what are we coming to?

  1. This is a repeat of topic in "Managed Care" section: I'd like to hear how nurses feel about our system of health care delivery in the U.S. And from nurses who live elsewhere, how do you feel about the access to health care in your country (and what do you think about the system in U.S.?)?

    To me, it is abhorent that people who live in one of the prosperous countries go without needed health care because of financial restraints; that people who have worked hard and saved some money in their lives can be wiped out financially by an illness; that the "working poor" wait until their condition is dire before obtaining care; and that we tolerate a market-driven health system.

    I believe that the FOR PROFIT must be taken out of health care. The U.S. has the most expensive system in the world (about 25% of dollars are spent on administrtion of insurance plans), and we have some of the poorest outcomes. WHY?

    According to surveys, people who live in Canada and England are largely satisfied with their health care systems, they go to get care when they need it, they pay no money and fill out no forms; and their overall outcomes are better.

    I'd like to hear how other people feel about this. Thanks!!!
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  2. 18 Comments

  3. by   glog
    I was fortunate enough to experience healthcare on my own bones in 2 different countries. Here in the US and in Italy, which has a system very similar to the one in England. The advantages of the Italian system are that you are always covered, your insurance is not tied into your job, you have no forms to fill out, no money to pay out. When you move into an area, you are assigned to a local clinic and you receive all your care in that clinic. Also it is highly centralized. For example, suppose you live in a city and your children receive their vaccinations. If you are transferred to another city, you don't have to go hunting for immunization records. They are kept recorded in a national central bank that can be accessed with a computer, a print out made and easy does it, it goes to the school. I always hear a lot of put downs about socialized medicine...wait times, choice, less technology, but the reality is that socialized medicine in Europe is no different from receiving care through a managed care company in the US. The difference is that it is simpler ( really no paper work) and it covers 100% of the population. Europeans get choice, short waiting times and high tech, just like Americans do if you have money. If you can pay out of pocket, you see a private MD and use a private hospital. Just like in the US, if you are the CEO of a company, you would probably have commercial insurance, see whoever you please and be able to afford that sometime gigantic 20%. I have come to the conclusion that what really scares the American population is the word socialized. It conjures up images of communism and bread lines and scares the hell out of people who have never been out of their towns. I propose that the word social medicine be dumped and that federal medical plan be used instead. What if every American were covered by something like Medicare with some adjustments to control costs. The thing is also that physicians in Europe don't earn nearly as much as they do here, unless they are internationally famous. An average salary is probably in the range of 80,000. That is opposed for example to MDs in NYC making about half a million a year in private practice. In Italy, nobody goes into medicine to make money. It is a calling. If you want to make money there you have to pick another profession.
  4. by   Paula
    I live in Canada and I feel that our system is really quite wonderful. No one is refused access to healthcare and all people are treated equally (most of the time). We do have a lot of problems, however. We seem to have developed into a "drive-thru" healthcare society where things (tests, etc.) are taken advantage of because "IT"S FREE!". This is the attitude of many Canadians and (obviously) it is NOT true. We pay for it in our taxes, etc. This creates waiting lists, etc. It can be very frustrating. All in all, though, it does work very well.
  5. by   LindaC
    Thank you both for replying: I don't think that the polictical climate in this country will soon see a federal insurance plan (but I sure like the name!). I will be keeping my eyes open and my heart open for a way to try to impact this HUGE problem which really hits almost every single person who lives here. If you have any ideas of how to become politically active on this behalf, please share your ideas with me. Thanks! linda.
  6. by   AnnieD
    Linda,
    I live in Canada as well and feel we have a pretty good system, but as Paula said, we do have some problems with the people that abuse it. If there was some way to control this without the cost of extra paperwork, it would be great. I feel strongly that if people would be proactive and take control of their health by living a healthy lifestyle, exercising and taking antioxidants which now are proving to be a necessary addition to our diet, we could save greatly on these costs, and possibly give discounts to those that do. Like smokers that pay higher premiums for life insurance! I do teach wellness and disease prevention so welcome anyone interested to contact me. I can send you to a great webpage also.
  7. by   LindaC
    Hi Annie, In what capacity do you teach wellness, who pays for it, private or govt health plan? In what area do you live? What are some of your subject areas for classes and who are the audiences? Linda.
  8. by   sblanchet
    I disagree that the United States would be better off with a nationalized healthcare system. There are many ways of addressing access issues without letting the government take over seven percent of the private economy. I only ever worked in one for-profit hospital which was in West Boca. I stayed four days. What a dump. I have also worked in non-profit hospitals which were also dumps but they had big names and seemed to get by on that. Access to healthcare in Canada has its own set of issues most of which stem from poor utilization and rationing as well as the way physicians are reimbursed. That is why you will see stories about many Canadians crossing the borders to pay for their needed healthcare which they cannot get in a timely manner in Canada.
  9. by   Tweety
    I work for a not-for-profit hospital where everyone is treated equal. We spend millions on indigent care and they recieve excellent care.

    I'm not poor. But because I have an income and insurance, I have to pay high premiums plus copays wherever I go. So I as a middle class person might wait before getting medical attention. The poor seem to have more options for free care than I do. Perhaps that's as it should be, but I don't see poor people waiting until their conditions are dire, they go to free clinics or to emergency rooms. I pay out the butt, and consider thoughtfully my before going to an md, as do the working poor.

    O.K. end of rant. Thanks.

    No system is perfect, and I honestly don't have any answers. But America usually finds a way of paying for their poor.

    Are you writing a paper for school?
    Last edit by Tweety on Feb 8, '05
  10. by   KrisRNwannabe
    I think Federal Insurance programs are going to be one of those things that will never be able to win. You will probably get it doesn't cover enough and i can't do this and that. blah blah. I would love it if it worked but I have pretty good insurance and would hate to give it up for something inferior. I do think the government probably wants to do it but it is a huge task and I think coming up with a solution it a long and difficult one. I would hope they wouldn't try anything unless it was the best they could come up with. i think the cost is probably an issue as well.
  11. by   SmilingBluEyes
    I agree w/tweety . The crummy systems in the USA mean the middle class is the least-served medically. I know many who work for a living but can't afford medical insurance. Should it be free or the government take over? Well seeing how our government does when it privatizes things (scary), probably not. But SOMETHING needs to happen so WORKING PEOPLE get care, period. It's a national disgrace that anyone in our country should go without care. There is no safety net for the working poor. What is wrong with that picture?
  12. by   zacarias
    People say that the US has the best specialists in healthcare and thus other systems fall short. Is that so?
    So what that the US may have cardiac surgeons that can fix rare anomalies. It's sure a feather in our cap but if we can't provide at least some healthcare to ALL of our citizens, then how are we so special? Canada may have waiting lists for treatment but at least EVERYONE can be treated.
    I guess the questions are, "Do we treat everyone even if some will die? Or do we treat some people with the best of the west even if some will die?"
  13. by   stsdoc
    Who develops most new groundbreaking treatments, procedures, technology, drugs, etc, etc. Canada, Italy? I don't think so. If you take the competition out of medicine, then its quality will decline. The reason that we have the best specialists is because they are paid handsomely, which, like it or not, helps attract the best minds into medicine. If you take away that incentive, the quality of medical school applicants will go way down. When there is no incentive to find a better way to so something (ie $$), then how many people do you think will be working their tails off to come up with these new treatments? This is the essence of the capitalistic society, Which makes the U.S. a GREAT place. All other countries feed off of our medical knowledge, our procedures, and our drugs. JMHO.

    We have some access issues, but as it's been said before, I've never seen anyone, no matter how poor, turned away from the hospital. What needs to be reformed is the INSURANCE industry. I have absolutely NO love for these folks.
  14. by   sblanchet
    The idea that it is better to provide care to all citizens rather than address specific issues of access for those who don't have it is absurd. Canada has its own access issues. It is common knowledge that some Canadian citizens die waiting for care because of the bloated bureaucracy and increasing demand on a limited system. Dying while you wait for care even though you are technically entitled to that care by law is a lack of access. No Canadian who needs urgent care and is told to wait can demand care. Is giving everyone the same equally poor care better than a system where advances in technology and treatment flourish? And, yes. I agree with the person who pointed out that other countries, including Canada, feed off our system while looking down their noses at us as if they are somehow morally superior. In addition the Canadian government, by virtue of being a large purchasing entity, demands drastically reduced prices on prescription drugs leaving US citizens to pick up the tab for the development of new drugs, in other words, subsidizing the drug prescription plans of Canada's citizens. So how about paying full price for your medications up there? It costs a fortune to bring a new drug to market here. In addition drug companies spend vast sums of money developing drugs that never make it to market and must be compensated for that expenditure, too; otherwise, no new drugs coming on board from anywhere! Can anyone reasonably expect countries like Canada to pick up the tab for that?

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