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?
Vermont had a single payor system from 2011 until 2014 until it was dismembered because of complaints of costs to small businesses. Americans have to tolerance of rationing. IMHO, there can be no rational solution without rationing. I've participated in many procedures involving patients actively dying. We are getting netter but there is plenty of lard in the system, including advertising and PR and offering patients futile therapies.
How people claiming this or that..at the end of the day, propose a solution that basically states: "it's my way or the highway."
A simple example would be:
A Private insurance company that can't get enough revenue: will go out of business (or get bailed out).
A government plan that is creating more deficit expenditure: trust me. it will not be scrapped but "our taxes" will go up to continually feed that plan.
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
I'm in Canada, and a coworker had to wait a couple months from colonoscopy to surgery.
If the government is running health care, AND they also have the ability to change labor laws. In Nova Scotia, Canada, the nurses were in a strike position a few years ago and the provincial government tried to put through a law to make us essential personnel, and unable to strike. There was already an agreement with the union to provide nurses for emergency care, but they wanted to take away our ability to strike entirely.
Those same people voted themselves a 10% pay raise and gave us 1%.
Government run healthcare leads to conflicts of interest, they need to keep departments separate, although I don't know how that could be possible.
....I can retire at any time with a really good pension and health care. Can you say the same?...
Seriously? I retired 2 years ago at age 61 with a good pension and health care, and guess what? When I reach age 66 I get a state pension on top because I paid National Insurance.
But Bernie is currently the loudest and most strident voice and he is calling his plan Medicare for All. As the loudest voice he is getting the most media coverage. So much so that a number of the hoard of hopefuls are jumping on the band wagon. So the general public is seeing his plan as a true Medicare plan. Perception is reality. Many of the posters on this topic have actually said they are in favor of a single payer - ie government - system.
Sanders has publically supported Medicare-for-all proposals, but is own proposal which he calls "Healthcare-for-all" replaces Medicare rather than expanding it to those under 65.
There are a number of variations of a single-payer plan out there, mainly because it's a far better product than the current individual and group markets. Personally, I don't like throwing money away, if I can get the same product for less money, then that's my preference, and single payer is not only less expensive than our current coverage system, it's arguably a better product as well.
At no time have I said I am against a system that would provide DECENT health care to people who can’t afford insurance. What I am against is taking insurance plans that people are happy with and have worked for years to keep away from them and reducing their take home pay through new payroll taxes. Yes, I have stayed in the public sector and turned down other jobs that paid more because of benefits. If you want to call that “gold handcuffs” then so be it. I can retire at any time with a really good pension and health care. Can you say the same? I simply don’t see where it is right to take away something many people have worked for their entire lives.
By all means let’s find a way to get health care to those who need it. Just let those of us who are happy where we are keep what we have worked for.
The biggest threat to the government provided coverage you're referring to is rate at which insurance costs are increasing. In 1998 40 states offered employees full coverage at no cost, by 2013 those 40 states had become only 4. Lower the cost of coverage and slowing the rate of healthcare cost inflation is far more likely to protect your level of coverage than doing nothing. And there's no reason why your employer would need to increase costs to you in any way if they truly need to use benefit coverage as a form of compensation to keep employees, they could cover your payroll tax increases and still have money left over.
So if not universal coverage, how should we get health care (/coverage) to those who need it?
I can retire at any time with a really good pension and health care. Can you say the same? I simply don’t see where it is right to take away something many people have worked for their entire lives.
Yeah we can. One of the biggest complaints from the private sector is the quality of public sector pensions.
We get it though, you've got yours.
10 hours ago, subee said:
Vermont had a single payor system from 2011 until 2014 until it was dismembered because of complaints of costs to small businesses. Americans have to tolerance of rationing. IMHO, there can be no rational solution without rationing. I've participated in many procedures involving patients actively dying. We are getting netter but there is plenty of lard in the system, including advertising and PR and offering patients futile therapies.
Lets be honest about this first, they did not have a single payer system, because it never got implemented, they passed a bill and then realised they couldn't figure out how to get it to work at nearly every level. These kind of misrepresentations are why this discussion is so toxic.
Yes funding was a big one of course, but they failed at every level, this is clearly too big for one state to try to push forward on their own.
I’m not opposed to Medicare for all - all who want or need it. What I am saying is there are people in this country who are happy with their benefits and we should not be forced give up what we have if we don’t want to. And even if I was allowed to keep my current plan, I don’t want to have higher taxes eat into my paycheck for something I wouldn’t be using so yes, I am selfish Not all of my years in the public sector have been in health care and the sacrifices I made at that time have made me cynical
Also, My first wife was covered under Medicare due to her being on dialysis. The first four months my insurance paid due to the four month waiting period. Everything went smoothly. From the day her Medicare kicked in till her death three years later, it was a constant battle with the system. Can’t use this doctor, have to change dialysis centers, have to do this, can’t do that.
I don’t want to be told what doctor I can use and I don’t want to be told what hospital I have to use. Any one who says that won’t happen has forgotten “ if you like your plan you can keep and you can keep your doctor.” I might add that if you think the government will do a better and more efficient job just look at the VA.
Why would you not use the single payer system? You would be paying into it. If you want to insist on using private healthcare then continue to pay extra. That is what happens in other countries, the people who want to and can afford it pay for private. It runs alongside the system not in place of it.
Under a single payer system hospitals and doctors are not in competition with each other. This allows them to specialise and not duplicate services.
14 hours ago, KonichiwaRN said:
Somewhere along the line, people started thinking that a single system that replaces (forces) everything away will remain all noble and pure.
Just like a Thesis someone starts to type up.
It's just that..in the real world,
it just doesn't happen that way.
Except that it does in Europe and most other industrialised countries.
If the government is running health care, AND they also have the ability to change labor laws. In Nova Scotia, Canada, the nurses were in a strike position a few years ago and the provincial government tried to put through a law to make us essential personnel, and unable to strike. There was already an agreement with the union to provide nurses for emergency care, but they wanted to take away our ability to strike entirely.
Those same people voted themselves a 10% pay raise and gave us 1%.
Government run healthcare leads to conflicts of interest, they need to keep departments separate, although I don't know how that could be possible.
Well here in the states hospital administrators give themselves bonuses and raises and then toss us the crumbs.
KonichiwaRN
159 Posts
Somewhere along the line, people started thinking that a single system that replaces (forces) everything away will remain all noble and pure.
Just like a Thesis someone starts to type up.
It's just that..in the real world,
it just doesn't happen that way.