthcare costs from their taxes, just as employers can? Take care.
  6. by   kinesjl
    Quote from ghillbert
    Your "these terrible things will happen" theories are just that, theories - not based on fact. You do not show any basis for your theories.

    Perhaps under this plan, something like an MRI won't be able to charged at several thousand dollars, when it costs nothing like that to provide. The amounts charged and reimbursed are ridiculously inflated - who's getting all the bonus?

    My home country has both UHC and private insurance. Why would anyone take private insurance? Because you get to skip lines, and choose your surgeon, and go to fancier facilities. Why else? Because you get a tax break - you pay a lower medicare levy. Plus, tax rates are NOwhere like 54%.

    I think it's interesting that the people who are most against UHC are the people with no actual experience of it.
    On the contrary, the state models, such as Massachusetts, which are often cited as a blueprint for health care reform, provide ample evidence of the pitfalls of governement health care.

    Although the state has reduced the number of residents without health insurance, 200,000 people remain uninsured. Moreover, the increase in the number of insured is primarily due to the state's generous subsidies, not the celebrated individual mandate.

    Health care costs continue to rise much faster than the national average. Since 2006, total state health care spending has increased by 28 percent. Insurance premiums have increased by 8–10 percent per year, nearly double the national average.

    Program costs have skyrocketed. Despite tax increases, the program faces huge deficits. The state is considering caps on insurance premiums, cuts in reimbursements to providers, and even the possibility of a "global budget" on health care spending—with its attendant rationing. A shortage of providers, combined with increased demand, is increasing waiting times to see a physician.

    Giving the government greater control over our health care system will have grave consequences for taxpayers, providers, and health care consumers. That is the lesson of the Massachusetts model.
  7. by   darrell
    Quote from Sade
    I was curious what folks thought of the idea of changing our tax codes to allow individuals to deduct ALL healthcare costs from their taxes, just as employers can? Take care.
    Beautiful. I can afford, say, $100 per month for healthcare. Handle it through a risk pool or whatever. I can not afford $1200 per month for two people's meds (our current real-life estimate) plus a few thousand more for office visits, labs and whatnot. Even if it is deductible.

    Obviously I can get rid of the cars, drop the cable and Internet, tighten up the meal belts and stop visiting relatives - all of this will save money which can then go into healthcare expenses. Not much good for the economy, I suppose, and certainly not an improvement to my quality of life, but prioritization and all that....

  8. by   Sade
    Currently, it is illegal for individuals to cross State lines to purchase health insurance.

    A market study by eHealth Insurance found that prices vary drastically from State to State. For example, in their study they found the 10 top cities for affordable health insurance all had policies with premiums under $60/month. In contrast, for the exact same policy in New York City the premium was $334/month. The study found that there is a direct correlation between the amount of regulation the State Governments place on the insurance companies and the costs of the premiums. For example, in New York City their State Government forces Insurance Companies to sell policies at the same price to everyone, regardless of age or health for the sake of universal access. This results in increased premiums for everyone. Younger people tend to drop or not get the policies because it's unfair to them.

    A market study by the AMA surveyed 294 Metropolitan Cities and found that in 95% of the cities 1 insurance company provided coverage for 30% of the population. In 50% of the cities 1 insurance company provided coverage for 50% of the population.

    IMO - We have a monopolized managed care system with little or no competition, entwined with hyperregulation by State Governments, entwined with our Federal Government making laws cripling competition by not allowing interstate commerce of insurance policies....... and we wonder why the average salary earning individual can't afford health insurance anymore??? Take care.
  9. by   buransic
    Re: Top 10 Most Expensive Cities in the World.
    I'm thinking it might be more coincidence. Switzerland has a federal program for basic coverage and people have to buy supplemental insurance for coverage for chronic or catastrophic conditions. In 2006 they spent 11.5% of GDP on health care. The US was number one at 15.3%. Japan? Twenty-first at 8.1%. Canada was 8th at 10.0%. Hmmm...the country with the highest, by 35% over the 2nd highest, spend as a percentage of GDP is us (US). That's also an interesting coincidence.
    Last edit by buransic on Jun 24, '09
  10. by   Sade
    HMO's have considerable government regulation and oversight. Here's a real life example.

    I am a 39 year old mother, that is disabled and in a wheelchair for life. My doctor has told me that I need a medically necessary surgery, and that I will die an early death without it. The catch is, my HMO will not pay for this surgery. I have been through three appeals already, and I went through a State Board of Appeals last Monday. I lost again. The reason I lost is: the state claims they cannot make the HMO pay for my surgery because there is no law saying that the insurance must pay for a medically necessary surgery.

    The logic behind HMO's is the control of health care costs. There is an obvious historical correlation between government involvement in trying to control health care costs, which started in the 1970's, and the increases we see in health care costs today. The high costs of health care we see today is not a result of a free market, but a result of a free market morphing into a controlled market. Take care.
  11. by   MedSurgeMess
    We've gotten way off of the subject: How will UHC change nursing?

    Let's hear from the nurses from various countries with UHC-how is you pay as it relates to the cost of living in your area
  12. by   rnnowalways
    Thank you, Spidey's mom. You had done a lot of research on this subject. Being a person who lived in a country with a Universal Healthcare, I am totally horrified by a prospect of having the same sysyem here. And so is everybody else I talk to who came fromthe same background. We have a first - hand knowledge about it. IT DOES NOT WORK!! It decreases a quality of care, and the main reason it cuts costs - that sick people do not get the care that they need. There is a long waiting list for necessary procedures, including very necessary ones. THAT IS HOW THE MONEY IS SAVED!! think about all your family and friends with health problems, all your elderly mothers, fathers and other relatives, and decide - are you ready to let them die because of the lack of a necessary care which will not be provided to them under government-run plan. I know first-hand how it works, I lived with it - believe me, IT IS BAD. if a person is older than certain age, government decides if they are worth giving a care they need to survive, after all - they will die sooner than a a younger person, who might need it more. it will be rationed. Will senators who try to push this nightmare helath care through use the same system? i know now they do not have to pay for anything and the healthcare plan they use covers everything with them making their own choices regarding which procedures they need to have. Nothing is limited or rationed out to them. It is a lie that we will have the same or even close to that sysyem - BECAUSE IT IS VERY EXPENSIVE! But they want to ration it out for us! I feel it is extremely unfair.

    It will be a nightmare. And yes, nurses and doctors will get paid less, and there will be less innovation, because all the monetary incentives for it will be gone - did you see anything which is run efficiently by government? look what they did with our tax dollars so far? bonuses for those who ruined this country and all the bailouts? for us? not...
  13. by   MaritesaRN
    Quote from MamaKitty13214
    I went to a Single Payer event in Rochester, NY, last month where Rep. John Conyers (he & Dennis Kucinich co-wrote HR676, which I would advise everyone on this forum to READ before spouting off about "government-run" health care) was a guest along with Rep. Eric Massa, newly representing Rochester and a very vocal advocate of Single Payer. I was asked to speak about my experience as a case manager/discharge planner at a public hospital where all the uninsured patients are dumped by private hospitals. To be fair, the public hospital where I work is also a Level I trauma center, so the "higher level of care" transfers are often appropriate. Before I got to speak, Rep Conyers was asked about reimbursement by a physician in the audience and Conyers said that Medicare rates would be increased and that he believed all nurses should also get a raise!!

    Health Care will NOT be "government run" under HR676. There is a lot of confusion in the debate because of many of the terms which are used. "Universal health care" really is universal coverage for a privately delivered, publicly financed system. "The Government" won't tell you what doctors you can see & what you can & cannot have the way FOR PROFIT insurance companies currently do if they still decide to cover you after you've gotten sick. And the FOR PROFIT insurance companies have worked their way into the Medicaid & Medicare programs by offering "managed care" options which are supposed to be less costly, but are actually devised to allow the FOR PROFIT insurance companies to exploit these publicly financed programs by deciding what to ration.

    So a lot of this anti "universal" health care and anti Single Payer propaganda is coming from the Insurance Industry. They don't want to lose the cash cow of the health care industry -- those poor CEOs can't live without their multimillion dollar salaries and corporate jets.

    As for the first post on this thread, please don't be so naive as to believe that there isn't an agenda behind what all these economist authorities are spouting -- look deeper into the backgrounds of these people and follow the money. Betcha none of them has ever had to decide whether to buy food or medicine or pay the rent or get your pills. Not a single one. They are telling you not to look behind the curtain and are distracting you with lots of shiny baubles.

    Statistics can be manipulated to prove any point desired and the LAST study on anything health related I would ever trust would be anything by Blue Cross/Blue Shield or any drug company. As far as I am concerned those statistic manipulating reptiles have their heads up their anal sphincters and have absolutely NO connection with what working and poor people have to deal with in every day life. And I'll betcha there's some connection somewhere to either Insurance industry or Big Pharma.

    And lastly, "The Government" is "We the people". Unfortunately, "we the people" have been dumbed down and lied to for a generation or more and we don't hold our elected representatives to task. Too many of them are bought & sold by insurance industry & Big Pharma and the decimation of Medicare/Medicaid and favorable legislation for these huge corporations is proof of it. So "the government" has become separate from "we the people" and corruption runs deep and wide.

    We as nurses really need to become more politically active in changing our crumbling system and follow the lead of the California Nurses Association in advocating for a Single Payer system. Profit does not belong in health care -- there is NO ethical justification in what the for-profit insurance industry has done to the people of this country. PERIOD. Single Payer is the ONLY solution and I will fight for it until the day I die.

    Well said , well done. I myself do not understand as to why some people just can not see the "light". thank you so much for putting it in an accurate and correct perspective of the universal health or others call it socialized medicine.