Socialized Medicine the myths and the facts

[madwife2002]

The first and the most obvious concern is the cost to the patient and their family, we all know how devastating an illness can be for patients and their family many times I have witnessed the despair when a diagnoses meant further treatment which insurances question and in some cases wont cover. I have seen patients needing costly drugs to keep them alive and being unable to afford them, causing repeated admissions to repair the damage so called none compliance has caused. The first question in none compliance is were the pts actually refusing to take their medication or was it simply they could not afford to buy their medication because they don't have enough money and other bills need to be paid first? If the real reason is the cost then surely it would be more simple of we provided these medications at a more effective price or that all medications cost $5 no matter what they had? Outrageous I hear you shout but the cost of the repeated admission is far more costly than by helping prevent a repeat admission, by providing medicine they can afford.

How about blood tests could these not be done in the doctors office before the pt leaves for home and forgets to go and have a blood draw, or simply cannot get to the lab to have them drawn. I have personally waited in doctors office hours (and paid for the privilege) then been sent to the lab, miles away to sit and wait for blood work to be done. Why could the doctors not employ somebody to be at the office to draw blood on patients?

We should be looking at improving preventative medicine rather than patch it up and see.

Many times I have seen patients discharged with a new diagnoses of diabetes, no follow up at home can be organised because in my city nothing exists to assist these people. There should be a diabetic home nurse who monitors these patients in their own home-rationale, this would again help prevent admissions for diabetic complications, and none compliance.

So you wonder what has this got to do with socialized medicine. Well, in the UK if you have...

• Children
• Over 60 for women and over 65 for men
• Diabetes
• Asthma
• Thyroid problems, etc...

...then you get all your medicines for free.

There are in place specialized RN's who focus is on preventative care in the community. There are telephone help lines which anybody can utilize for free.

Maternity care is free a midwife will be assigned to you for the duration of your pregnancy and up to 6 weeks later. The cost of the birth-nothing no matter how you deliver.

I have been asked what kind of care do you receive in a socialized medicine country and I ask them, I am a product of socialized medicine you tell me how my care differs from nurses who have paid outrageous amounts of money to train as a nurse?

Of course even in the UK you can have private care if you chose to pay, this is an advantage if you need hip replacements, knee replacements, eye surgeries-other wise you may have to wait. There are initiatives in place to reduce waiting times for surgeries in the NHS and I hear that dr's can now book surgeries from their office at hospitals all over the UK which helps reduce waiting times, plus hospitals get fined if they don't meet their quota.

I agree MRI's and CT's are not as freely available, but again initiatives are in place to improve the waiting times. Emergency care no different all patients will receive emergency care.

Poor conditions yes there are poor hospitals and there are excellent hospitals, no different to Phoenix AZ.

Questions??

[elkpark]

Blue Cross Blue Shield is number one Insurance company in the USA- NON Profit, in my State Tufts Health Plan - Non Profit, Harvard Pilgrim Non Profit, http://en.wikipedia.org/wiki/Blue_Cross_and_Blue_Shield_Association

They cover 1/3 of Americans, another group Medicare and Mecaid

United Health and Aetna are for profit and check Yahoo finance ----- they are there .

Majority of Americans are covered by non profit.

What ever raise you enjoy working as nurse is caused by the For Profits paying high rates. They are the one you can thank for you raises.

I'm delighted that you have so many non-profit options for health insurance from which to choose (an option you don't want the rest of us to have, I notice.) You happen to live in an unusually progressive, civilized, and enlightened state, which is certainly not representative of the rest of the country.

It may well be the case that 1/3 of Americans have BCBS coverage, but BCBS is not "an insurance company" (singular). There are many separate, independent BCBS organizations (originally, there was one in every state, although there has been quite a bit of consolidation since then), and it is certainly not the case that all state BCBS groups are non-profit. The wikipedia article you cited explains this (wikipedia as a reference? really??), if one actually reads the article. Over the last couple decades or so, BCBSs have been converting to private-for-profit companies, slowly but surely. As time goes by, more and more of them are private-for-profit insurance companies indistinguishable from all the others.

"On August 15, 2008, Horizon Blue Cross Blue Shield of New Jersey, the State's largest, and only non-profit health insurer, filed an application with the NJ Department of Banking and Insurance (DOBI) and the Office of the Attorney General (OAG) to convert to become a for-profit insurance company. Horizon's latest bid to convert raises numerous concerns relative to the health of NJ consumers and taxpayers."

http://www.njcitizenaction.org/horizon.html

"A national trend the last decade involves not-for-profit organizations - especially health care service providers and insurers - converting to for-profit status. From Oregon to Maine to New Mexico to Georgia - and dozens of states in between - not-for-profit health care providers have been merging and seeking a change in status to become forprofit entities. Officials of Blue Cross Blue Shield of Delaware have said the company may seek to make a similar transition in the future."

http://www.allbusiness.com/specialty-businesses/non-profit-businesses/967901-1.html

"If you know the history of the Blue Cross Blue Shield Association and the way the public has been screwed in a number of non-profit conversions to for-profit companies, then you can clearly see what is happening. Establishing a non-profit co-op leaves the door open for corporate takeovers by private insurers. Consumers Union has a whole section of its website dedicated to the conversion of non-profit entities to for-profit status. One area of primary concern is the non-profit health sector. Among its many documents (PDF link) is a paper detailing the extant pressures pushing non-profit insurers (like most Blue Cross Blue Shield plans) into for-profit status. The drive toward for-profit status and abandoning its charter for the public benefit was a Reagan era change in tax status for Blue Cross Blue Shield plans." (emphasis mine)

http://www.boomantribune.com/?op=displaystory;sid=2009/7/10/19102/0938

Here is the link to the Consumers Union paper, since the PDF link in the original quote quit working when I cut and pasted it: http://www.consumersunion.org/conv/

[C-DIFF PHIL RN]

you know that case manager that you see walking around placing those sticky notes on the charts for doc's to look at reminding them to transfer patients to lower levels of care, before the doc tears it off the chart and tosses it in the trash. Well with Govt Care, she will be replaced by a G-Man...and he'll just write the order himself with the head govt bean counter co-signing it. Dont fool yourself..with govt care the govt will take over and there will be bean coun ting on steroids.

[Ginger's Mom, MSN, RN]

I never said that I don't want non profit insurance companies to go away if anything they should expand. I was aware BCBS has some profit making arms, but according to your posts most have had opposition. It would a great opportunity for non profits to open up. To me that is what health care reform should be about choices and plan that are written nation wide.

[GiGiOm]

Elkpark, very sorry I came off cranky. My bad. I was having an off day and my post was much more abrasive than I intended. However, it doesn't excuse my tone and I apologize. I am frustrated these days with the scare tactics that seem to be working. They are definitely working in my state as most every nurse I work with is afraid of reform, even though they agree it's needed. HR 3200 is actually online now. It is a very long bill. Doesn't look that much different from what we already have now, except for paying for end of life counseling and eliminating pre-existing conditions clauses as grounds for denying insurance. Also eliminates insurance companies' abilities to rescind insurance except for nonpayment. It is full of legalese and will take awhile to read. :)

[elkpark]

To me that is what health care reform should be about choices and plan that are written nation wide.

That is what the "public option" proposal is all about -- more choices for all Americans.

[MaritesaRN]

That is what the "public option" proposal is all about -- more choices for all Americans.

:typing

Nurses should not be afraid of the health reform------in the contrary ! More people will be covered and treated , and very little , if not, none should fall through the cracks ! Nurses are patients advocates and must push this reform for it is the good of all patients and all people that needs healthcare! Let me share some thoughts from one of our senators in response to my on line plea to help push the health reform with the public option;

" The status quo is unsustainable- Americans will spend more than $2.5 trillion on health care this year, more than one in every six dollars in the U.S. economy. In all, we spend twice as much per person on health care than other advanced nations, yet the United States ranks near the bottom of the 30 leading industrialized nations in basic measures of health such as infant mortality and life expectancy.

The situation is even worse for individual families, who are struggling to afford skyrocketing premiums and increased co-pays and deductibles. Health care premiums have more than doubled in the last nine years, and one respected study shows that, if we fail to act, the average California family will have to spend 41 percent of its income for health insurance premiums by 2016.

The growing number of uninsured is also contributing to higher costs- 46 million Americans do not have health insurance, and every day, another 14,000 Americans lose their coverage when they become seriously ill or lose or change their jobs. To make up for the coverage gap, families pay on average an extra $1,100 a year in premium costs.

Moreover, poor regulation of insurance companies means that even those with health insurance coverage are not always guaranteed to get the benefits they are promised. Every day I hear from Californians who can't get health insurance because of a pre-existing condition, or who are denied the medical treatment prescribed by a doctor because of insurance company bureaucrats. This is wrong, and we have to do better for our families.

People who are fearful about the health reform , please get the facts straight from the white house.gov

[Ginger's Mom, MSN, RN]

:typing

Nurses should not be afraid of the health reform------in the contrary ! More people will be covered and treated , and very little , if not, none should fall through the cracks ! Nurses are patients advocates and must push this reform for it is the good of all patients and all people that needs healthcare! Let me share some thoughts from one of our senators in response to my on line plea to help push the health reform with the public option;

" The status quo is unsustainable- Americans will spend more than $2.5 trillion on health care this year, more than one in every six dollars in the U.S. economy. In all, we spend twice as much per person on health care than other advanced nations, yet the United States ranks near the bottom of the 30 leading industrialized nations in basic measures of health such as infant mortality and life expectancy.

The situation is even worse for individual families, who are struggling to afford skyrocketing premiums and increased co-pays and deductibles. Health care premiums have more than doubled in the last nine years, and one respected study shows that, if we fail to act, the average California family will have to spend 41 percent of its income for health insurance premiums by 2016.

The growing number of uninsured is also contributing to higher costs- 46 million Americans do not have health insurance, and every day, another 14,000 Americans lose their coverage when they become seriously ill or lose or change their jobs. To make up for the coverage gap, families pay on average an extra $1,100 a year in premium costs.

Moreover, poor regulation of insurance companies means that even those with health insurance coverage are not always guaranteed to get the benefits they are promised. Every day I hear from Californians who can't get health insurance because of a pre-existing condition, or who are denied the medical treatment prescribed by a doctor because of insurance company bureaucrats. This is wrong, and we have to do better for our families.

People who are fearful about the health reform , please get the facts straight from the white house.gov

When I have listened to the President he had made so many errors, one pediatricians do not take out tonsils.

Second, surgeons get paid a global fee and do not get paid three times if there is a complication.

Third, with DRGs if a patient is readmitted within thirty days you can't resubmit the bill.

In my opinion, torte reform is needed. Second there should be national standards for insurance companies to adhere to and if they deny a claim unjustly they s

Should pay a huge fine, that is unacceptable behavior. Pre exisiting conditions exclusions should be removed.

I would prefer to deal with insurance bureaucrats since you can talk to them unlike Medicare of Medicaid.

Yes, read whitehouse.gov and then read the opposition and usually the truth is somewhere in the middle.

[Ginger's Mom, MSN, RN]

That is what the "public option" proposal is all about -- more choices for all Americans.

My understanding or the public option is a government run plan that can under cut any private insurance company, to me this would mean less choices. And people would not have the option or the freedom not to elect an insurance plan.

[C-DIFF PHIL RN]

I going to take a stab in the dark here a say that many health insurance compainies will go broke and bankrupt after the majority of clients jump to the govt health plan. so i would think the idea of more choices will be decreased to only very elite high $ policies and the govt plan.

[MaritesaRN]

I going to take a stab in the dark here a say that many health insurance compainies will go broke and bankrupt after the majority of clients jump to the govt health plan. so i would think the idea of more choices will be decreased to only very elite high $ policies and the govt plan.

Well the point to have the government plan is to have an edge over the high priced private insurance, among the other "exclusions" that puts a person for minimal to 0 coverage, due to high premium dollars.

Ex. If a person have cancer, the private insurance will not allow (pre -existing) this person to have access to treatment....so guess what? the person will then have to go to either medicaid or medicare to get treatment .....and the government ( medicaid & Medicare) will end up footing the bill ALONE, while the private insurance simply enjoy collecting big premium money and exorbitant profits from the healthy people......watch it, if you get sick real bad, this private insurance will try to stick you w/ pre "existing" accusations.

Look man I have worked in private and public insurance and very aware of the pros and cons of both........ but the point is the private insurance will not go bankrupt.....they just simply learn to compete instead of monopoly, and they will be in contract mode w/ the government for varied services, just like what is going on now, such as the complimentary insurance these companies offer w/ medicare. Just a very small example !

The public plan serves as a "buffer" to high priced private insurance premiums------- this is called competition! Where there is competetion there are better and wider choices for the consumers , for people like us! Another thing ---the purpose of the health reform is for all citizens including the vulnerable children, to have access to an available health insurance when they need it . We need a big reform , and as nurses we need to be the strongest advocate for this , considering that health care will be available to everybody! I am an RN that is working and is insured , but I can hardly afford the deductibles or the 20% from a PPO plan ----and to think I have a health insurance from my company !!!!!!!!!

How about those without health insurance ? Yes, sure, they will get treated thru Medicaid or Medicare ----and you are wondering why these funds are dwindling away ? Let the private insurance companies share in the downside, and not just the government (medicaid & Medicare) ....why should the government take the people that the private insurance do not want to be responsible for ? Well , let us make it fair, so hence the public option ..............there is no real reform w/o this public plan ------sure if the government plan is cheaper for you and your family , wouldn't you want this? ( Unless you are one of those independently wealthy person ?)

I have read and listened to both arguments, by the way. Sure opposition parties can compromise ----just be sure that they do not compromised the health of the people vs. profits !!!!

I really can not understand why there is such an opposition to something that will offer health care to all ????

I have said my peace w/ this issue and I will not expel any energy on this anymore. I have faith that the majority of America are still the thinking people, and not a bunch of mindless sheeps.

My apology for not tiptoeing around and getting hot about it-------I just can not understand as to what is keeping some people to see the TOTAL picture?

[dlatimer]

I don't know that a government plan would be less costly - I would think so, but I don't know. Healthcare is so expensive in the US. How do the other countries pay less, live longer and have lower birth deaths?

"My concern is that non-profit does not necessarily mean low cost and efficient. Profit is what is left over after expenses are calculated, and those expenses include everything from CEO salaries to artwork in hospitals. Another bonus for non-profit health insurance plans - as with any non-profit - is that they can apply to the IRS for income tax exempt status, and many do."

Colorado Health Insurance Insider, January 2009.

http://www.healthinsurancecolorado.net/blog1/2009/01/14/non-profit-does-not-necessarily-mean-low-cost/

[C-DIFF PHIL RN]

mindless sheep huh?? so now if i dont agree with this govt plan i'm considered a mindless sheep...well thats rather arrogant. if half of the united states population has some speculations about this govt back plan its not because we are a bunch of damn mindless sheep. how insulting.