Health Care Law vs Patient Outcomes

Nurses Activism

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The way I understand our current Third Party Payer system the major decisions are made by a company looking to cut costs and make a profit. Drs are encouraged not to order 'unnessasary tests' (as if they would waste their time or effort on any test that is truely unnessasary) and Nurses are encouraged to not bring 'unnessasary' equipment into the patients room, streaching our care between 8-10 patients in the acute care setting and in LTC the ratios are extreemly frigtening.

But at the same time countries with a Single Party Payer system run into their own chalanges; Wait lists, higher taxes, and some treatments are not covered, not to mention it can be a buerocratic nightmaire. While I have never worked in a country with a Single Party Payer system, I am sure Health Care Providers are met with just as many chalanges.

As Nurses our priority isnt cost, profit, or politics; it is and always will be our patients. So my question is; Which system shows better Patient Outcomes, and why? Has there been a study done compairing them that I am not aware of? I want to better understand what is best for this country, and more importantly my patients.

*** I would like to see the evidence of that being true. Sounds OK but I am sceptical. With my fantasic experience as a patient, the father of a patient, the husband of a patient, the grandson in law of a patient and as a nurse in a single payer health plan I lean hard in that way. Especialy since I paid less in taxes as a percentage of my income in that country than I do now in USA.

That said I am willing to concede that just becuase a single payer system can provide great and timely care at a low cost, that doesen't mean it can be pulled off by Americans.

You are right, we don't have evidence. We don't have any model to choose from as an example that we can replicate and predict the results with certainty.

I know you mentioned earlier too your % of taxes were less in the other country. Unless you know how all your taxes are broken down, it's hard to say if that is meaningful or not. The government in your other country probably spends a lot less on other things then the U.S. And do you really know how much you pay in taxes? I know many of us just look at our paystubs, and then forget that we often get a big refund once a year. Most of us in the end pay a lot less then we think.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
You are right, we don't have evidence. We don't have any model to choose from as an example that we can replicate and predict the results with certainty.

I know you mentioned earlier too your % of taxes were less in the other country. Unless you know how all your taxes are broken down, it's hard to say if that is meaningful or not. The government in your other country probably spends a lot less on other things then the U.S. And do you really know how much you pay in taxes? I know many of us just look at our paystubs, and then forget that we often get a big refund once a year. Most of us in the end pay a lot less then we think.

*** Uh, yes I know how much I pay in taxes, except sales tax. I don't keep close track of that. I also knew how much I paid in taxes when I was working in New Zealand.

If this healthcare situation isnt sorted out in a way to improve patient outcomes, Im not going to live long enough to recieve SS. Heck, I was talking to a friend today who wears her contacts twice as long as recomended becouse she cant afford to go to the optomitrist every year, and her insurance only covers every other year (which as we all know predispositions her to infection). It is not financially possible to put enough money in a HSA to cover multiple chronic illnesses, and it certianly wont help you for illnesses yet to come. People would wait to recieve preventative and early care which would compromise their long term health, we've all seen that first hand, so the methoid your proposing doesnt seem to be effective for giving our patients a long health productive life. Your argument is still strongly based on finances and not on patient outcomes, give me some facts as to how this is better for our patients and I might change my mind but right now a single party system has more facts to back it up, and as some other countries have proven it is financialy possible.

If this healthcare situation isnt sorted out in a way to improve patient outcomes, Im not going to live long enough to recieve SS. Heck, I was talking to a friend today who wears her contacts twice as long as recomended becouse she cant afford to go to the optomitrist every year, and her insurance only covers every other year (which as we all know predispositions her to infection). It is not financially possible to put enough money in a HSA to cover multiple chronic illnesses, and it certianly wont help you for illnesses yet to come. People would wait to recieve preventative and early care which would compromise their long term health, we've all seen that first hand, so the methoid your proposing doesnt seem to be effective for giving our patients a long health productive life. Your argument is still strongly based on finances and not on patient outcomes, give me some facts as to how this is better for our patients and I might change my mind but right now a single party system has more facts to back it up, and as some other countries have proven it is financialy possible.

If you take the few hundred dollars or more you pay for insurance premiums a month, and if your employer kicks in a few hundred dollars a month that they would for insurance and instead put it into a HSA, this would be $5 to 10K a year. In most cases, this would be more then a enough for preventive care and management of many chronic conditions and to purchase a insurance plan for emergencies and serious illnesses. For those in need, the gov't would contribute to a HSA.

You are correct, I don't have definate results to show what outcomes would be in a free-market healthcare system as there is not one that exists to model it after. However, I do know that almost every good and service I have in my life offers a variety of choice, price, quality, and value because of a free-market economy. And innovators are always looking for ways to improve these goods and services.

You say that a "single party (I think you meant payer) system has more facts to back it up". But you haven't supplied these facts. Please show me where 300 million people who are currently in a healthcare system where, although far from perfect, everyone gets some level of care, who are then put on a single payer system. Show me the better patient outcomes that have resulted.

The way I understand our current Third Party Payer system the major decisions are made by a company looking to cut costs and make a profit. Drs are encouraged not to order 'unnessasary tests' (as if they would waste their time or effort on any test that is truely unnessasary) and Nurses are encouraged to not bring 'unnessasary' equipment into the patients room, streaching our care between 8-10 patients in the acute care setting and in LTC the ratios are extreemly frigtening.

But at the same time countries with a Single Party Payer system run into their own chalanges; Wait lists, higher taxes, and some treatments are not covered, not to mention it can be a buerocratic nightmaire. While I have never worked in a country with a Single Party Payer system, I am sure Health Care Providers are met with just as many chalanges.

As Nurses our priority isnt cost, profit, or politics; it is and always will be our patients. So my question is; Which system shows better Patient Outcomes, and why? Has there been a study done compairing them that I am not aware of? I want to better understand what is best for this country, and more importantly my patients.

Here is one such study:

http://www.ncpa.org/pdfs/sp_Do_Other_Countries_Have_the_Answers.pdf

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

You know it occures to me that I have experience as a patient and working in two single payer systems. One in another country and one run by our own government, the VA. The VA has great outcomes and is relitivly low cost.

How Veterans' Hospitals Became the Best in Health Care - TIME

I don't know. I think there is a reason people come to the US for medical care.

Yeah, people who can afford it, or are given it pro-bono.

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