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??

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?

No it's not. I agree with you 100%. I believe it's counterproductive to the patient's we serve to replace a failed system with another failed system. Take care.

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

http://videolog.uol.com.br/video.php?id=415355

This is a normal government funded hospital in Recife. And yes it's true as another has commented that the private pay hospitals are very good and in many ways comparable to American hospitals.

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.

The last I checked the unemployment rate in Brazil was hovering just a little under 9%. Most everyone contributes in Brazil. And figuring in all the taxes from federal, municipalities, gas, food, social security, etc... I'd say the cumulative tax rate in Brazil is around 60%. Brazil does have enormous contrasting economic disparities. But overall it's not a poor country and it's nothing like you portrayed it to be in your comment.

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.

You're entitled to your opinion but your comments are totally contradictory to the eroding confidence in the Canadian system which is being fueled by fears of unstainability, fears of incremental tax increases, and patient dissatisfaction with the timely access to care. I agree that you'll always have propaganda from people with an agenda. (Follow the money) But it is psychotic to believe that somehow every independent report and survey originating from a Canadian source is somehow scued data or biased opinions.

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

:yeah:Wow , well said !!!!! It is our system that is ill and not working. I agree that ER must treat what comes to their door for treatment no matter what. It is so easy to point fingers or blame other issues to the illegal immigrants................ like I said they can fix this by giving temporary green cards for them to work over the border, and this will make those cheap employers pay the proper minimum and good working conditions.

Also , who will harvest or work in these farms of which nobody wants to work with. Be thankful we have the availability of these hard working people. I can not understand why these issues are so tangled up ....like oranges and apples !!!! I f what I hear is really what and how some people think, then we have a long way to learn to grow up.....................

1a2s3d: Wow! You sound really angry that someone has a different viewpoint. You actually sound borderline hostile. I am glad we have nurses who have experienced socialized medicine willing to share their opinion of a system they are familiar with. After all, we cannot make an informed opinion if we don't have adequate information at hand. But there's no need to get angry at someone simply because they have articulately expressed an opinion you don't agree with.

:yeah:Wow , well said !!!!! It is our system that is ill and not working. I agree that ER must treat what comes to their door for treatment no matter what. ...............

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.

Specializes in OB, HH, ADMIN, IC, ED, QI.
You're entitled to your opinion but your comments are totally contradictory to the eroding confidence in the Canadian system which is being fueled by fears of unstainability, fears of incremental tax increases, and patient dissatisfaction with the timely access to care. I agree that you'll always have propaganda from people with an agenda. (Follow the money) But it is psychotic to believe that somehow every independent report and survey originating from a Canadian source is somehow scued data or biased opinions.

unstainability is the way I see it, but I imagine that you meant unsustainability. The Canadians who I know and have as relations, believe in the high standards of care they receive, with little waiting time (sometimes less than I have in the USA, which is why I've resorted to what has been labelled "doc-in-a-box". I've gotten better care there than from some of the private internists I've seen and fired.....Canadians uniformly appreciate the care they receive, and don't wish that others didn't benefit from tax money they've spent on others' care! The economic capability of sustaining their single payer system, is based on lower costs, better utilization of professionals (such as Nurse Practitioners who spend more time with patients than doctors do). Also, we overdecorate our facilities, while in Canada their spending goes to better and more up to date equipment, and not color coordinated furniture in lobbies, waiting area, and patient rooms. Rooms and hallways stay the same color, have few if any pictures (unless they're donated), and certainly waterfalls and koi stocked pools far from patients' rooms or the departments where they have treatments and diagnostic studies aren't esthetic necessities, as they are here.

Patients who complain about waiting too long either need assertiveness training (not to be confused with agressiveness). My sister makes her necessary multiple appointments with her palliative care physician (she's 80 years old with severe spinal stenosis), in advance, that is 3-4 appointments forward, as her doctor recommends. This cuts down on repeat telephone calls and assures monitoring of her medications. Of course there's always the passive aggressive types who don't verbalize their concerns to someone who could do something about them.......

Taxes.....hummm, good question.

When I worked in Germany the tax rate was roughly something like this for a middle income couple.

One paid 50% taxes.

One paid 33% taxes.

Of course, the one with the HIGHER income would pay the 33% tax, if possible.

Therefore, I made 2400 D-Marks a month. But I took home 1200 D-Marks.

(This was in the 80es, and D-Marks no longer exist nowdays, this currency merged into the Euro.)

At least I got something for my taxes. In those days the health insurance also included a pair of glasses a year, and the most a person could be charged for a Rx was 5 D-Marks.

What do we get for our tax money in the USA? Are they even going to send us our shares of General Motors so we can frame them and hang them on the wall?

I read that the 'new' health plan that Obama is letting Congress craft will include 'taxes' on health benifits provided by employers, something that Obama was opposed to during the campainge, and the other guy favored.

I am telling you, these people who run our government are so 'in bed' wiht the Special Intrests groups that 'we the people' will not win, no matter which of the two groups are holding the reins.

The admisistration and Congress expect the health care system to 'save' the economy', in the report I read today on NBC.

How is that supposed to happen?

I thought health care was supposed to 'save' the health of the populance!

Why does no one DO something about a total overhaul of this broken, disfunctional system?

Specializes in Medical.
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.

I can't speak for other countries with universal health care but in Australia the taxation rate varies depending on your annual taxable income, from nothing ($180,000). The average Australian full time nurse's income falls in the third tax bracket, between $34,001 and $80,000, which is taxed at $4,200 plus 30c for every $1 over $34,000. More simply, if you earn $75,000 you pay $16,500, or 22%. Additional taxes include the Medicare levy (1.5% of taxable income or $1,125) and a GST of

My gross income will spill over into a higher tax bracket this financial year, but I'll be paying tax at the third level rate because as a nurse in the public system I'm able to utilise salary packaging and I have ~ $18,000 of tax deductible items (work and education expenses and charitable contributions), which decrease my taxable income. With a very good salary I'll pay around 16% tax this year, including the Medicare levy.

Medicare has no lifetime cap. I never have to worry that I'll lose my home if I have a stroke, get cancer or am involved in a serious accident, even if I lose my job or am unemployable. I don't drive, but even if I did I doubt the price of petrol here would outweigh that.

Originally Posted by ceenurse

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.

This is my second attempt to respond to this post. My first attempt was moderated for some reason that was not shared with me.

When one posts information that is inaccurate one perpetuates the ignorance that exists regarding countries where there is universal healthcare. To answer your question NO countries that have universal health care do not have 50% + income tax.

2009-2010 UK Tax bands are as follows:

Starting rate for savings: 10%*£0-£2,440

Basic rate: 20% £0-£37,400

Higher rate: 40% Over £37,400

As for the tax on petrol in the UK:

The UK pre-1993 had the 3rd cheapest fuel in Europe. The increased duty on fuel was meant to discourage the increasing number of people who used their personal vehicles. It is also a way for the government to make money, of course. It was, however, the Conservative government who executed this large jump in fuel duty (Conservatives are similar to the Republicans in the USA).

Costa Rica's income tax doesn't exceed 25%, last I checked.

Individual income tax in Germany only become 45% when one earns OVER 250,000 Euros per year. It is 14% up to about 52,000 Euros per year.

Nuff said....

Specializes in RN, BSN, CHDN.

When I lived in the UK we were taxed aprox 1/3 of my income which included the national health care. I pay more out of my pay packet here for medical insurance, life insurances, short term disability, long term disability, dental and eye car.

In the UK I got 8 weeks and 2 days paid vacation, 6months full pay ofr sickness and 6months half pay. Nurses dont get laid off if they didnt return to work after 3 months nor were they laid off for having an opinion.

Last week a patient said to me they were afraid of socialised medicine nurses because the standard would drop, so I asked her how my care was for the past week and she said excellent to which I replied well I am a product of socialised medicine. The pt was shocked, I am concerned about the fears people express re socialised medicine it has such a stigma.

In AZ the amount of money given to hospitals for medicare and access has been reduced ensuring that drastic cuts have been made, jobs are on the line because that is the only way hospitals see to save money.

Remember in socialised medical countries the wealthy can still have insurance for their medical care if they chose to do so, which means they can have non emergency proceedures done when they chose. Emergency care would be free to all.

We need to look after our poor whether we like it or not that's what makes us a civilised country, and seperates us from the 3rd world