Healthcare is NOT a basic human right.

[Asystole RN]

If one were to read the Constitution one would realize that the Constitution does not grant anyone freedoms, liberties, or rights. The Constitution only protects freedoms, liberties, and rights from transgressions on part of the government. A right is something that is inherent to the individual, comes from that individual, and is maintained by the individual. You are born with such rights like the right to speak freely, the only thing that can be done to that right is to have it infringed. No one can grant a right to another, only limit or impede the exercise of that right.

Healthcare is a human invention that does not exist in the natural environment. Only through the work of others and through the taking of resources from one party and giving to another does healthcare exist. You cannot force someone to give effort and resources to another and call that a right. In the absence of human intervention the individual would live their lives and succumb to the natural forces which would act upon their bodies.

Do I think we should provide preventative care and basic primary care? Sure. Do I think that we can? Maybe. Do I think that healthcare is a basic human right? Absolutely not.

[JMBnurse]

I have been here for the entire program. It has been tweaked since the democratic governor commisioned a study that found it was unsustainable. MCO's were responsibe for signing people up in the beginning and no one was denied. Look at the entire history of the program. Good intentions, but none of the promised benefits have occured.

http://www.memphis.edu/mlche/pdfs/tenncare/TennCare_Bulleted_Timeline.pdf

I have, as well. It has definitely been tweaked a lot, as will the AHA. I think it may be a little unfair to criticize a program today for problems it had 18 yrs ago. The timeline also shows that lawsuits have cost a great deal of money. We will have to disagree that "no one was denied", because I personally know people who were and have been. In 1994 and in 2012. I'm not saying TennCare is perfect, certainly not, and the AHA will share some of the same problems of early TennCare, because it does not go far enough.

[BlueDevil,DNP, DNP, RN]

One only need to look to France. Arguably the best health care in the world. However, it is true socialized medicine. The French also pay very high taxes and there is definitely rationing. Frankly, I think that is the way to go. The question is how many more people are going to suffer before we admit it.

Even without adopting a single payer system, taxes are going to have to be raised and rationing is clearly a must. There really is no way around either of those two fundamentals, the politicians just aren't brave enough to tell you.

[FMF Corpsman, MSN, RN]

37 Degrees, You still haven't answered the question as a good ways back, ARE YOU A NURSE?

[37 °C]

37 Degrees, You still haven't answered the question as a good ways back, ARE YOU A NURSE?

This is to realmaninuniform, who was obsessing over the question:

It is irrelevant. You need to not worry about the person, and refining your ad hominem attacks, and concern yourself more with the argument at hand. Focus on the facts, the claims, and the evidence.

Nurses have no particular knowledge of health care policy unless the chose to pursue it. It's hardy touched upon at the undergraduate level. You may have some exposure to it while pursing an MSN. If you're really interested in the subject (you've given the impression that you're mainly interested in the ideology of libertarian economics), then you can pursue an MPH. You can get a start with a certificate in patient advocacy.

You claim to be a nurse. You are an anonymous person on an Internet message board. Why should I believe you? Why should I care? It has no relevance. Either you can back up your claims with evidence or you can't. How many welfare queens (as you see the uninsured poor) you patch up is irrelevant to the subject under discussion. So are your anecdotes.

Why do I have to lecture a "scholar" on the obvious?

[37 °C]

One only need to look to France. Arguably the best health care in the world.

Based on objective measures, such as the WHO's, that is true. It's been true for a number of years.

(Digression: Look at the rapid progress they made in hand washing a few years ago. Within a year, they had a very high level of conformance. Compare that to the experience in the U.S.)

However, it is true socialized medicine.

It is not socialized medicine! The U.K. has socialized medicine; France does not. France has private and public hospitals, just as we do. Physicians are not employed by the government — they're in private practice. Health insurance is regulated, and it's generally obtained through one's employer. (That is not necessarily a cause of their system's success, but it is a correlation.)

The French also pay very high taxes and there is definitely rationing.

No system offers infinite coverage, so someone has to draw a line somewhere. To those who are happy to let a for-profit insurance company draw that line themselves, I suggest they look into our recent history in that area.

The "high tax" issue is a red herring as far as the healthcare system is concerned. The French spend a bit more than half of what we do per capita. That is a fact. Whichever route we pay for health care, it comes out of the same pocket.

Frankly, I think that is the way to go. The question is how many more people are going to suffer before we admit it.

Many. Even with the implementation of the ACA in 2014, millions will still be uninsured, in a large part because of the recent Supreme Court ruling on the matter, when they upheld the constitutionality of the mandate.

Even without adopting a single payer system, taxes are going to have to be raised and rationing is clearly a must. There really is no way around either of those two fundamentals, the politicians just aren't brave enough to tell you.

I don't know what kind of insurance you have, but every plan I've seen has limits. The lifetime caps have been repealed as a consequence of the ACA, but there are still limits. We need to decide rationally what those limits should be. Gov. Richard Lamm of Colorado tried to broach the subject in 1984, but people didn't want to think about it. Daniel Callahan wrote a book about it in 1987. Oregon has specific limits on Medicaid. (Oregon has an interesting history in healthcare legislation; for that matter, so do Hawaii and Massachusetts, even before "Romneycare.") Meanwhile, we routinely perform hip replacements on 90-year-olds, and spend an enormous amount of money of end-of-life care, some of which is pointless.

Please be careful when using words such as "socialized." It is a dogwhistle word for many Americans.

[malamud69, BSN, RN]

I must say the heat between 37 C and realmaninuniform is entertaining...I believe 37 C has the upper hand...I would have to say once Ayn Rand was evoked...all rational thought left the building...as the absurdity of following works of fiction at its minimum supports such absurdity as dianetics and scientology for example, and at its worst the man-made myth that is religion...In other words, at that moment the argument/debate was lost...Maybe that is why people actually listen(follow?) to Rand Paul/Ayn Rand and all of that idiocratic thought...I guess if at least the names are similar you might as well believe the mumbo jumbo...Thank you 37 C for bringing rational thought to the often misguided realm of human fears built upon fear propagated by a herd mentality and what was watched last night on the television...(insert any biased/empty news program here...)

[uRNmyway, ASN, RN]

Jeweles26: you were happy to be educated in Quebec. A province that has the lowest education costs in the nation. Yet, you have the nerve to complain about the high taxes in Canada. You directly benefitted from those taxes.

When push came to shove, you took your heavily subsidized education and moved to the US to avoid paying taxes on your income. I think you may be the perfect American. Use the system for your own benefit.

Grinding poverty is present in Canada on many of our reservations but this is an entirely different conversation on fiscal mismanagement by Indian Affairs and band councils.

We can tell horror stories about any healthcare system. Where America seems to differ from much of the rest of the world is in the concept of working towards a greater good.

Sure, Quebec has the lowest education cost in the nation. They also have the highest taxes. And with all the student loans I will be paying back over the next 20 years, as well as the 45% of my income that was being taken from my salary over the 4 years I worked there after getting my RN licence, I can ASSURE you they got back what they invested in my education. Then there is the fact that both my parents have also been paying taxes their whole lives, neither one of them went to college, and my brother is a high school dropout, so no higher education costs there either. So all that to say, no, I dont think I owe any more.

[Chisca, RN]

Nurses have no particular knowledge of health care policy unless the chose to pursue it. It's hardy touched upon at the undergraduate level. You may have some exposure to it while pursing an MSN. If you're really interested in the subject (you've given the impression that you're mainly interested in the ideology of libertarian economics), then you can pursue an MPH. You can get a start with a certificate in patient advocacy.

Not so sure about that.

I follow Medicare rules on hemodialysis religously because those rules determine my practice on a daily basis. I've learned a huge amount from two dialysis blogs by patients who routinely comment on government policy. Knowledge is where you find it. Even on healthcare policy. I think the more control we are willing to give to technocrats the less freedom we have. They have all the right credentials but seem to be wholly lacking in realizing the impact it has on the level where I practice. We are citizens in a Republic and I'm not sure I want to surrender that right now. I know my patients don't.

[wooh, BSN, RN]

Re: Nurses have no particular knowledge of health care policy unless the chose to pursue it.

Not so sure about that.

I follow Medicare rules on hemodialysis religously

Thus you chose to pursue it.

[Chisca, RN]

Re: Nurses have no particular knowledge of health care policy unless the chose to pursue it.

Thus you chose to pursue it.

I think from the examples that follow that statement 37 was speaking of validating that knowledge with degrees.

[cdsga]

We do surgery every single day with patients with no insurance and not a prayer for getting a dime. So people don't get turned away in droves. The VA in my city is mediocre at best, with surgeries performed by residents and interns. I also see patient's being shuttled from outlying hospitals to the main hospital per agreement with a major healthcare group when there is a very fine surgical team on call at that outlying hospital. That is not efficient use of personnel or point of care service. I also work part time at a transitional care facility where vast amounts of money is spent on end of life care.

The underlying cause of all this issue when you compare this country to others is that we expect luxury care with a pauper's budget. I don't know if any of us have catastrophic illness clauses in our insurance policies-Other countries may be doing very well, but statistics are just that-skewed and manipulated to show the best light. I think most definitely measures for reform are fine, but the law that was passed to go into effect in a couple of years was not even read by those who passed it. Politics is playing more of a role in an industry where they used to stay away from except for certain things. There are good regulations, but there are also onerous regulations that do nothing but add burden to the day to day efforts to deliver the best of care.

The regulations in this country are growing by the minute, and that changes the very efficiency of our delivery system. Nurses used to be able to admix med-now pharmacy is the only one that can do that for you. Nurses used to be able to give mouth care to trach patients, now respiratory care does the trach and mouth care. More and more things have a bureaucratic level added to it. Slowing response time to treatment.

I'm not short sighted, nor am I selfish. But I do know that being a nurse for 36 years-things have changed and I can't always say they have been for the better. We struggle along to try the next best thing. Hopefully with this election some changes will be made that are more pragmatic, enlarge the role of nursing, placing it at the table as an equal where we belong. Even if we increase taxes to 75% for the rich (like in France) it will not even dent the debt. When that tax bill comes for some of us, I hope we will gladly write the checks and be happy to give up your healthcare-to those who haven't paid into it nor will never pay into it. Don't even bother about be afraid of the penalty-because people will find an excuse not to pay.

[37 °C]

I think from the examples that follow that statement 37 was speaking of validating that knowledge with degrees.

No, I was implying that a nurse doesn't have much access to health care economics, etc. on the job, unless they chose to pursue it, and I explicitly said that undergraduate nursing education focuses little on the subject, though at the graduate level he or she might, depending on the curriculum.

There is a lot of information on the subject freely available, and there are graduate programs (MPH, MSW, master of health science in health economics, etc.) if you're really into it.

I think it's good for anyone employed in the healthcare system to have handle on its economics.