Should Healthcare Be Funded As A Basic Human Right? - page 2

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  1. Visit  barbarake21} profile page
    13
    Most of my family lives in Europe/Germany. All I know is that they pay signifantly less (per capita) for health care than we do here in America and - more importantly - they have an longer average life span.

    I wish more Americans would realize we do not have the best health care system.
    MandaRN94, sharonp30, silenced, and 10 others like this.
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  3. Visit  excellynnt} profile page
    8
    I don't care to choose a side for this debate, but here's my story:

    preface: I'm a veteran and a single mom. My son's dad is nowhere around and pays no support, so for me childcare for work and school all has to be paid for by me. Some people at work have another adult at home to stay with their kids, or they work when their kids are at their other parent's house. Not me, it's just me and my 8 year old son. (I have 2 older kids, but no longer living with me, my daughter has her own family and my son followed my footsteps and joined the Navy).

    Story: After the military, I have worked various customer service and waitressing jobs. I started school to become a nurse and soon after, divorce was filed and I was on my own. I applied for medicare for my son when my ex moved away and lost his insurance (I didn't apply for myself, I qualify for VA care, but I don't think my state gives medicaid to non-pregnant adults between the ages of 18-65 anyway.) When I applied, they told me I was well under the poverty line and qualified for food stamps as well and gave them to me. (Yay for us, we were able to eat more than just ramen!) I continued school and waitressing for the rest of my sophomore year. In the summer, I landed a student nurse/aide job at the hospital, I was SO excited. By the end of Summer though, I was dropped from public assistance because I made too much money. During the school year, I can't work a lot of hours, clinical schedules are hectic and I hardly see my son or keep up on schoolwork as it is. I reapplied for medical assistance for my son. I didn't ask for the foodstamps (again, I never asked the first time) but was declined the medicaid because the state feels I am able to work like I did during the Summer since I still hold the position and the hours are available for me to work. Over the next Summer, my work wanted me to work overnights. I couldn't get childcare for 20 hours a day (12 hr overnight shift then 6-8 hrs of daytime sleeping) so I was not able to maintain full time hours. We are broke, but I figure it out and we get by with no help from public assistance. I use school loans to supplement my income. To heat our house. To pay for my son's vaccines. To buy lots of brown rice because it's cheap and healthy. We don't have cable TV and I use a prepaid cell-phone. I drive a 17 year old car to and from my clinicals, with my brown bag lunch in the seat next to me. I will graduate this upcoming May and at the rate I spend/save now will be able to return some loan money and start paying the rest off and will get health insurance through my employer. We'll still eat rice.

    So, now, on to mandatory healthcare: If I had mandatory healthcare, my son wouldn't have missed his well child checkup last year. At least I have enough clinical skills to be able to know he's pretty healthy. But then again, if we move to a 'healthcare as a right' system, how will that affect HCPs pay? I certainly didn't get into nursing for the money, but I am going to rely on half my paycheck to pay off my student loans so I for one certainly can't afford a pay cut if one comes.

    It's a vicious circle, a double edged sword. As a user of the system, a victim of the system, and a victor over the system, I know reform is required, I just don't know where it must begin.
    sharonp30, tewdles, freki, and 5 others like this.
  4. Visit  wannabecnl} profile page
    5
    When I was in nursing school, my class was divided between those who believed in a more public system (akin to Canada or the UK) vs those of us who did not want the government that involved in healthcare. I will repeat what I said then:

    First, framing this argument as a rights issue is ignoring one basic fact: healthcare IS, like it or not, also a commodity. Do you work for free? Does the electric company give power for free to your hospital or place of employment? Are the bandages and other supplies donated? In most cases, I suspect the answers are No, No, No. It costs money to provide care. It just does. Now, you may not think the poor should pay that money, but someone is paying for it, and it isn't suddenly going to get cheaper when the government is in the middle of it. So let's stop calling it free care, because it is not.

    My second argument during our policy class was this: if you think that a two-tiered system exists now, wait until Obamacare kicks in. It may not be legal, but that doesn't mean it won't happen. If a patient is willing to pay a $5000 bonus to have his/her CABG in 2 days rather than in 2 months, how long before s/he finds a surgeon willing to take the bonus and change the schedule? And isn't it the patient's right to spend the money how s/he wishes? If an aging relative needs in-home care that is not covered by Medicare or its equivalent, and if that person or family has money to pay for the service, you can bet that a licensed nurse will fill that need. Isn't that the nurse's right, too, to work within his/her scope of practice as a private duty nurse? Unless the government is going to take away every person's disposable income (look at the former Soviet Union, where people's homes, food, and clothing were all paid for, but it cost a month's wages to afford one pair of shoes), it's unrealistic to think that a tiered system will not persist.

    Finally, people have argued about better health outcomes in nations with a more socialized healthcare system. You have to look at all the factors that go into the supposedly causal relationship, because it's not always clear. Yes, we may have a higher infant mortality rate than some other first-world countries, but do the studies all account for preemies and multiples resulting from IVF that may be more prevalent here? Do other outcomes account for smoking rates, obesity rates, nutrition (not just "we're the richest country so we must have superior nutrition": I'm talking about Big Macs and soft drinks vs. fish and red wine), ethnic diversity (such as African American people having higher rates of hypertension and responding to different medications), sexual health, etc.? Giving everyone "free" healthcare is not going to equalize these causal factors unless, again, the government is allowed to come into our homes and force us to eat, drink, sleep, have sex, and work according to some standard.

    Once a tax is in place, it's almost impossible to get rid of it. Let's not force this through because it feels good to do so without considering the realities and implications.
    jeannepaul, HM-8404, bbuerke, and 2 others like this.
  5. Visit  T-Bird78} profile page
    4
    Quote from PRICHARILLAisMISSED
    Then don't worry, because most of them ARE perfectly willing to stay poor and take the free bees. And remember, medicaid IS a free bee. So "No," I don't feel bad when they lose it because they now make more money than the required minimum to qualify for it. Now THEY get to see what it's like to pay others' way while also paying their own. You know, like the rest of us.

    And as for these single parents bettering themselves and losing the benefits because of it, why don't we fix that problem instead adding to our already too long list of handouts...
    As was mentioned by someone else, ACCESS should be given but not necessarily FUNDING. I was one of those single parents bettering myself. I went to nursing school when my son was in kindergarten. I was a single mom, going to school 40 hours a week, and started out waiting tables two nights a week. I was told that I made too much money to qualify for Medicaid (my son was approved for coverage but not me). Medicaid isn't given just because you ask for it. I received zero child support from my ex. I wound up having to work part-time at my son's daycare center, so there were days when I'd only see him in the mornings before school and kissing his sleeping face goodnight when I finally got home. I had no health insurance for that year but I did have access to health care. I had to spend 8 hours in the ER with bleeding and diarrhea and I'm still paying that bill. I was never willing to stay poor to collect the freebies, that's why I put myself through nursing school--so I could support myself and my child and NOT have to rely on assistance.
    sharonp30, tewdles, jeannepaul, and 1 other like this.
  6. Visit  VICEDRN} profile page
    6
    Quote from PRICHARILLAisMISSED
    Access to healthcare should be a basic human right, sure. But no. Funding of healthcare should not be. And please don't come back at me with something like "Well, we fund this or that..." because I don't care. We probably shouldn't be funding "This or that" either.

    I swear, the sense of entitlement in this country is absolutely mind boggling. People.... An individual's insurance plan is supposed to fund their access to health care. And I don't want to hear that some people cant afford it. The ones who TRULY can't afford it qualify for medicaid. Hell, how many millions of our citizens cry poverty, yet they sure can afford to have 2 cars and damn cable TV! WITH PREMIUM CHANNELS AND HIGH SPEED INTERNET!

    Incredible!!!
    Please do not call 911 like ever. We fund "this or that" police and firefighter services. Also, when your house catches on fire because your neighbor's is also on fire, please do not call your homeowners insurance first off.
    sharonp30, silenced, VanLpn, and 3 others like this.
  7. Visit  VICEDRN} profile page
    0
    Quote from wannabecnl
    When I was in nursing school, my class was divided between those who believed in a more public system (akin to Canada or the UK) vs those of us who did not want the government that involved in healthcare. I will repeat what I said then:

    First, framing this argument as a rights issue is ignoring one basic fact: healthcare IS, like it or not, also a commodity. Do you work for free? Does the electric company give power for free to your hospital or place of employment? Are the bandages and other supplies donated? In most cases, I suspect the answers are No, No, No. It costs money to provide care. It just does. Now, you may not think the poor should pay that money, but someone is paying for it, and it isn't suddenly going to get cheaper when the government is in the middle of it. So let's stop calling it free care, because it is not.



    Once a tax is in place, it's almost impossible to get rid of it. Let's not force this through because it feels good to do so without considering the realities and implications.

    Look at the study done in oregon when they did a medicaid lottery. there are better outcomes here in this country for patients that are funded...

    second, arguing the legality of the law is kind of silly when the president is a professor of consitutional law, don't you think?
  8. Visit  wannabecnl} profile page
    2
    Quote from VICEDRN
    second, arguing the legality of the law is kind of silly when the president is a professor of consitutional law, don't you think?
    I'm not arguing the constitutionality of the law. I'm merely saying that as long as people have disposable income, they will find a way to get what they value. If they want health care beyond the mandated/provided level and can pay for it, they will create a demand for that care, and someone will step in to supply that care at a mutually-acceptable price. Call it a second tier, a black market, or supply-and-demand economics, but regardless, it will exist.
    bbuerke and PRICHARILLAisMISSED like this.
  9. Visit  VICEDRN} profile page
    5
    Quote from wannabecnl

    I'm not arguing the constitutionality of the law. I'm merely saying that as long as people have disposable income, they will find a way to get what they value. If they want health care beyond the mandated/provided level and can pay for it, they will create a demand for that care, and someone will step in to supply that care at a mutually-acceptable price. Call it a second tier, a black market, or supply-and-demand economics, but regardless, it will exist.
    Did you look at England and Germany? You can buy private insurance in England. About 8% of people do. It really isn't worth it to them to do so. They are generally satisfied with their care.

    In Germany, when you reach the top income tier, you opt into another level of insurance but Germans actively try to avoid this or they don't take advantage because it embarrasses them to act like health care is more than a right.

    Let me know when you had looked at that study regarding health outcomes for funded Americans.
    silenced, VanLpn, dawnma, and 2 others like this.
  10. Visit  neurorn6} profile page
    9
    I grew up poor in Appalachia. No running water or bathroom (I am under 60 by the way). We were raised to work hard, help others and not ask for handouts. Before becoming a nurse, I had a child with a terminal illness and no money. Yet we found away with the help of God and CHOP to give him the best care possible. I raised a family, without insurance for the larger part of their lives. Healthcare is not a right. We are not guaranteed medical coverage. Because of entitlements, we have become a nation waiting for the next handout. Our citizens have forgotten their pride.
    This is not Canada, Great Britain or another European Country. Basically, if you need the services of a doctor or hospital, then you make arrangements to pay the bill. My daddy raised 5 kids on nothing and managed to pay his bills. Maybe we need to get back to basics and have a little pride.
  11. Visit  eroc} profile page
    5
    Quote from neurorn6
    I grew up poor in Appalachia. No running water or bathroom (I am under 60 by the way). We were raised to work hard, help others and not ask for handouts. Before becoming a nurse, I had a child with a terminal illness and no money. Yet we found away with the help of God and CHOP to give him the best care possible. I raised a family, without insurance for the larger part of their lives. Healthcare is not a right. We are not guaranteed medical coverage. Because of entitlements, we have become a nation waiting for the next handout. Our citizens have forgotten their pride.
    This is not Canada, Great Britain or another European Country. Basically, if you need the services of a doctor or hospital, then you make arrangements to pay the bill. My daddy raised 5 kids on nothing and managed to pay his bills. Maybe we need to get back to basics and have a little pride.
    Could not agree more.

    I think it could work only if the American people took better care of themselves.
    But most want a magic pill to take all the problems away.
    Comparing our country with other that have government health care is not the same. The average american doesn't know what the inside of thier local gym looks like, and practically no one knows what eating healthy really is...just what " a better alternative choices" are according to the label...if even that.

    Let everyone that supports free health care work for free...actions not words
    Last edit by eroc on Dec 4, '12
  12. Visit  wannabecnl} profile page
    4
    I just read a NYT piece about the Oregon study. Given my background in epidemiology and biostatistics, I was impressed with the "randomized controlled trial" nature of the work, but at the end of the day, it is looking at self-perception of health and a little deeper analysis of access, not actual health outcomes. It is a good start, but it is just a start.

    This is the bit I am waiting to see: "The study is now in its next phase, an assessment of the health effects of having insurance. The researchers interviewed 12,000 people — 6,000 who received Medicaid and 6,000 who did not — and measured things like blood pressure, cholesterol and weight." THAT will be better analysis of the actual effectiveness of the care received by people who did not previously have insurance. Access is not the same as results. There are many studies about how more health care doesn't necessarily mean better outcomes (Google pretty much anything by Elliot Fisher, Gil Welch, Steve Woloshin, and Lisa Schwartz to learn about that). I'm glad the conversation has started, but the Oregon study just doesn't prove that people are healthier because they have Medicaid coverage.

    Before I found that article, I had read a piece published this past July discussing another study by the authors who did the Oregon study. This was another well-designed study that compared mortality rates between states that had increased Medicaid enrollment and states that did not increase enrollment. It found a decrease in mortality in states that had increased enrollment. It looked at numbers on a county-by-county basis, not a patient-by-patient basis. The study adjusted for very important factors, such as age, sex, race, employment status, and income. Again, this was done at the population level, not for individuals.

    The authors acknowledge that the second study does not show--and was not designed to show--a CAUSAL relationship between increased Medicaid enrollment and decreased mortality. Furthermore, it is pointed out that the only state where a STATISTICALLY SIGNIFICANT effect was found was New York, meaning that improvements in mortality rate in the other states might have improved that much randomly, irrespective of changes in Medicaid.

    These distinctions matter a great deal. I'm going to try to download the actual studies for both of these to dig further into their design and results. It is possible that the coming study mentioned above will show an association between increasing coverage and better outcomes, or it may not. I'm not trying to keep poor Americans out of the doctor's office and the hospital (unless it's because of effective preventive care!), but my goal for my patients and others is better health, not more trips to the doctor.
  13. Visit  somenurse} profile page
    4
    Just jumping in, on page 4 or so, haven't read the previous 4 pages, and i have no idea if i am inserting this comment into some ongoing debate between a few ppl, or if some of those on AllNurses who are known for their love of polemics are engaging in rageful debate right now on this here page, but,
    here's my two cents.

    Should healthcare in the US be funded as a basic human right?

    short answer YES YES YES!!




    i haven't yet read entire article, as i have read much on this over the years, hard to find a point i haven't yet read or considered,
    but, this line jumped out at me:

    //" Among developed nations, the U.S. stands nearly alone in our failure to accept healthcare as a human right largely due to characteristic American ideologies of individualism and self-determination, distrust of government, and reliance on the private sector to address social concerns."//


    Uhm, a giant huge reason that USA stands alone in providing national healthcare to it's citizens, is,
    cuz USA also stands alone in spending over 60% of it's budget on military. No other nation comes anywhere close to that outrageous level of military spending.
    This is more a matter of priorities for USA, having giant overblown military,
    vs
    providing healthcare to it's citizens like everyone else does.

    Also, re: the distrust of govt, lol, some of this attitude is so unfounded, like the protest signs which read, "Keep your govt out of my medicare!" and stuff. We americans are not always the most informed of voters, as most news today is sooooooooooo slanted, that many of us are spoonfed our "own" ideologies, and stay fairly 'fact-free' in formng our conclusions.


    actually, there are several lines on this article i could chew on for a while, but, just wanted to put in my voice for the YES YES YES side of things.

    good bye!
    VanLpn, tewdles, nrsang97, and 1 other like this.
  14. Visit  PRICHARILLAisMISSED} profile page
    4
    Quote from MunoRN
    I think it's difficult to discuss such a generalized terms as "healthcare". Most people might agree that erectile dysfunction treatment is not a "right", fewer might agree that an emergent cardiac cath for a STEMI is a not a "right", but I don't know too many who would say that the dying STEMI patient doesn't at least have the right to a little morphine while they die, most would call that basic human decency. I'm guessing you were over-exaggerating when you claimed there's no part of healthcare that could be considered a "right" by the vast majority of society.

    I'm not saying the person in need of the STEMI should be ignored. That would be wrong. I'm saying that that person should be responsible for somehow paying for it sometime in the future. It should not fall on the government (meaning the rest of the taxpayers) to pay for this. Perhaps they can work it off or make decades of payments at 0% interest, but it should not fall on the rest of us. Let's be careful not to confuse "Rights" with "Morals." It is moral for me to give money to a needy homeless man, it is not his right to expect it.


    As with anything, there will be those who successfully work the system, but it's not "many millions". I have met many a medicaid patient and for most part these are good, responsible people. For instance having more than 1 car per family is typically an automatic reason to deny medicaid benefits. Total assets beyond clothes and other necessities cannot exceed usually around $6000 per family. Monthly income for a family of 4 usually cannot exceed about $650. Raising a family of 4 on $600 a month, now that's the high life.

    It IS many millions. Of course no census survey will be titled "Number of Americans who game the system." Look up statistics on the length of time many citizens stay on medicaid. I also want to be ABSOLUTELY CLEAR that I've never said that medicaid recipients are not good people. Many of them are. I said that many of them are users of the system and have failed at being independent ADULTS. And that is not an insult, it is a fact. After all, the very word "Independent" means to depend on no outside sources.

    Also yes, there are strict financial requirements for being accepted to medicaid. But they are so, so easily circumvented. An example is that many medicaid recipients do have more than one car and more than $6k in assets. BUT, this second car is in their mother's, or anyone they can trust who does not reside with them's name. But it's still parked in front of their house or apt, is it not. THEY use it while the one who registered it in their name will have to ask them if they can borrow it. And I believe that you have forgotten that no one actually raises a family of 4 on $600 a month, because if they only make that, or in the ballpark of that, they are likely receiving supplemental income from the government anyway plus section 8 or something similar that pays dwelling costs.

    Please,let's look at the whole picture and not defend our positions with half truths, deal?
    I hope this clears some things up for the "PC" crowd
    Last edit by PRICHARILLAisMISSED on Dec 4, '12


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