Universal Health Coverage? - page 5

This topic came up last night in our seminar. Again, we struggle and struggle with this concept. I often times look at Medicare and how they handle things such as coverage, reimbursment, etc. As... Read More

  1. by   fergus51
    LOL! I love the expression ass backwards and I couldn't agree more! It is honestly something I never considered because I have never done correctional nursing either in Canada or the US...
  2. by   shay
    Originally posted by Susy K
    Kinda like the extreme (and I mean extreme) pro-lifers who discourage abortion, but do nothing as far as helping the existing children in the world, or could care less about the death penalty.

    LOL!! I remember seeing a political cartoon one time of a sooty-faced little kid in a ghetto-type neighborhood sticking his head out of the window of his apartment screaming very loudly, 'YOO HOO!!! OPERATION RESCUE!!' :chuckle
  3. by   Stargazer
    LOL!! I remember seeing a political cartoon one time of a sooty-faced little kid in a ghetto-type neighborhood sticking his head out of the window of his apartment screaming very loudly, 'YOO HOO!!! OPERATION RESCUE!!'
    Hee hee! Exactly.

    In skimming this thread, I have to say one aspect that I didn't see come up much was the issue of taxes. Countries who have universal health coverage generally tax quite a bit more heavily than the US. I don't know what our Canadian friends are paying, but I have a number of European friends who pay a hell of a lot more in taxes than we do. For example, I have a lot of Dutch friends who pay close to 50% of their income to taxes.

    Prior to April 15th, there was a long thread on another (fairly international) board I post to regarding taxes. Some of the Americans whingeing (isn't that a great word? Brit-speak for whining) about their high taxes were practically laughed off the board--and then informed by their non-American counterparts that paying, say, 14 - 20% or so, on average, of one's income doesn't constitute "high" taxes anywhere else in the world but the US.

    I agree that Medicare and Medicaid funds aren't being well or wisely used now--and of course there are still problems with existing universal health care models such as Canada's and the UK's systems. But I think Americans are in for a big reality check if they think that any kind of universal health care can be instituted here without digging a little deeper in our pockets. I'm not saying I like it! --but I do think it's going to require a different mindset.
  4. by   fergus51
    Stargazer, I am in Canada now and have lived in the States. When I compare the extra I pay in taxes here to the amount I was paying in health insurance there, the difference isn't big at all.

    Frankly I think the gov't could afford it without raising taxes if we stopped paying for all the crap we do now.
  5. by   Stargazer
    fergus, as someone who's lived with both systems, what do you see as the major differences? How does Canada handle the inappropriate ER use that's been mentioned here so frequently, for example?

    And I have to say, despite what someone said upthread, that waiting lists ARE an issue. My hospital was one of four, back in the early '90s, who did CABGs on 50 Canadian patients (per hospital) sent to us who had been waitlisted for almost 2 years. And in my current job, I have to find ways to get around the waiting game in the UK for our Brit employees who need specialty care or non-emergent surgeries.
  6. by   Q.
    One of my biggest gripes is increase taxes. And as I've stated before, as a married, dual income, no children homeowner, my husband and I get taxed quite heavily and NO tax breaks, other than our house.
  7. by   fergus51
    Waitlists are an issue for non-emergency surgery cases, yes. I think that has more to do with our improper management of the resources we have. But like I said, we have dual citizen Americans coming back here to get prescriptions and treatments as well. My great uncle is dead because he didn't want to pay for a trip to the ER.
    Our emergency room just started a fast-track area to try to get the non-emergency cases out faster and there has been a big promo about the nurse-line (telephone triaging thingy) and the walk in clinics. It is still a BIG problem and needs reform.

    The reason I like this system better is because everyone can see a doctor when they need one and they don't have to worry about paying. The problem is there is a lot of overusage because of that. I work L&D, and I saw women in the States who came in all the time with no prenatal care because they didn't qualify for assistance but didn't have enough money for health insurance either (I think you all call them the working poor?) and would wind up in really bad shape when it would've been easy to treat if caught early. You don't see that nearly as often here. You also can't be discriminated upon because of pre-existing conditions. You don't have to worry about what plan to get or if your insurance from your last job will cover you until you get another or what payment plan is set up for your premiums or if your kids can get covered under it, etc. I think these plans are a LOT of beaurocracy and are so confusing and adept at denying care to people, that even those who HAVE health insurance have a hard time getting it to work! I think health care in the US is just such a maze for patients, and it creates a lot of needless waste.

    I just can't imagine denying someone care, or forcing them into bankruptcy to pay for it. It's tragic how many people in the US fall through the cracks and can't afford to access health care. I think that's something we would expect from a third world country, not from one of the world's leaders.
  8. by   fiestynurse
    Who really pays for employer-provided health insurance? Employees and taxpayers do. Most people accept limited health care choices because they think someone else--employers or government--is paying for their health insurance. But that is a misconception. As is true of every other commodity or service, there is no such thing as "free" health insurance. Employer-sponsored health insurance plans lead employees to believe they are getting free coverage, but economists show that workers actually forgo higher wages in lieu of health benefits.

    Economist Charles Phelps argues that "every dollar paid for health insurance is a dollar not paid in wages. This means that workers want to be careful in their selection of insurance, because they really are paying for it, even if the employer is making the payments on paper." John Goodman, president of the National Center for Policy Analysis, puts it this way:

    Health insurance is a fringe benefit which substitutes for wages in the total employee compensation package. The more costly health insurance becomes, the smaller the remaining funds available for wage and salary increases. The ultimate victims of waste in the medical marketplace are employees. This is one reason why take-home pay has been relatively stagnant over the past two decades, even though total compensation has been rising.

    Although workers' total compensation has increased over the past few decades, Goodman notes that workers' take-home pay actually fell by 6 percent between 1973 and 1991, during which time employer-sponsored health insurance benefits increased. Workers--not employers--clearly bear the burden of high health care costs in the form of lower take-home pay.

    A study by the Center for Health Economics Research explains why workers bear most of the burden of high health care costs and mandates.

    When faced with higher health care costs, businesses have three choices: (1) raise prices--placing the burden of higher costs on consumers; (2) accept lower profits--putting the burden on owners of companies; or (3) reduce wages and other labor compensation--shifting the burden to employees.

    Source: Jerry Cromwell et al., The Nation's Health Care Bill: Who Bears the Burden? (Waltham, Mass.: Center for Health Economics Research, 1994).
    Last edit by fiestynurse on Apr 29, '02
  9. by   prn nurse
    My heart goes out to you. You certainly tell it like it is. You should be testifying and telling your story to your state legislature every time they convene. If we all did that, they would listen and change things. They would have to listen. When is the last time one of the folks on this BB wrote a letter to your rep about anything?--------------- --------------------------- ? That is why things do not change. They do read the letters. The letters are valuable. One letter is said to represent the sentiments of a dozen people who did not write. Do you think if every one in the country took 30 minutes to write a letter and said, " Change the health system now !! Or else, I will work my buns off at the grass roots level to see that you are not re-elected !!" That's all you have to say. You do not have to write a lengthy letter. You do not have to tell them how to do it. If and when we demand it at the cost of their gravy train jobs, it will change. What are we waiting for? We are nurses. We could start it from this BB. We could set a date...July 4th..? for all letters to be mailed. We could call it"" RN Country's Healthcare Revolution"" All we have to do is email the idea to everyone on our email list , and hand out flyers at work, and have all our email buddies to email their addressee's and so on and so on...and if the change is not enacted by November, vote their asses out !! It is really simple. Democracy does work if you demand it. This is not a Republican vs. Democrat issue....this is not an issue for campaign promises...this is an issue that we can demand results NOW ! And get them. Nurses should be the creators and instigators...we are on the front lines and see the abuses ! If you all wanta do it, let's organize over on the political thread and do it.
    Last edit by prn nurse on Apr 29, '02
  10. by   fiestynurse
    There are a number of national and state organizations that nurses can join to assist in the Universal Health Care movement.
    I am active in Health Care for All - California, which led the lobbying effort for the passing of SB480 - a mandated study on health care options for California. (one of these options was written by an RN) The study clearly has shown that a single payer system is the most efficient and affordable method to deliver quality health care to all citizens. We are now working to educate the public through forums, leafletting, letters to all the major newspapers, etc. Our next step will be to get a referendum on the ballot and let the voters decide.


  11. by   prn nurse
    How long will it take to get a referendum on the ballot? And as far as getting the voters to vote in favor of it? Have you heard of any reasons why they would not?
  12. by   purplemania
    RE: "being penalized by SS because she elected to stay home and raise a family". Excuse me, but chosing NOT to pay into and participate in a program is not a penalty. It was her choice, though she now regrets it. My son lives in Sweden where he pays >50% taxes. He has "free' health care but it is restrictive and elects to pay privately sometimes. care for children is excellent and he gets reimbursed if they have medical expense here (grandbaby always gets sick the first few days she is here). There is no such thing as free lunch but we really need to rethink our public programs. This has no easy answer but I am glad to see other nurses working on the problem.
  13. by   Q.
    Purplemania- where did you see that post? I want to read that.

    A friend of my in-laws one day made a comment about how in order to get "top benefits" of Social Security, one must have made $70,000 or greater, and how that is soooo unfair that someone with more money should see better benefits. I'm not sure what benefits they were talking about, but my husband kindly pointed out that the person making >70K paid MORE into the system, thus, should receive MORE. They argued with my husband until the cows came home. He finally gave up.

    What is with that mentality?