How would Medicare for all affect nursing?

[Emergent]

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?

[nursej22, MSN, RN]

2 hours ago, MunoRN said:

I'm not sure how you're figuring something can continue to exist without anyone paying for it, particularly something very expensive.

Maybe we should have two systems, one for those that want to be in a system that's just paid for by people who feel like paying for it, and then one for people who would like there to be an actual hospital to go to when they need one.

This reminds me of former congressperson Alan Grayson: "the Republican healthcare plan is don't get sick. And if you do, die quickly."

[KonichiwaRN]

1 hour ago, ShadowNurse said:

The fact that we are a better option than (for example) Venezuela, whose economy has utterly collapsed and people are starving to death, is not a reason to say we care for our citizens well. And by the way, we de-stabilized Venezuela's regime in the interest of "fighting socialism" in South America.

Oh, so it's the United State's fault that Venezuela is in the state it's in right now?

[KonichiwaRN]

1 hour ago, morelostthanfound said:

I have to say that your posts are beginning to make less and less sense and you're coming across as extremely uninformed. You may not be aware but the number of American expatriates is on the rise as never before-all the way back in November 2012, the US State Department revealed that there were 6.3 million American expats living and working overseas-the highest this figure has ever been and the numbers have only grown since. Not too difficult to figure out that runaway health care and housing costs might be fueling this exodus.

I do agree with the housing costs rise being a driving force.

But you're not mentioning the $100,000 tax break that "expats" get. ?

Did you know that?

[KonichiwaRN]

4 hours ago, MunoRN said:

I'm not sure how you're figuring something can continue to exist without anyone paying for it, particularly something very expensive.

Maybe we should have two systems, one for those that want to be in a system that's just paid for by people who feel like paying for it, and then one for people who would like there to be an actual hospital to go to when they need one.

hmm, wouldn't non participating clinicians, already be in the category of being in the system "that is just paid for by people who feel like paying for it?"

[CommunityRNBSN, BSN, RN]

I gave birth in Japan which has a hybrid system. The hospitals are private but everyone has public insurance. In a lot of ways it was amazing— very little waste because there was no marketing (I’m thinking of the Alexa-equipped rooms in the US and other insanely unnecessary equipment AND drugs). A visit to the doctor cost about 8 bucks. I had a prenatal US at every visit because the OB just grabbed her US machine and spent two minutes doing it herself.

However there were trade offs. Nothing psychiatric or psychological is covered. Nor is childbirth, as it’s not an illness. The US population obviously expects insurance coverage for these and a host of other conditions that are not covered in japan.

(Full disclosure is that my understanding of the system was shaky at best so Japanese people feel free to correct me)

[MunoRN, RN]

10 hours ago, KonichiwaRN said:

Note.

Our nation's (or a geographical area): income tax payers vs non payers ratio.

And relate that to your gleaming European nation's example.

There is a tad thing with revenue vs expenditure.

You work. You should understand how that works. Debt is never a good thing.

You're correct that we can't have a system that we put less and less money into despite the system costing more and more, which is why there's really no other option other than to change our current system.

There was a short reprieve from this trend following the ACA, but the current problem is what's sometimes called the insurance 'death spiral'. Regardless of how many people chose to purchase insurance, our healthcare cost trends don't change (if anything our health care costs go up when fewer people carry insurance), so as fewer and fewer people are insured, those static costs are spread among a smaller and smaller group of people, which then drastically increases insurance costs which pushes more people off insurance and the vicious cycle continues until our healthcare system ceases to exist as we know it.

A medicare or other universal coverage system fixes these problems in two ways; it maintains a sustainable revenue by ensuring that everyone who benefits from the system and can contribute to it's cost does so, and it slows the rate of healthcare cost inflation.

I'm not sure what point you're trying to make with the percentage of the US population that pays income taxes, except it seems to argue against your point which is that we should continue to have a system where relatively few contribute to the costs, but about 80% of US households pay the taxes that pay for medicare, and European countries have similar percentages of the population that pays income tax, in France for instance it's 46% of households that pay income tax.

[KonichiwaRN]

So finally we agree on that one topic:

The main point that I am trying to make..is that I'm not "against" a health care plan for all. I am "against" (using the current system) a plan that no doubt will raise my (ours, the middle class, upper class, whatever) income taxes.

"Europe’s health care systems aren’t feeling very well.........

Doctors have been threatening massive strikes in Britain..... Italian regions are going bankrupt trying to fund medicines. Drugmakers are pulling diabetes drugs from Germany, blaming government-set prices that don’t let them recoup their investment...............

Highly specialized medicines.........entering the market at sky-high prices, forcing governments to choose between the need to treat their citizens..(Politico, 2016)."

I don't want higher income taxes. I see our nation and everything that they (government) start..they will just end up increasing more and more taxes.

Again, I emphasize the point where people from states like New Jersey are moving away..and these are the population that enjoyed the benefits of the high-real estate taxes (for their education system). Again, it's top tier in our nation when it comes to Public education.

[KonichiwaRN]

Test it on a microscopic scale.

Instead of trying to roll it out in a national level.

Test your theory of "healthcare for all" using a city, a county, or even a state.

See if it can work without

a) state residents moving out

b) the state asking for more funds from the federal reserves

c) drug & service prices in that state (or place) not skyrocketing

d) state income taxes not rising (or gas taxes, real estate, whatever hidden taxes that they use..like a "sugar tax.")

Then, if that model works smoothly for let's say..a decade, then I'll support your measure. And I'm serious.

[GrumpyRN, NP]

54 minutes ago, KonichiwaRN said:

"Europe’s health care systems aren’t feeling very well.........

Doctors have been threatening massive strikes in Britain.....

Really...? When? Where? The junior doctors went on strike in 2016 to protest poor rotas and contracts that the government forced on them (to try to bring in an American system) and meant things were unsafe for patients. The public supported them.

44 minutes ago, KonichiwaRN said:

Test it on a microscopic scale.

Instead of trying to roll it out in a national level.

Test your theory of "healthcare for all" using a city, a county, or even a state.

See if it can work without

a) state residents moving out

b) the state asking for more funds from the federal reserves

c) drug & service prices in that state (or place) not skyrocketing

d) state income taxes not rising (or gas taxes, real estate, whatever hidden taxes that they use..like a "sugar tax.")

Then, if that model works smoothly for let's say..a decade, then I'll support your measure. And I'm serious.

As opposed to looking at countries where this is already in place - France, Scandinavian countries etc. and using the evidence from them.

[KonichiwaRN]

Yes.

My main reason is: this nation's population and its culture cannot relate to places like France or Scandinavian countries.

Surely, you wouldn't be against using a control group that is relevant to the test group?

[GrumpyRN, NP]

1 hour ago, KonichiwaRN said:

Yes.

My main reason is: this nation's population and its culture cannot relate to places like France or Scandinavian countries.

Surely, you wouldn't be against using a control group that is relevant to the test group?

Ah of course. Those well known diseases and illnesses that only other countries get and not the USA. Or is it the other way around?

Population of the US;- 329,093,110.

Population of Western Europe, Australia, New Zealand, Canada who all have some kind of universal healthcare;- 4,699,787,701.

( https://www.worldometers.info/world-population/population-by-country/ )

Is that big enough a control group for you?

I'm sorry, but what you want to do is set up a micro test which is designed to fail and then claim victory. While 450,000+ people die without health care over the 10 years you want this "study" to run.

( https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ )

Also en passant, Life expectancy in USA is 79.772 while every area I mentioned with universal care is above that.

( http://worldpopulationreview.com/countries/life-expectancy/ )

[guest974915]

1 hour ago, GrumpyRN said:

Ah of course. Those well known diseases and illnesses that only other countries get and not the USA. Or is it the other way around?

Population of the US;- 329,093,110.

Population of Western Europe, Australia, New Zealand, Canada who all have some kind of universal healthcare;- 4,699,787,701.

( https://www.worldometers.info/world-population/population-by-country/ )

Is that big enough a control group for you?

I'm sorry, but what you want to do is set up a micro test which is designed to fail and then claim victory. While 450,000+ people die without health care over the 10 years you want this "study" to run.

( https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/ )

Also en passant, Life expectancy in USA is 79.772 while every area I mentioned with universal care is above that.

( http://worldpopulationreview.com/countries/life-expectancy/ )

You go Grumpy:) It's just a bitter pill that so many Americans can't swallow due to arrogance, pomposity, national pride...whatever!-that our health care system is at best, second rate and really only truly profits those at the very top. We deserve so much better!