How Will Universal Health Care Change Nursing?

TheCommuter, BSN, RN · Jun 19, 2009

I would LOVE to hear Canadian's perspectives about their plans, as it is true that I hear a lot of nightmarish stories. It would be nice to hear the GOOD things about it. Anyhow, back to the OP's question...how will it affect nursing??

Click on the blue link below to read the article.

Pros and Cons of Canadian Healthcare

MAISY, RN-ER, BSN, RN · Jun 19, 2009

Universal Healthcare....such a sticky but pertinent subject. Our ER visits have increased 100%, how much does everyone think that costs the system? As Americans the tendency to say "show me the money TODAY" creates poor planning and deficits, shortfalls tomorrow.

It's funny, I am taking a Master's class in Nursing, government and politics and a class in Morality and ethics in healthcare, a very interesting duo at this time in our government's history. After really looking at all sides and comparing, there are several facts which stand out. As a country we spend the most money. Canada spends 1/2 of what we do and has better outcomes all the way around. Other countries provide primary care keeping the overall cost the same but provided BEFORE THERE ARE MAJOR PROBLEMS therefore, it isn't only end of life care costing ALL for A FEW, but primary, preventive care for ALL (including dental). Mental health care is not stigmatized or specialized and is treated like any other medical condition (a proven fact that depression and stress breaks down the immune system leaving us open to illness).

We have the latest and greatest on every corner, but who can really use it? HOWEVER, even those countries are looking at some privatization. They wait for procedures and tests, and some facilities are not even comparable to our worst. YET their outcomes are BETTER!

So, perhaps we could start providing base care for all-a safety net. Perhaps we could require all healthcare personnel-doctors who are notorious for not paying back their student loans to either take a percentage of medicaid or assistance patients, or volunteer at clinics and facilities for lowered malpractice or delayed payments. Perhaps this should be applied to all medical disciplines and teachers in education-required 3-6 months internships to maintain patient health. There are lots of ideas, someone has to be willing to do it.

Will Americans wait for hours, will they be told what to do? I am sure if you ask the ones with nothing, they will say yes. Until you've been turned away, you cannot possibly know how that feels. Until you've seen a father of four beg to be seen by an orthopedist in the ER because no one will see him on the outside without insurance and his leg fracture is still in the temporary splint, he can't work, pay his bills or get a clinic appointment for 1 month-You don't know! There is no easy answer, but the one truth is if nurses don't get involved in Washington during this important time in history our voice will not be heard and counted. The AMA and insurance companies are there. Why aren't you?

Fiona59 · Jun 19, 2009

OK, in my province there is NO monthly premium. It was eliminated under the last provincial budget.

Patient ratios: In active treatment it's usually assigned number of beds (four on days, five on evenings, usually seven on nights). Depending on staffing availability it can go as high as six on days (very rare) and nine on nights. When this happens we all file unsafe working conditions reports with our unions. That's for surgical. I'm not sure what medicine floors do, I do know they have a different ratio.

LTC is higher. We don't seem to have the huge facilities that you do. It's usually around one LPN to 22 beds(does meds and any treatments, our LTC patients cannot be on IVs or TPN), with three NAs and one RN for the floor. I haven't worked in LTC since I was a student, so it may be better now.

ICU has one on one usually.

Dialysis 3-4 patients.

What concerns many nurses that I work with is more of a moral dilema. We see patients have millions of $ spent on them when we know they have little or no chance of survival, yet the systems continues to try and "fix" them because the family wants to try "everything". We've had nurses who've worked in the US say these patients would have been made "no codes" months ago for insurance reasons.

tencat · Jun 19, 2009

We have to do something. And those who don't like the current ideas that the president is proposing need to come up with alternatives. I don't see many other alternatives being proposed, other than to leave it alone and let it be, which is totally unacceptable. Health care in the US is going down the tubes quickly, right now without the help of the government. I personally know a family who is completely bankrupt now due to the illness of a loved one, and the person is requiring full-time care in a facility for the duration of her life. Her 80 year old husband is destitute, she requires full-time care that her family cannot provide by themselves, yet there are few options as she is on medicaid now (thanks to complete bankruptcy from medical costs) and no facility wants her. She is too young for medicare, didn't initially qualify for medicaid, and let an illness get completely out of control before seeking help because she couldn't pay for the treatments suggested by the doctors to help avert the crisis. If she had had affordable access to preventative care, the whole enchilada could have been avoided. Her story is not unique. She is one of the many who are falling through the cracks. Most of us in the US are one catastrophic illness away from complete financial ruin. Not acceptable. Something has to be done. If anyone has any good alternatives to current proposals, I'm all ears.

classicdame, MSN, EdD · Jun 19, 2009

does not matter how many have insurance or how much insurance "covers" --- if the bottom line is that hospitals don't get paid then jobs will be cut and probably not from administration. Our hospital now collects 29 cents on every dollar we charge to INSURANCE. So coverage does not mean adequate benefits.

I tell you - this expensive so-called plan scares me.

classicdame, MSN, EdD · Jun 19, 2009

I saw a bumper sticker the other day. I don't have a gun but agree with this sentiment:

I will keep my money and my gun and my freedom - you can keep the "change"

allnurses Guide · Jun 19, 2009

There are many other options. Health Savings Accounts (Whole Foods), the article about Safeway's health care plan, the John Stossel video has many ideas and also looks at Canadian healthcare, which has its share of problems and wait times and rationing. Plus, this is not FREE health care. It is paid for by increasing taxes. And Canadians are starting to complain and want changes.

Two of the websites I posted have other solutions.

The history of Medicare and the promises made and broken are a huge example of why letting the government run our health care is a very bad idea.

steph

tmgsn · Jun 19, 2009

I was very much talking to you with the article you copy pasted about how many Americans with incomes over 75 and 50 thousand dollars a year chose not to have health coverage. You then posted info about how single parents chose not to fill out "all that paperwork" to cover their kids or themselves.

Listen, I very much know fear when I hear it, read it, and see it. But, let me tell you-- I live with it EVERY DAY. I pray to God that my kids are safe. That if they get hurt, the insurance provided through partial medicaid will cover their injuries. That my student insurance will see me through. That I will have a job after graduation.

That does not change the fact that the system has been broke a very long time now. The poor people of this country need medical insurance, and NOT just when pregnant. Dental coverage, preventative and restorative care is necessary for the good of all. Have you ever worked with someone that had an abscessed tooth? Or had so many teeth pulled due to no dental coverage they could not eat normal food? Or get a job because their teeth were so bad? People are kinder, gentler, even pleasant to be around when they are not in pain or hungry.

If you really want to know the comparison of Health plans between the countries, PBS did an awesome documentary comparing them all-- check it out.

PostOpPrincess, BSN, RN · Jun 19, 2009

I won't participate in any government run insurance. The doctors I see told me the same thing; some of them are turning away Medicare/Medicaid patients.

I know my docs, know what my family and I need.

I'm not going to be told by some government numbers counter to tell me what to do...no way, uh-uh, I don't think so...

allnurses Guide · Jun 19, 2009

I was very much talking to you with the article you copy pasted about how many Americans with incomes over 75 and 50 thousand dollars a year chose not to have health coverage. You then posted info about how single parents chose not to fill out "all that paperwork" to cover their kids or themselves.
Listen, I very much know fear when I hear it, read it, and see it. But, let me tell you-- I live with it EVERY DAY. I pray to God that my kids are safe. That if they get hurt, the insurance provided through partial medicaid will cover their injuries. That my student insurance will see me through. That I will have a job after graduation.
That does not change the fact that the system has been broke a very long time now. The poor people of this country need medical insurance, and NOT just when pregnant. Dental coverage, preventative and restorative care is necessary for the good of all. Have you ever worked with someone that had an abscessed tooth? Or had so many teeth pulled due to no dental coverage they could not eat normal food? Or get a job because their teeth were so bad? People are kinder, gentler, even pleasant to be around when they are not in pain or hungry.
If you really want to know the comparison of Health plans between the countries, PBS did an awesome documentary comparing them all-- check it out.

I'm sorry - your post was a little confusing.

Yes, I have worked with someone with an abscessed tooth. I am a member of a medical mission organization that goes to Vietnam twice a year. We work in rural areas and in the dental clinic, usually pulling teeth to prevent abscesses. The hardest part is the kids.

My point in addressing the myth of 47 million is that people have to know the details and not just accept information without researching it.

I have seen and read about comparisons - and right now Canada and England especially are looking at changing their systems because it is too unwieldy.

I really like the idea of health savings accounts. I don't like the idea of the government running health care.

steph

arelle68 · Jun 20, 2009

I wonder if the US government is driving private medicine out of business so that they can take over everything. Look at the reductions in what they will pay for medicaid and medicare. If they aren't doing it on purpose, then their doing it on accident. They are obviously bankrupting the private health care system for some reason. Anyone know?

tmgsn · Jun 20, 2009

The health savings account only saves you money if you don't use it. If you have kids, you use it and pay twice as much! If you have any illness-- diabetes, arthritis, a car accident, a broken arm, vaccinations, checkups, dental work-- you name it-- the savings account will eat up your whole pay check. The only people that save on this type of health insurance are 18-28 years of age, single family-both parents working-- with poss one child, or maybe, a very healthy single older individual. Read into it. Apply the costs to more than one person, with 2-3 kids. American families are in the poor house due to the cost of health insurance/ medical/dental bills-- those of us that pay or care enough to fill out all that paper work. They offered that at my old job. It was a joke. My son plays football. I care so he goes to the doctor when he gets hurt. yea, I want my son to be in sports and academics too.

This is exactly why the poor have no health insurance. Because the more educated, the more income we have, the more it becomes all about me. I pray that does not happen to me when I graduate. I don't think the way things have been done is working out, do you? Or are you more worried about our paychecks?

The bottom line is the economy is not allowing things to remain the same. I know someone with health insurance that almost died this week to avoid going to the hospital. There will be fewer and fewer pt's in the hospitals, therefore fewer RN jobs.....

Actually- that is already happening here.

I just got a response about how the government was not going to provide their health plan. I know how bad the gov works. I have seen how the vets have been treated, or rather not treated. But we have to come together on this as a whole, as one team. We say how things work when we do! The gov will divide and conquer the American public and put in place what they see fit for us if we do not do this right.

We all know exactly how in touch with reality the senators are with what is really going down- (McCain).

Their income is over $125,000.00 per year and they get their annual raise, not like the state/city workers here that had all of their annual raises suspended, including the teachers.

We need to stop arguing amongst ourselves and agree to disagree on the end result so long as EVERYONE benefits in the end. We need to take care of our people here, our kids, we need to help each other until everyone has their basic rights met. Do you consider the treatment of Cancer/Leukemia/Diabetes a privilege to be earned?

After having both breast removed secondary to CA, do you consider reconstructive surgery-- optional? Should the woman really have to wait 5 years- CA free to feel like a woman again-To have breasts again? To have to pay full costs due to it being "plastic surgery"? Do you realize what kind of baloney is going on? There are more problems than we can begin to address on a chat page.

We all just need to step out of the box for a couple of minutes. Look beyond our own paychecks, pending student loan payments (mine!), 401k that went down the drain-mine too! And come together to be sure the gov does not pull a quick one but that we take care of our friends and neighbors alike.