To all "medical coverage is a privilege" folks: - page 2
You're presented with a five year-old who probably has appendicitis. The family is poor, does not have medical insurance, and they only have a small amount of money to cover diagnostics and treatment... Read More
Mar 26, '12 by BuckyBadgerRN, RNWell, while I agree that parts of your statement tend to align with some thoughts of my own, there are portions of your post that are just straight up untrue. There are PLENTY of people that work hard that do not have insurance. I myself work 2 jobs totally 50 hours per week, one of them is a very respectable-paying nursing job---with NO benefits. I am fortunate that my husband is able to carry our healthcare insurance through his employer, but many American's do not have that option.
Mar 27, '12 by BuckyBadgerRN, RNIn my state, Medicaid won't pay for a crown for a tooth. Well, not without the provider jumping through a milion hoops to try and get it pre-approved so they can be paid about 30% of the original fee, which isn't even enough to cover the lab bill....
Mar 27, '12 by great_buAs usual, the problem arises not from an ethical debate about whether it is 'right' for individuals to pay for their own healthcare or society to pay for it - ethically it would seem far more 'social' for payment to come from all for all. Unfortunately, we as a society can't afford all the healthcare that everyone needs. As a result of this, the limited amount of money available from society to pay for health must always result in some who get what they need and some who don't.
This leaves you with essentially two extremes of choice:
a) An entirely nationalised system where everybody gets 'free' healthcare (i.e. funded through taxation and free at the point of delivery) according to need - this is (sort of*) like the NHS in the UK where I work. Limited funding means that those who happen to suffer from very expensive to treat conditions do not get the treatment they need, regardless of how much they may have paid into the system through a lifetime of taxes (or not...), the rationale being that the limited funds must be spent where they will do the most good to the greatest number. In the original example above, the 10 kids with appendicetomies get their treatment ($50,000 to save 10 young lives) but a 50 year old with bowel cancer does not get the Bevacizumab ( a cancer drug that costs ~$50,000 to the NHS to give for a course of treatment) he needs because the NHS has to balance one 50 year old life against 10 kids. Great if you're the parent of the kid, less so if you're the wife of the bowel cancer patient (to push the example even further (but plausibly) - make the 10 kids come form poor families who have never paid tax into the system and the cancer patient a hard working man who has paid tax into the system for 30 years). Is this fair, or even morally acceptable ?
b) An entirely privatised system, whereby all individuals are responsible for meeting their own healthcare needs and those who can't afford it don't get it. This is (sort of*) like the system in the USA, the limited funding manifests as those who are personally less wealthy don't get treatment (even if it would be relatively cheap, e.g. $5,000 appendicectomies to save a life) and the more wealthy get treatment regardless(ish) of cost (even if a huge payment may only buy you a few more months of life - $50,000 worth of Bevacizumab buys you on average about 5 months more life expectancy for metastatic bowel cancer patients). On the one hand, the bowel cancer patient has paid all his working life for his healthcare but on the other hand, why do the 10 kids deserve to die from a totally preventable cause just because their parents were born poor ? Is this fair, or even morally acceptable ?
*Both are 'sort of' true - in the UK it is possible for bowel cancer man to get his treatment by paying privately, in the US the kids of the very poor will be treated under medicaid, so really what it comes down to is that as a society we have to decide which limited healthcare funding distribution option we are least uncomfortable with. Unsurprisingly, people who are wealthy enought to afford their own healthcare expenses generally favour option (b) and poorer ones who can't afford it favour option (a).....
Mar 27, '12 by StaragateI am part of the working poor. I have minimal insurance to myself and my kids. That is, if we have a significant event like a hospitalization, we pay 20% and the insurance pays 80%. It's not good, but it's better than paying 100%. For well child and checkups, then it's cash. Which is still cheaper than the monthly premium for most insurances. $100 for a visit vs. $600/mo for insurance. My husband has always had a full time job, but never had insurance since he always worked for small businesses that don't provide it. I had regular insurance when I worked full time at a school, but it only covered me. I am a student now, so I work part time.
I live in Arizona, which has cut all new medicaid applications since 2008 and so there are thousands of children without health insurance. If it weren't for the CVS and Walgreens clinics, they would get NO healthcare at all.
My point is that just because someone doesn't have insurance, that doesn't mean they are lazy or a drug addict. We live frugally, so we have to be creative to meet basic needs. As far as public assistance goes, I don't think adults should be forced to have insurance. For people like me, who are basically healthy, it's more of a cost than a benefit. (except for that rare hospitalization that is the accdent insurance is covering). Children shouldn't have to suffer or go without healthcare because of employers benefit packages. I think that states should cover kids in those cases. I hate that people don't get the care for their kids because of the cost. There are sliding scales, which is great and should be utilized as well.
Mar 27, '12 by nicurn001Quote from StaragateI certainly agree with the first sentence quoted , but the second para I wholehearted disagree with unless you are absolutely unable to pay for your insurance ( due to proved low income or physical or mental disability that stops you from being able to earn a income ). I have two reasons for this positionMy point is that just because someone doesn't have insurance, that doesn't mean they are lazy or a drug addict".
" I don't think adults should be forced to have insurance. For people like me, who are basically healthy, it's more of a cost than a benefit. (except for that rare hospitalization that is the accdent insurance is covering).
1) The choice to be uninsured does not get rid of the risk or liability that a healthcare problem would cause it simply places the liability on me , as I have to finance the uninsured expenses . This risk increases my private insurance costs.
2) by reducing the pool of insured , you reduce the number of people who share the costs of the risk the insurance policy covers , again raising the costs of my private insurance premiums .
I don't think adults should be forced to pay higher insurance premiums to cover those who choose not to have health care insurance when they can afford it !. It may be easier on their pockets but not mine .
Mar 28, '12 by tewdlesI have been a full-time employed RN for more than 30 years. I have always had health insurance. My husband had a serious health issue (in 2005) requiring surgery and hospitalization in a university hospital system with months of after care which included expensive supplies. Our health insurance company at the time refused to pay for ANY of the associated costs and dropped our coverage. I recently experienced a critical health issue, paid for by my insurance, but my already fragile budget was devastated by the deductables, co-pays, and loss of income. We are now filing bankrupcy and have lost our home. It is important to point out that my spouse and I do not (and historically have not) carry(ied) any credit debt other than our mortgage and have driven used cars that we have paid for with cash for more than 25 years.
The "individual mandate" was initially a republican concept that now is considered evil by many of the same folks who signed off on it years ago (think in terms of the push back against "Hillarycare"). I am still waiting to hear the modern proposal of the conservative leaders for the care of our most vulnerable citizens...those who are ill, injured, or disabled. Cutting medicare and medicaid is not a plan to improve our health care in this country.
Mar 29, '12 by interceptinglightMy 21-year-old daughter makes minimum wage ($7.25/hour --Idaho--caregiver at a group home) and pays nearly $200/month for medical coverage. I work at the local university and my healthcare package costs significantly less....however it comes with a yearly $5000 deductible per person on my plan. I'm paying for really no coverage at all outside of catastrophic illness or injury, in which case maybe even then I'd get stuck with the bill -- I don't even know what to expect! Better not complain, I guess, it's better than nothing...which is what I used to have. I'm 49 years old and doing my best to stay fit: keeping a healthy weight, staying active, and taking health supplements and vitamins and stuff -- god forbid I get sick cuz if I do it's coming out of my shallow pocket.Last edit by interceptinglight on Mar 29, '12 : Reason: typos
Mar 29, '12 by StaragateQuote from nicurn001What about those like me who can't afford it? It would be the choice between taking food from charities or insurance, since it's the same cost as my food budget. I like to reserve the food boxes for those who are truly destitute.I don't think adults should be forced to pay higher insurance premiums to cover those who choose not to have health care insurance when they can afford it !. It may be easier on their pockets but not mine .
Mar 29, '12 by BCgradnurse, MSN, RN, NP GuideQuote from StaragateYou're stuck between the proverbial rock and a hard place. There's something very wrong about this. You shouldn't have to choose. I don't have a solution, but I know what we're doing isn't working.What about those like me who can't afford it? It would be the choice between taking food from charities or insurance, since it's the same cost as my food budget. I like to reserve the food boxes for those who are truly destitute.
Mar 29, '12 by DespareuxAll I know is, I really despise the "sink or swim" attitude. It is simply wrong to have a nation with such a great divide in wealth without social safety-nets in place.
But, I do believe, our nation is quite spoiled with material things that, in the end, are absolutely meaningless.
Mar 29, '12 by romieWow! I am completely awstruck by the positions and rationales that are taken by many of this forum. I have to keep checking my URL/ HTTP web bar to make sure that I am, in fact, on the allnurses.com forum. In my nursing school we were taught that healthcare was not a privilege but a matter of social justice. People have a RIGHT to healthcare. While I am acting as an RN and providing healthcare I don't give a rats a.. who is paying the bill, but that it is my duty not only as a licensed healthcare professional to provide that person with expert healthcare, but it is also my duty as an ethical human being to help them. In nursing school we spent a whole semester (wow, one semester, which included weekly journal type papers and one research paper) on ethics. I'm probably a little biased because my nursing school is one of the primary sponsors and advocates of Emergency USA, which is a little like Doctors without Borders but has a nursing focus and we had regular speakers from the program. Emergency USA builds and sustains healthcare clinics in war torn regions and the latest press release from Emergency USA was a letter urging NATO to stop their barricade and open a humanitarian corridor to let injured civilians from the recent Helmand, Afghanistan bombing through to receive the free healthcare they need from Emergency USA nurses and physicians.
And I'm not some whimsical new grad idealist. I have worked two jobs as an RN at the same time. The first job paid my bills, the second job I made enough to just cover the medical benefits for myself and my spouse. I paid over 800 a month for health insurance and I'm still stuck with the bills and getting reported by collection agencies because I refuse to act like a bank and provide a temporary loan to the insurance company until they can get their act together to figure out who is suppose to pay what. Obviously this free market thing isn't working.
We are going to pay for it collectively whether we like it or not. Wouldn't it be more cost effective to pay for prevention and encouraging healthy behaviors. Our government doesn't think so. Our government won't pay a specially certified diabetes educator nurse 100 a week to counsel and monitor someone but will gladly pay 50,000 or more to amputate their leg and the ensuing aftercare.
The integrity of any culture or society is based on how well the weakest members are cared for. Do we want our society to be remembered for the Desperate Housewives of Atlanta, Dances with the Bizarres, Flee or for the quality of care and respect that your premature infant or elderly aunt received in their most desperate times of need?
I really need to avoid this topic because it really burns my soup.
Mar 29, '12 by brandy1017Quote from neatnurse30Most people's health insurance is tied to employment and if they lose their job most will not be able to afford health insurance and many may simply not even qualify for health insurance and companies currently deny anyone with a pre-existing condition.If the family has no insurance, then that means they are not working. Maybe they should have thought about birth control before conceiving a child which they can't afford. Why should I feel guilty now for all the folks who are irresponsible - produce kids, don't work, do drugs, illegals? Do you expect me to pay for all of them? If you think that healthcare is a right, then go ahead and pay for all of these people, and we'll see how quickly you'll change your mind.
I wonder what you'd do if that happened to you? Don't be so quick to judge others! It is ridiculous and immoral that we still don't have national healthcare for all. We should have basic national health insurance like medicare for all and then we could purchase any supplemental insurance as is already done with medicare. It would sure be an improvement from today and would cost less than what is spent for healthcare now, the govt doesn't spend millions for CEO's and their fatcats with bonuses, etc!
Mar 31, '12 by nicurn001Quote from StaragateI thought my intent was quite clear when I said "I don't think adults should be forced to pay higher insurance premiums to cover those who choose not to have health care insurance when they can afford it !. It may be easier on their pockets but not mine ". I've highlighted the relevant part ie. if your income is too inadequate to cover everyday living expense , then I support the idea of providing healthcare , but don't expect me to cover this cost if you have disposable income for the latest gadgets and lexus etc..What about those like me who can't afford it? It would be the choice between taking food from charities or insurance, since it's the same cost as my food budget. I like to reserve the food boxes for those who are truly destitute.