Medicine: Have we gone too far? And, is our system ethical as a whole? - page 3

Sometimes I disagree with some of the things that I do in my job. I'm sure we've all felt this, such as a 95 year old full code on a vent, or other such scenarios. Personally, I feel like... Read More

  1. by   medsurgnurse
    Quote from Jolie
    I am not trying to speak for the OP, but I would like to voice my opinion on this issue: I don't believe that those without private insurance should receive inferior quality healthcare, but nor do I believe that those who receive healthcare courtesy of the taxpayers should get benefits SUPERIOR to those of us who work to pay for ours and theirs.

    I lived in PA a number of years ago, at a time when recipients of taxpayer funded healthcare received comprehensive medical, dental, prescription, and vision benefits. Both my husband and I were gainfully employed, paid substantial premiums thru payroll deduction, and neither of us had dental or vision insurance. We also had to meet deductibles before our coverage "kicked in", and were limited in our choice of providers, while those covered (at no personal expense) by publicly funded plans had benefits far superior to ours with no financial obligations.

    That is not right, either.
    you're right.
  2. by   KellieNurse06
    Quote from SCRN1
    -
    - When working Labor & Delivery and Mother/Baby, I realized there were more patients there on Medicare than private insurance. The ones with Medicare got the same treatment, including all the freebies as anyone else. Who pays for all this? Taxpayers. These were people who fully able to work but refused so they could get free housing, free medical care, free groceries, etc and not have to leave home to work for it.
    Does it really matter????? Come on!!!! Regardless of what insurance anyone has should be irrelevant! Everyone should get the same medical care regardless if they medicare, medicaid, blue cross, harvard pilgrim.....whatever....There are people who fall on that line of making too much to get help but yet don't make enough to pay for insurance.......Come on I think you are stereotyping here.............Honestly who "really" wants to be on any type of public assistance really????? And God forbid if you or a loved one should ever become totally disabled.....and need to go on..*** ****** medicare/medicaid.......then I bet you'd have a change of heart real quick ...it's easy to judge when it isn't you.......so please don't say people are fully able to work but "refuse" to because you don't know that for certainty......
  3. by   StrwbryblndRN
    Everyone who posted previously has made wonderful points regarding health care. We are preaching to choir. Our profession allows us to be up to date on health care and the benefits of prevention. Unfortunately society does not have the full spectrum of information. They may have the resources but may not accept it. Or they take advantage of the resource and use it inappropriately

    It has been drilled in my head since my very first semester of nursing that "education starts at admission". I hope to see the same concept applied to our health care. The minute someone makes use of health care, that person should be educated about what is available and what they can do to maintain their own health. There is alot I could have learned if I knew what to even look for. Alot people do not even know to ask.

    I do not wish to see people not make use of health care in fear they will be rejected or condemned. But hope that people can educate themselves with information to make more informed decisions. (that applies to all aspects of life)
    am i asking too much?
  4. by   GardenDove
    There are, actually, some people who are permanantly dependent on public assistance, and do know the system inside and out. You can't project your own middle class standards on everyone and assume that everyone shares your desire to contribute and be productive. Yes, sadly, a certain segment of the population is not able to function within the framework of modern society and will seek to exploit the generosity of the social welfare system.
  5. by   StrwbryblndRN
    In regards to insurance. I went from the best insurance coverage to none for my family of 4. (Husband lost job, you can guess the rest)
    It bothered me to think that medical staff (doctors/nurses etc) would feel such contempt for my lack of coverage. (I noticed my peds office not as receptive as they once were when my children were sick)
    Yes it makes me mad to see anyone go to ER for stupid stuff. Yet who are we to judge. I do not work in a hospital currently so I do not see what everyone else sees. But I was on the other end of it. Besides as a nurse, I thought that informatin regarding coverage was handled through other means. Not by the nurses that treat you.
    Granted on a large scale it is draining our health care system but as a care provider I hope to do my job and not let it affect the quality of care I give. I know most of you do not do that but be very aware of any attitude you may give off. I noticed it quite a bit as a patient/parent of patient.
  6. by   Cattitude
    Quote from gardendove
    and part of the reason for high premiums is to pay for the last ditch, and often futile efforts, to save the life of a person who hasn't come to terms with his/her situation. since i've worked in the icu the past year, it's really driven this fact home to me how much we, as a healthcare community, spends on these heroic attempts to reverse the irreversable.
    i remember a guy we had in sicu for over a year. he was intubated but awake and alert for about 6 months of that time. he just could never quite get to that point to come off the vent. anyway, he was miserable. through the course of thar year, i got to know him pretty well and we got to chatting one night. i asked him did he want to go on like thi. he shook his head no very fast. and did it again. apparently, i wasn't the only nurse who had asked him this.

    alas, his health care proxy did not respect his wishes when he was first brought in, he should never have been intubated in the first place. finally, going into the second year he died...
  7. by   Agnus
    Quote from GardenDove
    The reason, though, that people don't address it is fear. People are afraid of death, pure and simple. Even devout religious people are.
    Interesting. I had someone ask me last week. "If we believe we will go to heaven, why do we fear death?"

    It is of course within every living organism the inate "need" and there fore struggle to survive. Reproduction is linked to this survival response.
  8. by   Agnus
    Quote from Strwbryblnd
    In regards to insurance. I went from the best insurance coverage to none for my family of 4. (Husband lost job, you can guess the rest)
    It bothered me to think that medical staff (doctors/nurses etc) would feel such contempt for my lack of coverage. (I noticed my peds office not as receptive as they once were when my children were sick)
    Yes it makes me mad to see anyone go to ER for stupid stuff. Yet who are we to judge. I do not work in a hospital currently so I do not see what everyone else sees. But I was on the other end of it. Besides as a nurse, I thought that informatin regarding coverage was handled through other means. Not by the nurses that treat you.
    Granted on a large scale it is draining our health care system but as a care provider I hope to do my job and not let it affect the quality of care I give. I know most of you do not do that but be very aware of any attitude you may give off. I noticed it quite a bit as a patient/parent of patient.
    Quite true. There is an attitude. AND it is not the exclusive doamin of the billing office to deal with this. Doctors and Nurses are underpressure to limit services and there fore expense extended to patients where we know no or very little of the money will ever be recovered.

    We tell ourselves even in this age that is not my domain. But the reality is the pressure is there. It is our domain.

    Back in 1962 my mother was admitted to Will Rogers Memorial Hospital in Saranac Lake NY. That hospital has since closed. But it forever has influenced my values about health care. We were never allowed to pay a single penny for her 3 month confinement and frequent returns as an out patient. They did not even make a claim on her medical insurance. She had a private room and what today would be considered extreem luxuries beyond what you can imagine. These were in the form of therapies that addressed the whole person. Today we would not even consider them but are just as valid as effective theapies. Wil Rogers saved my mother's life.

    They had a rule she had to have been completley discharged for a full year (I think I recall that is the correct time period) before they would accept a donation from anyone in our family. As long as she was a patient there they refused any money in any form from our family.

    I remember when in the 80's I lived in West Germany and my landlady told us that when she was in the hospital they refused money from her. That is how their national health care insurance worked. She tried to give them money as thanks and they refused. She wanted to do this because of the high quality of holistic care she received and they would not take it.
    Last edit by Agnus on Jan 21, '07
  9. by   psalm_55
    ACCESS to health care is unethical.

    i believe the USA is the only industrialized nation without universal access to health care.

    many of us have children who are 23 y.o. and kicked off the insuramce role. they/we must forage for affordable health insurance coverage and self-pay.

    if they are without insurance and need an expensive diagnostic test such as an mri, it's cash up front -- or no mri. and the average ER visit is about a thousand dollars.

    at the other end of the spectrum -- look how many 70 and 80 year olds (and older)are on cholesterol-lowering drugs. WHY???

    given the cost (which is being transferred to taxpayers now) and the age, haven't these drugs ALREADY done what was intended?

    they lower cholesterol in order to prevent a cardiovascular event. their effectiveness is measured in DECADES. so, one who starts on these drugs will see the actual intended effect about 10 years down the road.

    i don't get it.
  10. by   prowlingMA
    i totally agree. i have worked in ltc and seen miserable pt given life sustaining treatment when all they really wanting was to be free of pain and suffering and be in peace.
    it comes down to some people are afraid to die, plain and simple. if i am in pain and unable to breath, eat , or live without machines, let me go.
    living isn't having a life.

    then you could also bring up the topic that some couple go through million dollars worth of treatment to produce a baby when there are thousands of kids in the foster care system that need a good home. they may not be perfect blond haired blue eyed infants ( but who of us is perfect).
  11. by   Lovely_RN
    Well I for one don't think that having blue eyes and blonde hair = perfection but I digress. :spin:

    I think the issue is that many American's simply do not understand or accept death. The media plays a large role in this problem because the focus is rarely on the people who do die. The focus is usually on the miraculous recovery, the god-doctor who can save even the worst case and the one person out of a million who lives past their 100th birthday. Most people are simply in denial about the average human life-span and want to believe that it is common rather than rare to live past 80.

    Not only do they expect to live past 80 they also expect to be in perfect health, with good looks, and enough money to provide all of the luxuries they want. People don't ever believe that they are the ones who will end up in a substandard nursing home. Despite the statistics that say that majority of us will die in a health care setting most people stubbornly want to believe that they will die at the age of 100 or more in their sleep or at home surrounded by loved ones so they don't want to deal with nasty things like living wills or advance directives.

    A lot of it has to do with commercials for drugs that promise health and vigor well into your 70s and beyond; the television shows that portray doctors as being able to save anyone from any imaginable disease or health care issue. Have you ever seen a T.V show portraying someone who dies on a vent after lingering for 3 years in a nursing home? That would be considered boring T.V; unless the death is dramatic and unexpected it isn't sexy enough for television. Does T.V ever deal with the financial implications of all of the medical interventions of the god-doctor? What about the bill that runs into the hundreds of thousands or even millions of dollars? Nope, once miraculously cured the person leaves happy and content and no mention is made of who will pay the enormous debt incurred.

    No wonder people expect miracles they need to be educated in the reality of illness, disability, and inevitable death.

    Having national healthcare is not a cure-all for the problems of American health care. I recall a vacation to England in 1999, my friend got ill on our last night and we ended up in a London ER. It was a nightmare visit, 8 hours in the ER waiting area before she was triaged by the RN. We finally left after the RN told her that if she could stand it she was better off flying back to the States the next day because it was likely she wouldn't be seen by a doctor anytime soon. We also had a conversation with the wife of a man who had been waiting 11 hours to be seen by a doctor after leaving another London ER and waiting for a full 24 hours and never being seen by a doctor.

    National healthcare isn't all it's cracked up to be.

    There are solutions to our healthcare problems but they aren't nice or very fair solutions and that is the problem. We are going to have to eventually deal with the issues of who gets what because our healthcare system cannot keep hemorrhaging money and remain functional. It's going to be very interesting to see what happens to the baby boomers as they continue to age. I have a feeling some very tough decisions are going to have to be made in healthcare during the next 30 or so years.

    Things are about to get very ugly for healthcare in the U.S.
  12. by   GardenDove
    Interesting post,with many good points. You're right on the mark, I think, in your assessment of the media portrayal of medical miracles and the publics unrealistic expectations of immortality delivered.
  13. by   Cattitude
    Quote from falon
    there are solutions to our healthcare problems but they aren't nice or very fair solutions and that is the problem. we are going to have to eventually deal with the issues of who gets what because our healthcare system cannot keep hemorrhaging money and remain functional. it's going to be very interesting to see what happens to the baby boomers as they continue to age. i have a feeling some very tough decisions are going to have to be made in healthcare during the next 30 or so years.

    things are about to get very ugly for healthcare in the u.s.
    you are so right and just wanted to touch upon this one point. i know a few people get somewhat sensitive in regards to "everyone deserves healthcare no matter what" and in theory that's a very warm and fuzzy idea. it would be great. but unfortunately reality is going to hit at some point. the system is breaking.

    as part of my job, i do medicaid budgets for my pt's. even trying to keep costs down, each pt averages between 3,000-6,000 per month. our pt's stay on this program for years until death or hospitalization.
    we are just one tiny speck of sand in the desert. i can't even begin to imagine how many trillions are spent in the entire u.s.

    i do believe this. i need to plan well for myself because soc.sec. and medicare will probably be gone when i retire,if i make it that long .

close