I want to know what nurses think about socialized medicine.

Hi
I work as a Clinical lecturer practioner/ research nurse in acute stroke. So I co-ordinate 6 clinical trials, teach junior docs and qualified nurses from across the region which covers about 4,000 sq miles.I also assess suspected stroke patients in ED (as first point of contact with the stroke team) if our NP is away.

I have a Ba, advanced diploma in clinical research, teaching certificate and specialist ICU nursing qualification.I have been qualified for 26 years and earn $53,000 -BUT remember our COL is high.I am at the top of my band.

My total deductions from my paycheck each month (12 pays per year) is around $1580-this includes half of the NI $550 deduction (rest is paid my employer, but still going into the pot),income tax,pension and car parking.

I come out with about $2800 per calendar month.

Only place that pays higher to NHS nurses is London-where they get a 20% uplift, but COL in London is about 1 and a half to twice that of most other citites-hence loads of private agency staff in London.

Our acute/rehab (post thrombolyis patients, all acute strokes admitted to hospital, all rehab patients unless suitable for home rehab)has 30 mixed sex beds
4 single sex six bedded bays.
4 one bedded rooms (no bathrooms) for very sick or infected pts
2 bathrooms and 2 toilets for the whole ward.
Everything is in short supply and carefull monitored. The ward managers have budgets. they get one non clinical day per month-rest of time they have a caseload of patients.
We don't have equiv of LPNs anymore-their training was phased out in the 80s I think- there may still be some enrolled nurses but most converted to Rns.
Only other nursing staff are health care assistants.
May be 3 RNs and 4 healthcares on early shift but only ever 2RNs and 1 or 2 healthcares on nights.
NHS saves millions of pounds every year through unpaid overtime-staying late for an hour or so is expected if ward is busy or you have a new patient. It isn't acceptable to claim unless you work a whole shift as overtime. AND we have unions!

As forjoint replacements-they are rationed in the way that someone who has a pre-existing condition (other than OA) that means they would still be moderately disabled even after a joint replacement, would not get one.Age alone wouldn't be a deciding factor.
Wouldn't be offered a joint replacement until they met certain criteria related to pain, ROM at the joint etc, not exactly sure.I think this is partially because they know the artificial joints have a limited life span-so don't want to do it too soon, plus also I beleive shoulders are mainly done for pain-rather than improved ROM.But ortho is not my field by any means.
A neighbor of mine is 70- he has really bad RA and has had ops on hands/feet/wrists and is on treatment (? Gold or some other IV ).I noticed he was dragging his leg the other day and when I asked he said he needs an ankle replacement for OA. It took 4 weeks to be seen by a surgeon after seeing his GP and now he has to wait maybe 18 weeks for the op.
Orthopaedics is big money here as hospitals get paid extra money for getting the waiting list down -it's called waiting list inititaive, but think it might be just for hips and knees.

I don't think people appreciate how bad it can be here until they are patients, then they are often shocked at what we put up with.But then if they aren't happy with care then they take it out on the nearest person and don't really care why.

It has changed so much in the last 15-20 years since we became more financially controlled and they brought in managers and accountants.Unfortunately they seem to make cuts in nursing/support services etc first.Never seems to be management or Allied Health proffs eg pharmacists,physios.
Often there will be more physios and more pharmacists on the ward than RNs!

We are driven by government set targets-don't meet those and you lose your star rating and money.
Take for example the target that no one spends longer than 4 hours in ED, unless they need to be there. This was to try to ensure people got treated promptly and sent home or to wards as appropriately. Severe punishment if you don't meet the target. So what happens is that during a bed crisis (every day over the winter flu season) they will send patients to any ward that has a bed just to meet the target.So a stroke patient goes to a surgical ward or vice versa.
The whole idea of the target was to improve patient care, but because the target has to be measurable, they just look at the numbers and that's it. So then the targets for stroke patients to be admitted directly to the stroke ward are affected.

Just joined this site this morning and have spent most of the time since reading this thread. I wanted to know what other "in-the-trenches" RN's around the country thought about this. After reading most of the replies, I wanted to add only a few points that I think are important for all of us to remember, regardless of which side of this we come down on.

There was some discussion about what the Founders would think of government-provided health care, and what the Constitution says and doesn't say. I know that there's a large contingent of Americans who don't hold the Constitution in high regard, or deem it to be of any "importance or relevance" any longer. To these people I would only say, whether you think the Constitution is "outdated" or not, it is the basic law and foundation of this country. All our laws and policies are supposed to be constitutional. This is for your protection, and the protection of the liberty you take for granted. When you state that you don't hold it in high (or any) regard, you are saying that the foundation for all laws and the guarantee of basic individual rights is of no importance. The Constitution protects all of us, whether we think so or not.

There was also some references to various "media" outlets and websites as sources of unbiased information. One mentioned was mediamatters.org. I would only like to point out that this is a branch of the group of liberal groups funded by George Soros, an ardent opponent of Republicans, conservative thinking, and traditional American values based on free market principles. I understand the difficulty in finding truly unbiased sources of information; it's very hard. I'm not saying that the poster who referred to mediamatters was wrong in what she said, just would like for all to know that it is not an unbiased source.

I think it is the cost of health care in this country that is the problem, not access. I've been a nurse in an NICU for three decades and have never---not one time---seen a medical decision about a baby's treatment depend on whether the family had insurance or not. Never.

The access is there, but the cost is high. One solution in my opinion, would be to start with tort reform. JMHO.

I know for me, I know that we need some new solutions to the problem of the high cost. But I don't want the Democrat's plan because I don't want the government involved in my personal and private health care. Again, that's just me. I value my liberty and individual freedom and my privacy. I believe I would lose some, or all, of that with the type of health care plan currently being discussed. JMHO.

The high costs have been perpetuated in an upward spiral over the years by the big drug pushers and the private health insurance industry. That's why a $10 Aspirin on the hospital bill doesn't cost $10 over the border in other countries which already have an established Universal Health care system in place. Keep in mind the "current" high costs for health care in the U.S are created by "for profit" entities and naturally they want everything to be as expensive as possible.

However, in a public funded taxpayer system, the costs are placed under the microscope of the public taxpayer. Let's call it "public accountability" for public tax dollars spent if you will. You can't have public accountability with a private health insurance or for profit drug companies. That is the problem.

In fact, if you use Google, you can quickly find out that a Universal Health Care system will serve to actually "lower" the costs associated with providing health care services to the public.

For example:

http://healthcare.change.org/blog/vi...l_reduce_costs

I don't think many people really understand that.

But I would rather fork my private health insurance dollars over to a public system instead because they won't deny coverage, it will not be tied to an employer and the system will guarantee heath care to every American and they will do so with public accountability involved.

No inflated costs, no pre existing condition or out of pocket and co pay nonsense. Just straight care for straight tax dollars. Makes sense to me.

My Best.

Ah, yes, change.org. With respect, I do not consider that website to be at all unbiased. It's purpose is only to push the Democratic plan. The blogger has worked for Obama since during the primaries, and is currently affiliated with SEIU, which has ties to ACORN. I suggest visiting the Heritage Foundation, or Investor's Business Daily, both of which have presented thorough, detailed discussions of this plan, good points and bad. I don't have their links handy, but a Google search will take you there.

FWIW, I do look at what both sides are presenting, and know that the truth lies somewhere in between. But I suspect it lies closer to what the Heritage Foundation and IBD offer, than a blog written by an Obama worker.

Nice night, all.

The high costs you are talking about (like the $10 Aspirin) have nothing to do with insurance or drug companies.
The $10 Aspirin has to do with hospitals trying to stay afloat despite the gov't policies. Policies like EMTALA force ERs to treat pts and make the hospital absorb the cost. These costs are often enormous for inner city hospitals making them have to over charge for other things to make up the costs.

No drug company has an interest in Aspirin. It is cheap as dirt. Thus it has nothing to do with drug pushers or private health insurance. Furthermore, being under public scrutiny would change nothing. The costs would have to be paid somehow or the hospital would go bankrupt (like Georgetown in DC did in the 90s or Hanhemann in Philly did around 2000).

Currently it is genereally those without insurance that get the brunt of these out-of-whack charges because the insurance companies have negotiated these costs down. So in this instance


As to HR 3200 here's the quotation that the article quoted:
"H.R. 3200, as introduced, would already be on track to achieve tens of billions of dollars in Medicare savings each year, primarily as a result of provisions that would reduce payments to Medicare providers"

As the underlined portion states, their savings are coming straight out of the pockets of those who are providing the services. Doctors are already not accepting new medicare patients and they currently lose money each time they see a medicare patient- not make less money, actually lose money; the costs outweight the reimbursement. If reimbursement decreases even further you will see doctors actively dropping their CURRENT medicare patients. A health insurance is no good if no one accepts it.

Still inner city hospitals will be forced to accept medicare because they have no other option. So, while they already bear the brunt of provisions like EMTALA, they will be forced to accept even less money from medicare. Furthermore, gov't money given to these hospitals is getting cut under the current plan too (by >100 billion dollars). The hospital I work at takes care of 1/2 of the indigent patients in the STATE and in addition to medicare gets 130 million dollars a year to offset the cost of taking care of the indigent pts. Cutting not only medicare but also the money given to the hospital on top of that will work in the exact opposite direction Obama wants it to- patient care will suffer and people will be left without care.

But no one in the media talks about these implications... wonder why...

Heritage foundation was created, as it states in their mission statement, to further conservative ideas. This is not exactly unbiased. In reality, there no such thing as unbiased journalism any more.

We already have "socialized medicine" here in the U.S. in the forms of Medicaid, Medicare, VA and in a different form, the HMO's. That is a start to your comparison. I don't believe there is a simple answer to this. I have been without insurance and needed health care, and fell between the cracks. I found that working out a payment plan with the hospital and doctor worked out well.

But what I personally think, is that I do not want the government involved any more than it already is. This country is broke, trillions of dollars in debt, and this will bring us further to our knees. This is not what I want to leave for my children. America, wake up to the bigger picture. This is a power and money grab. Why are they rushing it?

Health care is not a right, it is a responsibility. But it is also our responsibility as Americans to help those out in need. I know a lot of people will be angered with me saying that. But when does it stop? Do I pay for your car insurance, your house insurance next? We can't pay for everything, and be the country we were supposed to be. We need to FIRST fix the problems with our current system, and maybe even dismantle some of it (good God! What?). Second, build it back up learning from the mistakes of the past.

Government beauracracy is not the answer. There are other options out there, but none are being reported. Here are the two main bills: HR 676, HR 3200. Check them out for yourselves at http://thomas.loc.gov/ and at http://www.congress.org/congressorg/home/, and click on "legislation". Be informed, not from just what you hear on the news and through heresay, but through your own research. Then, make your own informed decision.

We will end up with a smaller bureaucracy after health care reform.



at http://www.health-insurance-2008.org...-vs-canada.php

....Exactly.

Some people say they don't want "more government bureaucracy" involved in healthcare.

Well there's what the picture already looks like by comparsion.

Well said.. Thank you.

http://blunt.house.gov/Media/PDFS/De...hPlanChart.pdf

http://www.youtube.com/watch?v=FHbwd...layer_embedded

There are other solutions out there...presented and voted down. We can cover the uninsured, in other ways.