How soon we forget.

GHGoonette, BSN, RN · Feb 1, 2011

The South African government is also investigating a "National Health Care" system , but no-one has yet come up with a viable way of making it work. The proposal is to introduce taxation that will cover all those unable to pay medical aid premiums, thus providing funding for State hospitals, but where they have run into the wall is, if everyone, rich and poor, MUST belong to this system, where does that leave the private health care providers and medical aids? So far, it looks like we're a long way off implementing it within the 4 year time frame that was originally mooted.

The only way I can see it work is to increase VAT to pay for it, with the option to augment insurance if the individual requires more comprehensive cover and the choice of seeing a private practitioner and utilizing private hospitals.

Currently, health care is available to all; in the case of children and the aged it's free, alternatively calculated on your ability to pay....but don't ask about the quality of care if you can't afford private. Like Australia and Britain, waiting lists for surgery are horrendously long, and people have been known to die in waiting rooms.

Meanwhile, there are individuals who continue to milk the system for everything it's worth, similar to the young ladies in Carol's description, and steelydanfan's horse owner.

eriksoln, BSN, RN · Feb 1, 2011

See, for me, the "if you don't want to pay car insurance, don't drive" answer doesn't work. That takes my way to work away. Its not like its just a social frill. To me thats like saying "If you don't like paying for health insurance, stop breathing."

Talk to anyone on welfare or living on a fixed income (low income). They'll tell you having transportation is a huge separating factor between the middle class and them. They'll also tell you not having transportation to open up their job possibilities is part of what keeps them where they are. I believe it, I've lived it. I felt that way when I was a landscape laborer and couldn't afford a car. Again, its not just a social frill.

My biggest concern with it is, will the funds created from making people have insurance be the status que like........well, everything money related. Will huge portions of it go to politician/admin. pockets instead of towards providing healthcare? Thats what could kill the whole deal.

I still don't see a problem with mandating health insurance. Tired of coming on here and hearing about the person who wont pay their medical bills but has the latest/most expensive cell phone and smokes brand A cigarettes. Thats the mentality of a child who lives at home and thinks everything should be provided for them free with no responsibilities.

If thats how the general public acts, then treat'em like a child and take part of their allowance away. Make them pay for what they demand (healthcare).

catshowlady · Feb 1, 2011

I would like to point out a legal distinction, just as an FYI. The FEDERAL government is (theoretically) limited in its powers to govern only the situations laid out for it in the Constitution. They've really expanded their powers in more recent history under the "interstate commerce" clause. Many "strict constitutionists" believe that the federal government has far exceeded the powers that the original framers of the constitution intended for it to have.

The STATE governments, however, can govern just about anything they want, under "police power," unless it is given to the federal government by the constitution, i.e. making treaties. The federal government does manipulate the states into passing the laws it wants by threatening to withhold funds. One example of this happened in the 1980's when the feds threatened to withhold federal highway monies from the states unless the states passed laws raising the legal drinking age from 18 to 21. It worked, too.

The key difference in the case of car insurance is that mandatory insurance is demanded by the individual state governments, not the federal government. Had every one of the fifty states mandated health insurance (as Massachusetts has done), the laws would not be unconstitutional, since mandating health insurance is a matter of "police power" and state law.

The strict constitutionists are using this bill to forward their interests in keeping the federal goverment from getting bigger. The folks who are against more universal health coverage are using it too. It's not a popular bill , so it makes a nice target.

:paw:

ZippyGBR, BSN, RN · Feb 1, 2011

I see it this way. Many people take the position that they don't want to FORCED to pay for health care. Usually, they are young, healthy specimens who never believe anything will happen to them.
Fine, opt out, but don't come to my ER after a snowmobile accident, soccer fracture, miscalc during a hike that neccessitates air and search rescue and rehydration; and tell me "I don't have insurance, sorry"
You don't put in, you don't get.
If the Republicans want to play hardball, well here is the reality.

nail , head hit squarely ...

The irony of those complaining about ED abuse / misuse and can't pay / won't pay patients ... if you have a proper integrated health system where everyone has cover , the ED misuse is reduced - especially as you can assess and then refer to primary care for none emergencies and the won't / can't pay problem will be effectively eliminated.

the facts are simple

- by most measures the USA has very poor healthcare overall - especially when you consider the numbers of people who cannot afford adequate cover ...

- many of the problems with US healthcare are created 'in house' especially misuese of EDs as primary care

- Costs run out of control in the USA because between the patient and the provider there are many middle men taking their bite ... the broker, the insurer, the billing provider, the for profit institution

ZippyGBR, BSN, RN · Feb 1, 2011

Like ... Britain, waiting lists for surgery are horrendously long, and people have been known to die in waiting rooms.
.

Lies pure and simple.

never let the truth get in the way of a good old ignorant right wing rant ...

GHGoonette, BSN, RN · Feb 1, 2011

Lies pure and simple.
never let the truth get in the way of a good old ignorant right wing rant ...

I'll have to tell my family they're feeding me BS about the waiting lists then.

As for South Africa, deaths in clinic and hospital waiting rooms as a result of staff disinterest happen frequently. One was featured quite prominently in yesterday's morning rag-mother died of pre-eclampsia; the staff hadn't bothered to do her BP. Some of the State hospitals are cleaning up their act, after becoming a national scandal. Others....are not.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Feb 1, 2011

Both the MA and Obama plans count on having everyone pay premiums, those who are chronically ill, and those in good health. By including the healthy, the cost per person to the insurer gets diluted allowing for lower premiums for all. I am all for change in health care financing. I've been disabled for a year, could probably return to work if I can get the care I need, but spending half my income for my healthcare is bankrupting me. After 30 years in healthcare it really hurts to see that when your money runs out, so does your doctor.

ZippyGBR, BSN, RN · Feb 1, 2011

I'll have to tell my family they're feeding me BS about the waiting lists then.
As for South Africa, deaths in clinic and hospital waiting rooms as a result of staff disinterest happen frequently. One was featured quite prominently in yesterday's morning rag-mother died of pre-eclampsia; the staff hadn't bothered to do her BP. Some of the State hospitals are cleaning up their act, after becoming a national scandal. Others....are not.

slight difference between the State the saffas have allowed their country to get into vs the UK.

The fact remains that for genuinely clinically urgent needs in the UK you can and will be seen and admitted the same day.

odd that even if you don't need admission most specialities can see genuinely urgent patients within a day or two...

I think you need to prove your libellous accusations about healthcare in the Uk and stop believing the gutter press.

GHGoonette, BSN, RN · Feb 1, 2011

slight difference between the State the saffas have allowed their country to get into vs the UK.
The fact remains that for genuinely clinically urgent needs in the UK you can and will be seen and admitted the same day.
odd that even if you don't need admission most specialities can see genuinely urgent patients within a day or two...
I think you need to prove your libellous accusations about healthcare in the Uk and stop believing the gutter press.

I assure you, not one of my family members or friends in the UK are members of the gutter press. As I previously stated, I will inform them of your obviously superior knowledge. Perhaps they're just indulging in that famous UK working class pastime, the Gripe.

rita359 · Feb 1, 2011

http://news.yahoo.com/s/ap/20110131/ap_on_bi_ge/us_health_overhaul
Seems part of the arguement against Obama's bill is that people are going to be forced to purchase health insurance. Well........why not? A lot of states mandate buying auto insurance. Which one is more important? Doesn't seem like too much of a stretch to say you have to have it. Might help put an end to medical businesses having to give it away free.
So soon we forget. Many threads and even more posts comment about the "free care" we must provide in the ER and everywhere else. Seems to me this would be a step in the right direction to solve it. Whats the issue?
Eh, I'm all for it. Tired of running pain meds to a bunch of fakes who don't pay only to see another pt. with a real ailment get second rate care.

Problems with current health care bill are many. Many Attorneys Gerneral , who are learned in law, are saying the individual mandate is illegal. If that is illegal they will have to go back to the drawing board. Maybe next time they can get a bill that will have input from both sides. We can hope anyhow.

Murse406 · Feb 1, 2011

Here's the deal....The sky is always falling when your party is not in power, such as when this bill was crafted. Is it the best bill? NO but the reason for that is all of the opposition and haggling incurred by the right. You have to remember this was their idea not too long ago...think Bob Dole, Kansas Republican. The bottom line is that you are paying for it anyway. You pay with your monthly premiums and your taxes. Where do you think medicare/medicaid comes from? Think about it. Hospitals charge so much because a lot of folks aren't paying customers and a lot that are, via insurance private and public, are getting discounted/negotiated rates. The cost of healthcare is greatly exaggerated and inflated due to the current systems (already imposed by our government's regulations) lack of reasonable execution. Those of you who say it's not the gov'ts business are already to late and living in a fantasy world if you think today's system isn't governed by that model. Before you right wingers start trying to flame me....I'm an independent and try to think for myself. I don't let the Glen Becks/Al Frankens of the world direct my opinions. I think Lewis Black said it best when he said, "Democrats stand up and say, ' I've got a sh@#ty idea.' Then republicans stand up and say, 'I can make it even Sh@#tier." Just my .02. Current healthcare economics cannot sustain us. A lot of you may be healthy now and not care about insurance. However, medicare is running out and many of our generation at this rate will be SOL when we reach retirement age

TheChair1 · Feb 1, 2011

While I agree with your being upset at the truly "in pain" patient having to suffer d/t time being taken by the drug seekers.. I have to say, I feel this new healthcare bill will diminish the quality of care we provide... to both patients. My problem with this healthcare reform.. is that the area of reform NEEDED is not being addressed... ie too few nurses,pcts, etc to the multitude of patients we see daily.
I just cannot understand the resistance to hiring more healthcare staff to the increase in patients.. it's ridiculous.!

Who do you propose will pay for new healthcare staff to the increase in patients if people are not held accountable for helping to pay for their medical services? Where are the hospitals going to get the money to hire all of these much needed workers? Last time I checked, hospitals are big business enterprises...