Medicine: Have we gone too far? And, is our system ethical as a whole? - page 4

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   GardenDove
    The babyboomers are starting to be retirement age right now and have incredible clout, economically and in the ballotbox. I think that generation, of which I'm a part of, will break the bank.
  2. by   Lovely_RN
    Quote from GardenDove
    The babyboomers are starting to be retirement age right now and have incredible clout, economically and in the ballotbox. I think that generation, of which I'm a part of, will break the bank.

    Yes, it will certainly be interesting. Especially since for the most part baby boomers have grew up in the culture of expectation (no offense.) They expect to have it all and will expect to continue to have it all right until the very end.

    Btw, was I the only one who saw Hugh Hefner dancing it up at a party with the Playboy bunnies on ET (or was it Access) last week? Prime example given to people: even octogenarians are still getting their groove on!

    Or be like Tony Randall and have your first child at 76!

    What can I say? If they like it I LOVE it and I don't believe in ageism but a lot of people really do seem to believe that they will live forever.

    Me personally? I plan on living to be 120 so I will worry about making out my will sometime around my 99th b-day as I sit on the beach in my bikini sipping a mai tai.
  3. by   EmerNurse
    Working in a county hosp ER, I see a lot of the abuse that goes on. Just this AM, as I was leaving, a lady who'd been discharged for sinusitis with abx and motrin was signing back in one hour later, decided she "wanted a cat scan".

    Umm.. I can't help but believe that if she was paying $100 co-pay or if her insurance didn't pay for non-emergencies, maybe this wouldn't happen. As it is, WE are the ones paying for HER opinion of what she wants. And you know what? In this CYA medical world, she probably got what she wanted for fear of litigation.

    Are there hard-working people who just can't get insurance? Absolutely! I have family members in that position, and I believe that's an appropriate use of our medicaid dollars - but not for the ones that use it as their primary care physician for something they've had for 4 weeks but couldn't be bothered to go to the clinic until they "couldn't take it anymore" while presenting with symptoms I've had for 4 days and have been self-medicating with OTC meds in order to show up to work.

    Can ya tell I was in triage last night?
  4. by   Simplepleasures
    Quote from casbeezgirlrn

    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 .
    just think, what if the trillions spent in iraq could have been used toward improving our national healthcare....
  5. by   DeLySh
    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).
    Please be careful when making statements such as these unless you have walked a mile in the shoes of an infertile couple. You never know whose heart you might be breaking.

  6. by   S.T.A.C.E.Y
    I just did a big project on euthanasia, and end of life issues. I read alot of comments/posts talking about how assisting someone to have a peaceful death on their own terms was "playing God", but sometimes I wonder how prolonging a 95 y/o on a vent, tons of drips/lines, tubes, etc. isn't playing God. Yes, I understand the value we place on life, and rightfully so. But, I also think our system is screwed up to assume that Quantity of Life should be placed over Quality....
  7. by   AliRae
    Just to throw another piece into the puzzle here ...

    There's been much talk on this thread of prevention and care in older populations. What about the pediatric population facing congenital defects? There's, for the most part, nothing that could have been done to have changed the fact that these kids were born with various anomalies, and yet here they are! They live in and out of hospitals and MD's offices, and they cost millions of dollars. What's the point, really? I'm not calloused, and I'm not a "mean old PICU nurse." I just lost one my favourite baby ever. He died after living in hospital for nine and a half months. He was never home, and his cardiac condition was inoperable from day one. Why did we code him 6 or 7 times? Why did we spend millions of taxpayer dollars for a kiddo we KNEW wasn't going to preschool? I think it's a huge ethical issue. (In this particular case, my view of things is biased by the fact that I loved him, and would give any amount of money to have him back.) But still, the question remains- how far is too far? We push these kids to survive with what kind of quality of life?!

    I'm finished rambling now.
  8. by   Huscarl73
    A previous poster hit the nail on the head. The bank is empty, all the money that's supposed to be in it is gone. We have an entire generation, and even part of another one that spent that money. The spent it on everything but what it was it was supposed to be for.
    This contract with the generations was a good idea and it would have worked but the baby boomers broke the contract. The did more than break it they pissed all over it. This money is gone and just like my checking account they don't get to spend it twice.
    I see no reason that my generation should feel any obligation to break ourselves supporting their retirements, I see absolutely no reason why my children (5, 8 and 10) should be saddled with the huge amount of debt that they've already accrued and the tens of trillions more that are going to be added to it over the next 2-3 decades if this status quo somehow remains.
    This system, our system, teeters on the edge of an abyss. Just a few short years ago this edge was estimated to be sometime in the 2020's. If you've been paying attention to the astronomical deficits we've run up over the last 6 years or so you know that we've brought this quite a bit closer.
    What the ultimate solution is going to be, I don't know. But IMO that is going to include ten's of trillions of fake dollars that they've printed up coming home to roost. By any historical standard this should be causing double digit inflation, yearly. It's coming...
  9. by   Indy
    Well then, us 30somethings should definitely be voting... however, our generation is very much outnumbered by the baby boomers. They're going to be in LTC with a nursing shortage... they're going to be taken care of by overworked, understaffed nurses who can't afford their own insurance, let alone anything resembling retirement.
  10. by   GardenDove
    Huscar, you need to join the optimist's club!
  11. by   nursemike
    Quote from Huscarl73
    A previous poster hit the nail on the head. The bank is empty, all the money that's supposed to be in it is gone. We have an entire generation, and even part of another one that spent that money. The spent it on everything but what it was it was supposed to be for.
    This contract with the generations was a good idea and it would have worked but the baby boomers broke the contract. The did more than break it they pissed all over it. This money is gone and just like my checking account they don't get to spend it twice.
    I see no reason that my generation should feel any obligation to break ourselves supporting their retirements, I see absolutely no reason why my children (5, 8 and 10) should be saddled with the huge amount of debt that they've already accrued and the tens of trillions more that are going to be added to it over the next 2-3 decades if this status quo somehow remains.
    This system, our system, teeters on the edge of an abyss. Just a few short years ago this edge was estimated to be sometime in the 2020's. If you've been paying attention to the astronomical deficits we've run up over the last 6 years or so you know that we've brought this quite a bit closer.
    What the ultimate solution is going to be, I don't know. But IMO that is going to include ten's of trillions of fake dollars that they've printed up coming home to roost. By any historical standard this should be causing double digit inflation, yearly. It's coming...
    Mandatory euthanasia at 40 y.o.--there's the solution!

    Just recently googled the National Debt. It's just under 9 trillion dollars, or about 28000 for every man, woman, and child in the US. That's a lot, but...we aren't wasting trillions at a time in Iraq, on healthcare, or anywhere else. The billions do add up, but a trillion is still a lot of money.

    A big part of where baby-boomers squandered our national treasure was on educating our children. Also highways, healthcare, and defense. A lot has been wasted, but a lot has benefitted everyone alive today, including the children and grandchildren of the boomers. The reality is, we all expect a certain level of service, and we have to pay for it either through taxes or deficits. There are still too many people who think the government should pay for its various programs, rather than the taxpayers.

    As far as healthcare goes, I still think we probably spend more on 4x4s than on heart transplants. I think we'd see fewer full codes if we did a better job of educating people about advanced directives. I think we'd see fewer dubious ER visits if people had better access to primary care. I don't think we'll see much progress on the latter until we have a national health insurance program, but I'm sure I'll groan as much as anybody when I start seeing the premiums coming out of my paycheck. Still, universal health coverage ought to greatly reduce the need to draw money out of the general budget for Medicaid, and that money could then be used to help reduce the deficit.
    It's a proven fact that we can run the country without deficits. It does require some sacrifice to do so, and, unfortunately, a significant part of that sacrifice will have to be in the form of higher taxes (interpreting premiums on universal health care as, essentially, a tax).
  12. by   nurse4theplanet
    Quote from nursemike
    Mandatory euthanasia at 40 y.o.--there's the solution!
    :roll This made me laugh so hard that it scared my dog! lol

    I don't think we'll see much progress on the latter until we have a national health insurance program, but I'm sure I'll groan as much as anybody when I start seeing the premiums coming out of my paycheck. Still, universal health coverage ought to greatly reduce the need to draw money out of the general budget for Medicaid, and that money could then be used to help reduce the deficit.
    I don't know too much about universal healthcare programs. What type of implications would this have on healthcare employees? Are these the types of programs that are being used in Canada and Australia...I've seen some vague references to nurses being out of work for a portion of the year when the allotments have been exhausted. Is that true or am I confusing it with another type of program?
  13. by   Huscarl73
    You do have some valid points. For example there was a percentage of money that was spent that my, our, children will benefit from. Highways being one example. But IMO that the vast majority of it was spent to maintain the previous generations standard of living while pushing the bill for it off on the next generations.

    Your google for 9 trillion is was probably accurate for sometime relatively near this particular minute. Right now the interest on this takes up somewhat over one third of the federal budget. Which would be enough to turn our yearly 800 billion dollar deficit into a even or positive number. If we maintain this yearly 800 billion deficit in somewhat less than 10 years two thirds of our governments budget will go towards interest. At this point, or even before, we will have a massive economic collapse which will mean even less money taken in taxes worsening the situation. We are rapidly running out of time to fix this and I very well could be wrong but I havn't seen anybody running on this platform.

    Let's go back to health care and medicaid. The 9 trillion that you googled does not include several things. Which is the money that was paid in taxes to social security and medicaid. The last numbers that I have seen detailing the the debt for this was somewhat over an additional 5 trillion dollars. That is a mind boggling amount of money that was not spent for what it was taken for but to, again, maintain the baby boomers standard of living. To me, the only acceptable solution to this is substantially higher taxes to off set this while this generation is still part of the work force. If they continue to push this debt off into the future leaving it for us to assume for them they will deserve exactly what they are going to get.

    Now let's take it a step further. Where did this 9 trillion dollars come from? Did they just wave their hands and make it appear? That's exactly what they did. What happens when governments do this, inflation. Why has this inflation not taken place? Because the world still has faith in the american dollar. When the world loses that faith all that money is going to come home. When it does we will hauling wheelbarrows full of hundred dollar bills to the grocery store to buy a weeks worth of groceries. If you look at any historical example this is the end result of a government printing large amounts of extra money.

    GardenDove says that I should be an optimist. And I am to the point that I think this is still a resolvable problem. It would include many things. Less government, higher taxes and fewer jobs outshored leaving the taxes paid on them, for services done here to be collected by our government. I'm pessimistic because our government, our representatives and our political parties won't even acknowledge that this exists.

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