How would Medicare for all affect nursing?

allnurses Guide · Apr 16, 2019

On 4/13/2019 at 1:33 PM, 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=

The Townhall column is wrong!

Senator Bernie Sanders proposal is NOT like the system in the UK where the hospitals and clinics are owned and run by the government. Physicians, nurses, and other hospital and clinic staff are employed by the government.

Senator Sanders and the Democrats supporting Medicare For All propose a system much like Canada where the hospitals, clinics, physicians, nurses, and other hospital employees work for the hospital or re in private practice.

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What is Sanders proposing?
Medicare for All is a proposal to expand Medicare into a single-payer health system.
That means the federal government would be the sole, nationwide insurance provider for all essential and preventative healthcare.
It is not a universal health care system where the government would own and operate hospitals - instead, the government would pay private providers an agreed upon rate for their services.
Under Senator Bernie Sanders' proposal, first introduced in 2017 and re-introduced in April, Medicare for All would expand Medicare's coverage to include vision, dental, prescription drugs, nursing home care and reproductive health services.
The 2019 update to the plan also includes a long-term care coverage for patients with disabilities - amending one of the criticisms of his earlier plan.
The change also brings Mr Sanders' plan more in line with the version of Medicare for All proposed in the House of Representatives by congresswoman Pramila Jayapal of Washington state.
https://www.bbc.com/news/world-us-canada-47821997

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Medicare for All Act of 2019
https://jayapal.house.gov/wp-content/uploads/2019/02/Medicare-for-All-Act-of-2019-Bill-Text.pdf

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Medicare for All Act of 2019 Summary
https://jayapal.house.gov/wp-content/uploads/2019/02/Medicare-for-All-Act-of-2019_Summary-002.pdf

allnurses Guide · Apr 16, 2019

The cost of healthcare includes advertising, executive compensation, and the buildings, technology, and salaries of insurance company employees. The first group has a fiduciary duty to SHAREHOLDERS and NOT patients who need their products and services.

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The average healthcare CEO makes $18 million annually while one out of every five Americans is struggling with medical debt...
https://www.gq.com/story/eat-the-health-care-ceos

Look at the buildings owned by health insurance companies. It seems they are buying and selling our healthcare. WHY should shareholders make the most money in healthcare.

How about physicians and nurses?

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Aetna CEO Mark Bertolini will lose his job if the deal to sell the company to CVS Health closes, but he'll leave the company with about $500 million in stock and cash to soften the blow.
The bulk of that payout will come from shares of Aetna (AET) stock he already owns, as well as the stock options he already has the right to exercise, according to the company's filings...
https://money.cnn.com/2017/12/05/news/companies/aetna-ceo-cvs-payout/index.html

The top executive at the Centers for Medicare and Medicaid Services, Seema Verma, is paid $165,300.00 a year.

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In 2017, Seema Verma was a Miscellaneous Administration And Program at the Centers for Medicare & Medicaid Services in Washington, District Of Columbia. began working at the Centers for Medicare & Medicaid Services in 2017 with a starting salary of $165,300. Since then, her salary has remained the same.
Seema Verma is a EX-03 under the executive pay payscale and is among the highest-paid ten percent of employees in the Centers for Medicare & Medicaid Services.
https://www.federalpay.org/employees/centers-for-medicare-and-medicaid-services/verma-seema

Home Health Columnist / Guide · Apr 16, 2019

2 hours ago, xoemmylouox said:
I keep hearing about the wait times in other countries. My question is how many Americans simply just go without care because they can't afford it? How many don't address their health concerns, or receive any treatment because they cannot afford it? Those numbers are going to be hard to come by, yet remain a real problem.

Nurses who receive routine healthcare with PCP may not realize US has issues with wait times in many areas of the country. In Philadelphia area upon finding out ones pregnant, takes 2 months if lucky to get OBGYN/Midwife appointment. Home Health discharge planners setting up patients post hospital visit with PCP report taking 3 weeks to get appointment. I Tried to schedule inital appointment with dermatologist: 4 month wait; husband needed see Rheumatologist for new DX vasculitis requiring " daily prednisone until seen" -- 3 month wait.

From Beckers Hospital review 2017:

Patient wait times in America: 9 things to know

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U.S. healthcare requires a lot of waiting.
Overcrowded emergency departments in the U.S. have left some patients waiting more than one hour to be seen by a physician.
In a survey of 15 large U.S. metropolitan areas conducted by national physician search firm Merritt Hawkins, researchers found the average patient waited approximately 29.3 days to see a family medicine practitioner in 2016, an increase of approximately 50 percent since 2014....

So definitely need for more NP's in specialty areas to help reduce patient wait times post hospitalization. Increased need for RN's across the board due to increased number of patients now able to seek care along with aging baby boomers retiring developing age related health issues. NOW Home Health agencies are crying for experienced nurses as hip/knee/joint replacements sent home instead inpatient unit requiring next day visit to keep safe.

Endo.J · Apr 16, 2019

Just a brief comment from a UK nurse, suspected cancer patients can be seen within 2-5 weeks in the UK, if a cancer is suspected this escalates to a 2 week wait system, where all tests are aimed to be carried out in 2 weeks and then discussed at a multi disciplinary team meeting. Then they will be seen by an oncologist to discuss potential treatment options, within 62 days treatment should have commenced. Maximum 31 days after they first meet the oncologist which was by average within 31 days of referral. Hence the 62 day figure.

My husband had a suspicious mole two weeks ago he was referred and seen by a specialist within a week and was all clear.

Average nurses pay at £34000 is $44000 not $26000???

Our cancer survival is lower, sadly.

Healthcare is a growing concern everywhere, I've been reading this trying to understand more!

allnurses Guide · Apr 16, 2019

20 hours ago, DARLA766 said:
You are incorrect. He just discussed it about 30 min ago at the PA townhall. He used the VA as an example of what his healthcare plan would look like...government run. You would not be able to have your own private insurance.

Please listen again. Senator Sanders said, "We are NOT talking about government run healthcare." He said the Veterans Administration IS government run. He said mosr veterans think that the VA is a pretty good healthcare system ns the American Legion and the VFW strongly defend the VA healthcare that's government run.

He said, "What we are talking about is a single payer INSURANCE program, which means that you will have a card that says Medicare on it, you go to any doctor that you want and you can go to any hospital that you want."

MunoRN, RN · Apr 16, 2019

22 hours ago, DARLA766 said:
Have you ever tried to find a PCP for a traditional Medicare patient? Both Medicare and Medicare have low reimbursement rates. As a case manager, in my state, I find Medicaid is better for the patient. More dme is covered, patient can get a home provider, transportation to appts provided, little or no copay for meds that even Medicare will not cover.

22 hours ago, Daisy4RN said:
Many Doctors also do refuse Medicare along with Medicaid. If the only plan available was Medicare than it wouldnt matter, but if one of the other private plans are also available this would still be a problem.

Medicaid and Medicare are quite different in terms of reimbursement and acceptance by providers. About 60% of providers don't take or cap Medicaid patients, only about 4% of providers don't take or cap Medicare patients, which is unlikely to change under Medicare for all since there would still be luxury / boutique / concierge practices.

Medicaid is only for patients who as a general rule can't afford to contribute much or anything at all to their costs, so yes, it tends to cover more but that's because you can't squeeze blood from a stone.

A provider seeing only privately insured patients will make more than one seeing only medicare patients, although its not as though they'd be poor, an orthopedic surgeon for instance would be one of the biggest 'losers', making only about $362,000 per year instead of $457,000, but that assumes that all of their patients currently are fully covered by well paying insurers, which is becoming less and less common. Physicians would generally preferred to get paid something all the time rather than a lot but only every once in a while, which is why even Physician advocacy groups are making the switch to supporting a single payer plan.

Kitiger, RN · Apr 16, 2019

23 hours ago, OUxPhys said:
So you are saying they wouldn’t be government run hospitals, rather it would just be a federal funded plan, correct?

Whoever holds the purse-strings will run the program. Never think otherwise.

Daisy4RN · Apr 16, 2019

38 minutes ago, MunoRN said:
Medicaid and Medicare are quite different in terms of reimbursement and acceptance by providers. About 60% of providers don't take or cap Medicaid patients, only about 4% of providers don't take or cap Medicare patients, which is unlikely to change under Medicare for all since there would still be luxury / boutique / concierge practices.
Medicaid is only for patients who as a general rule can't afford to contribute much or anything at all to their costs, so yes, it tends to cover more but that's because you can't squeeze blood from a stone.
A provider seeing only privately insured patients will make more than one seeing only medicare patients, although its not as though they'd be poor, an orthopedic surgeon for instance would be one of the biggest 'losers', making only about $362,000 per year instead of $457,000, but that assumes that all of their patients currently are fully covered by well paying insurers, which is becoming less and less common. Physicians would generally preferred to get paid something all the time rather than a lot but only every once in a while, which is why even Physician advocacy groups are making the switch to supporting a single payer plan.

Yes, but it is already hard for some people in rural areas to get medical care because they cannot find a MD to accept their Medicare. The MD's will only accept a certain amount/percentage of Medicare pts. If there is private/concierge care available this will only make it harder for those pts to find a provider that will accept them as a patient. And, with the current laws a patient is not allowed to pay the difference to make up the loss so the MD will accept, MD is not allowed to accept payment from that pt. Maybe a ortho surgeon wouldn't mind the "loss" but a primary care MD might.

MunoRN, RN · Apr 17, 2019

20 minutes ago, Daisy4RN said:
Yes, but it is already hard for some people in rural areas to get medical care because they cannot find a MD to accept their Medicare. The MD's will only accept a certain amount/percentage of Medicare pts. If there is private/concierge care available this will only make it harder for those pts to find a provider that will accept them as a patient. And, with the current laws a patient is not allowed to pay the difference to make up the loss so the MD will accept, MD is not allowed to accept payment from that pt. Maybe a ortho surgeon wouldn't mind the "loss" but a primary care MD might.

It still seems like you're referring to Medicaid and not Medicare. It can be hard for any patient, Medicare or not, to find care in rural areas these days, these are what are called 'medical deserts'. The 4% of providers that don't accept or cap Medicare patients are unlikely to be found in these rural areas, these are typically found in areas where there is enough of a wealthy population to support these practice. There no "loss" to an MD for seeing Medicare patients, although there is for seeing a Medicaid patient. A primary MD who see's nothing but Medicare patients can expect to profit $170,000 per year, and while I would agree we should increase primary care Medicare reimbursements, I wouldn't call that a loss.

allnurses Guide · Apr 17, 2019

4 hours ago, herring_RN said:
Please listen again. Senator Sanders said, "We are NOT talking about government run healthcare." He said the Veterans Administration IS government run. He said mosr veterans think that the VA is a pretty good healthcare system ns the American Legion and the VFW strongly defend the VA healthcare that's government run.
He said, "What we are talking about is a single payer INSURANCE program, which means that you will have a card that says Medicare on it, you go to any doctor that you want and you can go to any hospital that you want."

Oh and "If you like your doctor you can keep your doctor" we all saw how that turned out!

Hppy

Roy Hanson · Apr 17, 2019

watch your pay cheque!

allnurses Guide · Apr 17, 2019

2 hours ago, hppygr8ful said:
Oh and "If you like your doctor you can keep your doctor" we all saw how that turned out!
Hppy

Who can name a perfect person? A politician who never made an error in a speech? A politician who always tells/told the truth?

I believe President Obama thought he was telling the truth because he didn't anticipate what some insurance companies did.

At nearly 75 I feel blessed to have Medicare. Before that I had to lose the doctor I like because my employer changed insurance companies.

If you doubt the facts about the 2019 Medicare For All bill just open the links:

https://jayapal.house.gov/wp-content/uploads/2019/02/Medicare-for-All-Act-of-2019-Bill-Text.pdf

https://jayapal.house.gov/wp-content/uploads/2019/02/Medicare-for-All-Act-of-2019_Summary-002.pdf

https://jayapal.house.gov/wp-content/uploads/2019/02/Medicare-for-All-Act-of-2019-Section-by-Section-Summary.pdf