What so you think is the biggest problem in Health Care?

[madwife2002]

I have been in health care for 21 years and the problems have always been the same no matter where I have worked nor in what town, country etc.

My biggest gripe is the lack of staff I can probably count on 2 hands the time that we were fully staffed.

Now I am a manager and I know from behind the scene how difficult it is to staff my unit, it is my biggest headache. The way that the upper management calculate staffing requirements is almost 'alien' to me!

I think it should be a simple math ie we have x amount of pts, x amount of days so we need this many nurses and PCT's! But where I work it is not done that way, it done by division of hours etc. So this means staffing is worked to the exate number but does not allow for vacations, call offs, higher acuity in fact it is rigid.

[itsmejuli]

The bottom line is the shareholder of any public company. As long as profits are up who cares about patients and staff.

[nebrgirl]

it's both extremes...insurance and pharmacutical companies raking in big bucks, and a medicad system that is broke. Insurance and pharmacutical companies need more government oversight, medicad needs to inact a co-pay, and people need to quit arguing that medical care is not a right...that was decided with EMTALA

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

Thank you all for giving me back my faith in humanity. For years I've felt like I was alone complaining that the equation of dollars vs lives was completely stacked in favor of dollars. I go a step further, though. The constitution guarantees the right to life. I believe to my last breath that someday a case will go through the supreme court and right to health care will be seen as inextricably linked to the right to life. It's insanely unconscionable that in the richest country in the world people die because they can't afford the medications they need, while insurance and drug companies make huge profits. Money can buy many things, but lack of it shouldn't cost a life!!!!

[Fiona59]

But wait many of the problems you describe in your privatized system exist under universal healthcare.

Staffing needs somehow magically change on weekends and evenings despite the number and acuity of patients remaining the same.

We all have access to healthcare but it will depend on where you live how fast you can access it. High risk pregnancy in the high Arctic, you'll be medivac'd down south to Edmonton, Winnipeg, etc. Need specialty surgery? South you go. Trust me, at times it seems our northern residents wind up on specialty units faster than locals.

Drug costs are still a problem for many. Unless they have a benefits package through an employer or are on Social Assistance (Welfare) people have problems paying for their meds.

Lack of money will prevent access to meds, not medical care.

[nursel56]

Thank you all for giving me back my faith in humanity. For years I've felt like I was alone complaining that the equation of dollars vs lives was completely stacked in favor of dollars. I go a step further, though. The constitution guarantees the right to life. I believe to my last breath that someday a case will go through the supreme court and right to health care will be seen as inextricably linked to the right to life. It's insanely unconscionable that in the richest country in the world people die because they can't afford the medications they need, while insurance and drug companies make huge profits. Money can buy many things, but lack of it shouldn't cost a life!!!!

Unfortunately at this point it's hard to see how we extricate ourselves from the monstrosity (talking structurally, not quality-wise) of the semi-for-profit semi-publicly funded thing we are dealing with right now. It's very depressing.

I am just tired of reading story after story of parents of children with cancer literally forced into side careers as fundraisers for their children, where they may raise $10,000 if they are lucky. . through making necklaces and virtual "Lemonaide Stands" the price of a few weeks supply of certain chemo drugs. How can this be?

On the other end are the demand issues. The staggering cost of treating essentially lifestyle related illnesses and the amount of money spent on keeping a not really alive person "alive" for several very, very expensive months before what was going to happen anyway finally happens. I know that isn't just one problem- I'm sorry.

[llg, PhD, RN]

I think the fundamental problem underlying most of the problems is that society has not "worked through" the questions of "What kind of health care does it want?" and "What are people willing to pay for?"

Policies are made of the basis of conflicting social mandates. People want "everything" in terms of what's available for them and their families. However, when the tax man (and/or insurance agent) comes to collect on payment for providing those deluxe services, people don't want to pay. So the government is caught trying to develop a system whereby everyone gets the maximum in services, but only pays the minimum. That results in a complex, mucked-up system that doesn't work and is fertile ground for abuse of all types.

In essence, we all want the government to give us the freedom to keep grandma alive on a venitlator etc. as long as WE want. We want no interference in our personal decision-making and we want unlimited money at our disposal to spend. However, we don't want to pay the bills for that care, and we certainly do not want other people to have access to unlimited amounts of our money so they can keep their grandmas alive indefinitely.

Until we resolve that conflict of desires, we will have a mess.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

But wait many of the problems you describe in your privatized system exist under universal healthcare.

Staffing needs somehow magically change on weekends and evenings despite the number and acuity of patients remaining the same.

We all have access to healthcare but it will depend on where you live how fast you can access it. High risk pregnancy in the high Arctic, you'll be medivac'd down south to Edmonton, Winnipeg, etc. Need specialty surgery? South you go. Trust me, at times it seems our northern residents wind up on specialty units faster than locals.

Drug costs are still a problem for many. Unless they have a benefits package through an employer or are on Social Assistance (Welfare) people have problems paying for their meds.

Lack of money will prevent access to meds, not medical care.

We're already paying the highest price in the world, but not getting the best healthcare. I doubt congress has the ability to see beyond it's individual pockets to correct the problem. Evetntually I hope for some kind of huge public pressure to create a system as close to perfect as humanly possible. We are paying too much for what we get, and I don't accept other's premises that the poor are scamming the system en mass. It's our system, we're only powerless if we allow it. As The California Nurses Association says, we don't need insurance, we need healthcare. It's our system, lets fix it right. Start by getting our priorities right; life is MORE important than money. We CAN get better care for LOWER COST.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

People abusing the system. They're sucking medicaid dry for a bunch of nonsense.

Been in healthcare about 33 years (57 yrs old). Last year made about $70K. January of this year my back went from a perfect storm of injuries, aging, disease processes, and genetics. Saw 15 docs just wanting someone to fix me so I could get back to work (New Englander work ethic; hard work fixes everything). What I'm left with is SS Disability $24K/year. That makes me too wealthy to get medicaid, so I have to buy my own health insurance. In 2 years I can get Medicare. If I can find a job I can do from my bed by phone while taking pain meds I may be able to do better. I'm living with my soldier daughter for now.

Can you explain to me how I can abuse the system and suck medicaid dry? I need all the physical and emotional support I can get at this point. I hesitate to put all this personal information out there, but hopefully other nurses will protect their bodies from the damage done by nursing and not end up like me.

[jjjoy, LPN]

We can also look at other agencies/organizations that end up "milking" insurance, both private and public. Sometimes, products, services and tests are pushed upon patients who may not really need or even want them but "you don't have to pay for it, insurance will cover it" so why not?

I don't know if there's really any way to enforce balance between offering products/care/services to those in need and human ingenuity in finding ways to maximize personal gain - organizations that may encourage unnecessary use of their product/service because they get financial rewards, people who accept unnecessary goods and services because "they don't have to pay", etc. Then toss into the equation that even if only true necessity won the day, there still probably would not be enough resources to meet everyone's health care needs.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

We can also look at other agencies/organizations that end up "milking" insurance, both private and public. Sometimes, products, services and tests are pushed upon patients who may not really need or even want them but "you don't have to pay for it, insurance will cover it" so why not?

I don't know if there's really any way to enforce balance between offering products/care/services to those in need and human ingenuity in finding ways to maximize personal gain - organizations that may encourage unnecessary use of their product/service because they get financial rewards, people who accept unnecessary goods and services because "they don't have to pay", etc. Then toss into the equation that even if only true necessity won the day, there still probably would not be enough resources to meet everyone's health care needs.

Get enough people concerned and involved in intelligent desire for change is probably the best start. The city of Denver has more MRI machines than all of Canada, last stats I saw. Allowing me a little artistic license, healthcare is suffering from "the 7 deadly sins."