10 Excellent Reasons for National Health Care

menetopali · Jan 23, 2009

you want health reform and lower the cost of care? try tort reform. one of the reasons that the VA does better is that many defensive medicine practices aren't needed in the VA system. another item to improve access is standardization of paperwork and use of IT (another big cost saving realized by the VA that also improves continuity of care). increase the number of PCP (MD/DO/DNP) and pay them for coordination of care, preventative medicine, and pt education that they perform so more people would want to go into primary care. last but not least, require that people actually contribute some portion of the cost of healthcare they receive in a meaningful way, that would cut down on the calls to 911 for a prescription refill (had that in my ED Saturday night), visits to the ED for shoulder pain for the past ten years (had that one two weeks ago), and the always fun "rash" for six months (had that one in my ED at 2AM last week). none of this requires a single payer system but all of it requires that we use some common sense in fixing the system that is currently broken.

RN_Canada · Jan 23, 2009

Here in Canada hospitals do not get paid on "fee for service" basis in order to prevent exactly what you are describing as rationing. Hospitals are publicly owned (under law) and are given a "global budget". They receive the same amount of money no matter how much service they provide!

This can also lead to rationing.

The provincial government where I live is trying a new idea which is pay for performance. You get rewarded with more money if you do a really good job!

The hospital sets certain targets for improvement ( like reducing wait times , or speeding up service in the ER) and if they meet those targets they get more money!

It seems to be working and the hospitals themselves are amazed at how much improvement they can make because they thought they were already doing the best they could!

The key to this type of system is measurement because you have to be able to prove that you have made the improvement without any additional cost ie you have not created another problem in the system down the line ( such as readmissions for complications)

Mahage, LPN · Feb 17, 2009

Only since you're so fond of the printed word.
http://www.liberty-page.com/issues/healthcare/socialized.html#britain
I am British. My grandfather died after an MI, needing a CABG, he didn't qualify because he was retired and no longer paid taxes. 72 years old.
My aunt had ovarian cancer at age 68 and was only treated pallitively because there were younger woman who were in line ahead of her. She died.
My cousin had a toothache, needed a root canal, had to wait 6 weeks for her root canal, ended up with infection in the bone, even though she was on antibiotics. She died at age 38.
An uncle had afib. They refused to do an ablation on him because he was a smoker. He was in his 50's when he died.
These are a few examples from real life. I'll keep my private insurance Thank You.
In theory UHC sounds great, I don't mind helping pay for it, in reality it sucks.

So since when were surgeries always aproved and medications approved and available through private insurances?

allnurses Guide · Feb 17, 2009

Only since you're so fond of the printed word.
http://www.liberty-page.com/issues/healthcare/socialized.html#britain
I am British. My grandfather died after an MI, needing a CABG, he didn't qualify because he was retired and no longer paid taxes. 72 years old.
My aunt had ovarian cancer at age 68 and was only treated pallitively because there were younger woman who were in line ahead of her. She died.
My cousin had a toothache, needed a root canal, had to wait 6 weeks for her root canal, ended up with infection in the bone, even though she was on antibiotics. She died at age 38.
An uncle had afib. They refused to do an ablation on him because he was a smoker. He was in his 50's when he died.
These are a few examples from real life. I'll keep my private insurance Thank You.
In theory UHC sounds great, I don't mind helping pay for it, in reality it sucks.

The author regarding profit and organ transplants:

http://www.liberty-page.com/issues/healthcare/organs/main.html

I'm really sorry your loved ones suffered. I know of tragis deaths I think could have been avoided if not for private insurance (PacifiCare, Aetna, HealthNet and others) denying needed care.

HM2VikingRN, RN · Feb 18, 2009

I dont know where you got 6k a yr for health insurance, is that what you pay right now ? If I had a choice, I would prefer to keep my own private insurance and not pay the extra taxes for UHC, since I dont need it.
Maybe that should be an option for those who dont want to be covered on this UHC. What do you think ?

I pay 2600 directly for family coverage. My employer pays 7500. That is roughly 10k/year. Take 25% off for profit that leaves 7500/yr. As a nurse I make 60k. Even with a 10% tax I would pay less than I currently do for family care. The tax funded system would be cheaper and easier to administer than our current system.

HM2VikingRN, RN · Feb 18, 2009

The author regarding profit and organ transplants:
http://www.liberty-page.com/issues/healthcare/organs/main.html
I'm really sorry your loved ones suffered. I know of tragis deaths I think could have been avoided if not for private insurance (PacifiCare, Aetna, HealthNet and others) denying needed care.

Trafficking in human organs is repugnant

Honnête et Sérieux · Mar 22, 2009

I see I'm late into this thread, but after taking a moment to review it, I see folks have a head start on promoting false ideas and unsupported comparisons.

First, it doesn't matter if "health care" is defined as a right or a privilege, because no matter how we define it, it doesn't mean 1. that someone is obligated to provide it, and 2. that someone is obligated to pay for our health care. For comparison, gun ownership and "the pursuit of happiness" are also rights, but we have no expectation to require that someone will sell us a gun or "happiness," or that someone else will pay for our gun or happiness. So for that reason, I don't know how you can say that the right of health care cannot exist in a free-market system...it's illogical to say that.

Next, the dollars we so eagerly want to dump into issues like Stem Cell Research would be dramatically rationed in a UHC system. In 2008, Canada committed to $100 million . That is less than 1/3 the amount George Bush committed INITIALLY to stem cell research UNDER federal funding restrictions. In 2008, the last year of Pres. Bush's final term, the US (via the NIH), spent about $1.13 billion on SCR...this doesn't consider private and state funding, which is greater. Is there a UHC country out there spending more than this? Additionally, certain hypocrisy is evident when we want to dump billions of tax dollars into SCR for hopeful cures for things like MS and Alzheimers, but we'd balk if a pharmaceutical company asked for federal dollars to develop a medication to do the same thing.

And I don't know why a "nurse/paramedic" would have to live paycheck to paycheck. I worked as a paramedic (two jobs) full-time WHILE attending nursing school full-time, incurred no debt, and actually gave substantial amounts of unreimbursed money to a well-deserving classmate so said classmate would not have to drop out. I was able to do that because I don't carry debt. I don't buy what I don't physically have the money in my possession to buy...including my vehicles. I save save save. The reality is that most of America at any economic class/level is overleveraged and in over their head in consumer debt, and it's not rationale to just blame medical issues as the item that would put them "underwater." A failed transmission or a broken appliance could do the same thing...so why don't we socialize our home appliance industry and our automobile industry as well? (oh, wait...we are heading that direction). The reality is that people experience medical bankruptcy in UHC countries just like they do in the US. The second reality is that folks like many of us who have behaved responsibly will have to pay for the poor decisions of others.

The "45 million uninsured" is a debunked myth. It was too convenient to include people who are not Americans, who are eligible for public payor programs and are simply too lazy to enroll, or are uninsured (by choice) for brief periods of time such as when they take a break between jobs.

BTW, I found the "$12 dollar fast food combo" example to be amusing. Quite frankly, it would be a solution to many problems if fast food were less accessible. Why not? We essentially do the same thing with tobacco.

And the "infant mortality" argument is invalid. UHC countries are routinely not attempting to resuscitate infants at the same level of acuity as we are, AND they are not including them in their reported data as we are. Meanwhile Canada, who boasts a better "infant mortality" rate, sends their sickest neonates to the US by the hundreds because they don't have enough NICU beds.

Then here comes the oft-repeated "fireman and policeman" argument, convenienty failing to recognize that around 70% of all firefighters are VOLUNTEERS, and that for every ONE police officer in a tax-funded role, there are TWO MORE people employed in the private security sector to fill the 66% gap. Does anyone think that 70% of the current nursing force is willing to start doing this as a VOLUNTEER? The school comparison is just...well...I would never use our publically funded education system as an argument to support anything operated in a similar manner! And maybe we don't have a two-tiered court system (debatable), but we also don't treat everyone the same in our court system.

I also see arguments against an insured capitalistic system using the "they wouldn't cover" argument. I hardly see how this supports a UHC gov't system. There's a lot of stuff they aren't going to pay for either. And when I see people advocate for a "Canadian-type" system, I just hae to chuckle! Canada is in deep doodoo...and here's how they are filling in the gaps in their system; expansion of PRIVATIZED healthcare! And as John Stossel showed us, we can't reasonably tie the type of healthcare system to our longevity, because the healthcare system is NOT able to influence all of the issues that determine longevity, especially in the manner in which we calculate and compare it.

And while we might not want to worry about physicians emigrating the last nation of last lucrative resort, we will need to worry about people simply not wanting to be physicians anymore...or nurses.

Since we've shared this bit of info, I pay about $1k in premiums for my coverage; health, eye, dental. I then pay copays ($30 bucks) for Dr. appointments, and another $100-200 at the optometrist because I like the more expensive lenses. In comparison, I pay about $1k for Auto insurance for one vehicle and one motorcycle...and my copays are much larger (granted, I don't use them and I choose to keep my deductibles high). In addition, I set aside about $4-5k additional each year toward my next vehicle purchase because I know I'll need one eventually. For retirement, multiply that amount annually by about five. These are all things I may or may not need, but I prepare for them. The mechanisms are in place, and the need for them should not be a big surprise. And just as I take care of my vehicle (preventatively) so it will last longer, I do the same for myself. I don't know why healthcare is such a mystery to some folks that they have to demand that the gov't solve the mystery for them.

Mahage, LPN · Mar 22, 2009

And I don't know why a "nurse/paramedic" would have to live paycheck to paycheck. I worked as a paramedic (two jobs) full-time WHILE attending nursing school full-time, incurred no debt, and actually gave substantial amounts of unreimbursed money to a well-deserving classmate so said classmate would not have to drop out.
.

Genius! :bow:

RN_Canada · Mar 22, 2009

I see folks have a head start on promoting false ideas and unsupported comparisons.

Oops , it would appear you are guilty of this as well.

And when I see people advocate for a "Canadian-type" system, I just hae to chuckle! Canada is in deep doodoo...and here's how they are filling in the gaps in their system; expansion of PRIVATIZED healthcare!

Privatized health care is illegal in Canada so I can hardly see how it is being promoted. The Canada Health Act stipulates that health care provided by the provincial insurance plans must be publicly funded and administered. If provinces allow private health care then they risk having their funding for health care cut off by the federal government so that will hardly happen.

In order to have private health care work alongside the public system (and this works in many countries) Canada will have to change a federal law. Since there is a very complicated procedure that requires consensus from all the provinces it is not likely to happen.

Universal health care in and of itself is a concept. It has to be supported by laws for it to work in any country. The US is in a perfect situation to take this concept and create law that will take the best of the best and correct the worst of the worst. The USA can learn from everyone else's mistakes.

Just because Canada has UHC doesn't not mean the US have to have the Canadian style system. Make your own! Make it better!

If they had the will the US could create a health care system that could be a jewel in the crown of UHC. Sadly that will never happen as long as attitudes such as that illustrated by the following statement prevails.

The second reality is that folks like many of us who have behaved responsibly will have to pay for the poor decisions of others.

You already do that when you purchase insurance for your car and your house.

Universal health care is not about individual responsibility or rights it is about the collective moral obligations and responsibilities we have to each other as a society. If the citizens of the USA don't get that it, they will not be able to design a workable system.

In 2008, Canada committed to $100 million . That is less than 1/3 the amount George Bush committed INITIALLY

Canada's population is 1/10th that of the US. Contributions should be measured in relation to the size of the tax base not the absolute dollar amount.

Is there a UHC country out there spending more than this?

In relation to the tax base and in comparison to Canada's contribution, the US contribution was paltry. (I did not check the reference I am merely going by what you have written).

Universal Health care is not even about funding...if the people and government agree that is it a priority then it will be funded.

Using ethical reasoning (which all nurses should be able to do) we would ask the following questions:

What actions bring the most good to the most people?

what actions fulfills our moral duties and obligations to each other?

What action best shows that we care for each other?

I can hardly see privately managed for profit health care as the answer to any of these questions.

The only system that will put the needs of people first is a publicly funded not for profit system.

nicurn001 · Mar 22, 2009

Unfortunately RN Canada , in the USA the attitude of why should I be responsible for somebodies mistakes is all too prevalent .

Those who hold that attitude seem to have forgotten , how insurance works ! . We buy liability ( car, house , health ) insurance to cover ourselves from the mistakes of others or ourselves .

So why is it that Americans accept , the risks of others through buying insurance , yet use accepting the risk of others ,as a reason not to accept UHC?

Honnête et Sérieux · Mar 23, 2009

oops , it would appear you are guilty of this as well.
privatized health care is illegal in canada so i can hardly see how it is being promoted. the canada health act stipulates that health care provided by the provincial insurance plans must be publicly funded and administered. if provinces allow private health care then they risk having their funding for health care cut off by the federal government so that will hardly happen.
in order to have private health care work alongside the public system (and this works in many countries) canada will have to change a federal law. since there is a very complicated procedure that requires consensus from all the provinces it is not likely to happen..

seems as though you may be mistaken.

it has already happened.

are you familiar with the cambie surgery center? the private facility owned and operated by brian day (president of the canadian medical association)? is he operating his facility illegally?

are you familiar with the 2005 supreme court ruling which determined that the gov't cannot ban private care (after a patient waited a year for a hip replacement)? in this ruling, in the event of extended waits, the gov't (quebec) decided to use private providers as their fallback...seems to support my position that private care is being relied upon to fill in the gaps.

that is just the beginning...do a little search on the expansion of privatizing health care in canada and it would appear not to be so cut and dry illegal.

universal health care in and of itself is a concept. it has to be supported by laws for it to work in any country. the us is in a perfect situation to take this concept and create law that will take the best of the best and correct the worst of the worst. the usa can learn from everyone else's mistakes.

agreed...learn from them and stay away from them...and thereby be critcized for not repeating them. that's what it looks like to me.

just because canada has uhc doesn't not mean the us have to have the canadian style system. make your own! make it better!
if they had the will the us could create a health care system that could be a jewel in the crown of uhc. sadly that will never happen as long as attitudes such as that illustrated by the following statement prevails.
you already do that when you purchase insurance for your car and your house.

not true. people who exhibit malbehavior in their driving or purchase a home in a hurricane zone pay more to insure their honda and 2,000 sq. foot home than a person who drives responsibly and bought a home in west virginia. additionally, not everyone has a car or a home..they can rent and opt out of home insurance, and they can choose who they want to insure them and shop for prices and services which suit them. some people have basic coverage, while others have full coverage...and they pay for it. some people drive a ford focus, and their neighbor drives a lexus. they both needed transportation, but they each individually decided what to buy, and the guy driving the focus can hardly expect the neighbor driving the lexus to supplement an auto upgrade. the comparison is understood, but inadequate.

each according to their need, preference, capacity...and motivation.

universal health care is not about individual responsibility or rights it is about the collective moral obligations and responsibilities we have to each other as a society. if the citizens of the usa don't get that it, they will not be able to design a workable system.

that's a difference of opinion. unfortunately there is no shortage of people who are all too willing to take advantage of the idea of "collective moral obligations and responsibilities" while refusing to function themselves in a moral and responsible manner, and the very appearance that uhc advocates seem to either not understand or forget that this reality exists is troubling to me.

the reality is that the system is not the travesty that everyone propogates it to be. when canada stops sending their sickest neonates to the us, and when cleveland is no longer the hip-replacement capital of canada, then someone might have a point.

canada's population is 1/10th that of the us. contributions should be measured in relation to the size of the tax base not the absolute dollar amount.

you want relation? canada's population is roughly the same as california's. calif. committed $3 billion. just california.

in a related vein, one hospital (md anderson), spends more on cancer research than the entire country of canada. the us is committed to scientific advancement, and the "paltry" comment is insulting. just my view.

in relation to the tax base and in comparison to canada's contribution, the us contribution was paltry.

see my previous statement. relative to tax base, it's no not the evil american medical machine that falls into the "paltry" category.

universal health care is not even about funding...if the people and government agree that is it a priority then it will be funded..

odd that you would say that since the cost of health care is usually one of the first things used to compare healthcare systems across borders.

and i'd like to point out a conviently ignored fact; in spite of the alleged "priority," it won't be the "people" decided where the buck stops, what services are rationed and denied. the people will pay, but the gov't will decide. that is not the country i want to live in.

using ethical reasoning (which all nurses should be able to do) we would ask the following questions:
what actions bring the most good to the most people?
what actions fulfills our moral duties and obligations to each other?
what action best shows that we care for each other?.

when these questions are applied equally to all people, they make sense. unfortunately, most advocates of uhc only want to apply these "actions" to those who have succeeded personally. since the auto insurance industry was referenced, let me say that i won't interfere with a gov't plan that would apply that philosophy; you can opt out and pay nothing, and you aren't insured. you can exhibit high risk behaviors and pay more. you can buy coverage that only pays for the basics, or you can pay more, but the whole package, and get everything covered...but i don't think that's what uhc advocates have in mind.

i can hardly see privately managed for profit health care as the answer to any of these questions. the only system that will put the needs of people first is a publicly funded not for profit system.

you might want to remind the gov't of canada, because they are increasingly looking to private health care for these answers.

RN4MERCY · Mar 23, 2009

honestly and seriously,

have you read the book? ten excellent reasons for national health care

http://www.thenewpress.com/index.php?option=com_title&task=view_title&metaproductid=1711

by motivating cooperation and shared responsibility rather than competition, a national health care plan promotes the collective health and well-being of all who live here. if, as nurses, we take our role to be patient advocates very seriously—meaning that we will advocate for our patients at the bedside to receive the best care, but we’ll also advocate against insurance companies, hospital administrators, and hmos who focus on the bottom line at the expense of the sick and injured. we must be willing to speak out against politicians who are sacrificing our right to healthcare for the benefit of their corporate cronies: for-profit insurers and pharmaceutical companies. such politicians should be ashamed of protecting the gigantic insurance and pharmaceutical corporations, while abandoning a real concrete solution to protecting and ensuring the health and welfare of our nation's people.

only a publicly financed, publicly administered healthcare system can provide health care based on patients’ needs, and make sure that every person has access to quality care by removing insurance waste. we are facing formidable opponents. healthcare corporations are making hundreds of billions of dollars in profit, and funneling it to politicians, because they want the status quo maintained. without single-payer health care, we will continue to waste money on administrative overhead, deny health care to millions, and cause many of the underinsured to go with out adequate treatment due to expensive co-pays or rising premium costs.

in the united states, we are paying for care that we're not receiving. insurers are ripping us off. ours is a system problem, not a money problem. we need to eliminate the for-profit insurance system that avoids sick people and reinvest the money currently wasted in administrative overhead, and use it to provide actual care for people. canada's medicare system may be a bit underfunded, compared to what we already spend for health care in the u.s., but it does fulfill its obligations to canadians by providing essential health care based on medical need, not on the ability to pay. the other important point to keep in mind is that there are no waits for emergency care and it is the patient's doctor who determines the treatment plan and prioritizes the patient's care, not some insurance company bean counter. :rolleyes: