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| No. 10 | 
Jun 27, 2009, 11:16 AM
 Re: Health Care: The Ticking Time Bomb Originally Posted by cursedandblessed  However, I don't want to be stuck under a system that does not allow me treatment when I need it, and by the doctor of my choice. I do not want employers thinking that just because there is a government option, they no longer need to cover their employees. That is my biggest fear in government healthcare. Just because the government states that nothing will change, does not mean that the employer's won't see this as an opportunity to save money.
In my experience, it's the private insurance companies who limit treatment and choice of physicians.
We are the only country that links insurance coverage to employment, and it makes no sense. I think one of the best things we could do (short of going to a true, universal, single-payer system) would be to break the tie between insurance and employment. A lot of people are unaware of the history -- employers first started offering health insurance to employees during WW II, when wage freezes were in put in place by the government and employers were looking for other ways to attract good employees, other enticements they could offer besides more money. That made sense, I guess, at the time, but we've been stuck with this system ever since and it's a dumb system, IMHO. Especially in this current economy -- when so many people are getting laid off from their jobs, not only do they suffer the economic blow of losing the income, but they also lose their health insurance at the same time!
Plus, speaking of "choice" -- as it stands now, we're at the mercy of our employers and whether they choose to offer good insurance or sucky insurance. I currently work prn at an inpatient psych facility -- and, as a prn RN, I don't have benefits, so it doesn't affect me -- but a frequent topic of discussion at work is how ironic and frustrating it is that our big-healthcare-"system" employer apparently feels that mental health treatment is important and worthwhile enough to operate a "full service" inpatient/outpatient mental health program, and they sure want local people to come there for treatment -- but the health insurance our (cheap) employer provides offers NO psychiatric coverage; if any of the facility's employees needed psychiatric treatment, that's just too darned bad.
 | | Advertisement Sponsored Links | | | | No. 11 |
Jun 27, 2009, 12:14 PM
Re: Health Care: The Ticking Time Bomb
Well, Jopacurn, you are very special indeed and must have lots of resources to be able to afford the best doctors on a self-pay basis.
Docs that do not want to participate in a government insurance progam don't have to now, and won't have to under healthcare reform.
As a PACU nurse, you have limited exposure to patients and don't have an opportunity to listen to patient's stories about paying for their healthcare; insurance premiums, copays, co-insurance, denials, bankruptcies, etc.
| | No. 12 |
Jun 27, 2009, 01:07 PM
Updated
Jun 27, 2009 at 08:13 PM by HM2VikingRN
Re: Health Care: The Ticking Time Bomb Originally Posted by cursedandblessed [b][i][COLOR=indigo
However, I don't want to be stuck under a system that does not allow me treatment when I need it, and by the doctor of my choice. I do not want employers thinking that just because there is a government option, they no longer need to cover their employees. That is my biggest fear in government healthcare. Just because the government states that nothing will change, does not mean that the employer's won't see this as an opportunity to save money.
Countries with UHC typically have better access to health care when sick than do Americans.  at http://www.commonwealthfund.org/Cont...imeliness.aspx
and  at http://www.commonwealthfund.org/Cont...can-Healt.aspx
The proposal is not going to allow employers to opt out of their responsibility to provide contributions to the cost of health care. IOW its going to become a "pay or play system." Either you provide a health care benefit package to your employees or you will pay a tax to purchase health care for your employees. No more free riding for Walmart.
I definitely support a public option!
| | No. 13 |
Jun 27, 2009, 08:57 PM
Re: Health Care: The Ticking Time Bomb Originally Posted by indysmom Well, Jopacurn, you are very special indeed and must have lots of resources to be able to afford the best doctors on a self-pay basis.
Docs that do not want to participate in a government insurance progam don't have to now, and won't have to under healthcare reform.
As a PACU nurse, you have limited exposure to patients and don't have an opportunity to listen to patient's stories about paying for their healthcare; insurance premiums, copays, co-insurance, denials, bankruptcies, etc.
You are making assumptions based on my name. Since I worked ER, Trauma, and ICU AND med-surg--yes, I've heard MANY STORIES--a lot more than you, perhaps?
I've also been a nurse for 18 years. The problem I see, with the government's insurances (Medicare and medicaid anyone?) is the hoops and endless red tape that many disillusioned physicians I know personally who are already saying, "no more."
I don't know about you, but I don't see any of our young docs going into general practice--do you???
So with THAT limited amount of GPs wiling to do that, who will end up with the short end of the stick?
I think that healthcare reform SHOULD BE DONE; but not by government bureaucrats whose only true reason for doing this is for votes.
I say give it back to the people in the front line--the healthcare provider.
| | No. 14 |
Jun 27, 2009, 09:35 PM
Re: Health Care: The Ticking Time Bomb
I'm afraid you are misinformed. Medicare and Medicaid (administered by individual states) are not the reason for the "endless red tape"; it is private insurers who require more and more documentation because they don't want to pay providers! Medicare is a entitlement program - it's budget and expenses are established by legislative law. Yes, they do want to keep down costs and provide cost-efficient and effective health services, but they are not motivated by profit.
A primary reason there is a shortage of primary care physicians is because their services have been devalued through a system where private insurance establishes the economic rules.
You should pick up the latest issue of Consumer Reports. There are a series of articles in this issue which explain in a very easy to understand manner how the health system will likely change and the repercussions of health care reform.
And by the way, I have spent nearly 20 years doing health planning and strategy consulting for public and private entities. I have also worked in many hospital departments including patient financial services, so I am well aware of the financial challenges facing both providers and patients.
Nurses have a lot to gain through healthcare reform, including the realization among policy makers of the true economic value of the services we provide.
| | No. 15 |
Jun 28, 2009, 09:11 PM
Re: Health Care: The Ticking Time Bomb Originally Posted by indysmom I'm afraid you are misinformed. Medicare and Medicaid (administered by individual states) are not the reason for the "endless red tape"; it is private insurers who require more and more documentation because they don't want to pay providers! Medicare is a entitlement program - it's budget and expenses are established by legislative law. Yes, they do want to keep down costs and provide cost-efficient and effective health services, but they are not motivated by profit.
A primary reason there is a shortage of primary care physicians is because their services have been devalued through a system where private insurance establishes the economic rules.
You should pick up the latest issue of Consumer Reports. There are a series of articles in this issue which explain in a very easy to understand manner how the health system will likely change and the repercussions of health care reform.
And by the way, I have spent nearly 20 years doing health planning and strategy consulting for public and private entities. I have also worked in many hospital departments including patient financial services, so I am well aware of the financial challenges facing both providers and patients.
Nurses have a lot to gain through healthcare reform, including the realization among policy makers of the true economic value of the services we provide.
Go to www.MiamiHerald.com and take a look at OUR costs--Miami is a special region and we are haves and have-nots. No doubt about it.
Yes, their services (GPs) have been devalued for the very reason you cited--but no one is addressing the other issues--such as a much needed Tort reform. Why do I go to other countries to "practice" real nursing? Because it is TRUE nursing, not this "write it all down and cover your butt nursing or else you will get sued nursing." As for the GPs, again...I know of NO ONE IN MY CIRCLE that is gung ho about becoming a "GP." And moreover, you still haven't explained how this new healthcare system would "encourage" participation by the real good docs. Any suggestions? Now that Medicare is telling the hospitals/docs/HCPs that "bundling" will be the way to go.....(which I agree with) still doesn't address some underlying problems- Where will you get the "new" docs when the older docs say, "I don't think so." As usual, those who spout this wonderful new system never come up with the details to make it realistically implementable.
Tell me how more of your information once you're in the frontlines, not spouting information from behind the desk.
| | No. 16 |
Jun 28, 2009, 09:53 PM
Re: Health Care: The Ticking Time Bomb
Some doctors don't want to take medicare and medicaid, not because of the "red-tape" but because they do not get paid what they want to get paid. Dentists won't accept medicaid because they get paid 10% of what they want for a procedure and yes it is a lot of paperwork. I've dealt with medicaid and private insurance. Private insurance has as much red-tape now.
A single payer system would be great!!! Some Dr's may no longer have his and her convertables in the garage of a 3million dollar home, but a lot of us that are getting rich off healthcare dollars are going to have to take a cut to get our patients the care they need and DESERVE. I'm 100% for it
If the Doctor does not like the system that used to make him rich he can move to either a 3rd world country and see how that works out for him or another universal-type healthcare system because, I think, were about the only medical industry thats 100% capitalistic!
| | No. 17 |
Jun 28, 2009, 11:55 PM
Re: Health Care: The Ticking Time Bomb
I don't have a lot of sympathy for the docs. So, their salary drops from $250K a year to $150. Docs in other countries with universal healthcare systems make a nice living, get to focus on patient care and don't have the administrative burden our docs do. Of course, it is all about economics, which is how the specialty distribution occurs. A more reasonable payment system where the financial disparity is less between primary care and specialists would help in balancing supply and demand. Also, financial assistance for docs going into primary care is available, but not to the extent where it has changed behavior, yet.
I am very familiar with the Miami market, having been a mergers and acquisition specialist in that market. It isn't any different from any other large market with a significant number of immigrants, large numbers of uninsured and a large number of tertiary hospitals competing for the small number of GHI patients. Phoenix, La, Atlanta and Dallas all are dealing with the same issues.
A problem with staffing in Miami is salaries are generally lower because it is such a desirable place to live, they don't have to pay as well. Also, in Miami, there are not a lot of large multispecialty groups, but mostly solo practitioners and small practices. This makes it more difficult to deal with administrative challenges and expenses related to a practice can not be spread among multiple physicians. The market is more fragmented.
Health care reform is an incredibly complex undertaking and not everyone will be with happy the result. The ultimate goal is to ensure all citizens have access to an established, standardized level of quality care. I believe a profit motive is an obstacle to quality care. If you can remove the profit motive from the equation, you can devise a more balanced and equal system of care.
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