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How would Medicare for all affect nursing?

Nurses   (4,473 Views 122 Comments)
by Emergent Emergent (Member)

Emergent has 25 years experience and works as a Emergency Room RN.

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There's talk and hope in many quarters that the United States will end up with Medicare for all. How would this affect nursing?

I currently pay a lot for my portion of high deductible insurance through work. It's basically mainly useless to me since I'm healthy, don't take meds etc. Even going to the doctor would cost me. 

Honestly, the middle class has become the new underserved in America. Frugal, responsible people think twice about going to the doctor because of huge copays that have made basic healthcare a budget buster.

How would Medicare for all affect the middle class, nursing in particular? Employers would no longer have to pay for insurance. Would they pass savings on to us in the form of higher wages? How would we fare economically with higher taxes? Would the poor government compensation to facilities drive down wages?

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

4 Followers; 31,459 Visitors; 2,610 Posts

I just read an article comparing the UK system of universal health care as it is done in the UK and how that would compare to US Medicare for all. This comparison is relevant because Bernie Sanders proposal is largely modeled on the UK system .

The average wait time in the UK for planned medical procedures is 9 months and the treatment queues just keep getting longer. It takes 62 days for the average cancer patient to be seen by an oncologist. The percentage of patients  who die of cancer is markedly higher in the UK than in the US. 

The average nurse with 20 years experience gets around 34,000.pounds a year. That amounts to about 26,000.00 dollars a year in US dollars. 

It has been estimated that Medicare for All would cost 32 Trillion over 10 years. An increase in the national debt the US cannot afford.

Hppy

https://finance.townhall.com/columnists/danieljmitchell/2019/04/09/medicare-for-all-would-copy-the-bad-features-of-the-uks-governmentrun-system-n2544488 

https://www.google.com/search?q=How+much+does+a+nurse+make+in+the+UK&ie=&oe=

https://www.x-rates.com/calculator/?from=GBP&to=USD&amount=1

https://www.google.com/search?q=cost+of+medicare+for+all+32+trillion&ie=&oe=

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Emergent has 25 years experience and works as a Emergency Room RN.

6 Followers; 2 Articles; 63,583 Visitors; 2,701 Posts

15 hours ago, hppygr8ful said:

I just read an article comparing the UK system of universal health care as it is done in the UK and how that would compare to US Medicare for all. This comparison is relevant because Bernie Sanders proposal is largely modeled on the UK system .

The average wait time in the UK for planned medical procedures is 9 months and the treatment queues just keep getting longer. It takes 62 days for the average cancer patient to be seen by an oncologist. The percentage of patients  who die of cancer is markedly higher in the UK than in the US. 

The average nurse with 20 years experience gets around 34,000.pounds a year. That amounts to about 26,000.00 dollars a year in US dollars. 

It has been estimated that Medicare for All would cost 32 Trillion over 10 years. An increase in the national debt the US cannot afford.

Hppy

https://finance.townhall.com/columnists/danieljmitchell/2019/04/09/medicare-for-all-would-copy-the-bad-features-of-the-uks-governmentrun-system-n2544488 

https://www.google.com/search?q=How+much+does+a+nurse+make+in+the+UK&ie=&oe=

https://www.x-rates.com/calculator/?from=GBP&to=USD&amount=1

https://www.google.com/search?q=cost+of+medicare+for+all+32+trillion&ie=&oe=

How to pay for it remains the big question. I do think our system currently is bloated and beholden to commercial interests. Take away drug advertising and reductions in defensive medicine could improve that.

Regarding nurse wages, the would be a huge negative for our profession to see wages go in the toilet. 

One big advantage of single payer is the ability to get fantastic prices on medical equipment because of the ability to buy in huge lots. 

How long does it take to see an oncologist in the US? I'm always hearing of big waits for appointments from my ER patients. 

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

4 Followers; 31,459 Visitors; 2,610 Posts

I'm still doing research on average wait times for procedures in US. From my own experience I waited 1 week from Dx of suspected colon cancer to Biopsy and removal of 18 inches of colon.

Hppy 

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traumaRUs has 27 years experience as a MSN, APRN and works as a Asst Community Manager @ allnurses.

14 Followers; 130 Articles; 185,769 Visitors; 20,654 Posts

Medicare for all would further break our system. We (US) can't afford this. I've lived in countries where healthcare for all is the norm. When we lived in S Korea and my son needed cardiac testing done, since we as US citizens paid top dollar for the services, we literally were seen first. We had an appt within 2 days (and this was not an emergency). When we arrived at the hospital, we were whisked to an exam room and walked out of there after all testing and explanations were done within 4 hours. I questioned the extremely full waiting room (people sitting with sleeping children, feeding some kids lunch, others with small children sleeping on mats on the floor and I was told that the usual wait for an appt was 4 - 6 months and that everyone arrives at the clinic at 8am and then they just wait to be called. 

In Spain, I had a child in a Spanish hospital - again, because I was an American, I never waited in the waiting room, I was always seen first. Again, I questioned this because it didn't seem very fair but I was told that since the American government paid better than the Spanish government I got top priority care. 

Is this fair? No. This is what Americans would need to get used to. And I personally don't see that happening. 

I personally have two health insurances - and I still waited 2 months for major surgery which wasn't elective.

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

4 Followers; 31,459 Visitors; 2,610 Posts

Just read that the average wait to see an oncologist following DX is 21 days. This was based on a statistic from 2013. But further reading indicates the target to be seen is 21 days as well. 

Hppy

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morelostthanfound has 27 years experience as a BSN and works as a R.N..

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1 hour ago, traumaRUs said:

Medicare for all would further break our system. We (US) can't afford this. I've lived in countries where healthcare for all is the norm. When we lived in S Korea and my son needed cardiac testing done, since we as US citizens paid top dollar for the services, we literally were seen first. We had an appt within 2 days (and this was not an emergency). When we arrived at the hospital, we were whisked to an exam room and walked out of there after all testing and explanations were done within 4 hours. I questioned the extremely full waiting room (people sitting with sleeping children, feeding some kids lunch, others with small children sleeping on mats on the floor and I was told that the usual wait for an appt was 4 - 6 months and that everyone arrives at the clinic at 8am and then they just wait to be called. 

In Spain, I had a child in a Spanish hospital - again, because I was an American, I never waited in the waiting room, I was always seen first. Again, I questioned this because it didn't seem very fair but I was told that since the American government paid better than the Spanish government I got top priority care. 

Is this fair? No. This is what Americans would need to get used to. And I personally don't see that happening. 

I personally have two health insurances - and I still waited 2 months for major surgery which wasn't elective.

     I disagree.  While the associated costs of Universal Healthcare coverage will most certainly be staggering, in comparison, the U.S. has spent trillions (with a  'T'), on completely failed foreign policies-occupations of Iran, Iraq, Afghanistan, Syria, Libya....  Add to that, the U.S.'s unparalleled defense spending-nearly 3 times that of all other NATO countries combined! Then there's foreign aid in the form of economic and military assistance to developing countries, all the while, millions of our citizens live without very, very basic, yet essential healthcare.  Personally, I can't believe that we as a democratic and free society can't do better by our citizens in terms of essential 'quality of life' issues .  Though I am certainly no expert, it is very obvious to me that our current health care system is broken beyond repair and completely untenable for the future.  The prospect for many of working all their adult lives only to have their entire savings devoured in hospital/medical costs is a sad, sad commentary for our country!

    In terms of Emergent's question, I anticipate that if Universal Healthcare were to become the norm, the uptick in the utilization of healthcare services would demand far greater numbers of providers (especially nurses) to serve this greater need.

Edited by morelostthanfound

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WestCoastSunRN has 20 years experience as a BSN and works as a CCRN.

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Great topic and one I have often wondered about.  It would be great to hear from nurses across the pond, specifically, to speak to the poor wages.  

I don't think universal healthcare will fly here for a number of reasons. I also think we can do much better than we do.  

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juan de la cruz has 27 years experience as a MSN, RN, NP and works as a Adult Critical Care Nurse Practitioner.

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I feel like funding is going to be the biggest question that seems to be unanswered. In simpler terms, I think taxes will have to increase to fund Medicare for all. I'm not sure all Americans will be on board with that concept.

The other detail such as long wait times and quality of care and salaries are also a consideration. However, we already have some form or managed care in this country and HMO's are pretty much operating in a similar manner. There are also "closed healthcare systems" that already model what a single payer system would look like. For instance, in California we have Kaiser Permanente which is an entity composed of three subsidiaries...the Kaiser Foundation Hospitals, the Kaiser Permanente Medical Group, and the Kaiser Permanente Insurance. 

It's a tightly held system that controls which physicians a member gets to see, which hospitals the member gets admitted to and when and where procedures are done, and how much insurance is going to pay for the service. I work Per Diem in that institution and I can see some benefits and downsides. On the other hand, they seem to have it together in terms of cost-containment compared to the academic hospital I work full time for. Their salaries are comparable as well. 

I think for Medicare for all to work, there has to be some private enterprise involvement in terms of delivering the services and that is the case with Medicare plans at the moment anyway.

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

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19 minutes ago, morelostthanfound said:

     

    In terms of Emergent's question, I anticipate that if Universal Healthcare were to become the norm, the uptick in the utilization of healthcare services would demand far greater numbers of providers (especially nurses) to serve this greater need.

They may add more nurses but the wages will likely go down and be stagnate which is the case in every country that has socialized health care. Nurses are considered mid level government employees.

Hppy

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

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4 minutes ago, juan de la cruz said:

…......For instance, in California we have Kaiser Permanente which is an entity composed of three subsidiaries...the Kaiser Foundation Hospitals, the Kaiser Permanente Medical Group, and the Kaiser Permanente Insurance. 

It's a tightly held system that controls which physicians a member gets to see, which hospitals the member gets admitted to and when and where procedures are done, and how much insurance is going to pay for the service...…. 

I have Kaiser insurance and was able to change/choose my physician without any issue when my physician and I did not have a meeting of the minds.

And the quality of care I receive is top notch.

Hppy

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nursej22 has 30 years experience as a MSN, RN and works as a royal pain in the tuchus.

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And what will happen to the executives of for-profit insurance companies who continue to "earn" their millions in yearly compensation, and their poor share holders? 

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