Do you want to have to win a lottery to see the doctor?

Nurses Activism

Published

The National Post reports on how some Canadian doctors have held lotteries to determine which patients to eliminate from their practices, while other doctors held lotteries to decide who they'll accept. By shedding some patients doctors hope to avoid imposing a 5-minute appointment assembly line on the rest of their patients. Similarly, restricting new patients through a lottery keeps patient loads manageable.

Both lotteries reflect the severe shortage of primary doctors in Canada -- yet another example of medical personnel shortages (and surpluses) that tend to crop up under nationalized single-payer health care systems. (Last year it was a nurse shortage and hospital consultant glut in the U.K.)

After being kicked out of her doctor's practice, one patient was forced to drive 18 kilometers to the next town to find a doctor.

More~~~

http://www.statehousecall.org/canadian-doctors-hold-lotteries-to-decide-who-gets-access-to-care

Specializes in Acute post op ortho.

the lottery system has already been used in the rationing of care in oregon.

the oregon health plan was conceived and realized by emergency room doctor john kitzhaber, then a state senator,[1] and dr. ralph crawshaw, a portland activist.[2]

it was intended to make health care more available to the working poor, while rationing benefits.[1] at the time, oregon was considered a national leader in health care reform.[3] the law passed in oregon was not initially compatible with federal law, so a waiver was needed. president bill clinton approved the plan on march 20, 1993, though he required a revision to the plan due to a concern about whether disabled people would have equal access.[4] at the time, medicaid covered 240,000 oregonians.[4]

in 1994, the plan's first year of operation, nearly 120,000 new members signed up, and bad debts at portland hospitals dropped 16%.[1]

the plan's costs increased from $1.33 billion in 1993-1995 to $2.36 billion in 1999-2001.[1] significant cuts were made to the oregon health plan's budget in 2003.[5]

new enrollment in the program were closed from mid-2004[6] until early 2008, when a lottery-based system was introduced. tens of thousands of oregonians signed up, competing for 3,000 new spots in the plan.[7][8]

http://en.wikipedia.org/wiki/oregon_health_plan

Specializes in Critical care, tele, Medical-Surgical.
good, then you are prepared for the cuts that will come with government run care. the purpose of government run care is to:

1. reduce costs

2. expand the rolls of insured persons.

and you thought you were stretched a far as you could go.

because 'nursing' is viewed as one of the top 3 major expenses, and the 'expanded rolls of insured, means-- many, many many, more patients in the doctors office, clinics, outpatient facilities & hospitals, one of the solutions is to replace rn's with 'a flexible "skill mix" of nurses and lesser-skilled/unskilled workers.'

abstract:

this qualitative study reports on the perspectives of hospital staff nurses regarding the recent restructuring of canadian healthcare. they were the group on the front lines bearing the brunt of the changes. yet, mostly they had not been consulted, as the decisions were made elsewhere. twenty staff nurses working in a variety of toronto hospitals were interviewed and described the impacts on themselves and their patients. while restructuring focused on deficit reduction and increased efficiency, the factors affecting quality of patient care and work life of nurses were neglected. the major strategies employed - increased workloads, casualization and deskilling - changed nurses' work at the bedside. stable teams disappeared as nurses were hired into casualized positions. care was reduced to specific tasks and routinized, to be carried out by a "skill-mix" of workers. the nurses' relationships with patients, the "heart and soul of nursing," became largely limited to managing care for a number of patients over one shift. lack of time and continuity with their patients left nurses dissatisfied. the voices of bedside nurses and their suggestions for change add some novel perspectives to the restructuring discourse.

"each time a new task is given away to another worker some of my colleagues say, 'well, what is there for us to do now?' i can see our roles vanishing, they could be vanishing."

http://www.longwoods.com/product.php?productid=17025

this happened in both canada and the united states in the 1990's.

we need to work to get national rn ratios passed to prevent hospitals cutting staff and harming patients.

http://www.calnurses.org/nursing-practice/assets/pdf/s1031.pdf

the ratios for long term care facilities.

Specializes in Acute post op ortho.

The government is only looking to do 2 things.

1. cut costs

2. insure more people

Nurses are in the top 3 costs, government will change the rules to reduce costs as they see fit.

Otherwise, the numbers just won't run.

Be prepared to lose your job & see taxes skyrocket, that's the only way to sustain HR3200.

If you're ok with that, well good for you.

Specializes in Psych , Peds ,Nicu.
The government is only looking to do 2 things.

1. cut costs

2. insure more people

Nurses are in the top 3 costs, government will change the rules to reduce costs as they see fit.

Otherwise, the numbers just won't run.

Be prepared to lose your job & see taxes skyrocket, that's the only way to sustain HR3200.

If you're ok with that, well good for you.

What is your alternative ? , If healthcare inflation is allowed to continue unabbated the cost will bankrupt the USA .

Specializes in Hospice.
Interesting - on Poverty in the Cities.

City, State, % of People Below the Poverty Level

1. Detroit , MI 32.5%

2. Buffalo , NY 29.9%

3. Cincinnati , OH 27.8%

4. Cleveland , OH 27.0%

5. Miami , FL 26.9%

5. St. Louis , MO 26.8%

7. El Paso , TX 26.4%

8. Milwaukee , WI 26.2%

9. Philadelphia , PA 25.1%

10. Newark , NJ 24.2%

U.S. Census Bureau, 2006 American Community Survey, August 2007

What do the top ten cities (over 250,000) with the highest poverty rate all have in common?

Detroit, MI (1st on the poverty rate list) hasn't elected a Republican mayor since 1961;

Buffalo, NY (2nd) hasn't elected one since 1954;

Cincinnati , OH (3rd)..since 1984;

Cleveland , OH (4th)..since 1989;

Miami , FL (5th) has never had a Republican mayor;

St. Louis , MO (6th)....since 1949;

El Paso , TX (7th) has never had a Republican mayor;

Milwaukee , WI (8th)..since 1908;

Philadelphia , PA (9th)..since 1952;

Newark , NJ (10th)...since 1907.

Einstein once said, 'The definition of insanity is doing the same thing over and over again and expecting different results.'

It is the poor who habitually elect Democrats---yet they are still poor...

These are also the 40% or so of our population who receive an 'income tax credit' amounting to a return that is GREATER than they're scheduled FICA.

In other words, these people get back MORE than they paid in, it's a social program designed to offset the tax load on the poor.

And when did statistical correlation prove causation? C'mon!

Specializes in Acute post op ortho.
What is your alternative ? , If healthcare inflation is allowed to continue unabbated the cost will bankrupt the USA .

In 1993 when "Hillarycare" was introduced, they predicted healthcare would bankrupt us by the year 2000. We were fed a picture of gloom & doom. Remember?

Didn't happen. In fact, when you look at the overall gross adjusted inflation rate, health care took a small dip.

Why? Because advancements in technology become more common, market forces drive down costs through competition, ect....

Competition is a good thing for the economy. Government messing in the private sector ends in disaster in this country.

Specializes in Critical Care.

It's about time we stop our socialized military, too. We need competition in our choice of military.

Specializes in Acute post op ortho.

Where have you been?

Who builds jets for the Air Force?

Or ships for the Navy?

Private sector contractors.

They have to bid for the job.

Duh.

Who gets caught in corruption when financing these contractors?

You know, like Barny Frank & Fannie Mae.

Congress, that's who.

Specializes in Critical Care.

The government holds a monopoly on the training of and use of soldiers, unfortunately. A little bit of competition will encourage innovation and lower costs.

Support our troops!

And by our troops, I mean the ones I hold 14,000 shares in and not yours.

Specializes in Acute post op ortho.
The government holds a monopoly on the training of and use of soldiers.....

Is there a government that doesn't?

Specializes in Critical Care.
Is there a government that doesn't?
Besides the point. Let's defeat socialism in all it's types. Government is good for running nothing, amiright?
Specializes in Psych , Peds ,Nicu.
in 1993 when "hillarycare" was introduced, they predicted healthcare would bankrupt us by the year 2000. we were fed a picture of gloom & doom. remember?

didn't happen. in fact, when you look at the overall gross adjusted inflation rate, health care took a small dip. would love to check this , but when i googled "overall gross adjusted inflation rate " , no such thing exists , so i would be grateful if you could source these statements

thanks in anticipation of your response .

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