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??

[lamazeteacher]

Thanks for your input!! You couldn't have given a better example of my point. It's not sharing when it's forced!! Competition IS the answer to a better health care system. That is an unarguable fact! And by the way it's not our country's wealth. It's individual citizens who earned their wealth through initiative, {RESPONDER's ADDITION: CHEATING} and desire to better themselves. Being successful is very simple and the funny thing is that ANYONE can achieve it. GET OFF YOUR BUTT, GO TO COLLEGE, DON'T DO DRUGS AND ALCOHOL, DON'T HAVE SEX BEFORE YOU'RE MARRIED, DON'T HAVE CHILDREN BEFORE YOU CAN AFFORD THEM, GO TO WORK EVERYDAY AND WORK YOUR BUTT OFF, ENJOY THE FRUITS OF YOUR LABOR. No one is saying not do help the vulnerable and defenseless!! But if you want me to help you defend irresponsible behavior your just as insane as your comment!! My advice for you is to pick up a history book, think for yourself, and shut off that stupid boob tube!!!!

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YOU HAVE TWISTED MY WORDS TO ADAPT THEM TO YOUR VIEWPOINT!! I've taken the liberty of changing your misspelled words to their correct form..... they seem very angry. As I'm sure you're aware, if everyone could achieve financial success, and it really was simple, we'd all be wealthy. Who wants poverty, consciously? Things do get in most people's way (remember the story of Pinnocchio?) on the way to school or wealth. If it's not noses, it's donkeys (pun intended).

The dictionary doesn't agree with your viewpoint of "sharing", rather it says "sharing is: receiving or giving a portion; participating". That was the context I used in my comment.

When competition in health care reared its ugly head in the '70s, doctors who formerly cared more for good outcomes (not just saving their you-know-what) and the well being of their patients, they became moguls. The cost of a normal birth in hospital (I delivered my son in 1973, was $250., having already paid the physicians' group $400. up front). That was before insurance companies would cover that. My OB became my neighbor a few years later, and when they divorced, his wife told me he'd cleared $800,000 that year(after the $100,000. malpractise premium he'd moaned and groaned about during my prenatal office visits - never mind my worries)! When insurance covered normal deliveries, you can imagine what it became (certainly not less).....

I left the hospital the same day my son was born, had no anaesthesia or other medications (I was the most surprised person about that, as I went in saying, "just because I teach prepared childbirth doesn't mean I'm not having analgesia if I ask for it"), and we eschued the champagne dinner that was offered in those days (in an effort to get "milk to come down" - the first day!) My (ex-) husband was as proud of the money saved by the aforementioned as he was of his new son.....

The pediatrician warned me, a former neonatal nurse, that jaundice might occur, if we went home earlier than was usual, and I replied, "Do you think I wouldn't recognize that?" I did wonder what there was at home, that might cause that...... By the way, in the late '50s, when I worked OB during my hospital nursing education, women stayed in the hospital 7-10 days for an uncomplicated birth, and 2 weeks if they had a C/S. I recall no baby other than the Rh+ born to Rh- moms or ABO incompatibilities, who became jaundiced those days! Something causes that, that wasn't around then.

So you can see that my personality is not to take things "lying down". I know universal/single payer health care programs work!! (Despite those made-up Republican paid commercials on TV now.) The only difference between Canadian and American people, and I don't say this lightly, is that Canadians have more concern for others (possibly because many have come from Europe lately, where universal health care is seen as essential), and there is respect for their government, whichever of 4 parties wins their elections. I pessimistically suspect the latter is due in part to the "mothers' allowance" that is a small amount of money (like the stimulus $) that has been sent to families monthly for each child born to them, until that child reaches 16 or 18 years of age, since the '30s or earlier. That was an example of their government caring about them! Money buys support.

What competition has done to health care here, is to make each hospital (and this is true even when a community in a small geographical area has 5-6 competing hospitals, as there are in the South Bay of Los Angeles); and they buy identical (or better) pieces of equipment, so they remain in the race for healthcare dollars. That is waste! Their lobbies and accommodations resemble that of 5 star resorts, which only the visitors appreciate, since patients are acutely ill, then discharged and have little awareness of their surroundings.....

Totally unethical, and expensive gifts are given physicians and the prople who work for them (I refuse to call an MA a nurse, but that's another topic) by pharmaceutical and equipment companies. I ask you, why would a person who makes way over 1-2 million dollars yearly after expenses and taxes (the average net income of big city physicians these days) need a free pen (that has the names of drugs on it, so friends and patients know who bought it)? - even if he wouldn't treat himself to such an expensive one ordinarily, or sticky paper pads and clipboards with the names of drugs on them? We all love to get gifts. :thankya: That practise is duly and exaggeratedly done in China, a communist country. If you've been there, you know the trinkets I'm writing about, which tourists prize (for a few days after the trip).

Are drug companies forced to give gifts and treat physicians to expensive, wine laden dinners; and host lavish lunches for all hospital professionals there? According to you, they're forced to share their wealth (which is a partially tax deductable business expense). That drives drug costs up, while insurance companies have turned their heads until the last few decades, when it became apparent that it hasn't helped their profit to pay such high prices. (That proves your point that any idiot can make lots of money). Why, I ask you, should treatment cost so much? Wouldn't specific drugs be appropriate anyway, without that ballyhoo? There are many identical ones (but birth control, HTN, and anticholesterol, the most commonly used ones, so why is all that necessary? Well, Americans do love a party, just look at all the election foolishness/madness! That's another topic!

Generic (? less expensive) forms of patented medicines are mandated (forced sharing) to be available within 7 years of the original ones being on the market. Yet some I have taken for 20 years, aren't available in generic form, yet - and they work best for me. The funny thing is, the generic form of Effexor (in the same 225 mgm dose I need, is only available in 2 capsules of 150 mgm and 75 mgm each, both in the patented and a new so-called generic same colored capsules (twice as expensive, you'd think). The real generic of it, in 225 mgm dose only, which I suspect is the effective one, is in a white coated tablet and works better to ease my depression and anxiety (familial). It is also just as expensive....... and requires a different prescription, due to the dose (and possibly adherence to the correct chemical formula?).

So I was dependent on the samples I could get until they stopped being given to physicians for more than a year before the generics became available. That created a $250. monthly expense for me, along with the same occurrence now with Prevacid (the only proton pump inhibitor that works for me, and yes, I've gone on the others without relief), another $250./month expense. Along with other meds I take (almost all generic, and somewhat less expensive depending on where I get it - the price fluctuates daily, I'm told by pharmacists), that meant about $650./month just to keep relatively healthy........ Good-bye savings! Hello (I hope), government regulation!

Of course the above woudn't be a problem or even a cautionary thought for someone making over $250,000 a month, but I wanted to be a nurse, and thought (in the early '60s) I'd marry someone who made more than I would (did he ever! but he had this need for expensive cars, homes, other women....and wouldn't choose to share household or our children's expenses). Where's a law saying that married men need to/must support their children and wife??? So I kept working (not that I didn't want to, I love being a nurse!!).:heartbeat Now he's forced to share his income with me by our divorce decree! However, he's a lawyer and moved out of state, hid most of his money, lives off his South Carolina wife, and is in contempt of the California court since he pays me a fraction of what I'm due. For some reason other male (mostly divorced) divorce/family law lawyers don't want my case, and female ones want $25,000 up front! Now there's a group making much more than $250,000 yearly.

So this universal healthcare thing involves caring, sharing (whichever way you want to look at it), and of course doing the RIGHT THING!!!

[1a2s3d]

Though they cohere with my starting position, I have not adopted these positions as a result of "listening to crap," "being lulled into" an attitude by anyone with an agenda, or concern about being saved from your predatory private sector.

Yes, I am well aware of the "poo poo" of John Rawls through my studies of John Locke. Redistribution, free handouts, and bringing the poor up on the backs of others who've earned it through their sweat and hard work. Yes, I'm well aware of his NONSENSE and the ultimately unsustainable concepts that he wrote about. But at least you know where your MARXISTS AND SOCIALISTS beliefs come from. You're the exception and not the rule like so many others on this website who take marching from the ANA and other intellectual midgets who spew this "poo poo".

[flightnurse2b, LPN]

i just wanted to thank madwife, sharrie, talaxandra and the other international nurses for posting information about the UHC programs.... your perspectives were very helpful, and have helped to cement my belief that the US needs to move towards a universal health care program.

[talaxandra]

One day I'll remember not to feed the trolls before I start.

[1a2s3d]

Professional Threaders.

[Grace Oz]

Universal healthcare works extremely well here in Australia. We have one of the best health systems in the world. Directly or indirectly, we all contribute towards it. If one chooses private health insurance, they have the added advantage - (or DISadvantage some might believe!) - of choosing either the public or private hospital system. One is not excluded from receiving care in the public system because one has private insurance. One is never told to go to a private hospital because they are insured. No, in Australia, EVERYONE receives care regardless of their situation.

Have no fear in relation to universal healthcare, it really does work and as with everything, there are pluses and negatives. But, overall, it works very well.

THANK YOU Talaxandra for your factual, relevant and eloquent posts! :)

THANK YOU, Madwife, for sharing the UK perspective on what is essentially pretty much the foundation for our own NHS.

Then again, us convicts still belong to the Commonwealth! LOL

[HelenofOz]

Just to add to Talaxandra's Aussie viewpoint, thankyou for your input, I had been thinking along the same lines for sometime, but did not have the facts re our Medicare charges to hand. It comes out with the tax, I never see it, I never miss it. I do know that under a certain income there is a reduced medicare levy, just as, if you earn over $AU100,00 per couple and have chosen not to take out private insurance there is an added surcharge (the surcharge threshold increases with the number of dependant children.

We also have private health insurance, which is an option which can be chosen, or not, depending on your point of view/financial position. It is not dependant upon our employers, but is our own decision, and arranged privately between ourselves and the health fund of our choice, thus if either of us change /lose jobs our private health cover is not affected, but continues until we choose to discontinue it. I think the cost is $AU318 per month for the two of us (if we had children at school or university they would also be included in that cover). The rate for a single person is half that. This cover includes full hospitalisation, approx 50% dental & optical costs, about 75% of specialist costs. And in an effort to encourage people to take out private health insurance the government reimburses 30% of the health fund costs. Also premiums can be waived for up to 6 months in forced retrenchments or drought.

And the choice to be a public or private patient remains mine at all times-if I am in an MVA the ambulance will take me to an appropriate hospital, where I will be treated by the appropriate specialists, in ICU/wards etc etc for free, unless I specifically choose to be a private patient and have the specialist of my choice, in which case I will be responsible for some costs.

Mind you that does annoy me that I pay medicare, health fund and then have out of pocket expenses as well. But the decision to have private insurance is mine alone.

My parents had private insurance for years, but as pensioners they have a more limited income, so now are just Medicare patients, and thus incur no charges for their doctor's visits, my father's dialysis and regular colonoscopies, and if they need an ambulance for transport that is also covered.

I can't imagine not having universal health care, and my husband is even worse, having grown up in the UK in the heyday of the NHS. All societies in all cultures have always had people who needed help, they should not be penalised because they don't live up to certain ideals.

[canigraduate]

Yes, I am well aware of the "poo poo" of John Rawls through my studies of John Locke. Redistribution, free handouts, and bringing the poor up on the backs of others who've earned it through their sweat and hard work. Yes, I'm well aware of his NONSENSE and the ultimately unsustainable concepts that he wrote about. But at least you know where your MARXISTS AND SOCIALISTS beliefs come from. You're the exception and not the rule like so many others on this website who take marching from the ANA and other intellectual midgets who spew this "poo poo".

Wow. Just wow. I haven't been on this site for very long, so perhaps this type of unsupported rage is common. I do not find your remarks helpful at all in explaining why universal healthcare is undesirable to you. It sounds like you don't actually know, either. Perhaps you could explain it to me, rationally and civilly. I would be most happy to understand. In any case, your behavior in your posts on this thread is unseemly and really makes you look like an blowhard.

[dlatimer]

As long as publicly traded hospital corporations and insurance companies run healthcare there will be less impetus to make healthcare affordable. These companies have their executive salaries as their main priority. That is because their salaries and bonuses are predicated on making money for stockholders. There is something that is contradictory when these corporations state the patient is their top priority when in fact it can't be since stockholders return on investment is the controlling factor. These corporations must realize that Obama and congress are serious about bringing costs under control as they have already given ground by stating they will not increase costs as predicted.

[MaritesaRN]

Having worked in a country which has socialised medicine I can certainly see the pit falls and the benefits. What I dont understand is the fear behind having socialised medicine In my opinion socialised medicine has more positive benefits than negative benefits.

The first and the most obvious concern is the cost to the patient and their family, we all know how devestating an illness can be for pts 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 pts 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 dont 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 personnally waited in doctors office hours (and paid for the priviledge) 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 pts?

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

Many times I have seen pts 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 pts 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 socialised medicine. Well, in the UK if you have certain illnesses for example

• 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 specialised RN's who focus is on preventative care in the community. There are telephone help lines which anybody can utilise for free.

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

I have been asked what kind of care do you recieve in a socilaised medicine country and I ask them, I am a product of socialised 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 dont meet their quota.

I agree MRI's and CT's are not as freely available, but again iinitiatives are in place to improve the waiting times.

Emergency care no different all patients will recieve emergency care.

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

Questions??

Madwife.....it is refreshing to hear this. The fear of medicine socialization have been propagated by providers, facilities and other capitalistic entities, that is now causing our present problem of high health cost. The AMA itself is an instigator of this spiraling high health cost. I can understand that they are protecting their own, but

it is costing us the public and arm and a leg to get any descent health care. Wher I work used to have a choice of HMO vs. PPO. Well things have changed now. In our companies health insurance , there is only a PPO and you have to pay 20% of this, if you have a doctor in the network. I had some routine or part of a preventive tests, and out of the total charge of 750.00 + dollars, my insurance only paid 450.00---- which means I have to dish out the remaining 300.00 !!! I am a healthy 62 yo ,and these are the easy labs such as the ekg , bone density and UTZ in my carotid and labs in the doctors office. the set up is good, with everything in there, but the the remaining cost for me to pay is still difficult , and i will have to pay this in installments! This is quite a change. I never have to pay this much for the preventive and routine tests!!!! Now I can personalize and even see more that we have a problem! I can understand why some people use the ER. they have no money to go to the doctor , and they wait until they are so sick, they have to go to ER!!! Yes, nurses , we definitely need a socialized medicine ! Our current system is not working and only fattening up the CEO's in the health industry.

Need to change this now.:angryfire

[lamazeteacher]

As long as publicly traded hospital corporations and insurance companies run healthcare there will be less impetus to make healthcare affordable. These companies have their executive salaries as their main priority. That is because their salaries and bonuses are predicated on making money for stockholders. There is something that is contradictory when these corporations state the patient is their top priority when in fact it can't be since stockholders return on investment is the controlling factor. These corporations must realize that Obama and congress are serious about bringing costs under control as they have already given ground by stating they will not increase costs as predicted.

You've put it the way it is!

I doubt that they'll reach the goal of bringing health care costs down 1.5%. They'll test our President just like N.Korea is doing now, and they'll all lose, and we, the people win......having prevention and early treatment.

We'll live to vote again for Obama; and anyone else in 2016 who cares about people's welfare and rolls with oppositional forces taking pot shots at ideals that will elevate this country to newer and better levels than ever before.

I just love the way he says "That's OK", when rude opposers shout epithets, as free speech in our constitution and everything else the USA stands for, is epitomized by him and those who support his programs!

[K.P.A.]

With socialized medicine, the treatment is statistically optimal. With user pays, it's the best the user can afford. If the user can not afford statistically optimal treatment then socialized medicine is a good thing. If the user can afford individually optimized medicine and is denied by the socialist system, then it's a bad thing (from that users point of view).

With socialized medicine salaries are by formula. Negotiation of higher pay based on individual strengths that do not fit the codified tables is no longer an option.

We can label those few who are affected negatively as whiners and get on with it now, can't we?