Health Care: The Ticking Time Bomb

[Joe V]

Our health care system hurts everyone. Premiums are expensive and increasing every year. Doing nothing today will cost taxpayers 2-3 times more in the next few years.

Currently, the "public option" is the biggest obstacle when it comes to health care reform. Many believe that it will be the end of health care as we know it today - others think that it is long overdue.

Would you support a public health care option?

[ShayRN]

Again, you all keep saying Universal Health Care. That isn't what is being proposed. A government option to BUY insurance. There are people out there who cannot get insurance due to preexisting conditions and excesive cost. That is NOT fair. I would not want UHC, I do want everyone who wants insurance the ability to BUY it without fear of not eating.

How many of you went to college on a FEDERAL subsidized student loan? How many GI's in the 50's were able to buy homes because of a government sponsered program that gave them low interest loans. Yes, we have a big government. But that is a fact of life, it isn't going to change. At least with our new administration I don't have the fear that my government is protecting me by torturing others. I am hoping and praying out Americans overseas no longer have the fear of the CIA listening in on their conversations.

[dlatimer]

Regarding the public plan cost. If all 40 million without health insurance would sign up the policy holder base would be so huge, the cost (and therefore the premiums/copayments) would be much less than today. Also, there would be no profit involved, saving more - and all those collecting medicaid (from state coffers) would be transferred to this public plan. If the quality of health increased in the general population - would more people work? Hopefully someone smarter than me (that includes about anyone) can figure this out.

[misswoosie]

Again, you all keep saying Universal Health Care. That isn't what is being proposed. A government option to BUY insurance. There are people out there who cannot get insurance due to preexisting conditions and excesive cost. That is NOT fair. I would not want UHC, I do want everyone who wants insurance the ability to BUY it without fear of not eating.

How many of you went to college on a FEDERAL subsidized student loan? How many GI's in the 50's were able to buy homes because of a government sponsered program that gave them low interest loans. Yes, we have a big government. But that is a fact of life, it isn't going to change. At least with our new administration I don't have the fear that my government is protecting me by torturing others. I am hoping and praying out Americans overseas no longer have the fear of the CIA listening in on their conversations.

How is a government option to buy insurance any different from us paying 6.5% of our salary towards our UHC?

Doesn't really matter what name you give the system. I didn't say it was fair that some people didn't have access to health care-I was pointing out that a government run scheme will ration care and resources and may lead to cuts in wages,facilities and technology.

Or maybe you think their will be a 2 tier system, 1 for those that have good healthcare insurance and a government run one for those who cannot afford other insurance? If this is the case I can imagine which hospitals will pay the highest wages,staffing levels, shortest wait times and the best technology.

I wonder where most people will chose to work?

[misswoosie]

Regarding the public plan cost. If all 40 million without health insurance would sign up the policy holder base would be so huge, the cost (and therefore the premiums/copayments) would be much less than today. Also, there would be no profit involved, saving more - and all those collecting medicaid (from state coffers) would be transferred to this public plan. If the quality of health increased in the general population - would more people work? Hopefully someone smarter than me (that includes about anyone) can figure this out.

If the 40 million without health insurance suddenly have access to disease management programmes, preventative and in patient care which they have not previously had, and the government sets targets for those aspects of care, then there will need to be a hell of a big pot of money!

[Fuzzy]

I cannot get health insurance due to pre existing conditions. The only time that I have ever had adequate healthcare was when I was on disability. I choose to go off of disability and go back to work. I know many people on disability who could work but don't due to the fact that they would lose their health care. Funny some of them are RN's with severe back problems. I would like affordable and available health care. Right now it is neither for me. The key word is affordable. I don't expect free but affordable. Right now health insurance if I could get it would cost one-half of my monthly income before taxes. That's not affordable.

I'm nearly 50 and I've never had a mammogram, I've only had two pap smears, and I have had very few medical screenings that are not related to my current medical issues. I tell my friends, that if I get cancer I'm just going to have to die as I certainly could never afford the chemo, radiation, or surgery. Same goes with a heart attack or stroke. Only the insured or the wealthy can afford medical care in this country. For the rest of us it's unavailable.

Fuzzy

[K98]

I cannot get health insurance due to pre existing conditions. The only time that I have ever had adequate healthcare was when I was on disability. I choose to go off of disability and go back to work. I know many people on disability who could work but don't due to the fact that they would lose their health care. Funny some of them are RN's with severe back problems. I would like affordable and available health care. Right now it is neither for me. The key word is affordable. I don't expect free but affordable. Right now health insurance if I could get it would cost one-half of my monthly income before taxes. That's not affordable.

I'm nearly 50 and I've never had a mammogram, I've only had two pap smears, and I have had very few medical screenings that are not related to my current medical issues. I tell my friends, that if I get cancer I'm just going to have to die as I certainly could never afford the chemo, radiation, or surgery. Same goes with a heart attack or stroke. Only the insured or the wealthy can afford medical care in this country. For the rest of us it's unavailable.

Fuzzy

My daughter is a nursing assistant/nursing student. She is covered under my insurance until age 25, but she could afford her own insurance through her employer. She makes 10.50/hr. I keep her on my policy because she is eligible. My point is, she is self-supporting on 10.50/hr and she can afford a decent plan that her employer offers. One of her friends doesn't pay for her employer plan because she chooses to have cable internet/BlackBerry instead. These kids are not wealthy.

[ACU_RN]

My daughter is a nursing assistant/nursing student. She is covered under my insurance until age 25, but she could afford her own insurance through her employer. She makes 10.50/hr. I keep her on my policy because she is eligible. My point is, she is self-supporting on 10.50/hr and she can afford a decent plan that her employer offers. One of her friends doesn't pay for her employer plan because she chooses to have cable internet/BlackBerry instead. These kids are not wealthy.

When I was in nursing school I worked a min wage job that didn't provide health insurance. My wife, son and myself could have milked the government and used the .gov medicine, but we didn't want to add to the problem. We went without health coverage for three years and paid as we went, some of which I am still paying. Not a lot though. It can be done WITHOUT the government.

[Fuzzy]

I pay for my own health care. Because, I don't have insurance, I get to pay full price. I cannot negotiate for a lower fee. If I don't pay, well I get sent to collections, I can get a judgement against me and I'm considered a poor credit risk. I don't qualify for any government programs because I'm single, have no dependents, and I work at a $12/hour job for a living. I have dial up Internet, no cable/ satellite TV, no cell phone. I walk to work instead of drive. Wash my dishes by hand as well as line dry the laundry. I live quite frugually.

Many times I decide if the doctor ordered blood work is really necessary in order to remain on medication. Sometimes I take one pill once daily instead of two twice daily as prescribed just to make the prescription last longer. In the hard months, I take my chances and go without the medication. Sure the pills are expensive but not near as expensive as the required bloodwork and doctor's visit every six months in order to keep the prescription current. I haven't ended up in the ER yet. If I did, I don't know how I would pay for it. So yes some affordable insurance would be a Godsend for me. It could even have a $5000 deductible. I just need a policy to take care of the major stuff.

Meanwhile, I know people who go to the doctor everytime the kid gets a snotty nose because their insurance will pick it up.

Fuzzy

[misswoosie]

I cannot get health insurance due to pre existing conditions. The only time that I have ever had adequate healthcare was when I was on disability. I choose to go off of disability and go back to work. I know many people on disability who could work but don't due to the fact that they would lose their health care. Funny some of them are RN's with severe back problems. I would like affordable and available health care. Right now it is neither for me. The key word is affordable. I don't expect free but affordable. Right now health insurance if I could get it would cost one-half of my monthly income before taxes. That's not affordable.

I'm nearly 50 and I've never had a mammogram, I've only had two pap smears, and I have had very few medical screenings that are not related to my current medical issues. I tell my friends, that if I get cancer I'm just going to have to die as I certainly could never afford the chemo, radiation, or surgery. Same goes with a heart attack or stroke. Only the insured or the wealthy can afford medical care in this country. For the rest of us it's unavailable.

Fuzzy

Regarding the mammogram, in Europe the guidelines for routine mammography do not recommend routine screening for women under 50. There is no evidence to suggest that routine screening at an earlier age is beneficial, and is more likely to be harmful.In the UK every woman between the age of 50 and 70 is invited for mammography every 3 years.

Because it is often perfomed in mobile units (ie trucks that go from hospital to hospital) it is done an a geographical area basis, so some women do not get one until they are 53. There are plans here to change that so that in 2012 all women over 50 will have had one by the time they are 51.

Regarding "other screening" we do not routinely check BP,cholesterol,serum glucose,urinalysis until age 55.

PAP smears are performed on all females aged 16 and over every 3 years.

There are now private firms offering (randomly writing to people at home) screening tests for aortic aneurysms,peripheral vascular disease and carotid artery disease at a cost of $240.

Despite the fact that we pay 6.5% of our pre-tax earnings towards the NHS and employer pays additional similar percentage (for me that's $5,500 per year or $460 per month) our system is rationed according to government guidelines. If the guidelines don't say it, then you don't get it unless you are prepared / can afford to pay for it privately The guidelines are often out of date as far as evidence from clinical trials go, and some GPs are either reluctant to follow them due to increased costs from their "budgets" or lack knowledge.

We also pay on top of this for dental care, prescriptions and eyewear.

Thinking about stroke- GPs are reluctant to start patients who have AF and who meet the guidelines on warfarin (coumadin equiv) because they think it is a dangerous drug or they have to pay specialist teams to monitor it.They wil put the patient on Aspirin depspite the well known and accepted evidence that warfarin is 3 times more effective then aspirin for stroke prevention in these patients.

The evidence for thrombolysis in acute stroke has been around for over 10 years, and whilst some (a few) hospitals in the UK have been doing it since the late 90s- the government has taken till last year to implement a national stroke strategy that says all hospitals that admit acute stroke patients have to have a thrombolysis service in place, however they don't say it has to be available 24/7 so many hospitals only provide the service Mon-Fri 9-5! which to me is unnaceptable. It is only since the advent of the national strategy and targets for stroke that the managers in many of our hospitals are listening to the Stroke Physicians and putting some extra resources into stroke care.I think you will find that is very different in the US.

Our system is very target and budget driven which is not always best for patients, but in addition guidelines are not always adhered to,especially by those in primary care. Money will be pumped into whatever is "en vogue"often by taking away money from a service that was "en vogue" the year before. For example, our Cardiology specailist nurse were given higher pay bands than a lot of other clinical nurse specailists because the government threw millions into cardiology. However that pot has now dried up so the cardiology nurse specailists have all been downgraded under the auspice of a "service reorganisation". Conveniently they waited until they had all done nurse prescribing courses before downgrading them.

I agree that for many in the US that have chronic diseases our system would be a better system. But you need to bear in mind that here many of those people have paid considerable amounts into the pot for many many years and taken little out, and have little control over what they can and can't have regarding investigations and treatment.

I wonder how much people pay for health insurance and how much a PAP smear or mammogram would cost over in the US?

[misswoosie]

What you are talking about is called competition which is a by-product of capitalism. If what President Obama proposes means getting health care for my ailing wife at an affordable rate I am all for it no matter what you call it. Our system of health care in this nation does not work.

I can understand that-but would you sacrifice quality for cost?

[Ron Houston]

I can understand that-but would you sacrifice quality for cost?

What good is quality when you can't afford it? No system will be perfect but the system we have now does not work. Some type of reform is needed. Quality for cost? "I would much prefer a bologna sandwich than to starve.". I don't think that the quality of health care will be compromised. Yes we have the best health care in the world but when one catastrophic illness can bankrupt a family. "What good is it?" When people die because of the cost. "What good is it?". We tout ourselves as a moral Christian nation, it is time we walked the walk instead of talking the talk.

[ACU_RN]

Hey Ron, the system we have now does work for 95% of us.