Obama health reforms

[K+MgSO4, BSN]

Can someone explain this to the non American amongst you. I am under the impression that it is regarding free healthcare?

As someone who grew up in Ireland, studied and worked there and now in Australia I am used to a universal healthcare system. Or as we call it the public healthcare system.

Here and in Ireland each resident is entitled to free healthcare, however there are waiting lists that in some cases are insane my dads spinal surgery for instance. He has been waiting 3 years. However for cancer treatment in Australia I see people come in with abdo pain,CT'd and scoped on that admission and returns in 6 weeks for a bowel resection.

I was in the US last Nov for a few weeks and trying to explain it to family was tough.

There is an end point though. There is no such thing as long term vented pts with no hope of recovery. That gets a one way extubation.

Yes I deal with complaints but care is based on pt need, not want.

[roser13, ASN, RN]

Caveat: I have not read the Healthcare Reform Act, but I don't believe that it mandates universal health care provided free of charge.

Two things I'm fairly certain about in the Reform: Insurance companies will be mandated to provide insurance to those who apply, even if they have pre-existing conditions and disabilities. That's HUGE to some of us. I also think that Americans will be required to have health insurance but will not face a penalty if they do not purchase it.

Adult children will be able to stay on their parents' health insurance until the age of 26. It used to be 18 (21 if in college), then moved to 23 I believe, and now will be 26.

Someone will be along to correct me if my few little tidbits of understanding are wrong:twocents:

[jojonavy]

There is an end point though. There is no such thing as long term vented pts with no hope of recovery. That gets a one way extubation.

I see plenty of futile treatment in the US health care. In Australia, they don't keep patients vented if their prognosis is bad? How do they go about justifying the extubation? Is there some type of committee that oversees it?

[K+MgSO4, BSN]

No we don't keep pt vented if there is no hope of weaning them off the vent. If a pt is intubated they are in he ICU. There they have the ICU docs and their treating team looking after them. A descision is made by the 2 teams and the CNC if treatment is going to be futile that they are extubated and sent to the ward on palliatve measures with NFR/not for ICU/not for MET(RR) calls. Comfort measures only.

There is an ethics committee in the hospital that can be contacted if anyone felt that this was wrong but it is up to the treating docs to decide if and when to cease futile treatment. Family meetings are had with the docs, SW and family and it is explained to them that there is no more that can be done we have tried to wean them off the vent but they can't manage without etc

We do everything we can but there is a point of no return.

[K+MgSO4, BSN]

Caveat: I have not read the Healthcare Reform Act, but I don't believe that it mandates universal health care provided free of charge.

Two things I'm fairly certain about in the Reform: Insurance companies will be mandated to provide insurance to those who apply, even if they have pre-existing conditions and disabilities. That's HUGE to some of us. I also think that Americans will be required to have health insurance but will not face a penalty if they do not purchase it.

Adult children will be able to stay on their parents' health insurance until the age of 26. It used to be 18 (21 if in college), then moved to 23 I believe, and now will be 26.

Someone will be along to correct me if my few little tidbits of understanding are wrong:twocents:

Thanks, interesting. Still like my socialised health care though :)