How Will Universal Health Care Change Nursing?

buransic · Jun 24, 2009

Single payer is not going to happen anytime soon. Looking at UHC from a mandated coverage standpoint, it'll put more money into the system. The folks that can afford insurance, but won't buy it, will put in some money. Of course, the bulk of the money will be the federal gov't, er, taxpayer dollars for the public fund option. This won't hurt the insurance companies one darn bit. In fact, it'll work like the Florida's Citizen's Property Insurance system where private insurers cherry-pick the low risk properties (in our case patients) and dump the high-cost/high-risk patients into the public pool. So, this is actually a good thing for insurers, they're just horse trading right now. The public plan will wind up paying for a lot of services, but, there will ultimately be some rationing in the form of approved vs. unapproved procedures, tests, and a so on. So, if you want to be on the public plan, but want premium care, you'll probably have to get supplemental insurance or pay out of pocket. The result will be lower demand for services. Oh, and the medicare covered patients that everyone thinks are uninsured, it'll be business as usual.

The overall result for nurses and doctors will look a lot like the current situation where a lot of elective stuff is postponed or cancelled because of the higher financial commitment that will fall to the patient. Thus, a shrinkage of demand might ease the staffing crisis, but it will also drive down salaries. Lastly, the Mass. example shows us that when uninsured people get insurance, that demand for routine services goes up. Perhaps a time will come where some of the work expended on acute care goes toward prevention. That would be a sea change.

MaritesaRN · Jun 24, 2009

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 same? How would a "single-payer" system be structured? Would this be the end of the insurance industry as we know it? I would like to hear from everyone who has an opinion about any of these questions.

:nurse: At this point , there are details that we can not see yet...but the point is to get the unviversal started, since our current insurance is profit motivated and leaving a lot of people w/o one ,since it is so darn expensive. And yes, the private insurance is for profit. I know I worked in several of them. Funny thing is I can not understand though---every time a CEO steps down or "retire", they go put w/ millions of money??? This must be part of the contract with this insurance CEO's. This happened with Blue Cross when they merged w/ Anthem insurance , and right after the merge , the pensions for the regular employees stopped, while the CEO bailed out w/ millions !!!!! Go figure that out!!!!

So bottom line is the private insurance needs competetion w/ another entity, separate from the private. To have a public insurance competetion will bring the insurance premiums down ( you need competetion in the market to get fair price, otherwise there is monopoly, like now w/ the inursnce companies. Waht happens in the nursing profession due to this changes? Well, let us be a part of a good change, and be pro active and watch and participate a change that could only be positive in results. No system is perfect, but our current health system is not working and is bankrupting the people, and the government as well ,since they are the ones paying for those uninsured patients that goes to the emergency room! So, yes , the government have a right to be in the picture of our health system. This should also help in the ratio, overtime, and benefits for nurses eventually....but nurses have to get on the band wagon and get your voices heard! :wink2:

MAISY, RN-ER, BSN, RN · Jun 24, 2009

First, congratulations on the birth of your baby.

As an educated woman who planned to have children you understood the costs involved. When we evaluate those having children planned or unplanned the one point that must be acknowledged is that no educated person would have a baby for the miniscule amount of money provided by the goverment. That being said, most plans only cover the mother during her pregnancy and six weeks afterwards. If you are worried about taxes, the truth is prenatal care and counseling to the underprivilaged and underserved saves millions in post labor complications and life long deficits experienced by the uncovered child.

President Clinton placed a cap on Welfare during his administration, the man you met may not realize that. The culture of generational welfare has not only improved, but changed dramatically. Catastrophe can happen at any turn for any American.

Lets just imagine a young woman has a baby who is employed and carries the primary insurance for the family. As middle classed Americans they have average bills and make changes to their lives to afford this child. Unfortunately during delivery the young woman who is a nurse experiences a stroke and becomes disabled( real story), now as the primary healthcare provider and the shared income provider for her family she can no longer work. If the family can afford Cobra, they don't get what they did as part of the employer sponsored plan, if healthcare lapses and a time period exists between coverage REGARDLESS OF ABILITY TO PAY, SHE NOW HAS A PRE-EXISTING CONDITION NOT TREATABLE FOR UPWARDS OF ONE YEAR AND SOMETIMES NEVER! So the American family who did all the right things, planned the right way, and expected a beautiful life is like the rest of the uninsured/underinsured of this country. Desperate for even basic care, and probably denied.

That's why we need a safety net for all Americans. It can and does happen to even those who work hard and seemingly have it all.

M

leshi · Jun 24, 2009

I've wondered how universal healthcare will affect nursing, but in Norway my friend there said that after their 40% tax rate (partially due to universal healthcare), RNs make 30k a year which is in the neighborhood of half what they make already. What worries me most is the queue - people are seen based on the order the government puts them in based on their illness. The UK has problems with this - people sometimes waiting and waiting to be seen - and the US has 3 times the population of the UK.

The healthcare system is bad as it is, but the advantage the US has over other countries is that we have states that are more self-regulatory than the provinces of other countries. If we use any sort of socialist healthcare, it would be more efficient at the state level. Some states already have it and we forget about the self-regulation that they have. With individual state-run socialist healthcare, there is less of a queue. "Crowd control" is easier the less people you have to manage - 12m (population of PA for example) is easier to manage than 300m (pop. of the entire US). With the higher population, the statistical occurance of people with the same ailment increases; also theoretically, within the state that decreases, possibly eliminating the bottleneck that may occur with nationwide socialist healthcare.

Point: ask your STATE REPRESENTATIVES for socialist healthcare, not the president.

MAISY, RN-ER, BSN, RN · Jun 24, 2009

Well what is truly interesting about our elected officials is that as part of their "serving" their country, healthcare is given for their lives. So at any level, state or federal do you honestly think they have any personal incentive to change to UHC? If anything, those big $ donors are probably the factors for which they'd vote down any aggressive plans to save Americans.

M

gusblom · Jun 24, 2009

Think about all the 44+ million people without coverage. Single payer is DOA now. That would be much more gradual. What if everybody had insurance? Wouldn't that be good. What if insurance was simplified and more standardized? What if all the adminstrative costs dropped like a rock? What if all the information in the world was at your finger tips? What if Doctors and Nurses got control of the system instead of the insurance companies trying to ram people through the production line? What if drug companies had fair prices and fewer side effects? It is going to get better for patients and therefore nurses! But, I wouldn't count on 1000 bed hospitals being there forever.

you're dead on 1RRRN. A few years ago a doctor from New Hampshire was jailed because he called an insurance company and left threatening messages on their voice mail because he was so frustrated that the insurance company was dictating to the doctor how to treat a patient. The insurance company has become a monster and we the populace are held hostage. With the government health insurance health care institutions will be better off because they will actually get compensated every time and will not have to write off billions of dollars every year plus the savings from efficiency which a modernized electronic system will create will increase profitability. Maybe there will be more money in it for us nurses as well. And who knows, since the government will have a say then we may get better nurse to patient ratios and better working conditions.

love ya.

MaritesaRN · Jun 24, 2009

I've wondered how universal healthcare will affect nursing, but in Norway my friend there said that after their 40% tax rate (partially due to universal healthcare), RNs make 30k a year which is in the neighborhood of half what they make already. What worries me most is the queue - people are seen based on the order the government puts them in based on their illness. The UK has problems with this - people sometimes waiting and waiting to be seen - and the US has 3 times the population of the UK.
The healthcare system is bad as it is, but the advantage the US has over other countries is that we have states that are more self-regulatory than the provinces of other countries. If we use any sort of socialist healthcare, it would be more efficient at the state level. Some states already have it and we forget about the self-regulation that they have. With individual state-run socialist healthcare, there is less of a queue. "Crowd control" is easier the less people you have to manage - 12m (population of PA for example) is easier to manage than 300m (pop. of the entire US). With the higher population, the statistical occurance of people with the same ailment increases; also theoretically, within the state that decreases, possibly eliminating the bottleneck that may occur with nationwide socialist healthcare.
Point: ask your STATE REPRESENTATIVES for socialist healthcare, not the president.

:nono: this might work in other states ( but you are talking about specifics of a system -universal or socialized,) that is not in place yet, but will be because our current health system is not working....a change is a must !! These are things to hurdle as we go thru the new health changes, and just like everything else , it is not going to be perfect , but definitely not disabled as the current health system. As for the State being in charge----this is not going to work for California! We are so broke (God knows where that money went? ) , and the governor is trying to get some money from the bottom of the pot , such as the family and childrens health insurance. Don't you think this is worth trying something new from the current system? With the way the rate is going now, everybody will be broke !!!! Please let us try to look at the bigger picture ...do not be afraid to try something different, specially when the current health system is so cancerous !!!! Let us change the system now , and a lot of other changes will follow as we go through the process. Unless you are one of those rich ones who have a lot of money to spend for your health care. :rolleyes:

nickyp077 · Jun 24, 2009

That was a great article about Canadian healthcare Commuter...

I also have the experience of dealing with both systems... I've lived in Canada now for 6 years. I personally don't understand why people would rather have no insurance than government provided insurance. When I lived in the US I was in a car accident, luckily, I was fine but, the paramedics insisted on me going to the hospital anyways just to make sure. I was fine but, they put me in a neck brace anyways and carted me off. I was just given a basic check at the hospital and they told me I could go home. The bill was over $600 for that ambulence ride. When I recently had to take the ambulence to the hospital in Canada, I paid $45 for the ambulence and of corse, nothing for the hospital stay (which was about 4 days). The food was fine, not great but, fine...

Most importantly, in Canada you don't hear about horror stories of families becoming COMPLETELY bankrupt because their little baby has some serious issues which have cost millions within a year or two. As far as I remember, I didn't have a choice in the US for insurance. It was only the insurance that my employer offered that I could use. I didn't get a choice of which company to go with... only a choice between a few different policies. There are private insurace companies up here... it just offers you above and beyond what your basic coverage as a Canadian Resident/Citizen. Instead of a public room, you get private (you can have private even if you don't have extra coverage, it's about $200 extra per day)... you get dental and eye which isn't covered by the basic coverage.

Personally in my experience, I don't see the "boogie man" behind government provided healthcare when we are talking about the health and wellfare of our citizens.

MamaKitty13214 · Jun 24, 2009

I would LOVE to hear Canadian's perspectives about their plans, as it is true that I hear a lot of nightmarish stories. It would be nice to hear the GOOD things about it. Anyhow, back to the OP's question...how will it affect nursing??

I went to a Single Payer event in Rochester, NY, last month where Rep. John Conyers (he & Dennis Kucinich co-wrote HR676, which I would advise everyone on this forum to READ before spouting off about "government-run" health care) was a guest along with Rep. Eric Massa, newly representing Rochester and a very vocal advocate of Single Payer. I was asked to speak about my experience as a case manager/discharge planner at a public hospital where all the uninsured patients are dumped by private hospitals. To be fair, the public hospital where I work is also a Level I trauma center, so the "higher level of care" transfers are often appropriate. Before I got to speak, Rep Conyers was asked about reimbursement by a physician in the audience and Conyers said that Medicare rates would be increased and that he believed all nurses should also get a raise!!

Health Care will NOT be "government run" under HR676. There is a lot of confusion in the debate because of many of the terms which are used. "Universal health care" really is universal coverage for a privately delivered, publicly financed system. "The Government" won't tell you what doctors you can see & what you can & cannot have the way FOR PROFIT insurance companies currently do if they still decide to cover you after you've gotten sick. And the FOR PROFIT insurance companies have worked their way into the Medicaid & Medicare programs by offering "managed care" options which are supposed to be less costly, but are actually devised to allow the FOR PROFIT insurance companies to exploit these publicly financed programs by deciding what to ration.

So a lot of this anti "universal" health care and anti Single Payer propaganda is coming from the Insurance Industry. They don't want to lose the cash cow of the health care industry -- those poor CEOs can't live without their multimillion dollar salaries and corporate jets.

As for the first post on this thread, please don't be so naive as to believe that there isn't an agenda behind what all these economist authorities are spouting -- look deeper into the backgrounds of these people and follow the money. Betcha none of them has ever had to decide whether to buy food or medicine or pay the rent or get your pills. Not a single one. They are telling you not to look behind the curtain and are distracting you with lots of shiny baubles.

Statistics can be manipulated to prove any point desired and the LAST study on anything health related I would ever trust would be anything by Blue Cross/Blue Shield or any drug company. As far as I am concerned those statistic manipulating reptiles have their heads up their anal sphincters and have absolutely NO connection with what working and poor people have to deal with in every day life. And I'll betcha there's some connection somewhere to either Insurance industry or Big Pharma.

And lastly, "The Government" is "We the people". Unfortunately, "we the people" have been dumbed down and lied to for a generation or more and we don't hold our elected representatives to task. Too many of them are bought & sold by insurance industry & Big Pharma and the decimation of Medicare/Medicaid and favorable legislation for these huge corporations is proof of it. So "the government" has become separate from "we the people" and corruption runs deep and wide.

We as nurses really need to become more politically active in changing our crumbling system and follow the lead of the California Nurses Association in advocating for a Single Payer system. Profit does not belong in health care -- there is NO ethical justification in what the for-profit insurance industry has done to the people of this country. PERIOD. Single Payer is the ONLY solution and I will fight for it until the day I die.

Shaka · Jun 24, 2009

If the truth be known, what are we going to do now.

I have a Hopi friend who says the answer to all of the chaos that is reigning down upon us, due to our passivity and lack of integrity in the past........is to Pray.

I am praying for all of us....I suggest we all do this.

mianders, RN · Jun 24, 2009

It has been a long time since I was able to log on to allnurses and this is the first thread I came to. I have read most of the post and there are some very strong opinions from each side of the issue. Each one can make strong arguments for their side and provide convincing data to support their opinions. I in no way have the answers to the problems in healthcare. As nurses we see so many problems in our healthcare systems whether it is here in the US or in countries with UHC. I have a nephew right now who was injured in a motorcycle accident and broke his arm. He was treated in the ER and his arm was splinted. He was told to follow up with an Orthopedic surgeon to determine if he needed a pin. Every surgeon he called wanted at least $500 for the FIRST visit. He has no insurance and no job. His only option is to leave the splint on for 4-6 weeks and hope it heals right. This is just one story. I am sure each of us can come up with more than one whether it is from personal experience or as a nurse. This is an issue that can not be rammed through just to say we did something though. It needs people from all interested areas to sit down and formulate a WELL THOUGHT OUT PLAN that would be best for our system here in the US. There will be disagreements and not everyone will be happy but it is time for a change.

Saúde · Jun 24, 2009

What do folks mean when they refer to a "moral obligation" in terms of our federal government providing universal health care coverage?

I must be missing something here because I've never read in our Constitution where it gives our federal government authority over the states on this subject.

IMO - The basis of this argument is equivalent to a person saying that I have a moral right to walk over to my neighbor and hold a gun to their heads and unlawfully demand that they give me their money to help me pay for my family's medical expenses? That doesn't sound too high-minded or virtuous to me.

I'd encourage more of the individuals within the so called "majorities" on this website who favor government funded universal health care to practice what you preach and start helping folks out at a community level with your own money. If the so called "majorities" within our communities truly lived up to the moral obligations they try to impose illegitimately onto their neighbors through our federal government, then many if not all of the disparities we see in our health care system would cease to exist. Until then save your breath on the "moral obligation" philosophies. Take care.