Wisconsin has gutted Medicaid, no mandated ratios!

Nurses Activism

Published

So with all the craziness befuddling many Wisconsinites lately a new tightly kept secret was finally brought to light. Governor Scott Walker has not only gutted Badgercare (Wisconsin's Medicaid) which many farmers rely on as well as low income and buy ins by people who have two part time jobs for instance, Seniorcare which is an RX drug program for low income Seniors (which had a $20mil surplus), cut the end-stage chronic renal program, and Familycare which helps to pay for long term care for disabled and poor elderly individuals. Also, there is absolutely no nurse to patient mandated ratio in Wisconsin (let alone hourly mandates).

Many of our hospitals that give care to Medicaid patients are already overburdened as we have had hospitals close, not to mention the many who have lost insurance only going in when they catastrophically need emergency care. This is going to shift the costs to hospitals who will then do two things, raise rates on cash paying patients, and cut staff to the smallest possible amount even if that means 12 patients to a nurse, as I see it anyway.

Most hospital systems are non-profit but having worked for one that is supposedly religious in nature, I can assure you it is a farce in some cases as I worked on the "for-profit" side. It is hard enough as a new RN to find a job but with hospitals tightening their belts not only do I fear it hard to find a job (even at a nursing home), I fear the patient safety aspect of this.

It has been well documented that not only hourly mandates over 12 hours but high nurse to patient ratios can be directly tied to medical error and patient mortality. Is it going to even be safe to practice nursing in my state?

I love my state so dearly and if what I fear happens, I fear our world-class award winning health care system will look like one of a third-world country, little supplies, rationing care, deciding monetarily if a life is worth saving because "we cannot afford it".

What are your thoughts?

Specializes in PACU, ED.

Perhaps you missed the quote from the Social Security Administration site. Your deductions for social security are not put into a special account for you. Instead, they are used to pay current retirees. To me and to many people that sounds exactly like the cash flow of a Ponzi scheme. You don't see the similarity but that's okay.

Remember stagflation from the Carter era; double digit inflation, interest rates in the high teens, and nearly 10% unemployment? Reagan's tax cuts stimulated a peacetime expansion that created 18 million jobs in 8 years and dropped unemployment from 9.7% to 5.4%. http://www.brusselsjournal.com/node/92

What I find interesting is the percentage of income tax paid decreased for the poor while their income increased. Even though the top marginal rates were cut, the rich paid a higher percentage of income tax after the changes.

If you really want to know what's happening, start doing your own research instead of relying on pundits, politicians, and extremists who will twist and lie to support their own personal agenda. For example, did you know that total government revenues increased every year during the Reagan presidency?

I've objected to federal deficit spending for decades, no matter who is sitting in the White House. It's amazing how many people change their opinion of deficit spending when their favorite political party is in power. Maybe you don't think deficit spending is a problem. It's America, we don't have to think the same.

"You don't lose weight by eating more and excercisng less and it's NO way to run an industrialized nation. What the hell, it's only your retirement, healthcare and the future of our kids grandkids at stake."

I totally agree with you here. That's why I think they need to take real action to both increase revenues and decrease costs. Congress has been almost totally wrong on how they are trying to contain health care costs. They've got to work on the overhead, not how we continue to pay ever increasing bills or just choosing to underpay our health care providers.

Personally, I'd like to see the Republicans kick back and let the President pass everything he wants. Jack up the tax rate on industry and people who earn over $150K per year. Make Medicare available for everyone. It would only take a couple of years to see if we like the results or not. Then we could either continue down that path or change directions.

Of course, a lot of people would be hurt along the way when hospitals go belly up and people find that nobody is able to accept Medicare when there is no higher paying insurance to offset the underpayment from the government. More corporations would move off shore and take their jobs with them and rich investors would probably move too, just keeping vacation homes in the US while making their income from overseas locations. Maybe I'm wrong but wouldn't it be a grand experiment!

First of all, if you want to be taken serious stop spamming the tripe and linking to crackpot websites, the websites of fringe rightwing candidates, ad nauseum. Stuff I use in the bathroom for paper has more credibility than that. Try educated objective sources that professional economists and universities use, like, you know, the Statisticial Abstract of the United States. Or at least Wikipedia.

I missed nothing and certainly not there. Yes, I realize SS isn't in a locked box. Seems to me that the candidate that proposed it was, Al Gore, got snorted at by people like you when he suggested it be so 12 years ago. And you then went and voted for teh guy "who you'd rather have a beer with" that turned a 3 billion dollar surprlus into 1 trillion in red inik in 8 years. So save it. You voted for it, you got what you voted for and if you want to give up your SS for the suffering friends of W. and bankers to crash and entire nations economy then puhleeze feel free to do so, but I'll be damned if you'll give up the rest of ours while I tip my hat and be quiet about it.

And stop calling it a Ponzi scheme unless you have something resembling evidence to support that claim.

It's far less of a "Ponzi scheme" ,at least by the arguments you have so far provided, than assuming we'll raise revvenue to pay for the DoD budget or the Dept of Homeland Security next year. That would be the case even if the program hadn't always been in surplus and used

Schools are funded by intergenerational tax transfers too (ie, the property taxes are paid for by people who don't have and I don't here the uber-fringers railing against that all the time. Interestingly the only time they seem to be shouting SOCIALISM and flapping their arms is when it's something

A Ponzi scheme is a fraudulent investment operation that pays returns to separate investors, not from any actual profit earned by the organization, but from their own money or money paid by subsequent investors (Wikipedia, 2011).

The Social Security and Medicare taxes you pay are not put in a special account for you. They are used to pay benefits for people getting benefits today, just as your future benefits will be paid for by future workers. http://www.ssa.gov/pubs/10006.html

(Bolding is mine.)

Hmmm, it looks like a duck and quacks like a duck.

I just hope it will keep laying duck eggs long enough for me to regain some of the money that's been taken from my pay over the years.

It is a problem that our federal government (spelled with both an R and a D) has been using excess SS funds to live the high life for several decades.

And if it looks like a crack and quacks like a quack, it probably IS a crackpot. If you wanted to ensure that social security surpluses were untouchable and not used by other candidates (like the guy who rode in behind him playing Texan in a new 200 million dollar Ranch built in 1999 he hasn't been in 12 times since) then you should have supported Vice President Gore's efforts to do so instead of joining the club laughing and snorting on AM radio who happen to live in 20 million dollar homes in Florida.

Where I come from we always understood we were wage-earners. If you want to be angry with someone be angry with yourself.

So...our health care delivery system is too expensive and the best way to control costs is to insure that only those who have insurance or can afford the cost receive the care? And those who have mental illness or substance abuse are not worthy of care? Do we begin to deny care for the diabetic who cannot control their diet, and the hypertensive who is overweight, the anorexic who continues to starve themselves, or the morbidly obese who continue to eat? Or do we treat them only if they have insurance or can pay cash? Are only the poor and the middle class subject to the rationing of care based upon compliance? Or can we deny care to the wealthy smoking COPDer too?

If disabled people have luxury items in their possession should we refuse care until they liquidate those "assets" so that they can pay for the care?

What about those who are unable to care for themselves...children, the elderly, and the infirm? Should their care be determined by their ability to pay? Perhaps we should reconsider NICUs, those patients are VERY expensive and many have no insurance to cover the cost of their care. Certainly abortion would be a much less expensive and more definitive way to deal with those pregnancies.

Which group of people will make these choices? Will this be a type of death panel? What criteria will be used? Will there be option to appeal? Will financial statements become part of the information we will have to give our physicians or the EMTs in order to receive care. Will the first responders need our insurance cards or investment portfolios to resusitate us on the street and transport to the ED? What will the monetary cut off be for those who are "pay as you go"?

Our system is clearly in trouble...I am not certain that rationing care based upon judgements of worth is the way we want to fix it.

Good points in all. I'd even be happy tho to see these types answer why they're remaining silent when the demagogues who suggest these cuts are simultaneously supporting tax cuts for their well-heeled donors.

For ways to ration care, we only need to peer across the pond. One advantage to universal coverage is there is only one group making health care decisions for everyone.

http://www.bbc.co.uk/news/health-12964360

We're already rationing care here. There's 75,000,000 uninsured people, another 50,000,000 underinsured people and millions of others in HMO's and medical costs are the single most reason people file for bankruptcy in the nation.

What was the point of putting an editorial from United Kingdom in your post anymore than posting fringe rightwing websites. It doesn't make your argument any stronger, quite the contrary. Ideal system or not, at least there there's never be a family that had to go into bankruptcy and lose their life savings because someone got sick. Their taxpayers also pay a lot less per capita than does the USA.

Oh, and those performance indicators already exist in the United States. Both the public and private insurers require them. Like, you know, DRG Indicators, ARQH, P4P and now meaningful use. That's a good thing. Treating patients holistically and accounting for outcomes makes a lot more sense than isolatedly just order more tests and treatments without knowing what has been done or is being done by others. Also puts some much needed accountability on the patients themselves, like diabetics who aren't controlling their hgAlC. What exactly is your problem with this?

clinton did do a better job of making ends meet than any other recent president. however, the national debt still increased every year. how did he have a budget surplus and still manage to add to the national debt? here's a good discussion of the smoke and mirrors that was used to make the claim that clinton balanced the budget. or should we call it fuzzy math?

http://www.craigsteiner.us/articles/16

1. a link to a radical rightwingers campaign is laughable.

try using the stat abstract, wikipedia, greenbook, official state and federal revenue and outlay tables and believable, objective sources that are neutral (money magazine, the economist, etc).

i mean if you're trying to make a serious point.

2. clinton did more than make ends meet. he inherited a > 200 billion dollar annual deficit from his predecessor, reduced it every year he was in office and ultimate left george w. with a 3 billion dollar annual surplus that george turned into 250 billion dollars of deficits his very first year by insisting upon tax windfalls for the well-heeled which were made retroactive to his inaugeration, cutting them while fighting a two front war, and ultimately left office with one trillion dollars of red ink. ( this is the same red ink the new founded appointers of the deficits, those savvy teabaggers suddenly became worried about as soon as their was a democratic president and a good deal of the reason nobody believes them especially as they've been the first to insist upon yet more tax relief for those suffering 1% along with draconian cuts to what's left of infrastructure spending and asking the middle class to take another big punch in the face).

clinton raised taxes on the wealthy, modestly, for the first time in 12 years (imo the real reason they wouldn't let up on him and it did not cause the grass to grow in the industrial parks or the stock market to crash, quite the opposite. because he did more than give lip service to the deficits, fr chair greenspan relaxed the money supply and it created a very prosperous economic climate and ultimately 23 million private sector jobs.

this is important because under both reagan and bush i government sector job creation exceeded private sector job creation, as it did under bush ii - another reason to take the uber-right's rhetoric about "socialism" with a big block of salt and another reason i'm decidedly unimpressed with their insistance that i should give up my retirement healthcare, social security and whatever remaining shred of security there is for the struggling middle class along with troops doing their third, fourth or fifth rotation in mideastern hellholes all so we can take another try at "creating prosperity" by giving the weyrichs, waltons, scaifes and koch's another big windfall. add to that , that not one of these names , nor reagan for that matter, can be found etched in that great granite wall in washington and i'm really not interested in hearing it. just saying.

3. deficits are the annual difference between revenues and outlays. the national debt is the accumulation of that historically and the interest in serving it. therefore how the national debt can grow even as deficits are declining or surpluses exist i believe is self evident.

furthermore a new president doesn't get to create a budget until the following november after taking office so for the first year they are operating on their predecessors budget. unless they do something , like w. did in making tax cuts retroactive to their inaugeration. reagan did that too. the right tried to blame their first year deficits on their predecessors policies very disingenuously.

4. because economies and populations grow over time and because a dollar today is not the same value as it was 30 or even 5 years ago the proper way to measure revenues and outlays is in percentage of the gdp.

obviously too if you owe 10,000 dollars it makes a huge difference how "broke" you are if you're annual income is 15k or 150k. same concept. for more information see any basic econ text. i recommend anything by samuelson for the basics.

i'll now point you to evidence-based facts on federal debt by administration for the past presidents and i can tell you're not going to like the truth. but you shoudl at least know it. oh, and needless to add, i hope, i'm not pulling my sources from mother jones or some equiv of a left wing rag or political campaign site.

http://en.wikipedia.org/wiki/national_debt_by_u.s._presidential_terms

please note that every single administration that has added to the deficits for the past 60 years has been republican with the biggest, by far, being the trickledown economic kings reagan and george w.

u.s. presidentsort_none.gifpartysort_none.gifterm yearssort_none.gifstart debt/gdpsort_none.gifend debt/gdpsort_none.gifincrease debt ($t)sort_none.gifincrease debt/gdp

(in [color=#0645ad]percentage points)sort_none.gifhouse control

(with # if

split during term)sort_none.gifsenate control

(with # if

split during term)sort_none.gif[color=#0645ad]roosevelt/[color=#0645ad]trumand1945-1949117.5%93.1%0.05-24.4%79th d, 80th r79th d, 80th rtruman [color=#0645ad]harry trumand1949-195393.1%71.4%0.01-21.7%ddeisenhower1 [color=#0645ad]dwight eisenhowerr1953-195771.4%60.4%0.01-11.0%83rd r, 84th d83rd r, 84th deisenhower2 [color=#0645ad]dwight eisenhowerr1957-196160.4%55.2%0.02-5.2%dd[color=#0645ad]kennedy/[color=#0645ad]johnsond1961-196555.2%46.9%0.03-8.3%ddjohnson [color=#0645ad]lyndon johnsond1965-196946.9%38.6%0.05-8.3%ddnixon1 [color=#0645ad]richard nixonr1969-197338.6%35.6%0.07-3.0%ddnixon2 [color=#0645ad]nixon/[color=#0645ad]fordr1973-197735.6%35.8%0.19+0.2%ddcarter [color=#0645ad]jimmy carterd1977-198135.8%32.5%0.28-3.3%ddreagan1 [color=#0645ad]ronald reaganr1981-198532.5%43.8%0.66+11.3%drreagan2 [color=#0645ad]ronald reaganr1985-198943.8%53.1%1.04+9.3%d99th r, 100th dbush ghw [color=#0645ad]george h. w. bushr1989-199353.1%66.1%1.40+15.0%ddclinton1 [color=#0645ad]bill clintond1993-199766.1%65.4%1.18-0.7%103rd d, 104th r103rd d, 104th rclinton2 [color=#0645ad]bill clintond1997-200165.4%56.4%0.45-9.0%rrbush gw1 [color=#0645ad]george w. bushr2001-200556.4%63.5%1.73+7.1%r107th split, 108 rbush gw2 [color=#0645ad]george w. bushr2005-200963.4%83.4%2.63+20.0

http://en.wikipedia.org/wiki/national_debt_by_u.s._presidential_terms

as i like to say, reality is a nice escape for those who don't care for science fiction.

Sorry, I've been rather busy with work and school, haven't had a chance to revisit this thread in a few days.

Anyway, to be precise, I'm really not "arguing" about anything on this thread so far: all I've been trying to do is to get through to people the facts of what Social Security ACTUALLY IS - an unsustainable, bankrupt Ponzi scheme. So, now that that point has been made, we can talk about alternatives. Right now, I think we'd all be better off with anything that wasn't an unsustainable, bankrupt Ponzi scheme.

We are really talking about about two different things here: (1) a social safety net of last resort, and (2) providing for a comfortable retirement.

Well, if so you haven't yet gotten through. Social Security alone has cut elderly poverty by over 65% in this country. Should the destitute people of the Great Depression have rejected the New Deal while waving the Federalist Papers? What exactly ARE you proposing besides truly asking the middle class who by the way have PAID into these programs to take another big punch in the face?

Calling a program that has been in surplus to the degree that it has been raided to pay for tax cuts to the uber-wealthy a "ponzi scheme" is moronic. And if the FICA tax pool designed for social security can be used to pay for tax cuts for the wealthy, wars and Congressmen to buy their mistresses condos in Ocean City, Maryland, please give me one good reason why THEIR taxes can't be raised and then have general treasury funds be used to supplement social security if that is truly needed which it wouldn't be if the nation had stayed on Clinton's economic track instead of playing Voodoo Economics Part 2 with the guy they'd rather have a beer with.

So far all I've heard from the Great Salespersons for the rich is that having destroyed real estate values across American and crashed the economy, the middle class should take another big hit and give up their Medicare and Social Security. Ain't going to happen quietly I can promise ya. Frankly I don't CARE where Congress finds the money when it's my time to collect but I suggest they go to their fatcat donors who they've been giving taxpayer funded freebie after freebie or for the past 30 years.

it's supposed to be a Government by , of and for the people, not a Government by, for and of the top 1%.

http://www.vanityfair.com/society/features/2011/05/top-one-percent-201105

Perhaps you missed the quote from the Social Security Administration site. Your deductions for social security are not put into a special account for you. Instead, they are used to pay current retirees. To me and to many people that sounds exactly like the cash flow of a Ponzi scheme. You don't see the similarity but that's okay.

Remember stagflation from the Carter era; double digit inflation, interest rates in the high teens, and nearly 10% unemployment? Reagan's tax cuts stimulated a peacetime expansion that created 18 million jobs in 8 years and dropped unemployment from 9.7% to 5.4%. http://www.brusselsjournal.com/node/92

What I find interesting is the percentage of income tax paid decreased for the poor while their income increased. Even though the top marginal rates were cut, the rich paid a higher percentage of income tax after the changes.

If you really want to know what's happening, start doing your own research instead of relying on pundits, politicians, and extremists who will twist and lie to support their own personal agenda. For example, did you know that total government revenues increased every year during the Reagan presidency?

I've objected to federal deficit spending for decades, no matter who is sitting in the White House. It's amazing how many people change their opinion of deficit spending when their favorite political party is in power. Maybe you don't think deficit spending is a problem. It's America, we don't have to think the same.

"You don't lose weight by eating more and excercisng less and it's NO way to run an industrialized nation. What the hell, it's only your retirement, healthcare and the future of our kids grandkids at stake."

I totally agree with you here. That's why I think they need to take real action to both increase revenues and decrease costs. Congress has been almost totally wrong on how they are trying to contain health care costs. They've got to work on the overhead, not how we continue to pay ever increasing bills or just choosing to underpay our health care providers.

Personally, I'd like to see the Republicans kick back and let the President pass everything he wants. Jack up the tax rate on industry and people who earn over $150K per year. Make Medicare available for everyone. It would only take a couple of years to see if we like the results or not. Then we could either continue down that path or change directions.

Of course, a lot of people would be hurt along the way when hospitals go belly up and people find that nobody is able to accept Medicare when there is no higher paying insurance to offset the underpayment from the government. More corporations would move off shore and take their jobs with them and rich investors would probably move too, just keeping vacation homes in the US while making their income from overseas locations. Maybe I'm wrong but wouldn't it be a grand experiment!

Allow me to interject some economic education please. I do have a substantial background.

Stagflation was coined by economist Paul Samuelson to describe the years of high inflation and high (for back then) unemployment from 1974 through 1985. Please note that is well before and after Jimmy Carters term and it is a result of failed supply-side monetary policy advocated by economist Milton Freedman (An Economic History of Monetary Policy of the USA) , who was right on his trade models but very wrong on much else - and oil shocks like the late 70's Saudi cartel, nothing at all to do with Presidential fiscal policy of Carter.

As for health inflation, yes, it's skyrocketed for 35 years and that, along with Reagan and Bush's and now Obama's deficits are a real problem. health care costs should have been addressed 15 years ago and hell knows people tried but the lobbyists including the AMA who is just happy to have physicians responsible for not much more than ordering tests and writing prescriptions the hell with their costs, not having to be responsible for patient outcomes. ( If anybody should resent that it's nurses who are responsible for everything that happens on the unit every time a pin drops from the unit secretary screwing up orders, a CNA not washing her hands to a 94 year old with sundowners falling out of bed all for a fraction of the financial rewards for this aggrevation).

Please keep in mind a "market based' solution to 35 years of double digit healthcare inflation meets a fiscal policy that thinks it's socialism to tax billionaires at the same rates they do nurses and truckdrivers , is in fact for another 150-250 million people to be without healthcare coverage, ultimately ourselves included. Or we can address it sensibly through things like the ONC is doing. So which is it going to be? I've already made up my mind and I actively support ONC's efforts.

Specializes in PACU, ED.

The US debt has increased every year of my life. That includes the Clinton presidency. http://www.treasurydirect.gov/govt/reports/pd/histdebt/histdebt_histo4.htm

If you have a reputable source that shows the total government debt has declined any year, I'd love to see it. According to the US government, the debt has only moved in one direction.

Date Dollar Amount 09/30/1999 5,656,270,901,615.43 09/30/1998 5,526,193,008,897.62 09/30/1997 5,413,146,011,397.34 09/30/1996 5,224,810,939,135.73 09/29/1995 4,973,982,900,709.39 09/30/1994 4,692,749,910,013.32 09/30/1993 4,411,488,883,139.38 09/30/1992 4,064,620,655,521.66 09/30/1991 3,665,303,351,697.03 09/28/1990 3,233,313,451,777.25 09/29/1989 2,857,430,960,187.32

ETA: The data doesn't seem to copy/paste well. Rather than reformat it, please just check the link to the government source.

The US debt has increased every year of my life. That includes the Clinton presidency. http://www.treasurydirect.gov/govt/reports/pd/histdebt/histdebt_histo4.htm

If you have a reputable source that shows the total government debt has declined any year, I'd love to see it. According to the US government, the debt has only moved in one direction.

ETA: The data doesn't seem to copy/paste well. Rather than reformat it, please just check the link to the government source.

And has been explained to you already that is entirely possible even as a President reduces the deficits or runs surpluses. Largely because the existing debt still has to be serviced - it's called interest on the national debt. I also did not claim Clinton did not run deficits - just that he reduced the ones he inherited every single year he was in office and finally eliminated it all together.

Once again deficit is the annual difference betweeen revenue collection and outlays.

National debt consists of the accumulation of it from all predecessors.

Specializes in PACU, ED.

What was said was that Clinton was able to create a surplus. If that were true, what did he do with his surplus? I think we've agreed that deficits increase the national debt. A surplus should reduce that debt shouldn't it?

Service on the debt is also a budgetary item. Can you really claim a surplus when some items on the budget require more borrowing?

What was said was that Clinton was able to create a surplus. If that were true, what did he do with his surplus? I think we've agreed that deficits increase the national debt. A surplus should reduce that debt shouldn't it?

Service on the debt is also a budgetary item. Can you really claim a surplus when some items on the budget require more borrowing?

What is hard about any of this? After inheriting a 200 billion dollar deficit from his predecessor he reduced it every year he was in office finally leaving President Bush with a surplus. You were provided these facts with my wiki citation. (Nothing is "left-out". Financing of the national debt is a complex array of short and long term financing and as with any loan you pay some of the interest regularly and other gets compounded and added to your principal loan. ) Had those surpluses been continued by his successor then yes, they could have been used to pare down the NATIONAL DEBT. Continued in this direction we would be facing a very different national conversation now and it is a travesty for the American middle class - or what's left of it.

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