Health Care: The Ticking Time Bomb - page 2

Our health care system hurts everyone. Premiums are expensive and increasing every year. Doing nothing today will cost taxpayers 2-3 times more in the next few years. Currently, the "public... Read More

  1. by   PostOpPrincess
    Quote from indysmom
    Well, Jopacurn, you are very special indeed and must have lots of resources to be able to afford the best doctors on a self-pay basis.
    Docs that do not want to participate in a government insurance progam don't have to now, and won't have to under healthcare reform.
    As a PACU nurse, you have limited exposure to patients and don't have an opportunity to listen to patient's stories about paying for their healthcare; insurance premiums, copays, co-insurance, denials, bankruptcies, etc.

    You are making assumptions based on my name. Since I worked ER, Trauma, and ICU AND med-surg--yes, I've heard MANY STORIES--a lot more than you, perhaps?

    I've also been a nurse for 18 years. The problem I see, with the government's insurances (Medicare and medicaid anyone?) is the hoops and endless red tape that many disillusioned physicians I know personally who are already saying, "no more."

    I don't know about you, but I don't see any of our young docs going into general practice--do you???

    So with THAT limited amount of GPs wiling to do that, who will end up with the short end of the stick?

    I think that healthcare reform SHOULD BE DONE; but not by government bureaucrats whose only true reason for doing this is for votes.

    I say give it back to the people in the front line--the healthcare provider.
  2. by   Bormio
    I'm afraid you are misinformed. Medicare and Medicaid (administered by individual states) are not the reason for the "endless red tape"; it is private insurers who require more and more documentation because they don't want to pay providers! Medicare is a entitlement program - it's budget and expenses are established by legislative law. Yes, they do want to keep down costs and provide cost-efficient and effective health services, but they are not motivated by profit.

    A primary reason there is a shortage of primary care physicians is because their services have been devalued through a system where private insurance establishes the economic rules.

    You should pick up the latest issue of Consumer Reports. There are a series of articles in this issue which explain in a very easy to understand manner how the health system will likely change and the repercussions of health care reform.

    And by the way, I have spent nearly 20 years doing health planning and strategy consulting for public and private entities. I have also worked in many hospital departments including patient financial services, so I am well aware of the financial challenges facing both providers and patients.

    Nurses have a lot to gain through healthcare reform, including the realization among policy makers of the true economic value of the services we provide.
  3. by   PostOpPrincess
    Quote from indysmom
    I'm afraid you are misinformed. Medicare and Medicaid (administered by individual states) are not the reason for the "endless red tape"; it is private insurers who require more and more documentation because they don't want to pay providers! Medicare is a entitlement program - it's budget and expenses are established by legislative law. Yes, they do want to keep down costs and provide cost-efficient and effective health services, but they are not motivated by profit.

    A primary reason there is a shortage of primary care physicians is because their services have been devalued through a system where private insurance establishes the economic rules.

    You should pick up the latest issue of Consumer Reports. There are a series of articles in this issue which explain in a very easy to understand manner how the health system will likely change and the repercussions of health care reform.

    And by the way, I have spent nearly 20 years doing health planning and strategy consulting for public and private entities. I have also worked in many hospital departments including patient financial services, so I am well aware of the financial challenges facing both providers and patients.

    Nurses have a lot to gain through healthcare reform, including the realization among policy makers of the true economic value of the services we provide.
    Go to www.MiamiHerald.com and take a look at OUR costs--Miami is a special region and we are haves and have-nots. No doubt about it.

    Yes, their services (GPs) have been devalued for the very reason you cited--but no one is addressing the other issues--such as a much needed Tort reform. Why do I go to other countries to "practice" real nursing? Because it is TRUE nursing, not this "write it all down and cover your butt nursing or else you will get sued nursing." As for the GPs, again...I know of NO ONE IN MY CIRCLE that is gung ho about becoming a "GP." And moreover, you still haven't explained how this new healthcare system would "encourage" participation by the real good docs. Any suggestions? Now that Medicare is telling the hospitals/docs/HCPs that "bundling" will be the way to go.....(which I agree with) still doesn't address some underlying problems- Where will you get the "new" docs when the older docs say, "I don't think so." As usual, those who spout this wonderful new system never come up with the details to make it realistically implementable.


    Tell me how more of your information once you're in the frontlines, not spouting information from behind the desk.
  4. by   c_beshore_rn
    Some doctors don't want to take medicare and medicaid, not because of the "red-tape" but because they do not get paid what they want to get paid. Dentists won't accept medicaid because they get paid 10% of what they want for a procedure and yes it is a lot of paperwork. I've dealt with medicaid and private insurance. Private insurance has as much red-tape now.

    A single payer system would be great!!! Some Dr's may no longer have his and her convertables in the garage of a 3million dollar home, but a lot of us that are getting rich off healthcare dollars are going to have to take a cut to get our patients the care they need and DESERVE. I'm 100% for it

    If the Doctor does not like the system that used to make him rich he can move to either a 3rd world country and see how that works out for him or another universal-type healthcare system because, I think, were about the only medical industry thats 100% capitalistic!
  5. by   Bormio
    I don't have a lot of sympathy for the docs. So, their salary drops from $250K a year to $150. Docs in other countries with universal healthcare systems make a nice living, get to focus on patient care and don't have the administrative burden our docs do. Of course, it is all about economics, which is how the specialty distribution occurs. A more reasonable payment system where the financial disparity is less between primary care and specialists would help in balancing supply and demand. Also, financial assistance for docs going into primary care is available, but not to the extent where it has changed behavior, yet.

    I am very familiar with the Miami market, having been a mergers and acquisition specialist in that market. It isn't any different from any other large market with a significant number of immigrants, large numbers of uninsured and a large number of tertiary hospitals competing for the small number of GHI patients. Phoenix, La, Atlanta and Dallas all are dealing with the same issues.

    A problem with staffing in Miami is salaries are generally lower because it is such a desirable place to live, they don't have to pay as well. Also, in Miami, there are not a lot of large multispecialty groups, but mostly solo practitioners and small practices. This makes it more difficult to deal with administrative challenges and expenses related to a practice can not be spread among multiple physicians. The market is more fragmented.

    Health care reform is an incredibly complex undertaking and not everyone will be with happy the result. The ultimate goal is to ensure all citizens have access to an established, standardized level of quality care. I believe a profit motive is an obstacle to quality care. If you can remove the profit motive from the equation, you can devise a more balanced and equal system of care.
  6. by   elkpark
    Quote from JoPACURN
    As usual, those who spout this wonderful new system never come up with the details to make it realistically implementable.
    Well, every other developed nation on the planet has managed to make UHC "realistically implementable," so it shouldn't be that much of a stretch for the US. There are certainly plenty of working models out there. It's not that the US proponents of UHC don't "come up with details" -- it's that the folks who have already decided they're opposed to any sort of publicly funded program on principle don't want to hear about possible models.
  7. by   mariposabella
    Well just another part of Obamas socialist plan. I see a lot of you are in agreement with Obamas socalist agenda. Oh you all just wait until the Senate passes the cap and trade bill this fall thats going to kill the U.S. Millions upon millions of jobs will be lost and it will cripple the lower and middle class. Im sure in a year we will be called the United Socialist States of America. You people have no idea what the gov't is up to.
  8. by   Fuzzy
    I feel that if the insurance companies, government and lawyers would stay out of health care then it would be available and affordable for most people. Oh I'm not covered by insurance because pre-existing conditions make very unaffordable and available to me. So yes I go without health care for the most part.

    Fuzzy
  9. by   mariposabella
    Quote from JoPACURN
    I think that healthcare reform SHOULD BE DONE; but not by government bureaucrats whose only true reason for doing this is for votes.

    I say give it back to the people in the front line--the healthcare provider.
    Ditto!
  10. by   lamazeteacher
    Quote from jopacurn

    i will support as long as i don't have to have it--or am forced to have it, that is. i want a choice and i'm not willing to be put on a "list" to for tests. no way.

    i'm reminded, reading the above, of an ad for something that had the jingle, "have it your way, have it your way......" i guess you live in a large enough community now, to be able to have immediate availability for mris, ivps, etc. have you a choice of any physician in any part of the usa now, with your health insurance, without paying more for "out of area" physicians?

    my personal friends (docs of different specialties) say that they won't participate if it causes them problems. some of them don't take medicare or medicaid now; and if my gp gets overwhelmed by it, well then i look for a gp who takes only private insurance.

    doctors also have had it their way for all their professional lives, since graduating medical school and completing whatever residency they chose (for which they qualified and which had space for them). recently, however, they've been told by insurance companies, what meds, procedures, tests, and procedures their patients can have, based on financial reasons, rather than health of their patients.

    there are plenty of problems with the current way insurance companies cause unemployment of older employees, charging exorbitant premiums for those over 55 years of age, with subsequent lack of availability at an "affordable" cost, of other health insurance, especially when an existing illness is on board.......

    uninsured patients have no source of care currently, other than ers which don't treat them except to stabilize their condition and hoist them out. that is very costly for taxpayers now - you, me, and everyone else who pays taxes. i was recently in an er lying there for 2 hours without being seen by any hcw, having been transported by ambulance with gi hemorrhaging. the charge for that was $5,000.

    my history given by the emts, was taken by the triage nurse (although uncharted), included my past episodes of gi bleeding, inability to stand that day due to weakness and dizziness, etc. i'm on medicare, so that was more costly (for taxpayers) than it would have been if a cbc had been ordered, blood drawn, and results in within a half hour, with the transfusions given that afternoon. then i could have gone home, instead of being admitted for 3 days during which my regular medications weren't available. a home health nurse could have drawn the next cbc, to see how much more bleeding happened, rather than having more expensive (than having it done at the same place as an outpatient) hospital ones done.

    doctors historically have been unaware of the costs of such things, and therefore have been ordered, by insurance companies regarding the possibility of getting everything from diagnostic tests to treatment and procedures indicated, based on costs. why are they so resistant to having doctors working for our elected government, doing that, instead of nurses hired by insurance companies making huge profits, with strict directions/guidelines to which adherence is mandatory, dictating care for the past 5 decades, at least? :angryfire

    i'm not willing to compromise my family nor me for the government's mandates.
    do you really prefer private, profit making insurance companies compromising your family's health, at great expense? they've been courting doctors and hospitals and pharmaceutical companies, often hiring the same lobbyists for similar goals. think about that, and what would happen if that continued......:thnkg:
  11. by   JimSEDRN
    There is no place in the Constitution that allows or states that heathcare is a the job of goverment . With that being said I think we should look very careful at the numbers the Congress has never been able to manage in any way Heathcare MCaid and Mcare are both so far in the red that we will never live long enough to see them even close to breaking even. I hope that people will look and the numbers, no country has been able to keep paying for it all as Dear Leader Obama would like us to belive that the goverment is going to do, all I ask is when I come to you in the ed and let you know that our new goverment healthcare that you are going to be forced to be a part of that everyone wants that the MRI or CT or PET scan that might give the Dr the info they need to save your life is not part of the goverment plan and you do not quilify for it.........sorry.
  12. by   MPRN1313
    when i come to you in the ed and let you know that our new goverment healthcare that you are going to be forced to be a part of that everyone wants that the mri or ct or pet scan that might give the dr the info they need to save your life is not part of the goverment plan and you do not quilify for it.........sorry.

    these days the only people who are going to refuse you the tests that you need are the private insurance companies. i have lived for years in a country with universal health care, and i can tell you the massive misinformation that is being disseminated about it here. under uhc, i never had to wait more than 1 day to see a gp, and you aren't "forced" into anything. i had my choice of physicians, and all my prescriptions were free. other countries have both a private and a public option. although everyone is covered under public healthcare, you can chose to have private insurance if you want (and it only costs a fraction of what it costs here and they aren't allowed to refuse coverage for anything).

    if private insurance actually paid for healthcare instead of spending millions refusing to pay for care, then it might work. imagine if you went to a restaurant, ordered a full meal, paid for the meal before you received it, and then the waiter told you that the chef would only give you a salad, even though you had already paid for a steak dinner. would you go back to that restaurant? that is what private health insurance companies are doing now.

    then if a restaurant opened that actually gave you all that you ordered and paid for, then the other restaurants would have to shape up or close down. that is uhc. and most physicians in uhc countries work both publicly and privately, so there isn't a difference in practitioner. what it would do is reduce the astronomical cost of healthcare by eliminating the "pay game", the doctor wants to get $100 for a procedure, so he charges the insurance co. $500 so that they will pay him his $100.
  13. by   Bormio
    Socialism means cooperative and joint ownership of means of production and distribution of goods by the government and the people. Have any of you who suggest this studied politics, world history or economics? Have you traveled to other countries? It would be really nice to actually have a discussion with learned, informed individuals.

    By the way, the constitution does make a reference to health (welfare) in the very first line:

    We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, PROMOTE THE GENERAL WELFARE, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

    It is beyond selfish to not consider the welfare of those who are living in poverty, facing illness without proper treatment or financial ruin due to lack of health insurance. As nurses, we should be supportive of any law, regulation, ordinance or norm that improves health and wellness for ALL.
    Last edit by VivaLasViejas on Jul 13, '09 : Reason: attacking

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