Is Health Care a Right?

Sally_ICURN · Jan 16, 2003

Originally posted by RN2B2005
There are many people who feel they are entitled to health care--these people tend to be Medicaid recipients, in my experience.

The quote above (and this is no flame) is a MAJOR, major generalization/stereotype. I feel like I'm entitled to health care and I'm not a medicaid recipient.

Anyway...

I think healthcare should be a fundamental right of all people no matter what their background or life-choices (good or bad--which is subjective of course) have been. Talk about issues in ethics, how do you pick and choose who gets what healthcare? That seems to be what managed care does...free from ethical concerns and under the guise of providing you a quality service.

I think that Managed Care/HMO's are the root of all evil and wrongdoing in healthcare. If you think about it, since managed care came about a couple of decades ago, that's when healthcare in this country really began to fall into the toilet. I believe this is when "restructuring" of hospitals starting taking place by outside firms that had absolutely NOTHING to do with healthcare, and I also believe that nursing took the biggest hit in this "restructuring" and the effects are still felt today. I think it's pathetic that a doctor who's a Senator who hold millions of dollars in stock in a managed care company that gets popped for ripping off medicare resulting in 2 billion in fines can be put into the most powerful Republican position in the Senate on Capitol Hill. I don't know, but not a whole lot of people seem outraged by this! I am.

I don't proclaim to have the answers to the problem, but one option (and I'm not even saying this is the best option) is a single payer health plan for the United States.

The quote below is from something I found online a while back while reading up on Managed Care. It's called "Damaged Care, Damaged Caregiver" and was written by a physician who quit practicing medicine due to the crap she had to endure with managed care. This is from Chapter 16 on the website.

A single payer system would give people greater freedom in looking for jobs. No one would be forced to stay in a position he can not stand because he can not afford to give up his health insurance. Middle aged people who dream of starting their own business would not have to worry about losing their health coverage. Since all doctors would be part of the plan, no one would be told "New Year, new contract. Time to change doctors again."
Those who say that the government has no business getting involved in health care should remember that our government is already providing health coverage for the neediest segments of our population, the elderly ( through Medicare) and the chronically ill ( through Medicaid). These are the people HMOs do not want to cover. Does it seem fair that we, the tax payers provide health care for the sickest while private HMOs reap the profits of insuring the healthiest segment of the population? Would it not make more sense to pool all the health care dollars into one insurance plan?
Before you answer consider this all too common scenario. A person works for years, only rarely taking advantage of the HMO coverage which his employer provides. Suddenly he becomes extremely ill--too ill to work. He has to quit his job. What happens to his HMO coverage? If he is lucky and has worked long enough, he can retire with insurance. Others can pay big premiums to keep their insurance. A fair number are left without any insurance coverage at all. They end up receiving their care at the local charity hospital until they can qualify for Medicaid. In other words, the HMO got all the premiums, but the government ends up paying all the bills.

http://www.swbt.com/~taylorjh/damaged/index.html

I think the viewpoint of this physician speaks volumes about the problem with managed care and their money grubbing fat little fingers. The quote above is but one tiny tid-bit of what she so eloquently, and sometimes hillariously (Chapter 1!), writes on her site about her story.

Quality healthcare should be a constitutional right for everyone.

Whew! That felt good!

~Sally

Flo1216 · Jan 16, 2003

Sally-right on. Like I said...its easy for people to turn up their noses and be judgemental of medicaid recipients when they are not the ones in that position. If a member of their family were seriously ill and had no health coverage, perhaps they would feel differently. People need to see the big picture. And these views are coming from nurses. I wonder what they would have thought of me when I was a bartender/student without insurance and required medical care.

LaurieCRNP2002, MSN, RN, APRN · Jan 16, 2003

This is an interesting discussion. As part of my graduate coursework, I took a class on health and social policy, which I felt opened my eyes to many things. I totally agree with those who have said our health care system is a mess. Recently, the NY Times had an article about a proposal by Sen John Breaux (LA) for universal insurance.

"...Senator Breaux not only reiterated his call for universal coverage, but also said he wanted to achieve it by having the government require every citizen to buy private health insurance, much as drivers are required to buy Liability Insurance."

"In our current health care system, we have all these boxes," he said. "If you're old, you're in the Medicare box. If you're a veteran, you're in the V.A. box. If you're working, you're in the employer-sponsored box. Each of these boxes has a huge bureaucracy and spends a lot of money.

"We need to get people out of these boxes which don't make a lot of sense. What we ought to say is that if you're an American citizen, you have to buy health insurance, just like drivers have to have liability insurance. But this insurance should come from the private sector and not be a single-payer plan like the earlier Clinton proposal and what some Democrats are talking about now. I would not support a government-run program. We just can't micromanage health care that way."

But Senator Breaux is quick to say that while the program he wants would not be run by the government, it would be regulated. Premiums would be subsidized by the government, depending on an individual's income. Companies, of course, could still pay the premiums for their workers.

Insurance companies might offer several levels of government-approved coverage with various deductibles and co-payments, much like the so-called Medigap policies available to Medicare recipients. Younger, healthier people might elect a basic plan.

"But everybody would have to buy at least the basic plan," Senator Breaux said. "Competition from the various insurance companies would help control costs; the government would help pay for the program and make sure that it works, that those offering insurance aren't scamming the system and that nobody is prevented from buying insurance or forced to pay higher rates because of things like pre-existing conditions."

He said such a plan would lower rates because it would force everyone, healthy and unhealthy, into big insurance pools and spread the risks. "Now, people 18 to 25 are the most likely not to have health insurance," he said. "They're the healthiest, and we need them in the insurance pool to help lower costs."

Such a program would virtually eliminate traditional programs like Medicare and Medicaid. "This plan would give older people private health insurance that doctors would accept," Senator Breaux said.

I certainly think this proposal is something worth exploring. Actually, some of it makes sense, which of course means there's little hope of it actually coming to fruition in the form Senator Breaux is proposing :rolleyes:

If anybody is interested in the full text of this article, feel free to email me privately and I'll email the article to you as an attachment.

Laurie :)

maureeno · Jan 16, 2003

while I do believe a just society would provide health care for all, I think there is a need for re-thinking what we mean by quality healthcare. More is not always better. We need informed consumers. Additionally we need to look at how our society's lifestyle contributes to disease. Meanwhile I'd like to see taxes on things like elective cosmetic surgery and body scans for the worried well; I'd dedicate the money to help cover insurance for the working poor.

Flo1216 · Jan 16, 2003

I would too. Society's lifestyle is a MAJOR contributor to disease, but of course public health funds are lacking as well. Increased health promotion is necessary, but unfortunately its expensive.

mark_LD_RN · Jan 16, 2003

it is not a right.

and i am totally against prisoners having health care, at best they should have minimal care for injuries sustain while in jail, period!

Flo1216 · Jan 16, 2003

Mark...I am assuming you have coverage. Just out of curiousity, if someone very close to you were without insurance and god forbid was diagnosed with cancer, do you think that they should be denied treatment and have no choice but to let the the cancer spread, and live the rest of their life in agony, even if they are not a prisoner, but a good, honest person? Do you really feel that your value as a human being lies merely in your abilty to obtain coverage? I am sure you encounter patients who have no insurance...do you look down upon them or feel they should not be there? Do you treat them differently then you would treat covered patients? The health care system is a mess and not quite fair, but should the line between the haves and the have nots be THAt defined?

sanakruz, ADN · Jan 16, 2003

I believe it is a right,just as education is in a free and civilized society.

Thank God, Mark it's not for you personally to decide. The posters above have all given thoughtful responses.

Why dont you join us here in the 21st century?

fergus51 · Jan 16, 2003

Just have to point out: Universal health care coverage in Canada does not = substandard care compared to the US. Several studies have shown that while some people do wait longer for certain treatments, it has no impact on their long term health. Also there have been studies on similar populations with the same diseases (like ovarian cancer) and those on the Canadian side tend to do better.

A good book on the subject is called Universal Health Care: What the United States Can Learn from the Canadian Experience

by Pat Armstrong, Hugh Armstrong, Claudia Fegan

It has research based evidence that compares the systems very well and goes beyond the hype. It is very honest about the fact that the Canadian system also needs some reform, but debunks alot of the myths Americans have about a single payer system.

Flo1216 · Jan 16, 2003

Fergus 51...are you from Canada? Wouldn't waiting longer for diagnostic tests, perhaps allow a disease process to worsen, though? I watched a documentary on health care in Canada and they were saying forexample, that there are limited MRI facilities in Canada and the wait is very long. I am not claiming to know what I talking about...I am just wondering. I will have to read the book, I suppose.

fergus51 · Jan 16, 2003

Yes I am from Canada. I have also worked in the US and may be going back. People in Canada do not wait long for tests if a doctor thinks it could be serious. I have had patients in the hospital get their CT scans and MRIs the same day the specialist consulted.

The problem with your logic about us not having enough MRIs is that the number of MRIs is not the only factor to be considered. There are private MRIs that we can use if we want to pay for them. And, although the US has more MRIs, they aren't well used. More machines does not equal better care if citizens aren't getting to them. Canadian angina patients and certain orthopedic cases also have to wait longer for surgery than their American counterparts. BUT- it has no bearing on their life expectancy or long term health. I have also heard all the talk about long waits, then my dad got his knee replacement 3 months after being put on the list. This was when the media was reporting a 2 year waiting list. If you ask me HMOs have been fear mongering in the US for years about "socialized" medical care. When I first moved to the US some of the people I worked with were shocked to find out that I was allowed to pick my own doctor and could get an appointment the same day I called.:) GASP! But Canada has a socialized system!

The book I listed goes into all of this and I would REALLY recommend you buy it or get your public library to order it for you. You will be very surprised if you are anything like me before I read it.

Flo1216 · Jan 16, 2003

It isn't my logic...it was the logic of the documentary. I have no clue what I am talking about:)