Universal Health Coverage? - page 6

This topic came up last night in our seminar. Again, we struggle and struggle with this concept. I often times look at Medicare and how they handle things such as coverage, reimbursment, etc. As... Read More

  1. by   rncountry
    Purplemania, my mother does not regret her choice of staying home to raise children. It is more a point that there are no options for here. She is 58 years old and did what she had been socialized to do. Growing up out of my group of friends one had a parent that worked outside the home, and she was a hairdresser whose shop was literally across the yard from her home, so she could always be available to her children. What is wrong here is to give no other options. I feel, not my mom, but me that women who did what society expected them to do are actively being penalized. My mom is not the only older woman I know that is up the creek without a paddle. My parents have a friend who won't marry the man she is living with because she will lose the benefits she has through her husband who died several years ago and they can't afford for that to happen. The woman is 60 years old and the man she is living with is 67. They have both had spouses that died, got together and after being together nearly 3 years moved in with one another for reasons of expense, but could not marry without losing benefits. It was a HUGE decision for people of this age to move in together without benefit of marriage.
    My real dad used to say something that sticks with me probably every day of my life. Can't never did nothing. I have typed that into a post more than once. It is always easier to say we can't do this because, we can't do that because, than it is to actively particpate in changing norms and standards that are with us presently. I think in this discussion it is necessary to realize that America is unique in more ways than not from other countries, and to think that this country which has invented or tweaked more innovations than probably any other country in the world today could not have universal healthcare with reasonable guidelines and reasonable costs is to say that we have lost the capacity to do what American's have always done. Who says a universal healthcare system has to look like Canada's or Britian's or Sweden's? I don't even think it needs to be something that has no persoal cost associated with it. I personally believe there should always be some personal cost to the consumer, otherwise abuse of the system is too easy, or you have controls like in the listed country that make it unpalatable to American's.
    So purplemania, what point I was trying to make was that it is simply wrong to have no options when you are 58 years old, with severe COPD, oxygen dependent with some snot nosed bureaucrat not even half her age telling her that there are no options because she had the audacity to do what society expected and stay home and raise her children. And while this uppty young man was informing her of this and making her feel as if she was basicly a useless old woman who was looking to drain the system, who had never managed to do a thing with her life, he did let her know that when she was 62 she could draw off my dad reinfocing that her life wasn't worth much without a man just like she had been told by messages all around her from day one. You have no idea the way this person talked to her, or how she was treated. What shocked me more even more was that it was in front of me. After I helped her to the car I went back into the building and let him just what a horrid little **** he was. I reminded him that I did worK, AND MY TAX DOLLARS PAID HIS WAGES, I then lodged a complaint with his supervisor. What I really wanted to do was knock him on his ass. So yes, while I understand what social security is all about I find it extremely distasteful that young people who have done little throughout their lives can draw disability, even if they have never worked a day in their lives because they don't work so meet the income guidelines, but my mom can't because she married, did everything expected of her and with my dad drawing $1100 a month he makes too much money for her to even be insured. There are many different messages in that from society. One, that what she did was not as worthwhile as having a career would have been. Two, she therefore is not a worthwhile and of course since she didn't work she isn't even worth anything without her husband. All of these messages suck, though they probably make me more angry than they do my mom. My mother is a worthwhile human being regardless of whether she worked outside the home or not and deserves to at least have the OPPORTUNITY to have insurance so neither of my parents go bankrupt trying to take care of themselves. Or is that too much to ask from our society?
  2. by   donmurray
    I have lived my whole life in a system where healthcare is free at the point of need, funded through taxation. Simple. Access to care when you are sick is a right, and taxation is the fairest way to pay for it. All insurance schemes, however good, require a division of the money pie wehre the first slice is taken to pay the profits and the shareholders, and only then is the remainder distributed in benefits to the sick.
    As to non-working mothers, who is to say that fulltime child rearing is an unproductive undertaking? It's certainly badly paid! and then you are to be penalised for nurturing the future generations. That is all wrong.
  3. by   MayeRN
    Wow! What a debate!

    I am from Canada. I believe the our medicare system should be maintained. People should be able to receive medical care, no matter their income. That does not mean there are not problems

    1. We are taxed far too much. Our government can and should put more money back into healthcare instead of giving themselves little perks ( that's another issue!)

    2. NP's are not used more, I believe, because doctors here fill threatened by them.

    3. Patients over use the ER. I educate my patients about when to go to the ER and when to visit their FP or go to the walk-in clinic - people are slow to catch on.

    4. A National Homecare Program needs to be developed. There are some areas of this country that do not have access to homecare nurses. My parents live in Newfoundland and one time my father stayed in hospital for 3 weeks for IV antibiotic Tx!

    5. There are long waiting lists for tests ( in my area). People who can afford to pay for MRI,etc. will however.

    Canadians take their healthcare system for granted. It can be saved - we just need the right people at the top

    Sharon
  4. by   prn nurse
    WHY did you take mom out to the car and go back in & let the A--hole have it ???????? I think it would have done mom a world of good to hear you whack him !! It would have made moms' day and done her proud !!!!
  5. by   VickyRN
    Our whole medical system as it exists today needs a complete overhaul, a major housecleaning.
    The stranglehold of the big pharmaceutical companies needs to be broken. They have much more control over the entire system than we can even conceive and they are the one BIG reason health costs are so exorbitant. These companies are reaping ENORMOUS profits from people's misery.
    Alternative types of medicine (such as homeopathy) need to be integrated into traditional medicine. Costs much less and can produce better results.
    Crazy practices such as 90-year old demented nursing home pt's with DNR status, staying for weeks in the ICU, on the ventilator, on expensive multiple drips, only to die later--well, it just needs to be stopped. A terrible waste of scarce medical resources. (YES, this does happen...all too commonly). Like I said, the whole system needs to be overhauled. Automatic DNR status for some patients and commonsense but humane treatment for such patients desperately needs to be instituted.
    As MayeRN suggested, broader use of NP's and homehealth nurses. Break the chokehold of AMA over nursing practice. We should all be equals. End the senseless reams of government paperwork which are making homehealth nursing such a drudgery.
    TORT REFORM--put an end to all those big, spectacular lawsuits, which are also contributing to skyrocketing medical costs and compel nervous doctors to order so many unnecessary tests, medications, and procedures. Let's put the ambulance-chasing lawyers out of business.
    These are but a few suggestions. As RNCountry stated, we CAN do this (no, rather we MUST do this), with God's help, commonsense, innovation, decency, and determination.
    Last edit by VickyRN on Apr 30, '02
  6. by   semstr
    I too, as Don stated before, was born and raised in a country where healthcare is free, but people who are working have to pay taxes for this. The more you earn, the more you pay.
    Plus there is also the possibility, to take an extra private insurance, so you can go to private hospitals and things like that.

    So I sometimes pay for stay-at-home-mothers, I sometimes pay for the homeless, I pay for people who are sick a lot and I pay for the old, who can't take care of themselves any longer.
    So, I am grateful for this system. Times can change very quickly for all of us, and I could be in a very unfortunate situation, like others are now.
    I know I will be taken care of, like I sometimes do now for others.

    Hasn't this got something to do with selfishness? People tend to look not farther as their own doorstep , as long as I am fine, who cares. This is 2002 for me.
    But, to change a system is not easy, it not only takes time, but apart from money, it needs people, leading and giving a good example.

    Take care, Renee
  7. by   fiestynurse
    Unfortunately, there has been a very concerted effort to spread disinformation about the Canadian health care system, a process that has been dominated by libertarian elements that wish to keep the government out of health care in the United States. Because knowledge about Canada by most of us is very limited, and because the supporters of universal health care coverage have not been adequately effective in carrying the message of the benefits of the Canadian Medicare program, the average individual in our country believes that the Canadian health care system is inferior.
    This misperception is not altogether the fault of health care reform activists. The message of a just, comprehensive health care system is a very complex message to deliver and exceeds the patience and desires of most Americans to study and absorb a subject that for most of them is very boring.
    On the other hand, the opposition can keep their
    message very simple by limiting the facts presented to very isolated problems within the Canadian system, while concentrating on simple rhetoric that lumps health care in with features of government that the public believes to be undesirable.

    The media readily report the isolated stories of problems within health care. The horror stories of managed care in this country abound, just as the stories of the deficiencies of the government program in Canada make good copy, or at least news filler.
    The conclusions that our citizens draw from these reports are that:
    (1) a patient bill of rights will correct the defects of managed care (2) we do not want a government system like Canada's.

    The members of the media reflect the same simplistic viewpoints, and most seem to lack the depth of understanding of the Canadian system that might otherwise influence their reporting stance. This is not laziness on their part but rather reflects the fact that they must make decisions on how to allocate their time effectively. The "government" health care system of Canada is simply not a priority for them.

    Our efforts should be directed to informing the media of the realities of the Canadian health care system. We can never tell them what stories to cover, but we can encourage them to base their coverage on a background of comprehensive knowledge of the Canadian system. An excellent beginning source for them is a 251 page report by the Canadian government on the status of their health care system, released February 2, 2001. It can be downloaded at:

    http://www.hc-sc.gc.ca/medicare/home.htm
  8. by   disher
    fiestynurse, have you ever considered teaching health and social policy to nurses? Many of your posts show you excel health policy debate.
  9. by   mattsmom81
    Forgive me if someone has mentioned these points already.

    I have a group of British girlfriends who came to the US in the 70's during the 'nurse invasion' brought on by the shortage then. They all became citizens here, eventually raising families, because in Britain, their salary is little more than minimum wage under national healthcare. They tell me they could not support themselves independently on their salaries in Britain! Are US nurses willing to take such a cut in pay should we go to a similar system? I sure can't see US docs taking ANY pay cut, so you know we would....!!

    With the current move towards BSN as mimimum, who will go into a 4 year program to make little more than minimum wage?

    I remember the last healthcare plan....and Hilary's famous quote about a main problem in our healthcare system being the 'overpaid handmaidens' in nursing.....but how quickly some forget.
  10. by   Q.
    Originally posted by mattsmom81
    I remember the last healthcare plan....and Hilary's famous quote about a main problem in our healthcare system being the 'overpaid handmaidens' in nursing.....but how quickly some forget.

    Are you serious???????

    All the more fuel for me to hate Billary Clinton with.
  11. by   fiestynurse
    I find that hard to believe, since Bill Clinton's mother was a nurse.
    She had a BSN and was nurse anesthetist.

    We also have nurses in Congress, such as Lois Capps, a former school nurse.
    Last edit by fiestynurse on May 1, '02
  12. by   VickyRN
    It's true, Hillary said it. Bad thing is, she has her eye on the Whitehouse in 2004, but I digress.... Ever wonder why so many Canadian nurses are down here??? Can't find fulltime employment under their socialistic system. Also can make better $$$ down here. I'm afraid Mattsmom81 is right. Government run health care==LOW PAID NURSES (just look at salaries for nurses in health dept's and schools).
  13. by   fiestynurse
    Also, Great Britian's system is much different from Canada's system, which is single payer. Great Britain is among the OECD countries with national health services, in which salaried physicians predominate and hospitals are publicly owned and operated. Britian's system has been grossly underfunded for years, which has kept nursing salaries low. Prime Minister Tony Blair is about to change all that.

    The New York Times
    April 21, 2002
    Blame Me if Health Plans Fail, Blair Says
    By Reuters

    Britain's Prime Minister Tony Blair said Sunday his government's mission to overhaul public health care was a huge challenge and he would take the blame if it failed.
    Opinion polls published Sunday suggested most Britons were ready to pay more for better health treatment.
    But they also revealed a widespread belief that Blair had broken an election pledge not to raise income tax...

    ...Chancellor Gordon Brown hiked taxes last week to pump billions of extra pounds into the ailing National Health Service (NHS).

    Wednesday, Brown outlined plans to pour an extra 40 billion pounds ($58 billion) into public health care over the next five years. Most of the money will come from taxes, with a one percentage rise in National Insurance -- a payroll tax -- right up the salary scale being the biggest revenue earner.

    Blair has refused to rule out further tax rises but said the changes to the health services were covered by Brown's steps on Wednesday. He dismissed as "nonsense" accusations that his Labor government was returning to a "tax and spend" policy.

    http://www.nytimes.com/reuters/world...ain-blair.html

    Comment: Innumerable models have demonstrated that public funding and public administration can deliver more health services to more people for less money. But public funding has been a major weakness of the existing programs.

    In the United States, our system of combining both public and private funding has resulted in the most generous health care funding of all nations, estimated to be 14.7% of our GDP for 2002 (Office of the Actuary of CMS). But we have seen that other nations that have relied on public funding have failed to provide enough resources to assure capacity that would prevent excessive queues for services. The British system has been frozen
    at 7% of their GDP, primarily because of political resistance to taxes.

    Apparently the administration of Prime Minister Blair has finally decided to confront the real issue. The National Health Service simply needs more tax revenue.

    The lesson for the United States is that we must counter political efforts to isolate the concepts of "taxes" and "government" as if they were topics unrelated to our social needs and desires. Leaving half of our health care system under private funding in the private sector has resulted in the worst inequities in health care of all industrialized nations.

    Most Americans do believe that we need greater equities in both access and coverage. The private sector has proven that these goals cannot be achieved without including taxes and the government in the comprehensive design of the system. Whereas other nations are facing the issue of needing more funding, we have already made the decision to devote the resources needed
    that would fund comprehensive care for everyone.

    Let's now define the proper role of government and taxes in a system that actually would provide the universal access and coverage for which we are already paying. Even the political opponents admit that a single payer system would do this. Why do you think they are excluding us from the forums on reform? Simply because the logic of our message is so clear that our voice must be stifled. Thus, the deceptive "tax and spend" rhetoric is being used to dismiss us in our absence.

    Let's end these deceptions by adopting more accurate rhetoric such as, "Comprehensive health care for everyone: We're paying for it! Let's have it!"
    Last edit by fiestynurse on May 1, '02

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Universal Health Coverage?