Universal Health Coverage?

Nurses General Nursing

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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 it is, they only pay 30cents on the dollar, are slow to reimburse, most often clinics and hospitals struggle financially and often times have to write off alot of procedures d/t Medicare. I sometimes see Medicare as a reflection of what universal health coverage would be; not enough money and care down to the least common denominator. Canada, our neighbor, is also struggling as there isn't enough money to care for all of their citizens. What is everyone else's opinion on this? What IS the answer?

Here is a poem I came across that I thought I would share:

Taken from the International Conference in Medicine held in February 2001:

Draped in Disquise

Cries for medical care equal to Canada or Great Britain is fair

Everyone's much better there, so why not us? We want their care

NO, they say, it isn't so

Don't give up what you have for the lesser care within our society

Am I to believe it's a disguise? A mask claiming to be better for you or me;

confusion, disorder split in two which shall we choose?

One bringing change, or another bearing mediocrity

Our lives are too precious to be bound by the arms of bureaucracy.

Other nations have tried and failed leaving only discontent and disparity

Look forward to what can be.

Not their past except it's history.

Lest the burning desire of what we lust becomes the aftermath of only dust.

If we turn our backs and pretend not to see, no more will we the envy be, and the failures of others becomes our destiny.

Learn from their failure, for left unexplored creates another worse than before.

By Linda Tofanelli

fiestynurse, have you ever considered teaching health and social policy to nurses? Many of your posts show you excel health policy debate. :)

Forgive me if someone has mentioned these points already.

I have a group of British girlfriends who came to the US in the 70's during the 'nurse invasion' brought on by the shortage then. They all became citizens here, eventually raising families, because in Britain, their salary is little more than minimum wage under national healthcare. They tell me they could not support themselves independently on their salaries in Britain! Are US nurses willing to take such a cut in pay should we go to a similar system? I sure can't see US docs taking ANY pay cut, so you know we would....!!

With the current move towards BSN as mimimum, who will go into a 4 year program to make little more than minimum wage?

I remember the last healthcare plan....and Hilary's famous quote about a main problem in our healthcare system being the 'overpaid handmaidens' in nursing.....but how quickly some forget.

Specializes in LDRP; Education.
Originally posted by mattsmom81

I remember the last healthcare plan....and Hilary's famous quote about a main problem in our healthcare system being the 'overpaid handmaidens' in nursing.....but how quickly some forget.

Are you serious???????:eek:

All the more fuel for me to hate Billary Clinton with.:(

I find that hard to believe, since Bill Clinton's mother was a nurse.

She had a BSN and was nurse anesthetist.

We also have nurses in Congress, such as Lois Capps, a former school nurse.

Specializes in Gerontological, cardiac, med-surg, peds.

It's true, Hillary said it. Bad thing is, she has her eye on the Whitehouse in 2004, but I digress.... Ever wonder why so many Canadian nurses are down here??? Can't find fulltime employment under their socialistic system. Also can make better $$$ down here. I'm afraid Mattsmom81 is right. Government run health care==LOW PAID NURSES (just look at salaries for nurses in health dept's and schools). :eek: :eek:

Also, Great Britian's system is much different from Canada's system, which is single payer. Great Britain is among the OECD countries with national health services, in which salaried physicians predominate and hospitals are publicly owned and operated. Britian's system has been grossly underfunded for years, which has kept nursing salaries low. Prime Minister Tony Blair is about to change all that.

The New York Times

April 21, 2002

Blame Me if Health Plans Fail, Blair Says

By Reuters

Britain's Prime Minister Tony Blair said Sunday his government's mission to overhaul public health care was a huge challenge and he would take the blame if it failed.

Opinion polls published Sunday suggested most Britons were ready to pay more for better health treatment.

But they also revealed a widespread belief that Blair had broken an election pledge not to raise income tax...

...Chancellor Gordon Brown hiked taxes last week to pump billions of extra pounds into the ailing National Health Service (NHS).

Wednesday, Brown outlined plans to pour an extra 40 billion pounds ($58 billion) into public health care over the next five years. Most of the money will come from taxes, with a one percentage rise in National Insurance -- a payroll tax -- right up the salary scale being the biggest revenue earner.

Blair has refused to rule out further tax rises but said the changes to the health services were covered by Brown's steps on Wednesday. He dismissed as "nonsense" accusations that his Labor government was returning to a "tax and spend" policy.

http://www.nytimes.com/reuters/world/international-britain-blair.html

Comment: Innumerable models have demonstrated that public funding and public administration can deliver more health services to more people for less money. But public funding has been a major weakness of the existing programs.

In the United States, our system of combining both public and private funding has resulted in the most generous health care funding of all nations, estimated to be 14.7% of our GDP for 2002 (Office of the Actuary of CMS). But we have seen that other nations that have relied on public funding have failed to provide enough resources to assure capacity that would prevent excessive queues for services. The British system has been frozen

at 7% of their GDP, primarily because of political resistance to taxes.

Apparently the administration of Prime Minister Blair has finally decided to confront the real issue. The National Health Service simply needs more tax revenue.

The lesson for the United States is that we must counter political efforts to isolate the concepts of "taxes" and "government" as if they were topics unrelated to our social needs and desires. Leaving half of our health care system under private funding in the private sector has resulted in the worst inequities in health care of all industrialized nations.

Most Americans do believe that we need greater equities in both access and coverage. The private sector has proven that these goals cannot be achieved without including taxes and the government in the comprehensive design of the system. Whereas other nations are facing the issue of needing more funding, we have already made the decision to devote the resources needed

that would fund comprehensive care for everyone.

Let's now define the proper role of government and taxes in a system that actually would provide the universal access and coverage for which we are already paying. Even the political opponents admit that a single payer system would do this. Why do you think they are excluding us from the forums on reform? Simply because the logic of our message is so clear that our voice must be stifled. Thus, the deceptive "tax and spend" rhetoric is being used to dismiss us in our absence.

Let's end these deceptions by adopting more accurate rhetoric such as, "Comprehensive health care for everyone: We're paying for it! Let's have it!"

Hillary Clinton DID NOT make such a statement, that is one of those urban legends. That story has made the rounds time and again with no basis in fact. Look it up, it ranks right up there with Nostradamus predicted what would happen on 9/11. While I don't know that I like Hillary much, I also think a bit of common sense would make it apparent the ANA would have howled at that. I don't think the ANA howls when they need to very often, but I can't see them letting that go by.

Next, why does anyone think that a universal healthcare system here would have to look like anyone else's? While we would obviously have a model it does not mean it can't be tweaked to fit the needs of this country. That includes decent pay for nurses. The world if full of possibilities, it is closed only when you decide it is closed and what you want is not worth pursueing or working for. At some point in time the only way for nurses to have what we want, what has been talked to death for years is to reach out there and take it. Quit waiting for someone to do it for you, quit worrying about whether it will upset someone or be unladylike. But just do it. Nurses could led a revolution in healthcare if we really wanted to, though that would mean frankly, that some old guard nursing leaders would have to be brushed aside. I guess it all depends on how bad you want something.

PRN nurse, I just want to let you know that I originally wasn't going to say anything to the guy at SS. But after I got out to the car I just couldn't not say something. Don't worry my mom knows she has a daughter with a rotten temper and a blunt mouth. :D

I also have to say this. It is delightful to have a discussion that can engender some passionate feelings, that has stayed a interesting conversation with no nasty comments or ill will anyway. I appreciate this.

Originally posted by VickyRN

It's true, Hillary said it. Bad thing is, she has her eye on the Whitehouse in 2004, but I digress.... Ever wonder why so many Canadian nurses are down here??? Can't find fulltime employment under their socialistic system. Also can make better $$$ down here. I'm afraid Mattsmom81 is right. Government run health care==LOW PAID NURSES (just look at salaries for nurses in health dept's and schools). :eek: :eek:

But where are the Canadian nurses going? You don't meet a lot of them in Mississippi, or Louisianna, etc. Wages here are between about 18 and 24 US$ (top end of the payscale reached after 9 years is 60 000$ CDN so about 40 000$ American plus whatever ot you want to put in). A lot of nurses in the US make less than that....

I just went to a lecture from a political science professor about health care, went into globalisation and the American Empire, etc. He had an excellent book there called "Universal Health Care, what the United States can learn from the Canadian experience". Authors are Armstrong, Armstrong and Fagan. I would highly reccomend it. It points out the fact that Americans spend more money on healthcare and that the care (as measured by patient outcomes) is not better because of the extreme differences between the rich and the poor. Also discusses the problems the Canadian system has and how to improve it. It is an excellent read if you want some facts about the issue. I've already requested it from my library so I can read the whole thing...

Specializes in Gerontological, cardiac, med-surg, peds.

Thanks, Fergus, for the book information. Sounds like a good read and a valuable resource. Have jotted that title down for future researching.

As a Canadian nurse I have some views on these issues (what a surprise eh???) !!!

I have thought long and hard about going to the States. I think the Canadian nurses who do go are drawn by the differences in the dollar, not better conditions. Believe me better conditions DO NOT exisit in the states, esp after reading the post, "would this pt be one to one in your ICU).

Canadian nurses are also drawn to the fact that you have sign on bonuses ( not here yet) and the fact that tution will often be paid for by hospitals. Many Candians however, come back after a year or two of working and with the diff in the dollar, pay off their student loans, ect. Another thing we do not have here are travelling nurses, and that attracts some of the RN's also.

What we do have here is a strong concern and heartfelt belief that health care is a RIGHT for every citizen. Our hospitals are not run like a business venture and the all mighty buck does NOT rule. We in Ontario, have strong union, and the top run ( 8 year wage scale) makes almost 33.00 dollars an hour. They are not poor, they are not hard done by. Being sick in this country is not a crime, and when you walk thru the hospital doors, your ability to pay HAS NOTHING TO DO WITH YOUR right to health care.

I will also have to read the book Fergus recommended...thanks!

I'm interested in how the Canadian healthcare system is funded, and how nurse salaries and strong union voice stays up. Love those nurse patient ratios in Canada! Too bad you don't use travelers or I may be up there ...;)

Excellent thread guys and gals! :)

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