A universal single-payer, not-for-profit healthcare system could help lift tens of mi

RN4MERCY · Dec 19, 2008

An impassioned plea for health care reform
at http://www.thenation.com/doc/20081229/w_thompson
Thankfully she achieved a full physical recovery but yet her story tells how each of us is a moment away from a lifeime of medical debt.

I awake to the news today that our auto manufacturers are closing for a day, "to save money," as they await bankruptcy restructuring or a "bail-out" loan. The workers are being forced to stay home and will lose money. If the plants close their doors, the workers will not only lose their jobs. They'll lose their health insurance and their families will lose their "coverage" too.

Mitch McConnell, the Republican Senator from Kentucky, blocked the bailout measure that was passed by the House, saying, "...Republicans won't allow the taxpayers to subsidize failure." This begs the question, what have the taxpayers been subsidizing during the last eight years of the Bush administration, but a Republican failure of doomsday proportions?

Speaking of HEALTHCARE, hospitals are closing beds, and limiting services. They're constructing more private rooms and hiring expensive "concierge consultants" and seeking "five star" service awards. And somehow, legislation was passed that the government will provide increased reimbursement to hospitals based on high "customer satisfaction" scores. Problem is, hospitals exist to provide care for patients who need it; patients are not qualified by education or licensure or experience to judge whether or not they've received the actual care they need.

What's wrong with this picture? A lot of money is being spent on marketing and administrative waste; and what about the public sector hospitals? Tying increased reimbursement to bogus "quality" indicators like "customer" satisfaction will further erode our public health infrastructure. Those out of work, without insurance or the ability to pay for it, will go without healthcare. Our public system is imploding right before our eyes. There are already over 47 million people without access to care.

Besides, where's the evidence that ties satisfaction to quality? And who's definition of quality are we, as healthcare professionals going to tolerate? Disneyland and the illusion that hospitals should perform like "the happiest place on earth?" Or the true quality standard of care: that which restores patients to their optimum level of health and function!

The rich will get richer, and the poor will do without, just like in the poorest third world countries. The "Out of Pocket" model of health care in this country has got to be replaced with a universal health plan, based on the single-payer model.

We've got a duty to change those circumstances that are against the interests of our patients, not to mention the fact that we all will need care at some point in our lives. Tying health coverage to employment just doesn't make sense.

Thanks for the post, Viking. I hope everyone who reads this will do all they can to encourage their legistators to pass HR 676, the expanded and improved "MediCare for All" law a reality. http://www.GuaranteedHealthcare.org

HM2VikingRN, RN · Dec 19, 2008

I was reading over at PNHP today. Administrative costs are even worse than we thought. Its 38% for our efficient private system. Duke University Hospital has more billing clerks than nurses!

allnurses Guide · Dec 19, 2008

I was reading over at PNHP today. Administrative costs are even worse than we thought. Its 38% for our efficient private system.Duke University Hospital has more billing clerks than nurses!

Stunnung!

allnurses Guide · Dec 20, 2008

insurance executive compensation

this is money people paid for healthcare coverage. how many received denials?

$1.6 billion

value of stock options of unitedhealth group c.e.o. bill mcguire at the end of 2005, as ceo of

unitedhealth group.

-robert simison, "sec investigates unitedhealth over stock-options practices," bloomberg news, december 27, 2006;

michael regan, "business 2006: who won, who lost," associated press, december 26, 2006.

and - http://www.medicalnewstoday.com/articles/54315.php

$22.2 million

john w. rowe earned $22.2 million in compensation as ceo of aetna. rowe has since left aetna.

-"forbes 2004 executive pay list," april 21, 2005. www.forbes.com/static/execpay2005/lirs5ni.html?passlistid=12

$3.33 million

annual compensation for michael b. mcallister as ceo of humana, inc.

-"2006 executive pay list," april 20, 2006. www.forbes.com/lists/2006/12/ag0q.html

Iam46yearsold · Dec 27, 2008

Vote Florence Shapiro and Kay Bailey hutchison out of office

allnurses Guide · Jan 30, 2009

[color=#004276]philadelphia city council votes to support single-payer healthcare

http://www.pnhp.org/news/2009/january/philadelphia_city_co.php

ZASHAGALKA, RN · Jan 31, 2009

Vote Florence Shapiro and Kay Bailey hutchison out of office

Gov't rationed care is a horrible idea. These guys tanked the economy, social security is on the brink of failure and is only dwarfed by the coming financial wipeout of Medicare. And, we want to trust these people with MORE control over our lives?

I think they've proven themselves to be stunning failures without giving them more to ruin.

And don't even compare the gov't with Big Health, Inc. They are one and the same. Big Health, Inc. acts the way it does because its lobbiests ensure gov't protection for what they do. Did YOU pick your health care company? Or, did your employer, at the end of a gov't tax break? Hmmmmmmmm.

I don't trust a politician more than I can throw them. They are all bought and paid for and I don't have the price for admission. They will make decisions, not in MY best interest, but in the best interest of the highest bidder/donor.

A fair share in a dismal, gov't rationed outcome isn't very fair. It's all very nice until it's YOUR family member that dies on the wrong end of a waiting list. Can't be helped, it's not personal, you know. It's just actuarial.

That said, Hutchison is leaving the Senate to run for Gov of Texas. AT least, that's what is widely predicted. I'm still mad at her for voting for the Sell-Out. Maybe she'll think twice about voting for the 850BN Great Rip-off.

(I heard a rumor that rocker Ted Nugent might run for her seat.)

~faith,

Timothy.

Tweety, BSN, RN · Jan 31, 2009

A fair share in a dismal, gov't rationed outcome isn't very fair. It's all very nice until it's YOUR family member that dies on the wrong end of a waiting list. Can't be helped, it's not personal, you know. It's just actuarial.
~faith,
Timothy.

How about if your family member died because they couldn't afford to see a doctor? How fair is that.

I will give you one thing, it is hard to consider trusting government with health care when they've made a mess of everything.

How about this idea: keep health care in the hands of private people as it is now, just fund it?

ZASHAGALKA, RN · Jan 31, 2009

How about if your family member died because they couldn't afford to see a doctor? How fair is that.
I will give you one thing, it is hard to consider trusting government with health care when they've made a mess of everything.
How about this idea: keep health care in the hands of private people as it is now, just fund it?

The system is much more equitable NOW when 86% of people have access to some form of insured care (with slightly more when you factor in that some have access to free or reduced cost clinics) and 100% of people have access to emergency care - than it will be when access to both routine AND emergency care is swamped.

Imagine what it could be if the gov't got out of the way? I'll tell you what it would be: the absolute best mix of quality for price. Instead, the solution for gov't interference in your health care is - drumroll - MORE gov't interference in your health care. Amazing.

So, because a black rotary dial phone from MA Bell is preferable to the risk of the market place, we should all trade in our cell phones and go back to the days of gov't domination over telecommunications. After all, EVERYBODY had a phone back then. If you stayed up really really late, the long distance rates would even go down . . . I don't doubt that the gov't could provide care for all. What I'm SAYING is that that care is a black rotary phone when you could have had a (non-gov't provided) blackberry cell phone. FOR THE SAME PRICE OR CHEAPER.

As it stands, ERs are swamped NOW because of EMTALA and the concept that "it's free". Except. Nothing is free. The trade-off is long waits to see an ER doctor. Now. Take THAT concept, and double the number using the system (because, it's FREE!) and then apply it to EVERY aspect of health care. Add to that the fact that the gov't can't pay for the Medicare it is providing NOW - and so, add to that 20-30% routine cuts in funding. (Then add in even more draconian taxation to pay for it all.)

THAT is what you will get. 100% of the people not getting access to adequate health care instead of 14% today. At least it will be "fair". A "fair" share in abysmal health care for ALL!

Congress cannot repeal the laws of economics. Even if they want to do so. Even if they REALLY REALLY want to do so. Supply must balance demand. When demand is infinite, then supply MUST be infinite (an impossibility), or, rationed.

I don't trust the fools in Washington to ration my ability to attain health care better than my ability to provide it for myself, if Washington were to leave me alone. Call me cynical, but faith is Washington is a form of derangement.

But, to your main point: He who controls the purse strings, controls and owns the thing. There is no difference.

What if we have the slaves do the work, and we'll just be the masters?

~faith,

Timothy.

HM2VikingRN, RN · Jan 31, 2009

Then again we could just model our health care system on the VA. Superior care at about 2/3 of the cost for our current non-system.

1. Emphasis on primary care

2. Means tested copays

3. Completely based on evidence based practice.

4. Group rates for medications.

5. The option to obtain fee based care from other provders.

ZASHAGALKA, RN · Jan 31, 2009

Then again we could just model our health care system on the VA. Superior care at about 2/3 of the cost for our current non-system.
1. Emphasis on primary care
2. Means tested copays
3. Completely based on evidence based practice.
4. Group rates for medications.
5. The option to obtain fee based care from other provders.

I've worked for a VA Admin Hospital. I know you work there, now. Nevertheless. Ask a wide range of vets (not just your patients) what they think about the VA.

You won't get an overwhelmingly enthusiastic answer. . .

Thankfully, most of them have a CHOICE. A gov't mandated option is anti-choice. It's not about providing a better product at a superior price. Its about ensuring that Big Health, Inc., does NOT NEED your choice in selling it's product. (These businesses will not go away; they'll just take over - via superior lobbying.) Except now, you no longer have a choice. Halliburton, in charge of YOUR health care. Take it, or leave it.

Gov't rationed health care is about those that would be in charge of the rationing. It has little to do and simply isn't in the best interests of - those that will be rationed from care as a result. (That would be you.)

Not everybody is convinced that the VA is the model of care you suggest. I KNOW. I KNOW. President Bush's Administration vastly improved the care over what it was when I worked there, under Clinton.

Still.

(and WHAT IS THIS with you gaining on me in post counts? I take a little vacation from the computer . . . sheesh!)

~faith,

Timothy.