Socialized Medicine/Nursing - page 2
Hi everyone. I am especially interested in how nurses are treated in the UK and Canada. I feel the US is moving more and more toward socialism, more taxes, more regulations, more government... Read More
Jun 16, '00Talking about the military's healthcare is a valid comparison, but those covered individuals are young, healthy individuals (for the most part), not aging, chronically ill individuals.
A one-payor system seems to be better at preventative intervention, which we as nurses usually support. On the other hand, being an American means that the economics automatically involve the free market, the invisible hand, and profits. That's a huge shift in thought for the culture. Just look at the other postings about nurses receiving the pay for the value of the work!!
Jun 17, '00Hey, I think Mary is right. How are you going to take the profit out of health care? Even the not for profits(LOL)believe me, are out to profit. Then, they re-invent the place every couple years, build this clinic and that, provide all these outreach services, refurbish units, spend money on accrediting bodies, and on and on. It's no wonder the patients expect four*star treatment, the facility markets itself out the ass with all this fluff, while totally losing sight of the real priority, the actual care provided. Then, what's really going on, is not lost on the patients, which is then reflected in their satisfaction level on the post hospitalization survey. In our facility, our satisfaction surveys have to reach a certain percentage for us to rec any gain sharing. So in effect, it's a set up, because we are expected to provide an outcome we can't possibly provide with the resources they allow us; then blame and penalize us for our poor performance, and mismanagement of our time! Now, re profiteering, do you mean to say that the government is not profiting in some way in your system? How is the money collected, distributed,etc? Do the doctors and nurses actually work for the government then? I'm confused on these issues. What about the level of motivation? If the motivating factor is not money in this system, what IS the motivator? What more effective motivation then money? I need enlightening!!
Jun 17, '00Also, Bunky, I've been trying to remember to ask you; since you're working in the States, you have to pay taxes here, right? Do you also have to pay into canada's system, and if so, how? Thanks.
Jun 17, '00Originally posted by bunky:
But PPL, if you take the profit idea out of healthcare, because it really has no business being there, there is no reason to hide! People get a decent paycheque, and the idea of getting more more more isn't as lucrative. What'd be the point in sneaking if it wouldn't line your pockets?
And in Canada, (I'M DOIN'THE FLAG THING HERE!) the money I give in taxes comes back to me in spades when I'm sick and I need help most. GO HABS GO! LOL! ha! ha!
By the way. Tim Hortons is on the move down here! they're popping up in Florida and are being added onto some Wendy's restaurants. We're taking over PPL. All a part of the master plan. LOL
Enjoy your responses on this topic as I have on other topics. I agree with your comments regarding profit in health care. On several posts, I have written that health and medical care should be a ministry and not an industry. I would like to know if, to your knowledge, most Canadians assume health and medical care to be a right or a priviledge and why? Perhaps this has contributed to a fairly successful socialized system in your country? Any nurses practicing in a socialized system please feel free to respond.
Jun 18, '00Bunky, everybody, check out the article re Canadian doctors/nurses leaving for US, in the latest online version of Nurse-zine. Very interesting and answers some questions, although it's focus is mainly on the docs, surprise! Still, it offers much to think about, plus, as an added bonus, maybe Bunky will stay here afterall! What say you, Bunky?
Jun 18, '00PPL look at the dates on that article that they gave in citing these numbers. As I told you in the socialized medical system, when there's a recession, it hits everything. I left during that time period to come here because we were in a bad recesssion and having kids means you have to do what you have to do. And no I don't have to pay taxes in Canada as well as here. If I were to return to Canada tomorrow I'd have to be in the country for three months in order to be once again covered under the Ontario Health Insurance Plan or OHIP, even if I didn't have a job I'd get coverage again.
And the military system does have elderly retirees to deal with though not as many. Having worked in a very unique little hospital here that had an agreement with a small town AFB to admit their patients, the care that young and old received was great. The AFB had only a clinic, so local retirees and the military personnel alike were admitted to my hospital and no expense was spared on them.
As for the government and whether or not they profit? Not during a recession they sure don't, but it is an obligation to them to continue to provide health insurance no matter what. They cutback on things to keep it going. They don't go all out and market themselves either like they do here because there's no reason to. To Canadians, a hospital is a hospital is a hospital. If one of the rural places gets a patient that they can't care for, they ship them to a larger center just like here. Unlike here, if I was at home and I got sick, I'd go to the nearest hospital and not worry. Here you have to think about which one your insurance company says you can go to.
And thank you mijourney. I always find your posts well thought out and very interesting. I can't answer for all Canadians but I get the idea that we all feel like we are fortunate to have what we have. Being here now and seeing how the other half lives, I feel even more strongly that Canadians are fortunate to have that. I agree whole heartedly that it should be a ministry and not an industry. People are always going to get sick. Aside from making a decent living out of caring for the sick, how can anyone justify making a killing out of it? No pun intended.
And lastly dear PPL, I think that the one doctor who said he made like $28,000 a year is full of it! No way! And things are changing there too. The economy has picked up and the governement is now ready to begin putting some serious money back into it's healthcare plans. It's not a perfect system, but I do think it's got the right idea.
Jun 19, '00OK Bunky, we're gonna miss ya when you're gone; and just remember where that "serious money" comes from! P.S. My hubby's dentist is Canadian, and he says he's staying!
Jun 19, '00Jerry, we're not talking about welfare here. How would making the government pay for it decrease anybody's incentives to work? You'd still go to work each day and find a load of sick patients who need your help. It's like saying that we'd all read our patients face sheets and determine what if any type of insurance they have and give the medicaid people substandard care because we're not profiting from them.
Yes, there is too much litigation and fear of litigation going on but that is a direct result of people fearing that they are being ripped off somehow especially if the patients outcome isn't favourable. You know, "the operation was a complete sucess but the patient died" but the family is still going to get the bill for it all.
It can and is being done sucessfully in other countires, and even as I pointed out in your military it is done well. We have military hospitals here that are world famous for the care they specialize in.
Something in this system has got to give. If we are to believe anything our hospital administrators have to say, then we need to believe that we are in danger of closing many hospitals here too due to lack of money. Modeling a new system based on a sucessfully run socialized system is as good a solution as any, because at least it is a proven way to deliver healthcare.
[This message has been edited by bunky (edited June 19, 2000).]
Jun 19, '00Yes Jerry, I agree. Also a big cost is the r&d, high tech and updated equipment, etc. I agree with the posters that think health care should be treated as a ministry, a calling if you will, but that's only in my FANTASY world! In my REAL world, I know you cannot have the Cadillac of care, on the Chevy pocketbook. Thanks again to all posters!
Jun 19, '00Hi, been reading your site for a few days now & find it very interesting, congratulations! Just want to add my two-cents from oz, we have a system similar to Canada (socialised) where everyone is entitled to tax funded public health care under "Medicare", a levy is payed from taxes ranging between 1-2%, low incomes & welfare don't pay & private insurance is optional however a push in oz is for a greater increase in private insurance to "take the burden off Medicare". After hearing & reading about the American health system I can understand better why many people are concerned about increasing the trend towards private health cover. The 'socialised' system is effective, yes it has its disadvantages, reliant on economic strength & government policy changes but it is an equitable system (majority of times) that provides health care for everyone. Ask most nurses what system they prefer to work in & they usually reply public r/t better pay & working conditions. Our 3 major public hospitals are upgradeding (rebuilt) in Queensland, the major children's hospital is public and transplant surgery is predominatly public. Private health care is a choice still, not a neccessity (but it is heading that way) however it does have its downfalls but on the whole I feel it decreases the profit making mentality of private health buisnesses and facilitates an environment that is orientated towards effective patient care and health prevention. Ofcourse some would disagree but i for one will join the fight to retain our public health care system.
Jun 19, '00Whew! Thank you LRM! I've been doing my best to explain this point of view and have been surprised by the silence from my fellow commonwealthers on this. Our healthcare system is like a national treasure to us in Canada too and it is well worth preserving.
Jun 19, '00Your'e welcome bunky, I have tried several 'chat' sites but found them all very dull, mostly nurses just moaning about their work environment, when i mention a public health system i can see their eyes glaze over from down here. Maybe its a cultural thing, i'm not saying we have a better system than USA, just a different perspective on what we expect and how we accept resources from the government. It is viewed in oz as a basic right to receive adequate education and health care from our taxes and the Australian people readily voice their opinions and demand these basic essentials. But like all things, change is coming and i fear our public health care system will eventually only be available to those who cannot afford private insurance, and eventually, because of this shift, it will be abandonned altogether due to decreased funds & priority. I have worked in both and when i finish my RN degree (end of this year) fully intend to work in the public system and advocate for it. It makes me very sad to read so many letters from USA nurses struggling with managerial obstacles when all they want to do is deliver professional safe nursing care to their patients.
Jun 20, '00I do not want the government to take over what is approximately 14% of the national economy. The loss of profit in any industry greatly diminishes the incentive to do better and economize at the same time. We all work for a profit each day. If we lost money in our jobs, we would change jobs in a hurry or find a way to reverse that trend. The 'single-payer' system so often referred to is actually a 200-million-payer system, because our taxes would jump to an even higher level. When more services are "given free by the government", there is less incentive for individuals to work.
A lot of the cost of our system is because of the threat of inappropriate litigation; it has destroyed other industries, and could cause serious harm to the care of our patients. We, as a society, need to reform the legal system to reduce litigation in general. After this, reduce the unnecessary government controls, then watch health care costs drop.
Every week, I find several patients with very minor illnesses or injuries demanding to be treated right away (these people create quite a disturbance, bordering on breaking the law), despite the fact that we have four patients on vents, one being coded, and a handful of CHF/COPD'ers on stretchers being treated at the same time. Because of privacy constraints, I cannot explain in detail why the wait is so long. Despite this, every patient is treated in a reasonable amount of time. While this amount of time may not always seem "fair" (there is really no such thing as 'fairness'), it is still very efficient, and nobody is turned away into the street because of their 'wallet'.
After seeing how government handles other programs (Dept. of Agriculture, Postal Service, Los Alamos lab, etc). the last group I want to control patient care completely is the bunch in DC .