"The Healthcare Crisis"

[avery]

I turned on the news this morning and yet another story about the impending doom of the "healthcare crisis." Obviously, the current system has some problems. For example, the millions of illegal immigrants in this country who are using the healthcare system and not only do not pay their bills but also, do not pay any taxes. Then, you have the people who come to the E.R. and abuse the services provided there. Coming to the E.R. because one wants the doctor to write a prescription for Tylenol so Medicaid will pay for it is not a valid reason.

Calling the ambulance because your water broke is another example of inappropriate use of resources.

So what are the answers? As nurses continue to be underpaid, it is unnerving to hear of the impending crisis with no clear resolutions.

My husband and I paid $400 dollars a month for his company supplemented healthcare. Was that affordable? No. Did we think it was necessary to have health insurance? Yes.

I personally feel that there are many people who choose not to be responsible for their own actions and would much rather blame their problems on someone else.

People tend to credit their success to themselves and their failure to others.

Avery

[RunningWithScissors]

Interestingly the VA is able to submit bulk bids and because of this has the lowest cost for medicine.

Thus we see the VA patients use community health resources, and then at discharge hear "I get my meds from the VA".

There may be people waiting for some elective procedures in countries with "socialized medicine", but MANY people have gone without medical care right here in the USA with NO medical insurance.

I would gladly work for less $$ if I had no health insurance premiums and wouldn't have to worry about medical expenses.

[cabkrun]

A recent pole of Canadian citizens found that 65 percent of them were happy with their health care. US health insurance have spent a lot of money trying to make Americans believe that things are bad in Canada. Most Canadian's are completely fearful of a US style health care system. I know this because my in-laws are Canadian. I go to Canada several times a year and have had many conversations with them and their friends on this subject. Of course the Canadian health care system has problems. But I can state this unequivocally most Canadian's think that our system is by far the worse system. One very big myth is that Canadian system is a socialized medicine. It is in fact administered by a private insurance company. Something like one third of the cost of our system is the huge expense that hospitals dedicate to dealing with the administrative paper work that is caused by having to deal with a lot of insurance companies. That is an expense that Canadian's do not have. Canadian's make pharmaceutical companies submit bulk bids for medicine and because of this pay far less than we do. The most recent medicaid/medicare bill passed by congress had a provision put in by the pharmaceutical industry to prohibit bulk bids. Interestingly the VA is able to submit bulk bids and because of this has the lowest cost for medicine. The number one reason for bankruptcy in this country is because of medical bills.

I agree with a lot of this. Like I mentioned, my husbands father has heart disease, and he isn't running over here for treatment. In fact, there was an article in the NYT yesterday about the difference between US and European Health care. We spend quite a bit more per person on health care, with worse outcomes. It's because of many of the things you mention above, and also because Americans feel entitled to many unnecessary procedures (and doctors permit them for fear of being sued).

I'm not saying any "system" is perfect, but I disagree that hordes of Europeans and Canadians are running over here to get health care. Actually, some of the opposite is happening...Americans going overseas because some operations are less expensive, and it is the only way for them to afford it.

[cabkrun]

I agree that the system doesn't work but for a whole different set of reasons -- disparity and the lack of equal access to health care. It's unfortunate the amount of people who do not have access to health care, especially considering that these people are generally impoverished, unhealthy, and members of ethnic groups that are historically prone to chronic and life-threatening conditions (i.e. hypertension, sickle cell, coronary disease, CVAs). They go to the emergency room because they do not have health insurance and cannot afford to pay out of pocket for a doctor's visit. What could have been prevented or possibly managed as a chronic but treatable condition turns into a medical emergency for the under or uninsured.

I hate to see immigrants blamed for everything. People who come to this country do so because they want a better life for themselves and their families, not to squirrel away what they can steal from the Americans. They do jobs that most of us wouldn't consider doing. They are illegal because most of them HAVE to be or they would never be on American soil.

This is true. And, unfortunately there is a doctor out there that has written a book that says the solution to our health care "crisis" is to make insurance pay for only the dire situations, and everything else should be paid for out of pocket by the people, with doctors competing for lowest cost of service. Excuse me? This is a solution? What will happen is people will stop getting preventative care, and colds will turn into pneumonia, high cholesterol and diabetes will go undetected, etc. This is a solution? Making people who can hardly squeeze by even with insurance pay for even more? I am of the mind that the health care of citizens is a matter of Public Health.

[mvanz9999, RN]

This is true. And, unfortunately there is a doctor out there that has written a book that says the solution to our health care "crisis" is to make insurance pay for only the dire situations, and everything else should be paid for out of pocket by the people, with doctors competing for lowest cost of service. Excuse me? This is a solution? What will happen is people will stop getting preventative care, and colds will turn into pneumonia, high cholesterol and diabetes will go undetected, etc. This is a solution? Making people who can hardly squeeze by even with insurance pay for even more? I am of the mind that the health care of citizens is a matter of Public Health.

This is exactly what I have been saying. It used to be that I could get basic, preventive care for a set office co-pay. $20-$30. The co-pay was used to discourage people from abusing office visits - running to the doc every time they had a cold. But it was still very affordable for most.

The trend now is to simply not pay for anything until a high-decuctible is met. For my current insurance $1,500.00. I cannot afford this, so I simply don't go. With something that may have been caught earlier - and be treatable - it's simply not going to be found until it's much more difficult/problematic. In the long run, it will cost insurers far more to pay for very expensive procedures. Like you say -- colds turn into pneumonia, high cholesterol will turn into a bypass.

How does this make any sense whatsoever? I have seen it a million times. The lawmakers and planners cannot seem to see past today. What's going to happen when they start paying for bypass surgeries that would have just been high-cholesterol? It's going to make everything worse, coverage will be less, and even fewer people will be able to afford medical care......

[oneLoneNurse]

I work on a psych unit, last night a female patient came out @ 7:30 pm and hit 2 co-pts and a guard after having received: Ativan 2/Benadryl 50 mg IM. My staff see the altercation: they were all taps, not heavy swings. I have to take action. Patient gets put on 1:1 while awake. We can not not take an action when an incident happens, it would look stupid.

Now, I knew the chances of this patient hitting out and actually hurting someone was 0 to none, BUT problem is I have to take an action. Patient has already received meds. Can't just pay a MHW while patient is awake, MUST pay the whole shift. We were lucky enough to get a MHW to stay for time and a half.

[chestrockwell]

There is a thread on allnurses right now about how much money drug reps can make. Really, does someone need to make $200,000 for selling drugs? That isn't anything to do with R&D, just selling and marketing.

QUOTE]

No drug reps make $200,000. Tht is a complete lie. Most companies start the reps at 50-55k. Anyone making even close to 200k has been doing it for 20 years and sells very specialized oncology druge, or medical equipment. Trust me. And besides the fact, how many drug treatments do you think we would have if the pharmaceutical companies were non-profit? Not many. For every dollar spent on health care in this country, only 10 cents is for a drug.

[banditrn]

I'm sure my opinion isn't popular, but here it is:

Do I want to pay higher and higher taxes so that illegal immigrants can receive health care? No, I don't. I would much rather my tax dollars went to help elderly citizens - who have worked, and paid taxes thru their lives - and I'd like to see better help for OUR working poor who are already citizens.

I'm not saying all immigrants are illegal - we have a large population in our area of decent hardworking people who are working and trying to establish themselves here. Those people contribute something to us besides just health problems.

[piper_for_hire]

I couldn't disagree more. So ... you would exclude elderly people that didn't work hard? What about wealthy people - the ones who enjoy life and don't work hard? What exactly is working hard? Okay - pretty obtuse stuff, but the point I'm trying to make is that once you start drawing lines and setting a price tag on human life, you are excluding people from healthcare. Are you that secure that what you contribute to society is deemed worthy? Who gets to make that call? Better hope that it is someone that you find like-minded or you may be in trouble.

[banditrn]

Yes, piper, I've drawn my line, for all the good it will do me. My taxes will go to support those that I don't want to support, while the ones that I do go deeper into a hole.

You have a right to your opinion, as do I, but sooner or later, someone has to pay for it! How many more can we possibly do that for?

[jojotoo, RN]

Yes, piper, I've drawn my line, for all the good it will do me. My taxes will go to support those that I don't want to support, while the ones that I do go deeper into a hole.

You have a right to your opinion, as do I, but sooner or later, someone has to pay for it! How many more can we possibly do that for?

banditrn - You are not alone in your opinion.