Health Care: The Ticking Time Bomb

misswoosie · Jul 12, 2009

The rate of pay you're suggesting is below starting salary for people without a degree, now. I doubt that salaries, if they're lowered, would descend to that!
Fear mongering prompts scare posts like this. The 1 % tax on those with very high incomes (over $200,000/year or more) will fund a great deal of the program, plus health care billing of employed persons. We have more than enough equipment for diagnosing illnesses now, as well as most other things.
Cost containment measures will diminish a lot of overages; and get people out of hospital and at home rather than staying in hospital where nosocomial infections are a threat, and cost additional amounts that wouldn't be necessary if the patient wasn't admitted. Doctors' fees will be more reasonable and realistic, asd well as those generated by hospitals. Huge premiums charged by insurance companies will be eliminated. Using nurse practitioners more, will also reduce costs.
Many surgeons book surgeries without trying more conservative approaches, first. Wearing a knee band prevented a knee replacement for me, after a PT recommended it. My surgeon was about to retire, and wanted one more for the road, I think..... I've not needed any more analgesics for it, since using the knee band.

I am still wondering what percentage of a salary people are willing to pay each month for this, especially knowing that they are paying for those that can't/won't work.

Anyone like to name a figure? Seems people are keen enough to quote the 1% extra tax for those earning over 200,000 because that won't affect nurses. But what would you pay? 1%,2%,5%

I think the $70 must have been pulled out of thin air.

With a govt run system you may not get a knee op until youhave constant night pain and all the painkillers have been exhausted.

rachelgeorgina · Jul 12, 2009

I'm Australian. & we have a universal health care system (Medicare) paid for out of as a tax at 1.5%. It means that every Australian is entitled to basic healthcare (i.e. can be seen in the emergency department without fear of bankruptcy, can see a bulk-billing (most) GP free of charge, are entitled to all standard medical care including major operations etcetc.) I fail to see what is wrong with this, honestly. It means that people can live without fear of loosing their health/life over a bank statement.

Medicare also provides a rebate/refund when you see a practitioner (e.g. a specialist) who charges more than the Medicare accepted fee. Some do, some don't. For some, it depends on where you see them (e.g. in their private rooms or in their suite in the public hospital.) Medicare sets a baseline fee for types of consults/procedures and so forth and will pay so much and then consumer/patient pays the remainder of the fee out of pocket, should they choose to see a practitioner who charges above the scheduled fee.

Furthermore, whilst every Australian is covered under the Medicare system, we have private health insurance companies with offer additional coverage (e.g. entitlement to 'extras' such a private vs. public hospital stays, single vs. shared room, further allied health services like physio, psychology, dietetics etc.) Private health insurance reduces the burden on Medicare by reducing public waiting lists for elective surgeries amongst other things in providing alternate options for those with the means.

So, Australians are not without choice when it comes to UHC. & at the same time, they are not left out in the cold to die, either, because there haven't any money in their bank accounts on the day they had a car crash, either. & all at a rate of 1.5%, which seems tiny, compared to the lives put at ease (and saved) as a result of "free" health care.

dlatimer · Jul 12, 2009

Maybe the problem with health care is just part of the business culture of the USA.

I was listening to an NPR program describing pathological personalities and was struck by the similarities of symptoms described and those demonstrated by the bankers [insert executives of almost any large corporation] during this banking/economic crisis. Lack of remorse or guilt, lack of empathy, lack of conscience, grandiose sense of worth, failure to accept responsibility of one's own actions, lack of realistic long term goals and pathological lying(1). Is this the direction of our society? These executives are people looked upon for leadership. We only learn what we experience. When this behavior is rewarded - what does that show about our culture of business? Our society in general?

What caused Rome to collapse?

(1) Wikipedia; psychopathic personality

lamazeteacher · Jul 12, 2009

Maybe the problem with health care is just part of the business culture of the USA.
I was listening to an NPR program describing pathological personalities and was struck by the similarities of symptoms described and those demonstrated by the bankers [insert executives of almost any large corporation] during this banking/economic crisis. Lack of remorse or guilt, lack of empathy, lack of conscience, grandiose sense of worth, failure to accept responsibility of one’s own actions, lack of realistic long term goals and pathological lying(1). Is this the direction of our society? These executives are people looked upon for leadership. We only learn what we experience. When this behavior is rewarded - what does that show about our culture of business? Our society in general?
What caused Rome to collapse?
(1) Wikipedia; psychopathic personality

dLatimer:

There you go again, getting to the heart of matters!!

While I don't think that all wealthy people, doctors, bankers, realtors, mortgage/money lenders, and insurance companies' CEOs are sociopaths, that was a component of some leaders' characters here, that led the way for others to mimic it, to be part of the "in" crowd.

There was agreement with so called "untouchables" who abused their positions by thinking that whatever they could accomplish for themselves and their companies, was worth self doubt (for those not afflicted with sociopathy). As nurses who have studied psychopathology, we are all too aware that some minds have no consciences. They see no risk, and hardly cover their "tracks", certainly not considering others' rights. They kept company with self righteous politicians in power, who were led by their love of money and the old saw that "everyone else is doing it!" Even our Presidents who used to be tantamountly trusted and revered, have become reviled as cheaters.

PARENTS!! Whatever else you do for your children, never let them do something, "because everyone else is doing it!" They need to learn early, that those who lead, and those who follow, can be mistaken. They need to develop and use good judgment skills, therefore the easy example of going off a cliff if their friend(s) did, isn't effective. You need to teach them reasoning skills, like, I could get hurt, I don't want to go there, if I do that life as I know it will disappear, etc. Their priorities need to be sound and well practised, and they need to know that figuring out the motives behind others' actions is what proves their worth. In other words, to "follow the money". Take the time to do that!!

As far as Rome is concerned, I don't think the heads of state here, role modeling such unchaste behavior as they have, played the fiddle. (I just had to put that in.) They certainly were distracted by their own sense of importance, as were the heads of that huge ancient state in Italy, and allowed themselves to become debached. As many criminals have done, they were "in too deep to back out". If they went down, they took others with them (to wit, Nixon and his henchmen). That is the structure of collapse. We are all bound to each other as humans (mimicking the food chain), and as has been seen worldwide economically, when one falls, no matter where they are in that cohesive chain, all fall down. That's what "Ring around the Rosie" is supposed to teach us!

You have to admire any leader who operates far from the mold, avoids posturing and lets assailing words pass overhead. He says things and plans with finite care, weighing issues, and advocates changes that were heretofore unbelievable, and travels this country, and internationally early in his Presidency to be in touch with the tempo at home and abroad. How could he make domestic and foreign policy decisions without having been in touch with those for whom he decides issues. He hasn't shown a need for revenge when those to whom he gave billions, and expected he might trust, thanked him by biting his hand. This man has shown patience in the face of criticism, understanding of each side's points of view in disagreements, sees "that there is the capacity for cruelty" and yet keeps a sense of proportion, with good humor. Above all else, he is a good spouse and parent, and expects nothing less of his constituents. Yet he's no messiah!

Certainly no perfect individual exists today, and it's a given, that errors will occur. Appropriate advisors and/or information could be unavailable, and conditions not discernable. Cutting the damages will be the course wisely taken when that happens. With the revision of health care more than anything else, it's evident that there will be more winners than losers. Those who lose (their cause, to keep the status quo), will only have slightly less money for their own disposal, and their health should be more intact. :yeah:

As I've posted before, we'll eventually graduate physicians whose objectives will center around elevating the health of those they touch, who can trust them. Currently we have too many distracted doctors who love their power and went into medicine to be "successful", a term which has nothing to do with the welfare of others. Unfortunately keeping one's eyes on overall goals, requires "blinders" to everything else.

K98 · Jul 12, 2009

As I've posted before, we'll eventually graduate physicians whose objectives will center around elevating the health of those they touch, who can trust them. Currently we have too many distracted doctors who love their power and went into medicine to be "successful", a term which has nothing to do with the welfare of others. Unfortunately keeping one's eyes on overall goals, requires "blinders" to everything else.

If there is no financial reward for becoming a physician, most candidates will opt to pursue something else. You cannot eat altruism, and while dedication to fellow man is admirable, most want a more tangible reward for decades of education and work. You will never see UHC in the United States, mainly because we are still (in spite of the "Messiah") a capitalist country. People work hard for financial reward. Nothing wrong with that. Hard work breeds innovation, government salary caps breed mediocrity.

ACU_RN · Jul 12, 2009

As I've posted before, we'll eventually graduate physicians whose objectives will center around elevating the health of those they touch, who can trust them. Currently we have too many distracted doctors who love their power and went into medicine to be "successful", a term which has nothing to do with the welfare of others. Unfortunately keeping one's eyes on overall goals, requires "blinders" to everything else.

If there is no financial reward for becoming a physician, most candidates will opt to pursue something else. You cannot eat altruism, and while dedication to fellow man is admirable, most want a more tangible reward for decades of education and work. You will never see UHC in the United States, mainly because we are still (in spite of the "Messiah") a capitalist country. People work hard for financial reward. Nothing wrong with that. Hard work breeds innovation, government salary caps breed mediocrity.

Well said.

lamazeteacher · Jul 12, 2009

As I've posted before, we'll eventually graduate physicians whose objectives will center around elevating the health of those they touch, who can trust them. Currently we have too many distracted doctors who love their power and went into medicine to be "successful", a term which has nothing to do with the welfare of others. Unfortunately keeping one's eyes on overall goals, requires "blinders" to everything else.
If there is no financial reward for becoming a physician, most candidates will opt to pursue something else. You cannot eat altruism, and while dedication to fellow man is admirable, most want a more tangible reward for decades of education and work. You will never see UHC in the United States, mainly because we are still (in spite of the "Messiah") a capitalist country. People work hard for financial reward. Nothing wrong with that. Hard work breeds innovation, government salary caps breed mediocrity.

Did I say no financial reward? It's a given that people work for payment for their services, or give them "pro bono", as a volunteer. The point is, that doctors abuse their positions, requiring more and more wealth in return for going to school and being a resident less than a decade. Their focus on accumulating wealth deprives patients of attention to their concerns. I see a doctor who left his office at 10:30 A.M. (off duty, hadn't been "on call", in fact he's never "on call", leaving patients with the option of going to the ED, or a doctor whose English is unintelligible. Another day the same week, he left at 3:00 P.M. Now his staff tell me he's about to retire (while he can still sell his practise for moocho bucks), in his 50s!

You cannot steal my message by misinterpreting it! :down:

lamazeteacher · Jul 12, 2009

Well said.

Canada is also a capitalist country! :yeah:

Ron Houston · Jul 12, 2009

I have found that quite a few of the opponents of any reform to America's health care seem to have the mistaken impression that proponents for reform are wanting something for nothing. Most of those that believe that health care needs reform are the ones that have struggled to keep their health care or have none at all because they can't afford it. Consider yourself blessed if you do indeed have health care. Please remember everyones health care situation is different and not the same as yours. There but for fortune go you are I.

lamazeteacher · Jul 12, 2009

the slippery road to totalitarianism is paved with good intentions.
really???? any totalitarianist government i've known has been established by coup, or succession.
they call the healthcare system in america broken. you agree that is is, in your own enboldened words below.
one person here wants to expand medicare. some people are misguided that it is a right or a privledge.
it is a human right to have health maintained, residing in a presumably civilized, rich country
they want to raise taxes on people and give that money to people who make less.
robin hood is a much loved story about the obscenely rich english nobles, who he robbed to give to the poor. that is not an agreed method of attaining enough money to survive now, so we have a "wefare" system about which those deprived of a tiny % of their wealth, moan and groan.
think about it, the government will force you to pay more money for a service that you will not even use.
taxpayers who don't benefit from many government programs, pay for them with their taxes. i don't use postal services, educational programs, "unemployment payments, despair military "protectionism", etc., etc., etc., yet my taxes over 56 years of employment, paid for them!
liberals would like you to believe that it is about the haves and the have nots. the so called rich versus the so called poor. heavens, no!!! that is what communism is all about, evening out finances with the presumed object of giving it to the people, equally.
if reform is going to happen, then reform needs to occur internally, i do agree that charging a massive amount of money to see a patient for 2 mins is a fraud during rounds. on the other hand we need to find out who these uninsured people are in the usa are? this magic number 47 million, how many of them are here illegally ? how many of them chose not to have health insurance? i want to know.
ok, i was uninsured for about 5 years, when unemployed here (due to age discrimination), and i am here legally. i paid the gouging premiums of cobra (aptly named for the snake, as it strangles one's finances); and because of having had breast cancer x 2, it was impossible to get private health care coverage, and my medications' cost ($1500./month) was also prohibitive. never one to be noncompliant, i begged samples of them from my doctors, and money from my family in canada (who were nonplussed that they cost so much, and bought them for me sporadically, for 1/5 of the cost in the usa, in canada). it tore my sister up to do that, as she was sure it was illegal for americans to do that (before it was). she had been an investigator looking into those in canada, who were suspected of abusing their health care system.
if you liberals believe that healthcare is a right, then i assume you believe it is a right of being an american citizen, no!!! it is only reasonable to have it when living in a country with ample resources, some of which were paid by my taxed income, for 48 years, when i could work.
those who are here illegally dont have those rights they do!!and should not be entitled to that benefit correct? wrong!!!
we didn't adequately seal off our country, allowing them entry by default! they have been exploited here, by american employers, working for pay no american would tolerate!
it does sadden me all the corruption, the massive charges for a two minute bedside visit, the high insurance premiums providers have to pay, and the greed of the industry. make no mistake, health care is an industry, like retail, or any other capital industry. it needs a major shake up when people can not get health insurance at reasonable rates. yea i am middle of the road on this one, at one hand, it saddens me to see people do without, but on the other hand, i know the government is horrible at running anything.. look at the postal service for example. canada privatized their postal service, due to what was thought to be too expensive and inefficient, and got far worse service, at 3 x the cost of ours. my sister sent me allergy otc meds (there, not here), that took 20 days to get to me, in the east portion of the us.
the solution? universal health care run by experienced medical professionals, with the government services only as the cashier, paying employees. guidelines and monitoring will only come from qualified, paid professionals, as it does now, for regulation of health care facilities. ltc ones could certainly use more of that!
my social security payments come to me correctly, in a timely manner. it is hard to get through to a worker there by telephone, though and so i go to the office and wait about an hour to find out something or redirect my checks if i change locations. the workers there have been exceptionally polite, informed, and useful! unfortunately politicians planning that program have made one spouse's payments of 50% of his/hers, available to all spouses they've had. in other words, if one person who made more money, therfore contributing slightly more from their pay, than their (possibly) 4-5 divorced ex-spouses. so 0.5 x 4 = 2, + 1 for the worker = 3 whole payments from one person's contributions to social security. no wonder it's about to become bankrupt!
despite some faults, the dmv is also efficient, considering all the work done by their employees, who are a little more dogged about adhering to better regulations.
please compare the changes i've made below, with those patrick wrote originally. i've embellished them according to my beliefs. lamazeteacher
1. no free insurance. people who are going to use a government backed program need to pay reasonable, affordable premiums, no deductibles like others.
2. preventive medicine needs to be emphasized, ie eating mostly nutritious foods, without partially hydrogenated products, excessive fats and sodium right, not getting to be a morbidly obese, and exercising, and enforcing recommended immunizations for children.
3. money hungry people with erroneous law suits need to be penalized. how? malpractise definitely needs to be punished, especially when mutilation and/or wrongful death occurs.
4. hospitals need to charge reasonable rates based on reasonable, fair prices from suppliers, and have comprehensive formularies of pharmaceuticals, that allow continuity of care (not possible now).
5. insurance needs to change.. i dont know how. how about getting rid of those companies that have been bleeding the medical system forever.
pharmaceutical companies "double dip", claiming research expenses elevate prices of their products, while having grants awarded for that.
6. public health care needs to happen and will work in the usa
7. either legalize or deport illegals who use health care system. if you legalize them, then they make fair reported wages and are taxed and become part of the system. if they're deported, then they are no longer a burden on american society/the system.
8. penalize malpractise and repeated inferior provision of care (like referring patients to overburdened eds when offices close early).
9. ensure that appropriately educated nurses in sufficient numbers, staff hospitals and clinics.
there it is, a system with which we can live! we can do it!!!

patrick1rn, MSN, RN, NP · Jul 12, 2009

the slippery road to totalitarianism is paved with good intentions.
really???? any totalitarianist government i've known has been established by coup, or succession.
they call the healthcare system in america broken. you agree that is is, in your own enboldened words below.
one person here wants to expand medicare. some people are misguided that it is a right or a privledge.
it is a human right to have health maintained, residing in a presumably civilized, rich country
they want to raise taxes on people and give that money to people who make less.
robin hood is a much loved story about the obscenely rich english nobles, who he robbed to give to the poor. that is not an agreed method of attaining enough money to survive now, so we have a "wefare" system about which those deprived of a tiny % of their wealth, moan and groan.
think about it, the government will force you to pay more money for a service that you will not even use.
taxpayers who don't benefit from many government programs, pay for them with their taxes. i don't use postal services, educational programs, "unemployment payments, despair military "protectionism", etc., etc., etc., yet my taxes over 56 years of employment, paid for them!
liberals would like you to believe that it is about the haves and the have nots. the so called rich versus the so called poor. heavens, no!!! that is what communism is all about, evening out finances with the presumed object of giving it to the people, equally.
if reform is going to happen, then reform needs to occur internally, i do agree that charging a massive amount of money to see a patient for 2 mins is a fraud during rounds. on the other hand we need to find out who these uninsured people are in the usa are? this magic number 47 million, how many of them are here illegally ? how many of them chose not to have health insurance? i want to know.
ok, i was uninsured for about 5 years, when unemployed here (due to age discrimination), and i am here legally. i paid the gouging premiums of cobra (aptly named for the snake, as it strangles one's finances); and because of having had breast cancer x 2, it was impossible to get private health care coverage, and my medications' cost ($1500./month) was also prohibitive. never one to be noncompliant, i begged samples of them from my doctors, and money from my family in canada (who were nonplussed that they cost so much, and bought them for me sporadically, for 1/5 of the cost in the usa, in canada). it tore my sister up to do that, as she was sure it was illegal for americans to do that (before it was). she had been an investigator looking into those in canada, who were suspected of abusing their health care system.
if you liberals believe that healthcare is a right, then i assume you believe it is a right of being an american citizen, no!!! it is only reasonable to have it when living in a country with ample resources, some of which were paid by my taxed income, for 48 years, when i could work.
those who are here illegally dont have those rights they do!!and should not be entitled to that benefit correct? wrong!!!
we didn't adequately seal off our country, allowing them entry by default! they have been exploited here, by american employers, working for pay no american would tolerate!
it does sadden me all the corruption, the massive charges for a two minute bedside visit, the high insurance premiums providers have to pay, and the greed of the industry. make no mistake, health care is an industry, like retail, or any other capital industry. it needs a major shake up when people can not get health insurance at reasonable rates. yea i am middle of the road on this one, at one hand, it saddens me to see people do without, but on the other hand, i know the government is horrible at running anything.. look at the postal service for example. canada privatized their postal service, due to what was thought to be too expensive and inefficient, and got far worse service, at 3 x the cost of ours. my sister sent me allergy otc meds (there, not here), that took 20 days to get to me, in the east portion of the us.
the solution? universal health care run by experienced medical professionals, with the government services only as the cashier, paying employees. guidelines and monitoring will only come from qualified, paid professionals, as it does now, for regulation of health care facilities. ltc ones could certainly use more of that!
my social security payments come to me correctly, in a timely manner. it is hard to get through to a worker there by telephone, though and so i go to the office and wait about an hour to find out something or redirect my checks if i change locations. the workers there have been exceptionally polite, informed, and useful! unfortunately politicians planning that program have made one spouse's payments of 50% of his/hers, available to all spouses they've had. in other words, if one person who made more money, therfore contributing slightly more from their pay, than their (possibly) 4-5 divorced ex-spouses. so 0.5 x 4 = 2, + 1 for the worker = 3 whole payments from one person's contributions to social security. no wonder it's about to become bankrupt!
despite some faults, the dmv is also efficient, considering all the work done by their employees, who are a little more dogged about adhering to better regulations.
please compare the changes i've made below, with those patrick wrote originally. i've embellished them according to my beliefs. lamazeteacher
1. no free insurance. people who are going to use a government backed program need to pay reasonable, affordable premiums, no deductibles like others.
2. preventive medicine needs to be emphasized, ie eating mostly nutritious foods, without partially hydrogenated products, excessive fats and sodium right, not getting to be a morbidly obese, and exercising, and enforcing recommended immunizations for children.
3. money hungry people with erroneous law suits need to be penalized. how? malpractise definitely needs to be punished, especially when mutilation and/or wrongful death occurs.
4. hospitals need to charge reasonable rates based on reasonable, fair prices from suppliers, and have comprehensive formularies of pharmaceuticals, that allow continuity of care (not possible now).
5. insurance needs to change.. i dont know how. how about getting rid of those companies that have been bleeding the medical system forever.
pharmaceutical companies "double dip", claiming research expenses elevate prices of their products, while having grants awarded for that.
6. public health care needs to happen and will work in the usa
7. either legalize or deport illegals who use health care system. if you legalize them, then they make fair reported wages and are taxed and become part of the system. if they're deported, then they are no longer a burden on american society/the system.
8. penalize malpractise and repeated inferior provision of care (like referring patients to overburdened eds when offices close early).
9. ensure that appropriately educated nurses in sufficient numbers, staff hospitals and clinics.
there it is, a system with which we can live! we can do it!!!
and that is an example of two people who have diffrerent opinions about how health care should be managed.
after reading lamaze twist and turn my posting here, i read this again and take issue with some key differences.
thank you for the spelling corrections btw, but i feel i got my opinion across.
1. enforcing immunizations ? sounds dictatorship
2. i will stick to the issue about healthcare in further postings about this subject
3. you believe public healthcare for everyone is a good thing, i believe it will be a disaster for the health of our country, our country is massive in size, an entity that large would need to tax more than 1 percent of income of people who make over 200 k per year.
4. would this socialization of medicine in the usa also include drug makers, medical device makers, etc ? it almost sounds like you want the entire entity of health care under government controll.. four letters for you ussr.

ACU_RN · Jul 12, 2009

Canada is also a capitalist country!

Not so much.

Health Care: The Ticking Time Bomb

Would you support a public health care option?