To all "medical coverage is a privilege" folks:

Nurses Activism

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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 of their child. (Any veterinarians on this forum?)

Because of the OMG free market stuff, you can remove the child's appendix for a minimum of...$5,000. However, this child's family cannot afford that and are not eligible for that much credit.

...what do you do? What if you're presented with ten such cases over the course of a month?

Nurses have alot of power to change health outcomes for everyone in America, "insurance" or not. When the law passes there will be great opportunity for public health nurses to manage and educate patients in preventing major hospitalizations. Know what you are worth, and work together, whatever you are making you are worth more- don't get caught up in simple minded arguments on hypothetical situations that are more of a moral debate and would never happen. The problem is we let people get really sick and then spend sometimes upwards of millions of dollars(made up prices by insurance company- kind of like the house you bought 6 years ago) in emergency/life saving procedures that by law hospitals have to provide(will never change so why discuss)- scenario-

you have a 100 patient load as a public health nurse- you see 5 pts a day- make calls, work normal hours- you know this dude, he isnt going to take his lisinopril- so you go surprise him on his front door step- take his pressure 190's- take yer pill dude- bp now 150's- hemmoragic stroke prevented- man happy, man scared you are going to show up on his door step maybe think he need to takey his pills to avoid that - me happy- 100 k in hospitalization saved, 3 million in for 2 years on a peg tube drooling with reoccurent bedsores in ltc - thats what we are worth..3.1 million...and saving dudes life- dont let this divide us like teachers - we are already scared to say anything about raises or work conditions in fear for our jobs- guess what guys there will always be another ass to wipe...

Specializes in Infectious Disease, Neuro, Research.

The primary flaw in the Public Health educational model is the idea that a majority of persons are able to grasp long-term consequences. Most cannot. A significant number of those that are able, choose not to do so.

From the perspective of someone with a chronic condition (diabetes): if the Gvt. chooses to force allocation of assets to sustain everyone, treatment methods will revert to the lowest common denominator (read sub-q long acting/short-acting insulin). Loss of most efficacious therapy by the compliant patient results in diminished states of health. Continued non-compliance by the inherently non-compliant (selling Gvt. provided resources for sex, dope, alcohol, or other coping mechanism) results in minimal demonstrable gain in societal health, with increased M&M among the compliant population. I fail to see the benefit, here.

Sorry, this is primary educational theory- the more hand-holding, the more the institution provides, and the less personal responsibility is required, the greater the level of developmental retardation and maladaption.

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.

People who think like this shouldn't be nurses. The sick child didn't ask to be born to parents without money.

Wow.

Lots of different opinions.. interesting reading. I will say that in my 30yrs + in healthcare, I've worked many different areas, and had the child landed in the ER, we ALL know he'd be treated regardless of ability to pay. COME ON. EMTALA rules...

Problem landed when government got involved in people's lives to the point that they are today. Whatever happened to the generation in America that worked hard, played hard, and met their financial obligations to society? They're dying. Wanna know what that looked like? Watch "Leave it to Beaver" or "My Three Sons" or even "The Waltons". The generations that followed have been enabled to this "entitlement" to the point that now everything has to be given to those who "won't". Free healthcare, more money for having more kids you cannot afford or support, free cellphones, etc, etc. Give the government the reigns on healthcare and you won't like what that looks like. Your next ER visit will be WORSE than your last trip to the DMV. And just know there is a REASON that Congress is voting in these rules for YOU and YOURS for which THEY are exempt. That sounds like a good idea to me.

Just sayin....

Specializes in MDS RNAC, LTC, Psych, LTAC.

@Neatnurse 30,

I work as an RN and I am not having children I have already raised them and the government isn't paying for them or me. I am most certainly not on drugs and I have no insurance because my employer only offers it to full time employees which I can't be due to health issues. I am looking for full time work while working part time and would love to have insurance but please dont use stereotypes and generalities about who is insured or not insured in the United States of America. Do some research at the CDC website and Medline you will see who is insured and who is not.

I'll jump in on this. Most hospitals will make arrangements with patients to pay off bills. $5000 to remove an appendix? Maybe in Mexico. I had shoulder surgery last year to repair a seperated shoulder and it cost 5 times that, just for the surgery. Labs, PT, pain meds,etc were all extra. Total cost was $48,000. Luckily the injury was a result of a car accident and the other drivers insurance paid (he was at fault).

But what if it was a heart attack, stroke or other type of accident? I worked full time and had insurance (BS/BS). I Paid $300 a month for that privledge. How much would they have covered??

Answer: about $20,000. They would NOT pay for: Ambulance ride or any procedures done in the ambulance, CT scans done in the ER, or Physical therapy. The would have paid a percentage for everything else. I know this because claims were filed with BC/BS before being turned over to the other guys insurance.

My point is you can be employeed with insurance and still owe a ton of money for medical procedures. Insurance companies say that they care about you but they only care about your money. I'm a nurse in a specialist's office and I fight with insurance companies daily to get approval for medications, tests, and treatments. ALL insurance companies fight with medical providers over payment.

It's not just the poor, or unemployed or lazy who rack up medical bills. It can happen to ANY of us. All it takes is the unexpected.

Specializes in Emergency.

"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." Quote from Neat Nurse....

my response:

I know a lot of people who WORK and are not able to afford insurance, and have jobs that dont offer insurance. And Indeed, most people do not ask to have an ill child, or cancer....

Specializes in PICU, NICU, L&D, Public Health, Hospice.

I will apologize first...I am sorry that I am going to offend some of you.

Arguments such as...if you don't have insurance you are not working, or you prefer to pay for a new truck instead of insurance, or you should take better care of yourself, etc, etc, etc are IMHO primarily based in ignorance and division.

There is no intent to improve any service, any process, or any access. There is only intent to lay blame and create division.

People who think that only the unemployed are uninsured are ignorant about health insurance.

People who think that people who work and don't have insurance simply don't have their priorities right are ignorant about the realities of those choices in those income brackets and situations.

People who think that only the uninsured are bankrupted by health care costs are ignorant of those facts.

People who think that only irresponsible people have costly health expenses are ignorant of too many things to list.

Flame on and Peace out.

BCGradNurse: Thank you for responding to Neatnurse30's comment in such a sensible and sensitive way. I agree with you completely and could not have said it better. In fact, my reply would have been really snarky! I truly hope we can achieve universal health care in our country one day. Now I have to stop typing, because everything else I can think of to say in response to that offensive comment is just too, well, not nice....

But there you are wrong because in order to recoup uncoverd costs of the uninsured who do not qualify for some form of assistance , then the cost is passed onto the customers , we then pay that through increased premiums .

To borrow another posters phrase " it burns my soup " , the group that could afford to pay for insurance but choose to shift the risk and therefore cost to me .

"...because in order to gain (extraordinarily MORE) than recoup uncovered costs of the uninsured..." --

There, fixed that for ya (not really you, but that often used phrase or explanation). I have no doubt disguised in many of the healthcare rate hikes that are supposedly 'recouping' for those who are uninsured, is the hidden agenda of more profit, more of the time. No way for we 'payors' to see it or prove it eh?

Board members do not face a puzzle of 'how do we maintain the profits we made last quarter', they in earnest seek to continuously, zealously RAISE their profits. There is no discussion pertinent to them like "the insured, loyal customers who have been with us for years should get a huss this quarter." Customer service is the surface-speak for attaining corporate goals.

Meanwhile we continue the infighting over who should pay, who should suffer or die since they probably made unwise choices at some time in their life - versus those who are oh so much brighter and more moral, and perhaps more lucky. We continue to be distracted, and the owners of the healthcare conglomerates continue to increase their revenue.

No one begrudges achievement or success - no, not even to 'corporations' who apparently are 'people' too now in America. The shame is that the definition of those goals is muddied with literally, unlimited greed in the midst of pain and suffering.

Specializes in PICU, NICU, L&D, Public Health, Hospice.

Well said Autymn...it is sad how greed has become so ingrained in the capitalist business model that we (the general public) now just accept that as the norm, when it HAS not been the norm in this country historically.

All right, I'll bite.

I've lurked on this site for a few years and this discussion was what finally prompted me to join.

Here is my anecdotal story to illustrate why we need universal coverage:

About 15 years ago, my mom sneezed, and afterward, her neck hurt. She spent a few months in pain, trying to correct whatever had happened with stretching before she finally went to her MD.

Her MD told her she could try traction, or she could have back surgery. My mom, who was on a great health care plan, wanted nothing to do with surgery if there was another option available. Her MD prescribed a traction device which is basically a jaw strap which is attached to a bag. She fills the bag with water, slings it over a door, and sits in a chair with the jaw strap on. It worked perfectly. The traction relieved her pain and she was good to go.

A few years later, my step-father died. My mom was insured through him, and stayed on his insurance through COBRA. A few months before her COBRA coverage ended, my mom started searching for personal insurance.

She was denied by every insurance company which operates in her state because there is a note in her medical record which says she was offered an option of back surgery and she declined. No insurance company was willing to provide coverage for her on the off chance that she get a wild hair up her a** and decide to undergo the back surgery which she declined before.

The upside of this story is that my mom is lucky enough to live in a state that has high-risk pool-coverage. She has health care insurance.

She has health care insurance at $800 per month with a $7500 deductible.

She pays $9600/year because her medical file mentions that 15 years ago back surgery was an option.

So ends my anecdotal story on why we need universal coverage.

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