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cwazycwissyRN 7,317 Views

Joined: Jan 1, '03; Posts: 1,537 (23% Liked) ; Likes: 897

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  • Aug 16 '09

    According to H. R. 3200 "The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research...with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures," ( The way this takes place is through QALY (Quality-Adjusted Life Year)which assigns a numerical value to each year of your life ( A year of perfect health gives a person a 1.0 while a year of sub-par health would be a number between 0 -1. If you are in a wheelchair, blind, or some disease (Parkinson's for example), then you automatically start with a lower score for that year. Age will also decrease the score.

    What is the justification for this? According to Peter Singer, Princeton ethicist and Liberal icon, "Health care is a scarce resource, and all scarce resources are rationed in one way or another,"( So who will tell David Letterman (bad heart), Magic Johnson (HIV), and others that their QALY doesn't qualify? Well for them probably no-one, but for you and me, hmmmm!

  • Jul 29 '09

    Oh my gosh, you said it very well! Maybe we should just let the States handle this.
    "The proper role of government is to provide equal rights, not provide equal things."

  • Jul 28 '09

    We already have "socialized medicine" here in the U.S. in the forms of Medicaid, Medicare, VA and in a different form, the HMO's. That is a start to your comparison. I don't believe there is a simple answer to this. I have been without insurance and needed health care, and fell between the cracks. I found that working out a payment plan with the hospital and doctor worked out well.

    But what I personally think, is that I do not want the government involved any more than it already is. This country is broke, trillions of dollars in debt, and this will bring us further to our knees. This is not what I want to leave for my children. America, wake up to the bigger picture. This is a power and money grab. Why are they rushing it?

    Health care is not a right, it is a responsibility. But it is also our responsibility as Americans to help those out in need. I know a lot of people will be angered with me saying that. But when does it stop? Do I pay for your car insurance, your house insurance next? We can't pay for everything, and be the country we were supposed to be. We need to FIRST fix the problems with our current system, and maybe even dismantle some of it (good God! What?). Second, build it back up learning from the mistakes of the past.

    Government beauracracy is not the answer. There are other options out there, but none are being reported. Here are the two main bills: HR 676, HR 3200. Check them out for yourselves at and at, and click on "legislation". Be informed, not from just what you hear on the news and through heresay, but through your own research. Then, make your own informed decision.

  • Jul 15 '09

    Unfortunately, the prez had the prez of the ANA on camera. The impression he gave the public, "she represents 2.5 million (or thereabouts) nurses and supports this bill!"

    She is not my voice.

    All of us in the medical field will be affected, gravely, by this.

    It's a scam and a sham!

  • Apr 13 '09

    I decline to get into these rudimentary arguments about what system is better. I think that we have a rather unique opportunity to insure everyone so that everyone has access and build a system by which we employ the most sucessful methods from UHC systems that have been deployed in many other countries. People love to scapegoat Canadian and UK system, truth is there are many different systems and policies in most other countries worth examining. Fact is that many countries have fundamentally good systems that could use fine-tuning in one way or another, but there of course areas of opportunity for improvement, doesn't mean the system is garbage.

  • Apr 13 '09

    I never argued the 'ethics' or morals of malpractice.

    What you can't deny, however, is that the massive awards and the subsequent practice of defensive medicine results in more expensive healthcare.

    So, you have to decide. Do you want a UHC system? Then you have to acknowledge that those system which are celebrated as 'successful' systems are not party to our brand of tort.

    What you can't do is try to force the implementation of a specific kind of healthcare system while failing to control the very issues which make it unaffordable...or even more disingenuous...ignoring the issue, or blaming it on someone else.

  • Apr 13 '09

    Sorry guys, but Michael Moore's movie is such a propaganda, I'm surprised professionals like you guys would even be watching it. Sicko....that's him all right.

  • Apr 4 '09

    Quote from herring_rn
    when we all have the same insurance doctors won't refuse patients based on their plan.

    they won't be able to. the government will mandate participation, regardless of inadequate reimbursement. that will force enrepreneurs into other professions. the number and quality of providers will go down. if you think the wait time for a specialist is bad now, just wait until there are no specialists left willing to practice medicine.

    and along with many thousands of nurses i will work to ensure reimbursement to providers is fair.

    that sounds good, and is an admirable goal, but look how far we, as nurses, have to go with critical issues such as staffing and mandatory ot. the truth is that we don't have the ability to significantly impact these issues now, and our ability to do so will decrease even further when the government has a monopoly on payment. just like trying to negotiate the price of a postage stamp.

    and primary providers will not have to employ the numbers of people to just do billing for the multitude of plans. those smart people who do billing can then do something useful.

    sounds good, in theory. but i think we all have at least anecdotal experience with trying to get care approved and paid for medicare or medicaid patients. i have seen absolutely no evidence that those programs require fewer personnel for providers, as our doctor's offices and hospitals employ staff members whose sole responsibility it is to pre-approve services, file claims, etc. then they wait for months to get paid for services rendered. only the government can get away with that.

  • Oct 19 '08

    doesn't everyone have a "right" to health care? it's easy to agree with a meaningless campaign promise such as "affordable health care for all".

    universal healthcare amplifies all problems. it reduces patient incentives to find the best possible prices for the best possible services/products available. patients in the u.s. who receive "free" (taxpayer-funded) health care have no incentive to conserve their health care dollars. care is "free" so they visit the doctor's office several times a month or request "free" prescriptions for over-the-counter medication such as tylenol.

    it reduces physician incentives to provide competitive care and reduces drug companies' incentives to provide new drugs and treatments.

    it steals from your wallet to pay for my health care. yes, you do have a right to health care, just as you have a right to food, shelter and property. however, you have no "right" to force others to provide these things for you - all "free" medical care is subsidized through taxes stolen from other people. the quality of "free" health care will deteriorate and the average citizen will get sicker. as the poor and middle-class wait for simple procedures, those with resources can travel to other countries for treatment.

    it destroys your privacy. suddenly your problems are mine and mine are yours. if you eat unhealthy foods or drive a motorcycle without a helmet, i have a direct interest in your business - you are going to see a provider on my tax dollars.

    it destroys your liberty. when you blindly support a system that bestows power on politicians and bureaucrats, they will receive their orders from those with the most money and this will not be you, your friends or your family. the power of government will be used against you as you are forced to use medicines or accept treatments from well-connected health care companies.

  • Sep 13 '08

    The original question, will universal healthcare ( in the USA) cut RN pay?

    In the long term, I doubt it. Supply and demand controls much of our economy and salaries. In the short term, if universal healthcare is suddenly implemented, I suspect there would be enormous changes in everything.

    Government screws up most everything it controls. Look at the education system. Yuch. We are where we are now because of governmental regulations that requires that anyone who has an emergency can go to the ER and not be refused. This, of course, can result in millions of dollars of unpaid bills in each hospital. This results in having to charge those who do pay even more to make up for the losses. At some point, insurance companies have to charge more for the inflated prices caused by the non-payers. At another point, insurance becomes too expensive for the average person to afford. There is a cause and effect to all decisions made.

  • Sep 13 '08

    Quote from HM2Viking
    If everyone is in the risk pool costs come down. (along with a consistent benefit set.) Paying a consistent percentage of income is not unreasonable. Right now we have 1/3 of our populace unable to afford adequate coverage. Family coverage is easily 1000/month. With 1/3 of our populace supporting families at 200% of poverty or below that represents 25% of their income going to health care. Absolutely unaffordable for a family. With 27% of their premium dollars going to expenses that is a tremendous upwards redistribution of wealth. (270$/month.) That 250 dollars/family would pay for a lot of preventative care.

    This is where I have a problem. It would be nice if everyone were to contribute, but as it stands now in this country, those with families (read: only people with minor children) and lower incomes pay next to nothing in taxes (some even get more money back) but use the most resources. So using this model, as the gov't often does, I would still be paying for far more than I could possibly use and have to deal with the realities that I think UHC will bring (ie ... only certain conditions covered, larger deductibles for those with higher incomes and such.) I just can't afford that and I think it's unreasonable to require that I give a larger portion of my (very hard earned) income than others. It concerns me quite a bit that I will still be penalized for being a responsible citizen.

  • Sep 13 '08

    Since everyone like anecdotal stories, here's mine.

    I was raised in the dirty south, poor to the extreme. I never once saw the inside of a dentist's office as a child, went to the doctor maybe 2 or 3 times in my childhood, and went to bed hungry 3 nights out of 5.

    As an adult, I've never had a job that didn't offer health care coverage. I've never been on welfare. I made the choice between gas for my 1979 Honda Civic and food many, many times. I don't (yet) have a college degree, but I did graduate from HS. First ever in my family, and still just one of 2 that did it.

    What I DID do is get a job as soon as I was able, and worked every day. When one job became untenable, I moved on to one that fit better. As I said, I made sure they all offered HC benes. I spent 15 years working on Death Row for the state of Texas prison system, having feces, urine, spit and sperm thrown at my face day after day, living with the scent and burning sensation of tear gas for hours and days at a time. I did all this with a HS diploma, and the motivation to keep my job, make a living, and have benefits.

    I'm married to a beautiful nurse, now, and we live pretty well on what I'd saved and what she'd saved and what she makes, while I go to school. About 6 months ago, I bought the first new car I've ever owned. First car that was less that 10-20 years old, in fact.

    My parents are still dirt poor (and old and sick - Dad won't last a year), and our daughter is poor, and we do what we can to assist them. That is our responsibility. It ain't yours.

    Using poverty as an excuse for failure just makes you a failure.

  • Sep 13 '08

    Sometimes you have to move to a more productive area. The days of great paying manufacturing jobs in this country are gone, no matter who the President is. I commend you for working two jobs to make ends meet. You are doing a lot more than most people would in similar circumstances. The good job will come when your fiance finishes RT school and perhaps at that point you can go to school and learn a valuable trade that will provide a more comfortable lifestyle. Your only limit to your potential in life is your motivation to succeed.

    Quote from Cat84
    I think that this is a great idea. I currently work 2 jobs to send my fiancee to school for resp therapy. He works two part time jobs because there are no full time jobs for someone who has experience with factories and security jobs. Thank God we do not have kids-I do not know what we would do. I am just wondering where all these jobs to support a family would come from. At least here they are certainly not plentiful.

  • Sep 13 '08

    Quote from Stanley-RN2B
    That's quite easy, in theory at least. Penalize the people that refuse to partake in preventative care. We do it for smokers and the obese now in some places.

    May be a little big brotherish but if you had A B and C available but only chose to utilize C the when lack of A and B leads to X and Y you have to pay more...

    It's sounds mean but we don't have a culture of preventative medicine. If we force that culture eventually it will become our culture and there will be no more need to force it.

    Of course I am a strong believer in sometimes people just don't know what is good for them and a little nudge is good... Where the nudging ends is always a problem of course. There, of course could be opt out options and such. Yes, complicated I know but nothing worth doing is ever easy.
    Once a freedom is given up it is gone forever. There is no getting it back. What right does someone else have to tell me that I can't go to McDonalds and eat what I want to and I can't drink a beer if I want to either. Pretty soon this country will be China and the government will have to pick our jobs for us too.

  • Sep 13 '08

    How much abuse do you see in the Medicaid system? You know, the "my kids has been sick for the last three days, so I waited until Friday night and brought him to ER" bunch. I see a lot of it. So Texas starts a health insurance program for low income kids-guess what happens! More kids in the ER that should have been in the Dr's office. My favorite is the "One kid is sick so I brought the other three in also" lady.
    The fact is that when people do not pay for something they do not respect it and they tend to abuse the system.
    Ask any Dr what Medicare reimbursement is for an office visit. Last I heard was $19. This has to pay for the doctor, the office, the office staff, supplies, etc. Then what happens, people complain that the doctor does not spend enough time with them.
    So now we change to universal healthcare and let the government control all the money. After all, they have done such a good job of managing social security.
    Plus we shift it to where no one has to pay anything for their healthcare. What is that going to do to our ERs and Dr's offices and clinics.
    I do not claim to have an answer to the problem. but I think that I do know a couple of things: 1. We need to FORCE people to accept at least some of the responsibility of the cost of their healthcare. and 2. letting the government control just about anything (especially where it concerns money) is a recipe for disaster.