Socialized Medicine the myths and the facts

Having worked in a country which has socialized medicine I can certainly see the pit falls and the benefits. What I don't understand is the fear behind having socialized medicine In my opinion socialized medicine has more positive benefits than negative benefits. Nurses Announcements Archive Article

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??

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
Can I just say a huge Kudos for all who have contributed to my blog I feel we have all discussed this huge hot potato in a very professional manner and I am proud to be a part of it!

Madwife you speak my mind! :smokin:

I've also had non-elective surgery, for a broken, finger, in the hospital where I work. Two hours after presenting to ED I'd been: assessed by a triage and a fast-track nurse; x-rayed; seen by resident, registrar and surgeon; fitted for a splint by hand therapy; and booked in for surgery. I had a k-wire inserted the following week, had outpatient plastics and hand therapy follow up for 3 months, and just had a two year check up. The whole thing cost me about $30, for a box each of Endone and paracetamol, and a course of antibiotics.

ETA: to convert currencies you can visit www.xe.com - it provides real time excahnge rates and converts any quantity, very valuable for those of us planning an overseas trip :)

With all due respect, this is a biased recounting. I work in the ER and patients with non-urgent complaints can sometimes wait for several hours just to be seen. However, when any employee presents to the ER with even a minor complaint, he or she will be seen almost immediately. I would be suspicious if you told me that employees at your hospital don't get that same preferential treatment.

The long wait times you hear about is propaganda put out here by the AMA, unless it happens in far off rural communities, where there are few doctors and less hospitals.

I live in the US. My son briefly dated a girl who lives in Canada. She had gotten a liver transplant in Canada and was in need of a second liver transplant shortly before they split up. I have no idea how long she waited for the first transplant, but she was fearful of dying for having to wait too long for the second one. She has family living in the US, so she went to visit them and pretended that her most recent illness started while in the states so she could get her transplant here. If the above is true about wait times being propaganda, how do you account for this? While I agree that many people procrastinate about making doctor appointments, I don't believe that she would put off making her appointments with her life at stake.

It is a common misconception that EDs are "required" to treat anyone that comes in. They are required, legally, to triage everyone who comes in and stabilize emergency situations -- they are not required to take care of any complaint that anyone has. More and more hospitals are starting to balk at treating everyone for everything, and there was a recent thread here about a hospital in SC that has started turning people away who don't have emergency problems. EDs are also lousy places for management of chronic illness.

I wasn't aware of the difference between triaging and treating as described here, but I can confirm that this is happening at my hospital. Our ER docs do not treat multiple complaints, but instead tell patients that they will treat their primary complaint and they will have to see their primary doc for everything else. They also will send away patients on some occasions when they come in for ridiculous things, like pregnancy tests, etc.

It looks like the Health Care Reform is dead.

In the USA, one thing that I have learned by this process doing a health reform by congress leads to political deals and the citizens are the losers.

I would like to see a National Vote on the issues of health care. Let the citizens decide not politicians.

In England the health care system was changed in one process not in bits and pieces like the US.

I attend a lecture this week and I learned the following:

In this presentation of a respected nation wide health care expert,it is belief that these factors driving the cost of medical care are the following:

Surprisingly small contributions from:

Profits of drug/device companies

Administrative costs

Malpractice

Aging of the population

Life-style choices

Personnel

The dominant factor - progress (60-70%) is main driver of rising costs

Safety and reliability issues are attributable to turbulence in the wake of progress as well.

So, it makes me think that due to success of medical advances and more safe and reliable systems are the drivers of increasing health care, we need to stop making demons of insurance companies and pharms and look at the processes we use to deliver patient care.

Specializes in Advanced Practice, surgery.
I live in the US. My son briefly dated a girl who lives in Canada. She had gotten a liver transplant in Canada and was in need of a second liver transplant shortly before they split up. I have no idea how long she waited for the first transplant, but she was fearful of dying for having to wait too long for the second one. She has family living in the US, so she went to visit them and pretended that her most recent illness started while in the states so she could get her transplant here. If the above is true about wait times being propaganda, how do you account for this? While I agree that many people procrastinate about making doctor appointments, I don't believe that she would put off making her appointments with her life at stake.

Although I am in the UK I doubt the wait in Canada was as a result of any waiting list, organ transplants are an emergency and therefore as soon as an organ becomes available and is matched with a suitable donor the teams involved move heaven and earth to get the recipient and the donor organ together. I doubt Canada is any different, therefore I would suspect strongly her wait for a liver would be as a result of a lack of appropriate donors and I am not entirely sure you can blame socialised medicine for that,

.......... although it's a nice try :yeah:.

I live in the US. My son briefly dated a girl who lives in Canada. She had gotten a liver transplant in Canada and was in need of a second liver transplant shortly before they split up. I have no idea how long she waited for the first transplant, but she was fearful of dying for having to wait too long for the second one. She has family living in the US, so she went to visit them and pretended that her most recent illness started while in the states so she could get her transplant here. If the above is true about wait times being propaganda, how do you account for this? While I agree that many people procrastinate about making doctor appointments, I don't believe that she would put off making her appointments with her life at stake.

Oh, come on -- that's hardly a typical example of anything. Plenty of people in the US die waiting for organ transplants -- there aren't enough organs to go around (in any country). There was no guarantee she would get a liver in time in the US, either. It all depends on where you are on "the list" and when organs become available. (In fact, in the US, she runs the risk of being next on the list when a liver does become available, but getting bumped by a Japanese mobster or some Richie Rich who has plenty of money to buy an organ -- I don't know if that would be the case in Canada ...)

Specializes in OB, HH, ADMIN, IC, ED, QI.
it looks like the health care reform is dead.

in the usa, one thing that i have learned by this process doing a health reform by congress leads to political deals and the citizens are the losers. you're right, and if the supreme court decision this week, to allow industrial monetary support decide elections, we will all be losers and return to serfdom.

i would like to see a national vote on the issues of health care. let the informed citizens decide and politicians reflect their wishes in government.

in england the health care system was changed in one process not in bits and pieces like the us. the change in the us, is that money dictates government, by providers of health care charging far too much for their services, medical equipment profiteering, inflated hospital bills paid by insurance companies' need to keep their allegiance. no fragmentation of health care has occurred, which gave rise to public protest against how many carefully prepared pages are in the health care bills. hardly anyone reads them, as it's a known fact that changes in it will occur before they can digest the current published version.

i attend a lecture this week and i learned the following:

in this presentation of a respected nation wide health care expert, it is a belief that these factors driving the cost of medical care are the following:

surprisingly small contributions from:

profits of drug/device companies

administrative costs along with the expectation that physicians' pffices, radiation and lab facilities and hospitals need decorative touches that are no longer affordable.

malpractice/fraud

aging of the population who resist change and have greater numbers of voters, not to mention accumulated dxs

life-style choices and inability to make consciencious decisions for health

personnel who want a percentage of wages obtained by other categories of health care workers

the dominant factor - progress (60-70%) is main driver of rising costs and downright greed (? %)

safety and reliability issues are attributable to turbulence in the wake of progress as well and stress due to insufficient funds for lifestyles.

so, it makes me think that due to success of medical advances and more safe and reliable systems are the drivers of increasing health care, we need to stop making demons of insurance companies and pharms and look at the processes we use to have healthy, less stressed providers deliver patient care.

i hope you are ok with my embelishments that i made to your thoughtful post. however you lost me when you asked for less focus on those who have brought medical care to its knees. before insurance company executives got carried away on their own ambitious agenda, we had reasonable coverage. employees were paid well, when "benefits" such as all their insurance coverage for medical, dental and vision needs were covered by employers.

that scenario was reduced to pilaging, by eliminating those with histories of prior illness(es), whose age portends more medical costs, and use of extremely overpriced medications to treat illness so older people and others can work. with medical practitioners, insurance companies, hospital administrators, and medical equipment producers walking (??running) in lockstep, supporting politicians who see that their interests are protected by government, no average individual will survive to "old" (55 years) of age. :bow:

To Lamaze Teacher:

I live in a state where insurance companies are highly regulated, I don't believe in policies with existing conditions, bloated paychecks for execs. In this lecture I was told the days of Pharms making 20% profit margins are over.

In fact the point was made if all health care agencies were regulated like electricity or gas the expenses would still be rising way above the cost of inflation. Also the current situation is a breakdown in Nash's theory of equilibrium.

The point being, health care is delivered in a fragmented unstructured way. That good healthcare is structure to serve the patient not to make profits. May I add the point of this lecture is health care is becoming unaffordable to middle class people now, and soon no one will be able to afford it.

Specializes in RN, BSN, CHDN.
To Lamaze Teacher:

I live in a state where insurance companies are highly regulated, I don't believe in policies with existing conditions, bloated paychecks for execs. In this lecture I was told the days of Pharms making 20% profit margins are over.

In fact the point was made if all health care agencies were regulated like electricity or gas the expenses would still be rising way above the cost of inflation. Also the current situation is a breakdown in Nash's theory of equilibrium.

The point being, health care is delivered in a fragmented unstructured way. That good healthcare is structure to serve the patient not to make profits. May I add the point of this lecture is health care is becoming unaffordable to middle class people now, and soon no one will be able to afford it.

I couldnt agree more with your last paragraph it worries me that health care is now not only unoffordable to the working class, it is now becoming unaffordable to the middle classes.

If it was made more affordable then more people would buy it and less people would present to the ER without insurance and no chance of ever paying the bill.

I think that maybe it suits the insurance companies to have the premiums so high because then they have less bills to pay because the ones who actually have insurance 'tend' to be the more healthy, younger clients.they happily sit back and let the hospitals pick up the 'bills' for the unemployed, poor, uninsured patient.

I couldnt agree more with your last paragraph it worries me that health care is now not only unoffordable to the working class, it is now becoming unaffordable to the middle classes.

If it was made more affordable then more people would buy it and less people would present to the ER without insurance and no chance of ever paying the bill.

I think that maybe it suits the insurance companies to have the premiums so high because then they have less bills to pay because the ones who actually have insurance 'tend' to be the more healthy, younger clients.they happily sit back and let the hospitals pick up the 'bills' for the unemployed, poor, uninsured patient.

Actually, in my home state - which has mandated healthcare, the insurance policies are not that expensive. My daughter is going off our health plan due to her age, her options are from $98 month to $600 a month for a Cadillac plan. This maybe the reason I don't feel the need to make a switch to socialized medicine. The only issue is that the state is two billion in the red.

Last stat I saw 98% of people in my state have insurance, I don't know if the state can continue this program though.

And perhaps the reason socialize medicine is successful is that they don't fragment care like the US does.

Actually, in my home state - which has mandated healthcare, the insurance policies are not that expensive. My daughter is going off our health plan due to her age, her options are from $98 month to $600 a month for a Cadillac plan. This maybe the reason I don't feel the need to make a switch to socialized medicine. The only issue is that the state is two billion in the red.

Last stat I saw 98% of people in my state have insurance, I don't know if the state can continue this program though.

And perhaps the reason socialize medicine is successful is that they don't fragment care like the US does.

What state do you live in? Just curious? We just had to get our own and it was $300+ a month for a family with a $10,000 deductible per person. Which is kind of crappy IMO though I am grateful we can afford it.

I agree about the fragmented care though, I read an article (I think in healthcare traveler) that said one of the huge wastes in our healthcare system is massive over ordering of tests which in part is because people see too many people without any continuity of care.