How Will Universal Health Care Change Nursing?

In my honest opinion, the healthcare system in the U.S. has already been crappy for the past twenty-something years.

I don't know why people are so afraid of the government "controlling their health" when right now the insurance companies are doing it.

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??

Here are two personal examples of my troubles with employer-sponsored healthcare.

I had a pelvic/abdominal MRI in 2005. Although I had coverage from two different insurance companies at the time the procedure was performed, both entities refused to pay the bill because they deemed the MRI "experimental." I was stuck with the $4,900 bill.

I had an overnight hospital stay last year. My employer-sponsored health plan provided 80/20 coverage, meaning that I was responsible for 20 percent of all covered medical expenses. The overnight hospital stay cost $20,000 and I had to pay $4,000 out of my own pocket. I am still making small monthly payments to the hospital so that the medical bills don't destroy my credit rating.

I would absolutely love having a system similar to Canada's, where citizens pay $49 monthly for their healthcare regardless of pre-existing conditions. Taxes might increase, but my medical bills will be nonexistent. This is a trade-off that I am willing to settle for.

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Pros and Cons of Canadian Healthcare

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?

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.

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.

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.

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"