How U.S. Health System Can Fail Even the Insured - page 3

colorado springs, colo. -- barbara calder lives in nearly constant pain. her limbs dislocate at the slightest movement, even when she turns over in bed at night. she wears her hair short because... Read More

  1. by   SuesquatchRN
    Quote from NurseCherlove
    Yeah, but you're talking about someone losing their job, for whatever reason, BEFORE gaining employment with another employer. Given that it is generalluy easier to find a job when you have a job and most people can't afford to just quit, not knowing when they might get their next paycheck (especially with COBRA rates), I don't know if the COBRA mandates even matter here.
    COBRA extends to insurance coverage, period, not only upon termination of a job.

    You can not be denied for a pre-exisiting condition provided that there is no lapse in coverage. Given that my husband has CAD and HTN and BPH and lots of the middle-aged male initials we have at different times moved heaven and earth to keep those COBRA payment made.

    COBRA does, indeed, matter here.
  2. by   NurseCherlove
    Quote from Suesquatch
    COBRA extends to insurance coverage, period, not only upon termination of a job.
    Cool. So you are saying that my friend could start interviewing at other facilities, accept a position, put in her notice at current facility, get on COBRA for like 1 month and then get put on the new insurance policy with new employer?
  3. by   HM2VikingRN
    single payer is not socialized medicine. it is socialized finance of health care. providers are not employees of the government but remain independent. see pnhp.org for an excellent discussion about this point:

    no. socialized medicine is a system in which doctors and hospitals work for the government and draw salaries from the government. doctors in the veterans administration and the armed services are paid this way. examples also exist in great britain and spain. but in most european countries, canada, australia and japan they have socialized financing, or socialized health insurance, not socialized medicine. the government pays for care that is delivered in the private (mostly not-for-profit) sector. this is similar to how medicare works in this country. doctors are in private practice and are paid on a fee-for-service basis from government funds. the government does not own or manage their medical practices or hospitals.
    http://www.pnhp.org/facts/singlepaye...php#socialized

    the allegations about canada are overstated:
    the u.s. supreme court recently established that rationing is fundamental to the way managed care conducts business. rationing in u.s. health care is based on income: if you can afford care you get it, if you can’t, you don’t. a recent study by the prestigious institute of medicine found that 18,000 americans die every year because they don’t have health insurance. that’s rationing. no other industrialized nation rations health care to the degree that the u.s. does.
    if there is this much rationing why don’t we hear about it? and if other countries do not ration the way we do, why do we hear about them? the answer is that their systems are publicly accountable and ours is not. problems with their health care systems are aired in public, ours are not. in u.s. health care no one is ultimately accountable for how it works. no one takes full responsibility.
    http://www.pnhp.org/facts/singlepaye...php#socialized accessed today.

    see also:
    [font=cremona-regular]canada, with a system of universal health insurance,
    [font=cremona-regular]spends about half as much on health
    [font=cremona-regular]care per capita as does the united states, yet
    [font=cremona-regular]canadians live 2 to 3 years longer.[font=cremona-regular]1 [font=cremona-regular]few
    [font=cremona-regular]population-based data are available on health
    [font=cremona-regular]habits and processes of care in the 2 countries
    [font=cremona-regular]that might explain this paradox. blendon
    [font=cremona-regular]et al.[font=cremona-regular]2 [font=cremona-regular]found that both us residents and canadians
    [font=cremona-regular]were dissatisfied with their health care
    [font=cremona-regular]systems; that low-income us residents reported
    [font=cremona-regular]more problems obtaining care than
    [font=cremona-regular]their peers in 4 other english-speaking countries
    [font=cremona-regular](australia, canada, new zealand, and
    [font=cremona-regular]the united kingdom); and that quality-of-care
    [font=cremona-regular]ratings were similar in the 5 countries.[font=cremona-regular]3

    [font=cremona-regular]among other studies, some,
    [font=cremona-regular]4 [font=cremona-regular]but not all,[font=cremona-regular]5
    [font=cremona-regular]have found better health care quality in canada.
    [font=cremona-regular]socioeconomic inequalities in health,
    [font=cremona-regular]commonly perceived as pervasive in the
    [font=cremona-regular]united states, seem less stark in canada.[font=cremona-regular]2,6–10

    [font=cremona-regular](lasser et al. “access to care, health status, and health disparities in the united states and canada: results of a cross-national population-based survey,” american journal of public health; july 2006, vol 96, no. 7)

    http://www.pnhp.org/canadastudy/canadausstudy.pdf accessed today.

    the evidence is quite clear from other countries that a well designed single payer system provides a longer lifespan, and better health outcomes overall.
  4. by   HM2VikingRN
  5. by   HM2VikingRN
  6. by   HM2VikingRN
    One last chart:



    http://www.commonwealthfund.org/char...?doc_id=539954 accessed today.

    While our system does well on the right care dimension we actiually do very poorly almost everywhere else. What I find interesting is just how well the oft-maligned NHS does in comparison to our system. Every country with a universal care/social insurance centered model pf health care outperforms our system. We need to ask what are they doing that we can copy? The German and UK models have a lot to teach us about building an effective health care system.
    Last edit by HM2VikingRN on Nov 24, '07
  7. by   SuesquatchRN
    Quote from NurseCherlove
    Cool. So you are saying that my friend could start interviewing at other facilities, accept a position, put in her notice at current facility, get on COBRA for like 1 month and then get put on the new insurance policy with new employer?
    Yes.

    I will tell you that my husband has CAD, BPH, and HTN and, through a hideous few years of no coverge/bad coverage/COBRA coverage he still has coverage. And there have been times that we drew on credit cards to pay the COBRA premiums so that he would not lose coverage based on pre-existing conditions.

    Now, were I your friend I would spend a small amount for a consultation with an attorney before going ahead and quitting, but I am 99.99% comfortable with my facts. They're borne out by experience.
  8. by   SuesquatchRN
    look at the kennedy-kassenbaum law regarding preexisting conditions.

    http://www.nls.org/at/at1297.htm
  9. by   x_coastie
    Quote from HM2Viking
    I believe in building a health care system that works. The profit motive is destructive to patients health and acts to increase health disparities rather than decrease disparity.
    What about RN pay? Is that not your personal profit? Should the hospital just pay your exact bills, with no frills "covered"? All that nasty, filthy, destructive profit that you make every two weeks on payday is just increasing the Pt's health care costs (and "increasing health disparities rather than decrease disparity".) And of course, it was not that "profit" that motivated you through years of tough schooling and difficult boards.

    I recommend everybody that thinks we should adopt a socialized health care system take out their checkbook and go to the nearest ER and pay someone's bill. Everybody wins, without screwing things up more than they are now.
  10. by   ready4crna?
    Quote from Sensoria17
    Spending on infrastructure and museums is peanuts compared to what is spent on war and foreign debt so I'm not sure what you are getting at other than you don't believe in fixing roads and bridges (at least in my area, I've never seen a bridge that didn't lead to anywhere) and museums aren't important to you.
    Ok, do not twist my words. I am a patron of the arts and I pay taxes to maintain and upgrade infrastucture. I used two specific examples of frivolous spending- 1.) a multimillion dollar new bridge in alaska that went to an island where the population did not need it. and 2.) a million dollar museum for woodstock. (We have the museum of american history in DC for this purpose already.)
    If you continue with assumptions and intellectually dishonest conclusions, without data and facts to back up statements, you lose your argument and debate over.
    Political debate should be just that. Debate. Facts and reasoned statements. I do not agree with all of HM2Vikings positions, but at least data are brought to the table for Debate and then discussion to defend a position. (HM-whether they are defensible remains to be seen )

    As for numbers in spending lets do healthcare VS. defense spending.
    here: http://www.nchc.org/facts/2007%20updates/cost.pdf
  11. by   Sensoria17
    Quote from x_coastie
    What about RN pay? Is that not your personal profit? Should the hospital just pay your exact bills, with no frills "covered"? All that nasty, filthy, destructive profit that you make every two weeks on payday is just increasing the Pt's health care costs (and "increasing health disparities rather than decrease disparity".) And of course, it was not that "profit" that motivated you through years of tough schooling and difficult boards.

    I recommend everybody that thinks we should adopt a socialized health care system take out their checkbook and go to the nearest ER and pay someone's bill. Everybody wins, without screwing things up more than they are now.
    An RN does well financially but does not become stinkin' rich like the executives. Let's get real here. My sister grossed $82,000 last year in CA. With the cost of living, believe me, she is not living high on the hog. Profit is almost the only reason I chose to go into nursing but only because it's the only career I could think of that I would like that paid enough to buy a home AND save for retirement.
  12. by   SuesquatchRN
    Quote from ready4crna?
    If you continue with assumptions and intellectually dishonest conclusions, without data and facts to back up statements, you lose your argument and debate over.
    No, no, no! You lose when you say, "Oh yeah? Well.... HITLER!"

  13. by   Sensoria17
    Quote from ready4crna?
    Ok, do not twist my words. I am a patron of the arts and I pay taxes to maintain and upgrade infrastucture. I used two specific examples of frivolous spending- 1.) a multimillion dollar new bridge in alaska that went to an island where the population did not need it. and 2.) a million dollar museum for woodstock. (We have the museum of american history in DC for this purpose already.)
    If you continue with assumptions and intellectually dishonest conclusions, without data and facts to back up statements, you lose your argument and debate over.
    Political debate should be just that. Debate. Facts and reasoned statements. I do not agree with all of HM2Vikings positions, but at least data are brought to the table for Debate and then discussion to defend a position. (HM-whether they are defensible remains to be seen )

    As for numbers in spending lets do healthcare VS. defense spending.
    here: http://www.nchc.org/facts/2007%20updates/cost.pdf
    Why don't you check your facts before posting? The link you posted shows COMBINED spending from both the public and private sectors. The U.S. government alone DOES NOT spend trillions of dollars on healthcare. See the U.S. budget. Medicare spending is under Dept of Health and Human Services which TOTALS about $620B for 2006.

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