Do You Want Universal Healthcare?

missjennmb · Jul 18, 2008

But we're already paying for the irresponsible people with our taxes.
I'd rather pay extra taxes to ensure that I am covered financially instead of the HUNDREDS of dollars I'm paying the insurance company just so they can profit off of me then tell me "no" when I need care.
To those that are worried about the gvmt interfering and delaying your care, don't think the insurance companies are doing this now?
I pay taxes to pay for the poor to have health coverage (welfare), I pay the insurance company to provide me with "health care", but then I also pay out the a** for all the copays, deductibles, and needed care that my insurance co refuses to cover. You know what, it's my turn to want to feel entitled (along with all the other middle class people)! You shouldn't have to be either super poor or super rich to be able to receive health care!

:yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah: :yeah:

Bravo! My sentiments exactly!

SteveNNP, MSN, NP · Jul 18, 2008

It really disappoints me that so many healthcare professionals would say that they don't think everyone deserves to have access to healthcare. In the US over 100,000 people die every year from lack of healthcare and we rank somewhere like 46 in infant mortality.

But everyone DOES have access to healthcare. The issue here is who's paying for it.

Like I said, I can agree with access to basic healthcare as a right. Basic.

Universal healthcare will not change infant mortality rates. Medicaid covers most uninsured pregnant women who seek pregnancy-related care. The US has one of the highest prematurity rates, probably due to the explosion of fertility services. The US also routinely resuscitates babies much younger than other countries. Most European NICUs will not aggressively resuscitate 23-24 weekers, which we do every day here.

No one has said that people don't deserve access to healthcare. I fear that universal governmental-run healthcare will put us one step closer to communism.

Quote/Pipsqueak: "I pay taxes to pay for the poor to have health coverage (welfare), I pay the insurance company to provide me with "health care", but then I also pay out the a** for all the copays, deductibles, and needed care that my insurance co refuses to cover."

Just to play devil's advocate, (I'm not saying corruption does not exist in insurance companies) some of the rigmarole companies put clients through is simply exercising fiscal responsibility. Say your knee is bothering you. You go to your GP, and he refers you for an MRI. The IC requires preauthorization because an MRI costs thousands of dollars. You (hopefully) aren't paying thousands of dollars a year for insurance for yourself. So who's paying what your premiums for the year don't cover for one simple test? The cost burden of caring for the uninsured is spread out to the paying insured. Ultimately hospitals are businesses, we all know that. You can't operate a facility in the negative. A universal payor healthcare system doesn't change anything. The financial costs of healthcare are spread to others. You will pay for it via additional taxation. Joe Blow who is able to work but doesn't, and therefore pays no taxes gets the same healthcare you get, and you're the one paying into it.

The one benefit I see to a universal payor healthcare system is that I can then go per diem. No need to stay full-time for healthcare benefits. I can work when and where I want.

This debate comes down to two structures of belief:

1) Everyone has a right to healthcare equal to that of everyone else. (Basic Right)

2) Everyone has a right to access healthcare. (Commodity)

missjennmb · Jul 18, 2008

Uhe US has one of the highest prematurity rates, probably due to the explosion of fertility services.

right... it must be fertility services. :uhoh3:

What about elective cesarean? What about all the medical interventions in pregnancy and birth, some of which bring on premature birth/adverse effects on the fetus? What about the idea that doctors will "take care of" pregnant women, thus elliminating their feeling of responsibility for their pregnancy in many cases? what about the whole idea that birth "MUST" happen on a time table, that babies cannot wait until their ready to be born (oops...she LOOKED like 38 wks instead of 32...) and women are not to be believed over machines (which have a huge margin of error) in regards to dates of conception, baby size, etc.

There are a lot of factors in why there are premature babies, but the whole "medicare is available" argument against universal healthcare is as much a falicy in regards to pregnancy as it is in any other area.... There is a percentage of the US that has too much money/insurance to qualify for medicare yet is too poor to afford the $1200 out of pocket patient fee (yes, even with blue cross/blue shield insurance, etc) on top of all of the medications/copays for specialists/etc/etc.

But regardless, I think that for the most part, pregnancy and birth is treated so much like a disease that it becomes a self fulfilling prophecy through the use of "preventative medical intervention". Many studies have shown how much safer babies would be if we didnt have to put our fingers into everything all the time (check out our spot on the infant mortality rate again and the differences between our country's ob/gyn practices and theirs!). But I digress... thats a whole nother debate.

coolpeach · Jul 18, 2008

I am not sure.......here is why.

On one hand I would love UHC if it worked to the benefit of everyone. By this I mean that everyone could get the health care they need in a reasonable amount of time. I know this is terrible, but also if our pay would not decrease too much. I have worked hard and struggled all of my life. I will graduate in Dec 09, and I have loans to pay back. I can't afford to have the nursing pay scale go south.

I have someone in my family who does not have health insurance, and gets a discounted health plan through the local county hospital (Parkland, Dallas). He is really happy to just be able to afford to see a Dr., but I can tell you it is really horrible. I often go with him to help him navigate the system etc. He must go to one primary Dr. which is generally a good 45 min to an hour away. Once he is there he pays his co-pay and generally waits at least 2-4 hours to be seen. This primary care Dr. treats colds, basic rashes etc, but anything more than that she refers to the clinics (cardiology, ortho, urology etc). If you go in with hypertension, or urination issues she does not even look in to that. She will tell you to call a main # in a week, and they will give you an appointment to the appropriate clinic at the main hospital. The clinics are all at the main hospital an hour and a half away. They are all staffed by residents and students wanting to go into that particular field. When you call the main number they will give you an appointment which is generally somewhere between 3 to 6 months away. This is a long time if you are in pain, or have some other emergent issue.

When you finally get your appointment at the clinic you must usually wait between 4 to 8 hours to be seen. Then the Dr. usually wants more tests because they do not do tests there its at a lab (MRI, XRAY, BLOOD WORK etc) they tell you to call the main line in about a week for an appointment to do the tests. When you call its generally about 2 to 3 months before you get the tests. Then you get to call the main line to get an appointment back to the clinic which is another 3 to 6 months. So it could take you over a year to find out what the problem is, and or get treatment for a simple, but important problem like high blood pressure etc.

If a patient goes to the ER because they have a BP of 170/150, and a PR of 160 they will not admit them to the hospital for tests to find out wht the problem is. They simply lower the stats and send the patient home, and tell them to call the Dr. to start the above process.

The hospital is also generally dirty, and has lots of homeless people, and people begging for money hanging around. They have very strict rules, and are NOT patient friendly at all. The patient is only allowed 1 visitor at a time, and only during very limited strict hours. In the ER the patient must go back by themselves, and they will allow one visitor if and when they deem appropriate. In addition, all individuals must go through a metal detector, and have their purses searched before entering the ER.

Its a very scary situation to me. I don't expect my medical care providers to be hostesses their for my comfort, but I would like basic rights and respect. I would like an appointment sooner than 6 months, and a clean safe environment.

I have heard people say that UHC would be what I described above and if it is I don't want it.

Mom2Chaos · Jul 18, 2008

I am absolutely against UH. It seems that most people have the unrealist viewpoint that the health delivery system will be exactly as it is now, only free. I don't think so!

I have been on many sides of this arena. Currently, hospital employed in an ED I see many patients who are unable to pay receive care regardless of that ability and the hospital works with them to accomodate their financial situation as well as provide information on charitable organizations that will provide assistance.

I also spent the first 15 years of my adult working life working for a major insurance company. Sorry to disappoint, but salaries within the insurance company heirarchy did not differ from those in the hospital heirarchy AND we didn't spend our days in meetings discussing how to "not pay claims to make more money". Au contraire.... I have sat in many meetings to develop implementation strategies to address new technologies. Sadly, one of the largest areas of concern in addressing new technologies is not profit, but litigation. In our current tort system, by approving and paying for a procedure/technology, an insurer is open to litigation for failures of that procedure, as lawyers and courts will dive whereever the pockets are deepest.

After resigning and becoming a SAHM mom (and subsequently a student, again) my family purchased individual health insurance. Our income dropped from the upper end of middle class, to the lower end- yet we chose to purchase health insurance for our family rather than the snazziest new cell phones, high-end designer clothes or movie-channels on TV. Yes, we had co-pays and cost sharing, but I found most providers were willing to work with us. Never did I feel that paying a portion of the healthcare that we used was anyone's responsibility but ours.

Lastly, I watched my own father (uninsured, middle-class) be diagnosed, treated (sort-of) and die of cancer under the VA medical system. Don't get me wrong.... the staff was wonderful, but it was definately like stepping back 20 years in time. It was much more of a system based on "patch-up and make comfortable until death", rather than innovation. The government program, while somewhat beneficial, did not function in a manner to encourage or allow for innovative treatment. I can't help but imagine an entire health delivery system built on this philosophy.

Also, did you know that when Hilary Clinton presented her UH plan during Bill's presidency, in included a clause that made it ILLEGAL to purchase private medical care outside of the national plan? SO, if the above situation that we went through with my father were to be happening under her proposed UH plan, it would have been a federal crime for us to choose to spend our hard-earned, taxed money on a private Doctor specializing in his disorder for additional options.

I didn't intend for this post to get so long.... I'm sure that I have lost many people by now... But I feel strongly that while the current system is far from perfect, there are tweaks that can be made that will be far superior to the level of care available rather than moving to an expensive, government-run system. I have yet to see an example of an efficient government-run program that actually benefits "the people".

ThatPoshGirl · Jul 18, 2008

My asthmatic 18-year-old nephew, two weeks out of high school, had a heart attack last month because a lung infection went into his heart. They told him he had pericarditis and they were sending him to a specialist to have the fluid around his heart removed. Then they found out he didn't have insurance. Despite being asthmatic, 18, and having just had a heart attack they discharged him the next morning and told him to go see a cardiologist.

I'm sorry but "I don't want to pay taxes so someone else can have healthcare" doesn't cut it for me. Tell me that after your 18-year-old nephew has a heart attack.

SteveNNP, MSN, NP · Jul 18, 2008

right... it must be fertility services.
What about elective cesarean? What about all the medical interventions in pregnancy and birth, some of which bring on premature birth/adverse effects on the fetus? What about the idea that doctors will "take care of" pregnant women, thus elliminating their feeling of responsibility for their pregnancy in many cases? what about the whole idea that birth "MUST" happen on a time table, that babies cannot wait until their ready to be born (oops...she LOOKED like 38 wks instead of 32...) and women are not to be believed over machines (which have a huge margin of error) in regards to dates of conception, baby size, etc.

You're right, this is another whole issue to be debated, and for the most part, I am with you on the current medical model of treating the natural process of birth.

(For the record, I was born at home with a nurse midwife!)

I work NICU, and see the end results of fertility treatment. These are the kids dying in NICU. 21-year old mom's pregnant with IVF triplets born at 24 weeks. 2 died. 26 y/o mom delivers 26 week triplets. 2 died. The average survival rate of infants born at 23-24 weeks is between 25-35% with today's technology. These are kids who would have been delivered and put in mom's arms, and the door shut behind the doctor. I can't say for sure that prematurity and the fertility boom are solely responsible for the abnormally high infant mortality rates, but I can say that from here, it sure looks like it. The programs and services to prevent mortality are in place, but there are many other cofactors for them not being used.

Oh, and everyone, here's a 38pg thread on UHC currently being discussed.....

https://allnurses.com/forums/f287/universal-healthcare-284055.html

VICEDRN, BSN, RN · Jul 18, 2008

YES

Several Random Thoughts:

*The VA is consistently rated one of the best care systems in our country. No one pays for care at the VA. (I personally would love a job there when I finish NS.)

*My mother is British and they love National Health Care!

(whoever asked about ventilated patients with no quality of life: I have heard my family talk about how they don't allow that kind of stuff in Britain. For whatever its worth, they think it is cruel to give a person or a family a false sense of hope and balance the costs with the outcome very carefully.)

*Health care is a basic human right.

*We need to invest in primary care, not critical care. There is no incentive for private insurers to cover treatments that prevent illness later on because they probably won't be insuring you then.

*Why should folks with private insurance have to pay costs when others pay nothing? How is that fair?

*Agree with the sentiment that no one can afford care when they are elderly.

RN1982 · Jul 18, 2008

That was me. I'm always complaining about having to pay via taxes for vented patients with no quality of life. I agree, that in Britain things are much different. In the U.S., it seems like we have to save everyone no matter what the cost. I think it should just be outlawed. If a patient is in a futile position with no chance of recovery, the docs should have the right to pull the plug without fear of litigation. I have actually heard of cases where something such as that happened and the courts sided with the docs. I'm not trying to be cold or mean but after seeing many patients in that situation it's sad and they are just better off in heaven where they won't have to suffer from chronic infections and bedsores.

VICEDRN, BSN, RN · Jul 18, 2008

SteveRn21:

You said:

Just to play devil's advocate, (I'm not saying corruption does not exist in insurance companies) some of the rigmarole companies put clients through is simply exercising fiscal responsibility. Say your knee is bothering you. You go to your GP, and he refers you for an MRI. The IC requires preauthorization because an MRI costs thousands of dollars. You (hopefully) aren't paying thousands of dollars a year for insurance for yourself.

I am paying THOUSANDS of dollars a year for my family's health insurance. I also pay thousands of dollars a year for our out of pocket expenses. No one in our family has "major costs" (thank goodness). The total tab comes to close to 12,000 out of pocket and a little less (on top of that) than that for premiums. This is what takes to insure the family of a small business owner.

Blue Cross Blue Shield of Georgia is owned by Wellpoint. Last year, the made 4 billion dollars in profit. They are not "exercising fiscal responsibility," they are screwing me!

JaneyW · Jul 18, 2008

No. We need to reconfigure our coverage for those that cannot do it on their own and increase the wage threshholds for Medicaid, but to hand over the whole system would just be folly at this point.

nicurn001 · Jul 18, 2008

I believe most nurses view themselves as patient advocates , so as I wish to ensure at least adequate care for my patients , I accept that as some of them are uninsured , that I am effectively paying towards their care through my taxes , again I accept this because I cannot condone the idea that anyone should be denied access to healthcare . But what irks me is that I am obliged to pay for health care twice .Once for the uninsured ( taxes) , then for my private insurance , which provides basically the same care as the uninsured get , without the frequent fighting to get what , I have found out when I need it is not covered.