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 ICU, MS, Radiology, Long term care.

Saude,

Thanks for the info. I can see how it can be very disturbing to have terminally ill patients 'discarded'. I also know the greatest part of finances spent on healthcare for many patients are in the last year of life. This ties up limited resources on those whose chances of survival are extremely slim. I think that is unfortunate and it may come down to just that. Some countries already practice a form of this benefit vs. cost system. If a system only has so much money to provide health care, do we spend unlimited amounts on dialysis, ventilators, etc. only to have the patient die? This has always been a very delicate area and one much debated by clinical ethicist. My guess would be some day this type of decision will have to be made prior to admission. Living wills and durable power of attorney for health care matters have resolved some of these issues, but you can always have a family member who doesn't agree with the living will, etc.

This topic is probably best reserved for it's own thread.

I appreciate the information Sharrie, I am not familiar with pounds vs dollars, maybe someone could convert it for me.

Shaka

It is not really a good way to compare by translating into dollars. In the UK your are paid in pounds. If you translate that into dollars, depending on the rate of exchange, it can look like a huge $$$ amount.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.

This is truly an informative site. Different backgrounds, different filters for perception , etc. But no matter what ,it is evident that there is a flaw of the deliverance of health care. We need to be practical and not much on idealistic....just do what is needed and makes sense. Maybe we should start as what is ethical in this area? Maybe start from there. Maybe this is the reason as to why we use the bible for our constitution and court rooms...we start with what is the right thing to do minus all the political , greed and manipulation of power and control and money that has infested our country and our health care , more than ever and getting worse now. Look around and see where we are now w/ our economy. I do not have to mention the ones responsible for this, and look where it got us. As people and citizens of this beautiful country, we need to get out from passive to assertive, and aggressive if need to. We need a change in our health care. Most specially , Nurses must be strong in this involvement and movement since the other health care professionals are too tangled in just making money!

Saude,

Thanks for the info. I can see how it can be very disturbing to have terminally ill patients 'discarded'.

I'm not sure I explained quite correctly. The preferences and better treatments apply to many other health conditions as well as the terminally ill. But that really wasn't the major point I was making anyway. My first point was do Americans really want the government telling Physicians and RN's who we can care for, when we can care for them, how we can care for them, and what care we can provide them? When considering whether or not America should adopt a Canadian style government funded health care system I am VERY concerned about the government control of and it's impeding of the physician and nurses plan of care for patients. For example, the care performed is ultimately limited to the resources available, resulting in patient prioritization and scheduling delays. As health care demand continues to increase over time resources will continue to decrease, remedied only by more taxation and or by incremental decreases in care provided. How is prioritization or delaying treatment, (and in the case of two tier systems that discriminate against the poor), any more ethical or moral than managed care which was my second point?

My first point was do Americans really want the government telling Physicians and RN's who we can care for, when we can care for them, how we can care for them, and what care we can provide them? When considering whether or not America should adopt a Canadian style government funded health care system I am VERY concerned about the government control of and it's impeding of the physician and nurses plan of care for patients. For example, the care performed is ultimately limited to the resources available, resulting in patient prioritization and scheduling delays. As health care demand continues to increase over time resources will continue to decrease, remedied only by more taxation and or by incremental decreases in care provided. How is prioritization or delaying treatment, (and in the case of two tier systems that discriminate against the poor), any more ethical or moral than managed care which was my second point?

Well, as it stands now, insurance company flunkies who are primarily concerned with generating profits for the company are deciding what treatment physicians can provide. Is that any better? We would pay less in taxes for a non-profit, single-payor system than we are now paying in premiums to the private insurance companies, who siphon a big chunk of that money out of the system to pay for unnecessary administrative costs and outrageous executive salaries.

I am curious, when you say the patients with a low survival chance are 'discarded', what does this mean in actual practice?

Also I wonder how can care preformed EVER excede the resources available, except in a 'fairy tail' report prepared for management?

I was so shocked to read on that thread 'Used Nurse, Dirt Cheap', that LTC allows 1 RN for 100 patients in some States.

Just do the math; in a 12 hour shift, with a 30 minute lunch break, no bathroom break and no charting that is less that 7 minutes per patient, not counting the time to walk from room to room. As every nurse knows, one patient can take up your entire shift.

Of course this is LTC, and a lot of patients don't need a thing but help into and out of bed, and a little help dressing and with meals, the facility doesen't want, or need, RN'S, LPN'S, or even Medtechs for this kind of assistance, but still, what kind of robot can do a job like that, take responsibility for 100 patients, any or all of whom can sue you or try to have your licence, which you worked like a dog for, and spent years of your life getting, revolked?

You know if anything goes wrong, or a temperature or high or low B\P gets overlooked, or goes unaddressed, who gets the blame? Not the healthcare corporation that made the decision to staff like this. Send me to a combat zone anytime, it's a lot safer!

The following is from the

'Neue Post' a very popular magazine, that's been around a long time and is published in Germany. It is kind of like a cross between 'People' and 'Good Houskeeping'.

I want to add this because I know that my above post has the very real possibility of turing this discussion into a gripe session about staffing and that was not my intention. (I can get carried away, just like anybody, with my personal peeves!)

People under a 'Universal Health Care System' have questions just like any body else, and this was an attempt to answer some questions readers had. (Jenny, I may need your help!)

Neue Post 25 February 2009

'These are Your Rights as a Patient'.

1. Can my Doctor refuse to take me as a patient because his\ her (I will use 'he' for both) practice is full?

Unfortunatly, yes. Just like you, as a patient, have a right to choose a doctor, the doctor has a right to choose his patients, even if he is the only specialist near you. If you are handicapped, and cannot get around easily (Germany is full of little villages) you can call the Association of Doctors for the Insurances (Kassenärztlichen Vereinigung) and they will try to try to get the doctor to accept you.

2. Do I have the right to a paticular medicine?

No. The doctor is given the room to decide on the therapy, and the Apotheker can choose to give you a less expensive medicine. If you don't wnat this to happen, ask your doctor to cross out 'the same' on the RX.

3. Is the Doctor allowed to treat Private insurance patients before me?

No, they cannot, even if some doctors will tell you they must see 'private insurance' patients first.Complain if that happens to you. If nothing helps, change your doctor!

4. Can I get a Second Opinion?

Of course! Especially by a difficult diagnoses a second opinion can be sensible and helpful. That may not make the doctor treating you happy, when you ask him to send you to another specialist (Überweisung), but he has to do this and you do not have to pay any more for this second opinion.

5. The doctor only has five minutes of time for me. Is that OK?

Not really, but the law did not write for an exact time for the visit. However, every doctor is (verpflichtet) supposed to inform the patient about diagnosises and therapies. Even when it sounds like thy are talking Greek (Fach-Chinesisch) to you, ask until you understand.

It will help if you write your questions down befor you go into see the doctor.

6. I forgot my insurance card. Can the doctor send me away?

The important thing between a doctor and a patient is trust. If the doctor trusts you he will treat you whether or not you have your card with you. He does not have to however. He con send you away. You are supposed to renew your insurance card once a Quarter (year). (Einmal pro Quartal müssen Sie die Versichertenkarte vor legen.)

7. I sat in the watting room 1 and 1\2 hour. That is too long, isn't it?

Yes, that is too long, when you have an appointment. You should ask why. You must accept 30 minutes of waiting time. However, emergencies come first, by law.

8. Am I allowed to look at my Personel Medical file?

Yes. You can see your file and make copies. The doctor can charge you 50 euro cent per copy. The doctor does not have to had over his personal notes. If you have a medical power of attorney they also have the right to see your medical file, and get copies at their own cost.

9. The first appointment I could get is in four weeks. Is that normal?

That depends on your complaint. If you have severe pain, or an emergency, your doctor must see you as soon as possible. If it is routine visit, it can be normal to have to wait four weeks for an appointment.

10. Why does the Apotheke not take my Rx?

Probably because it is no longer good. (gültig). A 'red' colored Rx has to be filled in one month. A 'private insurance' patient has three months for this Rx. A 'yellow' colored (Betäubungsmittle-Rezept) Rx. must be filled in one week. A 'green' Rx does not have a time limit.

11. I am still weak. Can the hospital discharge me anyway?

Whether or not a patient stays in the hospital is a decision for the doctor. If you feel you are being discharged too early you should discuss this with the doctor. (in Vorgehen Ruhe besprechen).

12. If I am a victum of a medical mistake in my treatment, who can help me?

I am sorry I don't know how to translate this because the legal system in Germany is a little different and I don't know legal terms in English either.

(Rechtsschutzversicherung, or if you don't have that, eine Schlichtungstelle, eine Patienteninititive oder Ihre Krankenkasse)

Some places for more Information and Addresses are:

Unabhängige Patientenberatung Deutschland (UPD)

http://www.upd-online.de

Patientenintitiative e.V.

http://www.patienteninitiative.de

Verbraucherzentrale Bundesverband e.V.

http://www.vzbv.de

So, there you have it. Now that system doesn't sound so bad does it?

And this is Germany. France is supposed to have a the best, Holland and Belgum are up there to. All of these systems are rated above the US by the WHO.

One of the first things you notice when you get off a plane from the US here are all the healty old peole walking around.

Now how come these countries, some of them not as big as some States in the US can manage to provide health care to their citizens and the US cannot?

I am telling you, there is something wrong with this picture!

Specializes in Med/Surg/Ortho/HH/Radiology-Now Retired.

Here in Australia, when having a prescription filled out, we are offered a choice of a cheaper brand of medication. However it is entirely our choice whether to accept that or not. It's up to the individual which one to have, cheaper V's more expensive. Being a Medicare only ( ie; uninsured) patient does not exclude one from having a choice. You just pay more if you choose the more expensive product.

Specializes in OB, HH, ADMIN, IC, ED, QI.
When considering whether or not America should adopt a Canadian style government funded health care system I am VERY concerned about the government control of and it's impeding of the physician and nurses plan of care for patients. For example, the care performed is ultimately limited to the resources available, resulting in patient prioritization and scheduling delays. As demand continues to increase over time resources will continue to decrease, remedied only by more taxation or an incremental decrease in care provided.

In Brazil, where you are, with 80% of the people relying on the government health care system, and no money coming into it, and the other 20% of the people who work and have health insurance getting funded care, there can be no comparison with the Canadian system, where at least 90% of the people are employed and contributing to the health care system. That money doesn't go to pay for ultra luxurious lobbies in hospitals, conference rooms, expensive office furniture and decorated doctors' offices, or the extra equipment that each hospital in the USA has, in order to compete with the others.

From what I've learned from my Brazillian neighbors, their insurance funded healthcare in Brazil is good, and they go back there for the less expensive procedures and treatments; and dental care that is too expensive here. Since he owns his scientific and medical equipment business that has offices there and in several states in the USA, emergency treatment would be provided for them here, using their insurance company here. They say the care given unemployed, poor people is awful. Their attitude about it is the same as yours.

Since I'm from Canada, still have many family members and friends there, I know that the health care system there is financially handled by government, and medical decisions are made mostly by physicians (who are very jealous of the inflated incomes of their American counterparts). Everybody gets good care! 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. Of course there are people here, and there who don't accept responsibility for making their appointments in a timely manner, and then blame it on the system.

In big cities there, the wait for procedures is the same as it is here, and emergency surgery is done as quickly. In fact, patients stay at rehab facilities after surgeries, to have the PT they need and monitoring. That means that equipment which is rented to each hospital discharged patient for use in their homes here, is shared in the rehab. facility, which saves the money that's spent on the higher number of the same equipment here. Also, the physical therapists can work with more than one patient at a time, which makes their care for a shorter time min the home as it's done here, especially including travel time. It's a waste of money.

Now I'm all for home health caring for patients so they spend less time in hospitals and that spares them from nosocomial infections (sometimes), but surgical things like joint replacements, have a better recovery rate when done in a rehab. facility, away from the "superbugs". Let me tell you, though, those facilities aren't fancy, and rooms are semiprivate no matter who you are - that saves money.

There's also a difference in the character of most Canadians. Traditionally people there hate to be "on the dole" (an old fashioned term), and want to be up and working ASAP after an illness. Malingering is unusual, as is the erroneous concept that when it's free, people see their doctors more often. They also have little sense of the system as being given to undeserving undesirables, who purposely don't work, due to lack of caring for themselves or the people whose income tax pays for their care. Taxes there are higher, but when you realize that the interest on mortgages is not tax deductable there, as it is here, and much fewer tax credits are given, that explains it more than thinking it's higher due to health care. Compared to the amounts paid here to insurance companies, the amount of each working person's income tax that goes toward health care in Canada, is less!

My sister worked as a detective in Canada, who investigated suspicious health cases for Equifax (the very company that reports credit here). She found that many of the people who dragged out the time for their recovery from an illness, were immigrants or people whose nature, as she put it, is "less than honest" - very frowned upon and certainly not considered "smart".

I remember another neighbor I had long ago, who worked as a "steward" (flight attendant) on international flights. He had an accident with a meal cart, and wasn't badly injured (had full range of motion and strength of all extremities and his back), but he was off duty for a year. He rented equipment while "off sick" to grade his property, riding around on it, until he went begrudgingly back to work, when his "leave" ran out. No one came to check on him!

I guess we're OK with that here, because it wasn't money from our paychecks to the government that paid for his time and health care, but it was from the employees of the airline for which he worked. The airline just ran it as a "business expense" which was tax deductable...... :o

Interesting, lamazeteacher, your post points out how a health care system reflects the mores of the society in which it is found, not necessarly the view of each individual in that society.

In the descriptions of 'Universial Health Care' systems in other countries a common denominator has been 'if you want more, use your own money, get private insurance and pay for more'. But the concept of delivery of healthcare to it's population is accepted as one of the functions of a countrys government.

In the USA, if you expect to get health care at all you get it from an Insurance company.

OR

* you join the Service (military system or VA)

* you either are, or are able to portray yourself on paper, as too poor to afford to buy insurance

* you are born a member of an ethinc group that is entitlied to free health care

OR

* you are an illegal alien

As maritesa stated in post # 48, "Illegal immigration is something that this country needs to deal with".

I am not casting dispersions on any particular group of people so please don't go all racist on me (I say that because I live in the southwest where most illegals come from Mexico, if you try to say a word about immigration the debate quickly turns into a headbashing session about what a racist you are to even bring up the subject.) I speak Spanish myself and I personally have the attitude that I would rather deal with an illegal alien from Mexico with a little education who wants to better him\her self, that with a tattooed Hispanic gang member, who can't speak Spanish, or speak an English that is free of obscenities used as adjetives, who is just as 'American' as I am, on a personal level.

Illegal aliens get free health care in the USA. This is form of 'corporate wellfare'. All the rest of us are paying for maintaining illegals in this country so that a few can benefit from the cheap labor of these people.

In case you have never been around a job site in the Southwest, a lot of illegals are excellent carpenters, and Mexicans are very creative with stone work. When building jobs, for example, are 'subcontracted' out, it is not the corporation who checks the work status of the people who build the very hospitals in which (some) of us recieve care. The corporation takes the lowest bid. It's all about the money.

The ER's in the US are overrun with people seeking primary health care. Do you think illegal immigration might contribute to this? Who pays?

I don't know how so many illegals get so much totally free health care in the Southwest. I have seen the 'Indigent fund' pay for a lot of health care, for the illegal workers, and their moms, dads and kids, that all live here in the US with them.

If these people were legals, they would be elligible for Medicaid.

This name 'Indigent fund'! What does that mean? It is straight out of Dickens. Who checks how 'indigent' these people are? Who admisters this fund? I see this as another way to pay, with public money, for health care for workers for whom employers don't take responsibility. The maids who clean your room in those over priced resorts, the dishwashers in those over priced restrauants, these people are usually illegals in the Southwest.

Is there something wrong with having a job like this? Why can't legal workers have a job like this and get treated with respect in the USA. Respect includes health care, in my opinion. A maid can slip on icy stairs, a dishwasher can get cut or scalded. WHY does a person have to be a 'charity case' in order to recieve health care for doing jobs like this? (I have done both jobs in my pre-nurse incarnation.)

One reason is that, as long as recieptents of 'health care' in the US get taken care of, with no questions about legal status in the country asked, then the employers get cheap labor, and the good old American taxpayer picks up the bill for keeping these people healthy enough to work.

I hope it is clear from my previous posts that I am not saying that some people should not get health care. I believe that basic health care, and pain control, is a right, and a country should address how it's citizens, collectively, as a group, should recieve this right.

If a person is an 'illegal alien' I believe they should revieve health care also. BUT, and this is the 'hook' on the question of illegal workers recieving health care in the US, they must then go before a court that will determine their right to be in the country. If they have a claim basied on fear of persecution in their home country, this must be investigated. Germany puts up 'illegals' in hotels, where they live for years while their cases go through the courts. Spain has a serious problem the last couple of years with illegals from Africa who make it by boat to the Canary islands. They put these people in camps. Each country has a legal way of dealing with the problem of 'illegals'.

Giving illegals free health care while turing a blind eye toward their status; letting unscrupulous employers use these people to 'turn profits', while lauding the virtues of 'competition' and 'free enterprise' while a countries 'middle class' strugles and foots the bill for services they themselves do not get just seems crazy.

It seems like Americans have been 'brainwashed' into thinking that this disfunctional state of affairs, that rewards and subsidizes those who 'hoodwink' the system and penalize those who follow the rules, is normal.

Remember 'you get more of what you subsidize'.

Socialized medicine sounds ok, but are we really prepared for the tax implications. Don't countries that have socialized medicine taxed 50% and up? How about the tax on gas? The Brits pay a whole lot more for a galloon of gas. Why? Because of all the taxes that are added on.

Specializes in OB, HH, ADMIN, IC, ED, QI.
interesting, lamazeteacher, your post points out how a health care system reflects the mores of the society in which it is found, not necessarly the view of each individual in that society.

exactly!!! thank you for pointing that out. having been "raised" in canada, i think my fierce objections to things gone wrong in the usa is based on (most of) that society's acceptance of health care being a right of all who were there. also, i've been in the health care field long enough to remember times here, when care of illegals was a "given" (literally). there were the days when pregnant women could come into our country, and once they gave birth, they and then their whole family became legal, due to their relationship to the american baby'd citizenship.

it was a more or less an accepted burden conferred by big businesses hiring them, who had clout in government.

in the descriptions of 'universial health care' systems in other countries a common denominator has been 'if you want more, use your own money, get private insurance and pay for more'. but the concept of delivery of healthcare to it's population is accepted as one of the functions of a countrys government.

that's true, as michael moore pointed out in his movie "sicko". there is acceptance in other countries that if illegals support themselves (therefore having been employed by someone there), they were not without resources, and could stay, and taxes were paid by their employers. here, for many, many years, the agricultural employers were mightier than any government enforcement agency worker, or union organizer (think cesar chavez), and their zeal for cheap labor and contributions to the coffers of the government made many heads in washington turn the other way....... although the citizens whose jobs they may have taken, resented their presence. even if citizens wouldn't actually want to do those jobs, they resented those who walked into the country and took them. many a barroom brawl has occurred, over that!

in the usa, if you expect to get health care at all you get it from an insurance company.

or

* you join the service (military system or va) and have what has been thought "less than" civilians' healthcare

* you either are, or are able to portray yourself on paper, as too poor to afford to buy insurance - think disabled and elderly people unable or unwilling to get medicare.

* you are born a member of an ethinc group that is entitlied to free health care such as native americans whose country was wrenched from their hands by settlers who thought any land upon which they walked, was theirs, and to whom diseases never encountered previously (like lice, flu, tb, you name it.... they hadn't had it before)

guilt was a factor in successive generations, who looked and actually saw the dismal results of the greed of their forebears (think alcoholism, poverty, and lack of freedom).

or

* you are an illegal alien whose illnesses became so bad/complicated that they were forced out of hiding, into "the system". it was hard to get them to believe that they wouldn't be deported, separated from their family here, etc. if they came "wretched to our shores" as a liability (they had pride and need for wellness and work). most often their families in their homeland depended on their earnings to stay alive.

i've worked in free clinics with them, as they were driven there by compassionate citizens, rather than confront their worst fears. most of them almost died and watched others die in airless vehicles they had paid thousands to drivers who ruthlessly took advantage of their circumstances.

after the 1989 loma prieta earthquake, when hundreds of illegals overcame their fear of being counted, and came to red cross shelters where i worked as a volunteer, in watsonville and santa cruz, it was hard to tell what they feared most, being visible/vulnerable to authorities, or the shifting earth below their feet. they preferred to stay in the tents, rather than buildings. once the schools opened, they wouldn't allow their children to go on the busses to take them their, in fear that they would be deported or, worse still used as slaves.

as maritesa stated in post # 48, "illegal immigration is something that this country needs to deal with".

i am not casting aspersions on any particular group of people so please don't go all racist on me (i say that because i live in the southwest where most illegals come from mexico, (originally, but now they're all over this country) if you try to say a word about immigration the debate quickly turns into a headbashing session (due to frustration regarding the manifold numbers here, and the mighty employers who seem exempt from the law)about what a racist you are to even bring up the subject.) i speak spanish myself and i personally have the attitude that i would rather deal with an illegal alien from mexico with a little education who wants to better him\her self, that with a tattooed hispanic gang member, who can't speak spanish, or speak an english that is free of obscenities used as adjetives, who is just as 'american' as i am, on a personal level.

when i worked in home health, i was told that if families spoke only spanish, they were not a threat to my wellbeing, but once their children who spoke english (due to their schooling here), they became susceptible to drug dealers, gangs, and whatever nefarious activities to which they were exposed. the contradiction was when a genetically disabled child was a sibling. in those families, children stay close to their families to help or hide from ridicule. gangs seemed to pretty much leave them alone, in the '80s and early '90s. i don't know if that's the case now.

illegal aliens get free health care in the usa. (if they dare come for it, to public health clinics) this is form of 'corporate wellfare'. all the rest of us are paying for maintaining illegals in this country so that a few can benefit from the cheap labor of these people. many are quite consciencious about having their babies immunized, which spares us from the illnesses they could spread if they didn't.

in case you have never been around a job site in the southwest, a lot of illegals are excellent carpenters, and mexicans are very creative with stone work. when building jobs, for example, are 'subcontracted' out, it is not the corporation who checks the work status of the people who build the very hospitals in which (some) of us recieve care. the corporation takes the lowest bid. it's all about the money. in affluent neighborhoods in southern and northern ca, "good builders" hire only legal workers, as the houses are so expensive, they can pay the wages of union workers. after buyers get their homes, many hire some illegal stone masons and carpenters to embellish their homes with walls and/or pretty fences around them, and of course, to clean them.

the er's in the us are overrun with people seeking primary health care. do you think illegal immigration might contribute to this? of course, if their situation is acute enough to risk detection who pays? us.

i don't know how so many illegals get so much totally free health care in the southwest. i have seen the 'indigent fund' pay for a lot of health care, for the illegal workers, and their moms, dads and kids, that all live here in the us with them. they may have been used to "county" hospitals where free care, without questions was available before big corporations took them over...... i was the infection control nurse at one of them in the late '80s. my worst memory is having to tell a man who was here by himself and had his wife and family in mexico, that the natural and accepted sexual outlet he'd indulged in, resulted in his acquiring aids. there were none of the better antivirals those days, and couseling him about safer sex was excrutiating for me, and for him. i imagine that he died without seeing his family again, as he didn't come back for treatment.

if these people were legals, they would be elligible for medicaid. possibly, or they wouldn't meet the criteria for it.

this name 'indigent fund'! what does that mean? it is straight out of dickens. who checks how 'indigent' these people are? who admisters this fund? i see this as another way to pay, with public money, for health care for workers for whom employers don't take responsibility. the maids who clean your room in those over priced resorts, the dishwashers in those over priced restrauants, these people are usually illegals in the southwest. i've never seen private funds back their healthcare expenses..... or benefits from employers.

is there something wrong with having a job like this? most americans on welfare consider work like that beneath them. why can't legal workers have a job like this and get treated with respect in the usa. respect includes health care, in my opinion. a maid can slip on icy stairs, a dishwasher can get cut or scalded. why does a person have to be a 'charity case' in order to recieve health care for doing jobs like this? (i have done both jobs in my pre-nurse incarnation.) when employers can get away without paying social security tax and witholding income tax for them, they do, as it's cumbersome - and those who command respect, want more money than is in the budgets of most households.

one reason is that, as long as recieptents of 'health care' in the us get taken care of, with no questions about legal status in the country asked, then the employers get cheap labor, and the good old american taxpayer picks up the bill for keeping these people healthy enough to work. the health care system in place now, makes that more expensive than prevention programs, although most didn't see it that way until recently, when the "elephant in the room" roared. that's how the "change" platform of our current administration was so successful. only in the face of such corruption as there was in our government, did the people decide to buck the system, for something better for all.

i can't say that the canadian system would survive if it had the huge numbers of illegals we have, to support. they don't and so ideals were maintained, but not without financial difficulties that brought u.s. insurance companies into play there, for those who want more, and can afford it. i;m sure it's those companies that suggested that canadians in a hurry (of their own inclination) for elective procedures, come to the usa for them, and of course they had to pay incredibly high prices for it, as canada's government isn't disposed to gouging. not from doctors, hospitals or pharmaceutical companies.

i hope it is clear from my previous posts that i am not saying that some people should not get health care. i believe that basic health care, and pain control, is a right, and a country should address how it's citizens, collectively, as a group, should recieve this right. absolutely!!! and the time has come, unfortunately too late for those who died here, waiting for funding of surgeries, etc. hospice does take them, due to private charitable giving programs.

if a person is an 'illegal alien' i believe they should receive health care also. but, and this is the 'hook' on the question of illegal workers receiving health care in the us, they must then go before a court that will determine their right to be in the country. for most of them, they're deported before that. if they have a claim based on fear of persecution in their home country, this must be investigated. occasionally that is proven, but it's difficult and lawyers cost more than most can pay. i have a friend whose son took pity on the illegal maids she had, and grew up to be an immigration lawyer. he heard the stories of the attempts my friend and her husband, an attorney for civil litigants, made for their household workers, who had to go back to their countries of origin for many years before their cases "came up". germany puts up 'illegals' in hotels, where they live for years while their cases go through the courts. i can't imagine that they could support many would-be immigrants in that fashion. the red cross's financial resources are strained by doing that following house fires, and in disasters their shelters are in already funded community centers and army baracks that are unused. spain has a serious problem the last couple of years with illegals from africa who make it by boat to the canary islands. they put these people in camps. each country has a legal way of dealing with the problem of 'illegals'. some of them do it in very unsavory ways, or with wealthy citizens backing it.

giving illegals free health care while turing a blind eye toward their status; letting unscrupulous employers use these people to 'turn profits' (called a larger profit margin), while lauding the virtues of 'competition' and 'free enterprise' while countries' middle class' struggles and foots the bill for services they themselves do not get, just seems crazy. open ended budgets cause catastrophic overspending. that's certainly not what banks were supporting, but their abilities to hide untaxed funds for big customers has a part in the collapse of our "infrastructure".

it seems like americans have been 'brainwashed' into thinking that this disfunctional state of affairs, that rewards and subsidizes those who 'hoodwink' the system and penalize those who follow the rules, is normal. in fear of losing our jobs/wherewithall, we supported that by saying nothing, going along with it.

remember 'you get more of what you subsidize'. (that has caused the downfall of the mighty corporations and the opening of the gates to poor immigrants "yearning to be free")

it's too bad that things have to get so perverse, before something can be done. it's the very political profiteers from corruption, who are balking at president obama's programs, as they are most likely "in the pockets" of the wealthiest people in our country, who prefer to subjugate others and get their votes to uphold the self serving "status quo". what a pity that it has gone on so long, that it brought this country to its knees!!! however, that's what allowed the exposure of the "good (bad) old boys".

this is a turning point in our culture that will forever define us!