How Will Universal Health Care Change Nursing? - page 7

How will universal health care change the Nursing profession? Will we finally get ratios? Will our pay go up, or down? What about benefits? Will the quality of care improve, slide, or stay the... Read More

  1. by   herring_RN
    Quote from it'sme, rn, bba, mba
    so candian uhc is the role model we should follow? check out this citation:

    october 18, 2005
    health care rationing in canada
    the fraser institute has released its annual analysis of waiting times in the canadian health care system. [link.]
    total waiting time between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, fell from 17.9 weeks in 2004 back to the 17.7 weeks last seen in 2003.

    do you really want to wait 17.7 weeks to see a cardiologist? surgeon? orthopedist? cancer specialist?

    not me. i needed to see an orthopedist and i waited 4 hours. not days. not weeks. 4 hours. and my insurance paid for it. i paid my $50 copay and walked to the back. then got sent to the pt next door. started therapy the same day. no waiting. great service. with friendly happy staff.

    which one do you want, walk in and get seen are wait 17 weeks.

    it is hard to argue with the facts, isn't it?
    i had pacificare private health insurance.
    in an accident my shoulder was injured.
    i went to my primary physician who recommended an orthopedic doctor and filled out the authorization forma.
    two weeks later i was allowed to see the orthopedist. by this time i couldn't move my arm. just extending my elbow was very painful.
    the orthopedist did an x-ray, prescribed pain medication and ordered an mri. also put me on state disability so taxpayers supprted me at about 25% of my usual pay.
    authorization for the mri took another two weeks of pain. i could hardly dress or wipe myself. brushing my hair was impossible.
    i had the mri but was told i had to get an authorization from my primary physician to go back to the orthopedist....two more weeks. and one for an appointment.
    then he prescribed physical therapy....two more weeks.
    four sessions were authorized but i learned a lot from my hero therapist. did the exercises twice a day and saw her once a week, improving steadily.
    finally i was well enough to go back to work, still doing the new exercises.
    i sure wish my wait had been only four hours or even four weeks. as it happened it took nine weeks from the injury to the start of physical therapy.
  2. by   tmgsn
    Quote from It'sMe, RN, BBA, MBA
    Strange, so if health care is so good in Canada why do so many cross the border to get treatment? And why is the news so loud now about the Canadians wanting change in their health care? Odd, the rosy picture you paint is not what the facts describe.

    Oh, don't worry about me gloating as I work as a staff nurse, I know it is only temporay until I rebuild my real estate investing business. And the really neat thing is that after only 4 months I have already been offered a VP position. So don't worry about me, I have a very bright future in front of me. Diversification and education with real degrees takes care of that situation. Have a great life.
    All the money in the world will not take good care of you in a LTC. Why did you become an RN? Has life been so bad to you as to make you this bitter? I simply stopped chatting when I felt I could not reach people here-- but this last post of yours has brought vomit to my lips. Tell me, does a staff nurse actually do pt care? It does not sound like you care enough about any one else to do that part of the job. I am not trying to attack you, but did you read your blog before you posted it? So cold. I am sorry for you, I will pray for you to find the love you must have had in your heart at one time to become an RN. Life is not, is not, all about money and position!
  3. by   MAISY, RN-ER
    Although some of us have alphabet soup behind our names, the meal isn't always good. Some of your statements are so thoughtless and skewed that I wonder how the institutions of higher learning you obviously attended would feel if they saw your disdain of the working poor or disadvantaged.

    You are right it will cost us alot, however I believe we will "reap what we sow" and overall it will break even and then reduce our costs when are citizens are actually given care. The haves always have in every country, and I am sure many doctors will pull themselves out of the pool by not accepting Medicare and UHC; unfortunately Medicare floats many a practice and hospital-their snobbiness won't last too long.

    UHC or a mixed plan should be initiated slowly and must be evaluated and re-evaluated for it's effectiveness. Both sides will have to play nice on Capitol Hill, something that doesn't happen often. Laws are routinely re-evaluated and modified and is also the reason all laws do not resemble their original proposals.

    Right now a good place to begin would be basic coverage to all American citizens for primary care. Require physicians at all levels to take the state healthcare based on their practice, so 10% of total patient count must be the US healthcare policy. Right there an improvement in care will be seen for those who can only be seen by appointment (months) in clinics.

    Any health plan initiated will be difficult to initiate, but initiate it we must! No one should be homeless due to mental illness, lose limbs because they can't afford their testing supplies/medicines/and physician, or die because no one would help them.

    All I know is that I don't want American children to be on a folder asking for donations to fix a cleft lip, donate because they can't eat, or for a dollar a day...... If something doesn't happen soon, it will be some of them. We just can't let that happen.
  4. by   geekgolightly
    Quote from It'sMe, RN, BBA, MBA

    First, I am not in an HMO, in fact I have traditional health insurance. Second, always quote your source of information to validate it. Third, present the facts in their entirety. Many of the deaths related to mortality in the US would still occured because those people would not have sought health care anyway. Those were life style issues. And there are many studies by unbiased groups that not only dispute these numbers but also the number of uninsured people in America.
    I wasn't questioning what health insurance you held? You said that you had been PRESIDENT of an HMO in an earlier post. That is what I was referring to. I suppose I should have quoted your own words back at you. I can do that if you like.

    It is immoral for HMO's to target health insurance carriers who have become ill and comb through their files for any clinical error, which is what HMO's do, as I am sure you are aware, what with having been president of one. That is not an accusation, it is not relative to circumstance, it is immoral by anyone's account.
    Last edit by VivaLasViejas on Jun 22, '09 : Reason: quoting deleted part of post
  5. by   geekgolightly
    Quote from It'sMe, RN, BBA, MBA
    I was the President of an HMO.
    For your perusal.
  6. by   geekgolightly
    Quote from geekgolightly
    Requoted just for you, It's Me.

    Are you really saying that the Commonwealth Fund is a biased organization? Although, I find that laughable, and would be mighty interested in what you see as non-biased (much like how FOX news is always whining about bias, but is certainly the #1 perpetrator of bias in media.)

    How about the World Health Organization? Or is that biased as well?

    "The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th ."
  7. by   Heogog53
    A friend of mine is paying for private health insurance coverage from BC/BS pays roughly $18,000.00 PER YEAR for coverage. That covers 4 people, two who have some medical problems, but nothing like diabetes, CHF and the like. So, if you take those who make 50k a year and take off the 18k off the GROSS, you have a family of 4 going from 50k to 32k per year...... just consider that they also have co-pays for visits and medications, on top of all that.....suddenly the 50k is even further reduced---and that's before rent/mortgage, food, clothing, and car payments.
  8. by   Fiona59
    I just finished my shift in your dreaded Canadian system. Nobody died (on my unit), nobody had their meds, stay or wound vac rationed.

    Everybody that presented in the ER with chest pain was monitored and seen by the appropriate specialists (including cardiologists). Babies were delivered by the Obstetric Team, the Ortho guys dealt with the broken bones and the OR staff kept themselves occupied. Number of bills issued--NONE (OK, those that came in by ambulance will get a bill for the ride in about two weeks).

    Number of people who complained about paying taxes to support their heathcare system NONE.
  9. by   geekgolightly
    More from the World Health Organization. As reported by Bloomberg

    May 21 (Bloomberg) -- The cost of health care in the U.S., the highest in the world, jumped 47 percent from 2000 to 2006, a study said. That didn’t buy Americans the longest lifespan.

    Americans paid $6,719 a person for doctors, medicines and hospital visits in 2006, up from $4,570 in 2000, according to a report released today by the World Health Organization in Geneva. The yearly spending is more than nine times the global average. With a life expectancy of 78 for a person born in 2007, the U.S. trails at least 27 other countries among 193 in the report.
    Last edit by Silverdragon102 on Jun 21, '09 : Reason: Edited down to conform with terms of service
  10. by   talaxandra
    Quote from it'sme, rn, bba, mba
    good information. and can you tell me what is the overall tax rate paid there? that includes federal, state, local and sales tax if any apply?
    thank you.

    in australia the taxation rate varies depending on your annual taxable income, from nothing (<$6,000) to "$58,000 plus 45c for each $1 over $180,000" (>$180,000). the average australian full time nurse's income falls in the third tax bracket, between $34,001 and $80,000, which is taxed at $4,200 plus 30c for every $1 over $34,000. more simply, if you earn $75,000 you pay $16,500, or 22%. added to income tax is a medicare levy of 1.5% of taxable income. high income earners who do not have provate health insurance are also liable for an additional 1% medicare surcharge.

    income tax accounts for about 60% of revenue; the rest is from excise and customs duty, gst and property taxes. the goods and services tax is capped at 10% and included in the posted prices of all goods (with some gst-exempt exceptions) and services. gst-exempt items consist primarily of fresh food and ingredients (flour, eggs, milk and butter are all gst-exempt, a cake attracts gst). council and state taxes apply to businesses and property owners; renters do not pay any local/council or state taxes.

    my gross income will spill over into a higher tax bracket this financial year, but i'll be paying tax at the third level rate because as a nurse in the public system i'm able to utilise salary packaging and i have ~ $18,000 of tax deductible items (work and education expenses and charitable contributions), which decrease my taxable income. i'll pay around 16% tax this year, including the medicare levy, on an income of around $90,000 gross.

    in 2006 the federal government commissioned a report comparing australia’s taxation rates with other oecs countries; the report breaks down comparisons with both oecd-10 and oecd-30 nations, covering “all forms of taxation collected in australia at national, state and local government levels.”

    the oecd sub-set (oecd-10) consists of australia, canada, ireland, japan, the netherlands, new zealand, spain, switzerland, the united kingdom and the united states.
    these nine members of the oecd-10 were chosen because they are broadly similar to australia in terms of their overall tax to gdp ratio and the role of the government sector in their economies (chapter 1 provides further details). the size of the subset needed to achieve a balance between the degree of similarity between the comparator countries and a sufficiently large sample of countries to provide meaningful comparisons without imposing excessive information collection demands.http://comparativetaxation.treasury....ve_summary.asp
    i haven't read all of it, but a few things caught my eye. first:
    the report shows that australia is a low-tax country. australia’s overall tax burden (31.6 per cent), measured as the tax to gdp ratio, is the eighth lowest of the 30‑member oecd. australia’s mix between direct and indirect taxation is in line with other oecd countries, although the composition differs. for example, australia’s indirect tax mix differs through a lower reliance on value-added and sales taxes, and a relatively higher reliance on property and transaction taxes, further, australia does not levy any wealth, estate, inheritance or gift taxes. [ibid]
    a statistical overview
    australia has a low overall tax burden compared with the oecd-30, both currently and historically. australia’s tax mix is in line with oecd-30 countries, although there are some distinguishing features.
    - australia is the eighth lowest taxing country of the oecd-30.
    - australia’s tax burden has typically ranked in the bottom third of countries since 1965.
    - australia’s tax to gdp ratio of 31.6 per cent is below the unweighted oecd-30 average of 36.3 per cent and above the gdp-weighted oecd-30 average of 30.9 per cent. [ibid]
    it is true that australia's overall tax rate is higher than that of the us. however, as the authors point out,
    one of the reasons the united states has a higher taxation revenue per capita than australia, but a lower taxation revenue as a proportion of gdp, is because it produces more gdp per person than does australia... the higher productivity and higher income of the united states give it greater capacity to raise more taxes than australia, while still potentially leaving its citizens with more disposable income than is the case for australia.[ibid]
    the full report, "international comparison of australia's taxes" by richard fe warburton and peter hendy, released in 2006, is available at: http://comparativetaxation.treasury.....asp?navid=011

    medicare has no lifetime cap. i never have to worry that i'll lose my home if i have a stroke, get cancer or am involved in a serious accident, even if i lose my job or am unemployable.
  11. by   talaxandra
    It'sMe, you asked Maisie about a few services that - I assume from your tone - you didn't included as part of universal health care access.

    In Australia some physical therapy is free and some isn't; hospital in the home programs are free but RDNS and allied programs attract a nominal fee. Dental care is not included here but is in many other countries; I'm not sure what the status of orthodontia is.

    Transportation to and from dialysis, and from home to or betweeen any health care service (eg outpatient's appointments) is covered by an annual (optional) subscription to the State's ambulance service. In addition to emergency ambulances we have transport ambulances - a five year membership to Victoria's Metropolitan Ambulance Service costs $300 for an individual (with three free months included) or $60/year. Family membership is double that; most insurance funds fully refund the cost.

    Though psychologists are privately financed, psychiatric services are fully covered. All medications are heavily subsidised by the Pharmaceutical Benefits Scheme.

    Clothing etc fall outside the purview of Medicare, but there's a strong social service safety net that includes subsidised housing, disability pensions and access to welfare associations that help those who are unable to work due to illness or disability (physical or psychiatric).
  12. by   lamazeteacher
    "I sure wish my wait had been only four hours or even four weeks. As it happened it took NINE WEEKS FROM THE INJURY TO THE START OF PHYSICAL THERAPY." quote from redherring, regarding Pacificare's lack of care (last 3 words are mine)

    Let this post be a WARNING!!! That HMO is renowned among HH workers for those kind of shenanigans. Your PCP could have referred you to P.T. and diagnostic studies, in any other HMO...... it appears that they don't have enough docs who will take the pay for service your orthopedic surgeon wanted, or no orthopedic surgeons have joined them on their approved list of providers, for the same reason.

    I don't hold Canada out as the standard of UHC, as the character of this population's distrust in government won't abide even the role of cashier, not decision making. Yet most of us sign HIPPA, which witholds information that, if patients knew about how many government agencies (incluiding police and courts) and people it allows to see their records, they'd never sign it.

    France's system looks very good. I loved the last scene in the movie "Sicko", with Michael Moore struggling up to the White House with his dirty laundry, because in France their healthcare program allows people who are sick to get their laundry done for free!
  13. by   lamazeteacher
    "Though psychologists are privately financed, psychiatric services are fully covered. All medications are heavily subsidised by the Pharmaceutical Benefits Scheme." quote from talaxandra's post #88

    I'm happy about President Obama's statement that physical and psychological/psychiatric conditions will receive equal funding when his
    healthcare program is passed. That has been a failing for a long time that health insurance companies perpetuated, and the cost of those services initiated.