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?

[BD-RN, BSN, RN]

On 4/13/2019 at 1:33 PM, hppygr8ful said:

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. 

34,000 pounds is 44,000 USD. The pound is worth more than the dollar.

https://www.google.com/search?q=34000+pounds+to+dollars&ie=UTF-8&oe=UTF-8&hl=en-us&client=safari

[TriciaJ, RN]

The Canadian system is actually administered provincially, not federally. Each province runs its own health care industry, some are seen as better than others. Some have user fees, others not. Most provinces cover major medical only. Dental, vision, optical, prescription are self-pay and now insurance policies are available to help with this.

I think federally would be a bad idea, just as it would be here. Too big and too cumbersome; much more prone to waste and fraud. Easier to hold provincial/state governments accountable. I still think a hybrid of public/private might have possibilities.

[offlabel]

Just look at the VA.

[MunoRN, RN]

8 hours ago, DARLA766 said:

Bernie medicare for all plan ends all private care.

None of the Democrat candidates' proposals include getting rid of private care, only private insurance, and that is only partial in many of the proposals. Health are delivery (hospitals, doctors, etc) wouldn't change.

[OUxPhys, BSN, RN]

4 minutes ago, MunoRN said:

None of the Democrat candidates' proposals include getting rid of private care, only private insurance, and that is only partial in many of the proposals. Health are delivery (hospitals, doctors, etc) wouldn't change.

Not true. Bernie is in record saying he wants to eliminate private insurance as did Booker and Harris (Harris later walked back her comments).

[OUxPhys, BSN, RN]

9 minutes ago, offlabel said:

Just look at the VA.

That’s not fair. VA is largest healthcare system in the world. There are good and bad VAs.

[DARLA766, BSN, RN]

8 minutes ago, MunoRN said:

None of the Democrat candidates' proposals include getting rid of private care, only private insurance, and that is only partial in many of the proposals. Health are delivery (hospitals, doctors, etc) wouldn't change.

None would be incorrect. Bernie plan does include getting rid of private insurance completely. The whole point of his bill is to replace private insurance with a government run plan.(Watch his town hall tonight. ) Private care was not clear wording.However, I didn't mention anything about delivery of care. I would assume that doesnt change only how it is managed.

[MunoRN, RN]

6 hours ago, Mini2544 said:

I also dont think that people understand Medicare is what it is because people pay into the system for 30,40 plus years. Then like you said, its bare bones at that. How can they say "Medicare for all" when the people who will be covered, have never paid into the system? There will still be people who dont work/pay taxes and will receive the same exact healthcare as those who float the system. It will never happen here. Physicians would not put themselves through the kind of schooling and debt they do, in order to make less money and be burdened with terrible govt regulation (worse than it is aready is) There is a reason we have as many foreign physicians as we do. Nurses would make less and work more.

People under 65 who enroll in Medicare would contribute they same way we pay into insurance now except less.

We'd still be sharing the cost of care for those who can't pay, although with less of a burden on the perpetually shrinking insured population who get stuck with an unfairly large burden.

There are large swaths of the country where healthcare services are becoming more and more scarce due to increasing uninsured and under insured populations, those doctors and nurses wouldn't get paid less because all their patients are covered.

[DARLA766, BSN, RN]

9 minutes ago, MunoRN said:

People under 65 who enroll in Medicare would contribute they same way we pay into insurance now except less.

We'd still be sharing the cost of care for those who can't pay, although with less of a burden on the perpetually shrinking insured population who get stuck with an unfairly large burden.

There are large swaths of the country where healthcare services are becoming more and more scarce due to increasing uninsured and under insured populations, those doctors and nurses wouldn't get paid less because all their patients are covered.

All patients would be covered but by a government run plan. Many doctors already refuse to see Medicare patients because the reimbursement is low. Can you imagine when the government knows the doctor has no choice how much less the reimbursement will be? I imagine that FNPs will be doing alot more instead of a doctor, but without the increased pay.

[VivaLasViejas, ASN, RN]

If Medicare for All is ever implemented---which I doubt---I think it would be better managed by the individual states. For example, Florida, which has a sizable elderly population, has different needs than say, Oregon which skews younger, especially in the larger metropolitan areas. One size doesn't fit all, but the federal government would probably force the states into lockstep because that is what it does. It regards certain segments of the population, like the poor or the disabled as a monolith and administers programs for them in a cookie-cutter fashion. Giving the states control of health care would likely minimize that. JMHO.

[offlabel]

25 minutes ago, OUxPhys said:

That’s not fair. VA is largest healthcare system in the world. There are good and bad VAs.

Fair has nothing at all to do with it. It is a single payer, national health care system.

[Duranie]

35 minutes ago, VivaLasViejas said:

If Medicare for All is ever implemented---which I doubt---I think it would be better managed by the individual states. For example, Florida, which has a sizable elderly population, has different needs than say, Oregon which skews younger, especially in the larger metropolitan areas. One size doesn't fit all, but the federal government would probably force the states into lockstep because that is what it does. It regards certain segments of the population, like the poor or the disabled as a monolith and administers programs for them in a cookie-cutter fashion. Giving the states control of health care would likely minimize that. JMHO.

I disagree with allowing individual states to determine how to implement any sort of socialized medical insurance.

A big part of the “appeal” of coverage-for-all plans is that, indeed, everyone is covered for all of their medical needs in the same way. My ability to have my needs met shouldn’t be different depending on where I live—either what is covered, or potential obstacles to accessing the covered services.

In my case for example, I’m relatively young— in my late 40’s. However my health needs are more like those of someone at least 20 years older. So let’s say that dh has a great job in the PNW... if WA or OR were allowed to have a plan which favored well-care and made it more difficult to access treatment for some things, or covered DME or HH differently, due to the area’s demographics, that would place a serious hardship on my family— we could be forced to relocate to someplace like FL, and dh could have to find other employment, and in his field, there aren’t the same opportunities there.

As it is now, there are already big differences in Medicaid coverage from state-to-state, and even Medicare differs somewhat because each state has different supplemental plans, that extend coverage to different things (like rides to dr visits are available on plans in some states, but not others).