Health Care for All, Just a (Big) Step Away - page 2

YOU may find it shameful that some 45 million Americans lack health insurance. Well, by reallocating money already devoted to health insurance, the government could go along way toward solving the... Read More

  1. by   SFCardiacRN
    I don't want to sound too harsh but...1/3 of all children drop out of high school in California. A few years later when mom kicks them out of the house and they can't find a decent job they want everything for free. I believe in welfare and taking care of the poorest of the poor. I don't believe in 40 or 50% tax rates. Sweden is currently at 50%. Hopefully we'll figure out how to cover everyone someday. It's just hard to find enough money for trillion dollar wars.
  2. by   SmilingBluEyes
    Seems to me, we are already covering these costs you fear. That people can't see this, is amazing to me. Working families like yours and mine, are ALREADY paying the tab for people w/o insurance and indigents. If not directly, then in shared costs in rising premiums and taxes, etc. Not to mention, our And working families are also without any form of health care coverage whatsoever. How wrong is that?

    We need to be a bit more forward-thinking here.

    I think it would be much wiser and well-thought to come up with a universal well-care plan, with single-payor system than the fragmented, messed-up, so-full-of-holes-it's-a-sieve, mish-mash we call "insurance" now. Insurance is a big racket. There has to be a better way!!!!
    Last edit by SmilingBluEyes on Dec 21, '05
  3. by   SmilingBluEyes
    Quote from Jolie
    SBE,

    I don't disagree that ensuring access to basic preventive healthcare would be more cost effective than dealing with the complex problems that result from lack of routine care. What a perfect world that would be!

    But I also think it is unreasonable to ask working families to contribute to further benefits for the uninsured, especially when those proposed benefits exceed what many working families earn thru their employment. My hubby's health plan with the $3900 deductible does not include dental or vision. That's another several hundred dollars of expenses that we must budget for each year, in a good year. God forbid someone needs a root canal or braces!

    I don't begrudge ANYONE decent benefits, but I don't think that those who rely on their fellow citizens to pay their healthcare bills should receive better benefits than those whose tax dollars pay for them.

    Also, I have found that people who are truly motivated tend to get the necessary services, regardless of ability to pay. How many families have access to Health Department Clinics, but decline because of inconvenience? When my first baby was born, I used the County Health Department for her vaccines, because our insurance didn't cover them, and the cost was prohibitive. They also offered well-infant checks, which I declined, because I wanted to have an established relationship with a private pediatrician. The NP was a wealth of information, and indicated that their well-child clinic was under-utilized. How many of those who could have used those preventive services ended up in theER instead, at a much greater cost? Personal responsibility, which our society seems to be lacking, is a big part of keeping healthcare costs down.
    Well, I have "motivated" friends who work 2 or 3 jobs, yet can't afford COBRA or other insurance. Victims of downsizing or jobs going overseas, some of them. A couple of them college-educated, and never have taken a penny of "welfare" in their lives. One I know is a NURSE and can hardly keep up---she is fearing she may have to drop coverage soon if things do not change. I mean, when ALL your bills go up, from fuel to home heating to food costs, what can you do, esp. if your salary stays basically stagnant????

    What about THEM? They are responsible people, all of them.

    When should any working family be unable to afford basic health care? And how far do you think YOU may be from that being a reality for YOU? I tell you, it's hell when it happens.
    Last edit by SmilingBluEyes on Dec 21, '05
  4. by   Jolie
    Quote from SmilingBluEyes

    I think it would be much wiser and well-thought to come up with a universal well-care plan, with single-payor system than the fragmented, messed-up, so-full-of-holes-it's-a-sieve, mish-mash we call "insurance" now. Insurance is a big racket. There has to be a better way!!!!

    The problem with ANY insurance or single payor system is that many participants develop the attitude that their healthcare expenses are someone else's responsibility, so cost is no issue to them.

    I have never been extravagant where healthcare is concerned, but have become even more frugal now that the vast majority of my expenses come out of my own pocket. For example, last year I suffered a serious knee injury which required a lengthy course of PT. After several weeks, I begged the doctor to release me to join a health club to continue my rehab on my own. I now have a lifetime membership to the gym for what a week of PT cost. I'm not advocating that course of action for everyone, but for a young, healthy, well-educated RN, it made sense. I would never have made such a request had my insurance been paying the bills, but being responsible for my expenses prompted me to think outside the box to save money.

    ANY third party payor system leads to bloated healthcare expenses. Only when individuals become responsible for their own expenses will costs be brought under control.
  5. by   Jolie
    Quote from SmilingBluEyes
    Well, I have "motivated" friends who work 2 or 3 jobs, yet can't afford COBRA or other insurance. Victims of downsizing or jobs going overseas, some of them. A couple of them college-educated, and never have taken a penny of "welfare" in their lives. One I know is a NURSE and can hardly keep up---she is fearing she may have to drop coverage soon if things do not change. I mean, when ALL your bills go up, from fuel to home heating to food costs, what can you do, esp. if your salary stays basically stagnant????

    What about THEM? They are responsible people, all of them.

    When should any working family be unable to afford basic health care? And how far do you think YOU may be from that being a reality for YOU? I tell you, it's hell when it happens.

    I am not implying in any way that people who can't afford insurance are irresponsible. Good gracious, our income puts us in the "rich" category, and we're darn near to being unable to afford it! But I am trying to make the point that those whose irresponsible choices drive up healthcare costs ought to be held to task.

    Insurance is not the only route to obtaining decent healthcare, especially for pregnant women and young children. By taking advantage of health department services in virtually any county in the nation, families can obtain many preventive services that would help them to avoid costly serious illnesses, such as prenatal care, well-child care and vaccinations. You certainly have cared for women with high-risk pregnancies and their critically ill newborns (whose healthcare costs us all a fortune) who never once attended a prenatal clinic visit, probably citing inconvenience. Where is their responsibility for the expenses they incur?

    I personally know of a number of private physicians who offer sliding scale fees and payment plans to families in need, yet my friend, an ER nurse states that she routinely sees parents bring their children TO THE ER for vaccines in the days leading up to the start of school. Where is their responsibility for the costs they incur?
  6. by   Spidey's mom
    Just last week I had a woman call about a very routine problem that could have been handled at our walk-in clinic however she said "well, I have Medi-Cal anyway and don't want to see a "walk-in" doctor".

    She came for an ER visit because she could, on Medi-Cal, afford it - and the taxpayers paid for it.

    Plus, the funny thing is our walk-in doc IS also our ER doc.

    So, instead of paying $40 at the walk-in clinic, we get to pay over $400 for the ER.

    For a minor thing.

    steph
  7. by   Dayray
    Yes something needs to be done. I just don't think a universal health plan is the way to go. There was once a proposition to make charitable organizations responsible for indigent care. I really thought thatwas a good idea.

    To some I may seem callous, but I assure you this is far from the case. I'm one of those people that give money to everyone I can and I even volunteer my time for causes for the poor. I have also experienced life from both sides. I was born into a welfare family and worked my way out of it. I'm not one of those people who think; "I did it so can they". There are many reasons why people are poor and most of those reasons are not as simple as "hey man go get a job". At the same time I did work my way out of it for the benefit of my children and wouldn't want that to be reversed by losing the subsidy my employer pays for my health insurance.

    Yes healthcare needs fixing but I disagree that universal health care is the way to do it. I'm not really sure how we should do it (although I have some ideas). I do know that if a universal health plan makes it into legal reality it is you and I who will pay for it. The middle class will pay because the poor don't have any money to pay for it and the rich will lobby against anything they would have to pay for. This is why I speak out so strongly against universal health insurance. It's also why I often criticize the current healthcare system.

    There are ton's of stories here about how bad the situation is. As I said before I agree it is bad but universal health insurance is not the answer to this. Health care reform is.

    I too feel the burden of the current health care situation. As I have mentioned many times before I have a child with CP. I also have a wife and 2 other children who require very expensive prescriptions every month as well as another child who doesn’t take any medicine (thank god). The only debt I have ever had has been for medical bills and there have been many of them.

    I work hard and I don't expect anyone too feel sorry for me over that. This year I'll end up with an income of $75,000 by working 625 hours of overtime and working every weekend. If I do the math correctly I have spent $4600 in insurance premium, $12,000 in taxes and another $3800 in deductibles. That still looks much better to me then paying that plus an additional $9867 (my employers contribution to my medical and dental insurance) plus paying additional taxes on what the government now allows me to deduct for health insurance.

    I'll also add that I have for the last 7 years lived with pain from my wisdom teeth. Both of them have broken and now there are holes where they used to be. Every now and then another piece breaks off and it hurts allot. I don't have them fixed because I simply cant afford the copay and the time off of work.

    -Deb on the issue that something needs to be change, you and I firmly agree. What I am trying to say is that universal health insurance is not the way.

    I realize that we already pay for indigent care and I really support that. There was a brief period this year when my state stopped providing presumptive Medicaid. I actually had a patient deliver a baby infected with syphilis. The mother was not able to get prenatal treatment due to there being no presumptive Medicaid. This child will live with paralysis because of the states decision. I don't really believe that money should be the consideration here but it's ridiculous that this legislation was passed to save money and now this child’s care will cost millions over it's lifetime when a few thousand for prenatal care would have done the job. There was also a racial motive underlying the passing of this legislation and this child was not of the race that was targeted.

    Paying for Medicaid/Medical is something that none of us like but it is still necessary. However taking everyone in the US and rolling them all into one big ball and insuring them will be far more expensive. Who is going to pay for it? Not George W, not Bill gates, not tobacco money, not anyone except for you and I.

    Some may think I'm a big meanie but really I'm not. Healthcare is a major issue and needs fixing. Universal health insurance had been preached as the answer to this problem but it would only make it worse. It would take the cost and firmly lay it at the feet of working America.

    Instead why not look at what fuels the rising cost of healthcare. Doctors spend hundreds of thousands of dollars paying for their education. Doctors also spend huge $$ paying for malpractice insurance due to cases that sometimes are legitimate but many times are not. Drug companies spend millions testing drugs for FDA approval. Joint commission causes every hospital to spend millions on staff to manage paperwork, still instead of making changes that would make us better able to deliver care to patients they add to the bureaucracy and say that we can't drink water at the nurse’s station or use abbreviations. On top of that most companies involved in healthcare are "for profit". Once the cost of doing business is met they must increase the price in order to show a profit.

    What I am saying is that our problem is not that there is no universal health insurance it’s that health care it's self needs fixing. Currently healthcare places too much burden and privilege on doctors. Many times our care is governed more by meical leagal and fear of being sued then by what is really best for the pateint. Also there is too much bureaucracy caused by government agencies and to top it all off it's a business. The American healthcare system is not designed for patients it's designed for everyone else involved in it but the patients.

    Nurses are intelligent people, that is why I hate to see them jumping on the Universal healthcare bandwagon. Instead we should look for ways to change the system and make it do what it is supposed to do,
    take care of patients.
    Last edit by Dayray on Dec 22, '05
  8. by   SouthernLPN2RN
    We currently have no insurance and I had to go to the dr this week for a UTI that had gotten to the point of fever and severe constant pain (for 2 weeks). I just got the bill today and the UA alone was $76. We didn't qualify for medicaid even when it was just DH working, and COBRA is astronomical. I am paying $150 a month for DD's meds, dh is just doing without his nexium. I think it's very sad that insurance is unreachable for many people. I remember making $7.45 an hour in 99 and insurance would have costed $94 a week. I feel for the just above minimum wage folks who would have half or greater coming out of their check for insurance. Now for me, I signed up for the lowest tier (starts in feb) and it's 80 a pp plus dental, which is 20. This is with the highest deductible available. The low deductible is ~$200 a pp. The difference in prices is way more than the deductible.
  9. by   EinnOgTveir
    Quote from stevielynn
    Just last week I had a woman call about a very routine problem that could have been handled at our walk-in clinic however she said "well, I have Medi-Cal anyway and don't want to see a "walk-in" doctor".

    She came for an ER visit because she could, on Medi-Cal, afford it - and the taxpayers paid for it.

    Plus, the funny thing is our walk-in doc IS also our ER doc.

    So, instead of paying $40 at the walk-in clinic, we get to pay over $400 for the ER.

    For a minor thing.

    steph
    In here (Finland) you dont have anyone going to the ER for a minor problem as universal healthcare allows them to go to their doctor (everyone is assigned to one) for the same money.

    I like universal health care even though it means waiting lists and high taxes. At least that way people get treated in the end. I dont see universal health care happening in US any time soon as your system is so dramatically different.
  10. by   SmilingBluEyes
    Quote from EinnOgTveir
    In here (Finland) you dont have anyone going to the ER for a minor problem as universal healthcare allows them to go to their doctor (everyone is assigned to one) for the same money.

    I like universal health care even though it means waiting lists and high taxes. At least that way people get treated in the end. I dont see universal health care happening in US any time soon as your system is so dramatically different.
    Was waiting for someone who lives a country w/universal healthcare to weigh in this way.

    Steph, the fact is, you will have abusers no matter WHAT system is out there. Some of the BIGGEST abusers are our insurance companies themselves, delaying or simply NOT paying the bills despite faithful payment from their insured customers. There are abuses all over; this does not in my mind negate the fact I believe basic healthcare should be a right, not a privelege for those who can pay for it.
  11. by   Fonenurse
    Quote from EinnOgTveir
    In here (Finland) you dont have anyone going to the ER for a minor problem as universal healthcare allows them to go to their doctor (everyone is assigned to one) for the same money.

    I like universal health care even though it means waiting lists and high taxes. At least that way people get treated in the end. I dont see universal health care happening in US any time soon as your system is so dramatically different.
    I agree EinnOgTveir. In the UK we have a mixture of free and private schemes. I believe 100% in the NHS which is free at the point of contact. This provides excellent emergency care (incidentally I would never go to a private hospital for emergency care) and the things that have waiting lists - orthopaedic and surgical cases can be waited for or paid for by private health care depending on the patient. Let's face it, we haven't got a bottomless pit of money, and due to the ever improving care there is out there it costs more and more each year. I think a system that allows for both private and 'paid through taxes' is best - at least it treats all human beings as the same - and those that are really well off can pay for 'the extras'.

    I personally really feel uncomfortable when I read the word 'indigent' or 'poor' as this is all based on money. At the end of the day we are all human beings and should all receive 'basic' care on an equal footing. I know this may offend some, and for that I apologise in advance, I don't mean to offend, but at the end of the day we are all equal - you can't take your money into the afterlife...

    The UK NHS is far from perfect, but I think we need as a society, to decide what is basic care, provide that through taxes and then work out a scheme where we pay for the rest. Simplistic I know, but the thought of folk deciding to pay for food or medicine on a daily basis just to survive is appalling! Perhaps I am just middle class and fortunate, but I can't bear the thought of others suffering when I have more than enough to survive..
  12. by   Jessy_RN
    I think it's a long way from now, the debate will continue for a while.
  13. by   SmilingBluEyes
    I just cannot get how we can debate providing for basic healthcare for all citizens. It's amazing to me anyone thinks it should be a privelege for a shrinking few.

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