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How would Medicare for all affect nursing?

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Emergent has 25 years experience .

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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17 minutes ago, herring_RN said:

I am nearly 75 years old and blessed to have Medicare. One reason is that I can go to any doctor who accepts Medicare. 96% of US doctors accept Medicare as payment. Currently Medicare pays about 80% of charges. 

We have a "supplement" or "Medigap" plan that pays all that Medicare does not.

When asked I advise anyone with an average or better income NOT to go with a Medicare Advantage plan. Too often the person not only cannot go to out of network providers, some require a referral by the primary physician. Making referrals decreases the doctors pay for that patient. That may cause some doctors to make less referrals.

No matter why you may want to see a physician NOT in your network your insurance would pay nothing. 

I really like my doctor. I met him when I was a 31 year old LVN  and he was an intern. In late 2009 I had coverage that I paid a little more than half the premium and my employer the rest. In December I received a letter telling me our health insurance company would be different starting the first of the year. My doctor was not in the new plan so I had to change doctors. Being basically healthy I did OK with a different doctor. As soon as I turned 65 I went back to my current doctor. He is considering retirement to enjoy his grandchildren. If so it will be twice this century I could not keep the doctor I like.

PS: If anyone really thinks our current healthcare is really the best, OR has a better idea, I am interested in posting here  on ALLNURSES.COM

OR if there is a leader, elected or otherwise with a perfect or almost perfect plan please post here.

 

PS: 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 

Well as a Libertarian I don't trust the government on either side of the isle. In 56 years I've never seen a politician do what they said they would do or have any so called promise deliver what was described to people the Government thought were to stupid to understand. Medicare coverage as it stands is severely limited and does not deliver what most people think it does. My mother received no help Medicare ( a system she and my dad paid into their whole lives) for the care due to Alzheimer' s because guess what the government doesn't care if grandma needs help with daily care. That care in considered custodial care and not covered by Medicare.  Our average bill b for her specialized care was between $8,000.00 to $9,000.00 a month. Which was paid for out of her living trust. 

But again this discussion was supposed to be about how Medicare for all would affect nursing. Since we can't stay on topic I'll just agree to disagree and bow out. 

Hppy

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osceteacher has 15 years experience and specializes in Practice educator.

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On 4/13/2019 at 9:33 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. 

 

Its a real shame that the first post is this often incorrect and fallacious one.

Bernie Sanders does not want a UK healthcare style system, for crying out loud people.

You take a few numbers and damn the NHS but do not do the same with the US. Your infant mortality rate is abysmal compared to the rest of the western world, your disease burden is through the roof, its (somehow) easier to get a doctor the same day or next day in the UK than the US, 
The US spends twice as much as the UK and has the worst life expectancy in the west. I mean we could go on finding statistics where one is better than the other but that narrative is a terrible way to have discourse on healthcare systems.

You try to compare the wages of 2 countries like they're both apples but also somehow manage to put 34,000 pounds as 26,000 dollars, you do know our currency is stronger right and that its actually $44,000.

You then erroneously imply that medicare for all would ADD $32 trillion instead of saving $2 trillion from the $34 trillion you already spend.

Reading your post was like reading a comments section on Fox, complete nonsense, you complain about this being derailed, yet if you hadn't posted fallacy after fallacy this wouldn't have happened.

Edited by osceteacher

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osceteacher has 15 years experience and specializes in Practice educator.

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11 hours ago, Endo.J said:

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!

Yes, unfortunately people will just take a statistic and use it as a gotcha moment, its a particularly egregious misuse of statistics that you see regularly from people on the internet.

We have lower survival rates from cancer but we have better maternal mortality rates, its all swings and roundabouts, fundamentally for me healthcare should not be the number one cause of bankruptcy, you shouldn't have to stay in a job just because it offers you better healthcare, you shouldn't have millions of people who avoid going to get help because they're not insured and 10,000+ people a year shouldn't die because of a lack of healthcare.

Yes, of course I'd love the NHS to be the number one for cancer survival rates and for no person to have to wait for surgery but there are always limitations to a free at point of access healthcare system but those limitations are equitable across the country unlike in the US which allows rampant abuse of the capitalist system to benefit the rich at the expense of peoples lives and health.

Edited by osceteacher

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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4 hours ago, osceteacher said:

Its a real shame that the first post is this often incorrect and fallacious one.
 

You try to compare the wages of 2 countries like they're both apples but also somehow manage to put 34,000 pounds as 26,000 dollars, you do know our currency is stronger right and that its actually $44,000.

 

I wish folks would read the whole thread - if they did they would see that I already acknowledged this mistake of mine and apologized for it.

hppy

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nursej22 has 30 years experience as a MSN, RN and specializes in med/surg,CV.

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To the original question, I don't think a single payer system will effect nurses much at all. Challenges with staffing will continue and people will continue to feel entitled. 

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osceteacher has 15 years experience and specializes in Practice educator.

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1 hour ago, hppygr8ful said:

I wish folks would read the whole thread - if they did they would see that I already acknowledged this mistake of mine and apologized for it.

hppy

Sadly I realised after I posted my second post and therefore couldn't edit my original, but that wasn't the only incorrect part of your post so I still stand by what I said.

 

37 minutes ago, nursej22 said:

To the original question, I don't think a single payer system will effect nurses much at all. Challenges with staffing will continue and people will continue to feel entitled. 

I imagine this is the case in regards to the original question, nurses will see far less bureaucracy but outside of that I'm not sure how things will improve or get worse for nurses, they'll just stay the same.

Wages were brought up but most single payer healthcare systems have nurses earning higher than the national average, Norway, Australia, Netherlands, Denmark etc all pay substantially above national averages and some are only slightly behind the US.  The UK is one of the few where its in or around the national average, but our benefits with the NHS are substantial (3 months full sick pay, 6 months half sick pay, I get 35 days annual leave a year etc) and enhanced pay for weekend and nights are rarely factored in but can amount to a good 30% increase on base salary. 

 

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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16 hours ago, hppygr8ful said:

Well as a Libertarian I don't trust the government on either side of the isle. In 56 years I've never seen a politician do what they said they would do or have any so called promise deliver what was described to people the Government thought were to stupid to understand. Medicare coverage as it stands is severely limited and does not deliver what most people think it does. My mother received no help Medicare ( a system she and my dad paid into their whole lives) for the care due to Alzheimer' s because guess what the government doesn't care if grandma needs help with daily care. That care in considered custodial care and not covered by Medicare.  Our average bill b for her specialized care was between $8,000.00 to $9,000.00 a month. Which was paid for out of her living trust. 

But again this discussion was supposed to be about how Medicare for all would affect nursing. Since we can't stay on topic I'll just agree to disagree and bow out. 

Hppy

This is my problem (one of them) as well, I do not trust the politicians to tell the truth and/or make decisions that are best for the people (not themselves). I would be happy with this Medicare for all plan for myself personally because it would help my current situation assuming the outcome is as they say. There has already been a history of us the people being lied to (as hppy points out) by the Obama admin re: the AHA.

https://townhall.com/tipsheet/katiepavlich/2014/11/10/obamacare-architect-yeah-we-lied-to-the-stupid-american-people-n1916605

What stops them (and I mean either party because they both do) from either lying again, or simply not knowing what they are doing and the practical outcome will end up being worse. I don't see how the working middle class are not going to get hit with large tax bills. The plan will also cover illegal immigrants, foreign students etc for all care, not just the services they already are receiving. And, yes I know, that they say it will be cheaper because they wont be using the ED for everything but I don't see that making up for the increase in medical care across the board they will be using. Also from what I have read the premiums will be based on income, so low income including people who work under the table (including illegals who also send back cash to relatives in Mexico or elsewhere therefore not supporting our economic system), foreign students etc. will not be paying premiums (or very little) but will have full access to medical care. Whether or not you think that non-citizens should have full access to the medical system, the point is IMO, is that it more than likely will hit the working middle class the hardest. I hope I am wrong but we just have no way to know.

 

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nursej22 has 30 years experience as a MSN, RN and specializes in med/surg,CV.

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6 hours ago, Daisy4RN said:

The plan will also cover illegal immigrants, foreign students etc for all care, not just the services they already are receiving. And, yes I know, that they say it will be cheaper because they wont be using the ED for everything but I don't see that making up for the increase in medical care across the board they will be using. Also from what I have read the premiums will be based on income, so low income including people who work under the table (including illegals who also send back cash to relatives in Mexico or elsewhere therefore not supporting our economic system), foreign students etc. will not be paying premiums (or very little) but will have full access to medical care. Whether or not you think that non-citizens should have full access to the medical system, the point is IMO, is that it more than likely will hit the working middle class the hardest. I hope I am wrong but we just have no way to know.

 

Undocumented immigrants have payroll taxes deducted from their pay, unless their employers are skirting the law, which would make the employers the "illegals ", in my opinion. And yes, depending on which party is in office, the middle class may bear more of the burden, in order that so-called job creators can buy back their stock and move money off-shore. 

Foreign students pay out-of-state tuition which is much higher that resident tuition, which goes to pay for a student health center, or they pay out of pocket. I should think that they may be taxed to cover costs. 

But even if the middle class continues to bear the cost, the over all cost should be lower, because of greater efficiency, absence of profit margins, and decreased pay for administrators.

And as for fraud, I feel like  see stories all the time of exposure of fraud schemes, like this one:

https://www.charlotteobserver.com/news/state/south-carolina/article229173659.html

 

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LilPeanut has 8 years experience as a MSN, RN, NP and specializes in NICU/Neonatal transport.

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12 hours ago, Daisy4RN said:

This is my problem (one of them) as well, I do not trust the politicians to tell the truth and/or make decisions that are best for the people (not themselves). I would be happy with this Medicare for all plan for myself personally because it would help my current situation assuming the outcome is as they say. There has already been a history of us the people being lied to (as hppy points out) by the Obama admin re: the AHA.

https://townhall.com/tipsheet/katiepavlich/2014/11/10/obamacare-architect-yeah-we-lied-to-the-stupid-american-people-n1916605

What stops them (and I mean either party because they both do) from either lying again, or simply not knowing what they are doing and the practical outcome will end up being worse. I don't see how the working middle class are not going to get hit with large tax bills. The plan will also cover illegal immigrants, foreign students etc for all care, not just the services they already are receiving. And, yes I know, that they say it will be cheaper because they wont be using the ED for everything but I don't see that making up for the increase in medical care across the board they will be using. Also from what I have read the premiums will be based on income, so low income including people who work under the table (including illegals who also send back cash to relatives in Mexico or elsewhere therefore not supporting our economic system), foreign students etc. will not be paying premiums (or very little) but will have full access to medical care. Whether or not you think that non-citizens should have full access to the medical system, the point is IMO, is that it more than likely will hit the working middle class the hardest. I hope I am wrong but we just have no way to know.

 

I would like to point out that the link that you posted about Obama "lying" about the AHCA, there was never any lying about it.  It was very transparent that we needed to put all the healthy people into the paying pool to be able to support the sick people. That article just rephrases it as "redistributing wealth from healthy people to sick people", which is a way of looking at it, if you are incredibly selfish and kind of evil.  Overall, the reason AHCA didn't work as intended was because it wasn't implemented as intended. 

As for the illegal immigrants etc, they still are entitled to live and to have emergency services here while in the country.  Nothing would change, unless someone is proposing that we should check someone's immigration status before treating them like a human being?

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Tenebrae has 8 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

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On 4/15/2019 at 1:46 AM, hppygr8ful said:

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 

Universal healthcare here

When mum was found to have lung cancer, she had her lung biopsy within 4 days and was in to see the oncologist within a week and started chemo within 2-3 weeks

When my brother in law got sick, he had his diagnosis withinn a week and was in for his whipples within 10 days. 

 

That said where I am, we have a brilliant oncology service. Other areas around the country are not as good. 

A few years ago I ended up with an infected axillary abcess. Required 6 days stay including surgery, plus IV antibiotics, total cost was around $12-16 for the oral antibiotics on discharge

Our system is far from perfect. Universal healthcare has its good points, it also has its not good points. That said, I am assured in the knowledge that if I get sick, or have an accident, I wont have to go bankrupt to pay the deductible on my insurance. If its an accident and I cant work for any length of time, ACC will pay 80% of my wage

I think the American insurance based healthcare system is hideous. Healthcare should be a basic human right. People shouldnt be dying for lack of a bone marrow transplant because their insurance denies the procedure on the grounds its experimental. Despite screes of actual medical evidence that stated as bone marrow transplant was a well recommended course of treatment for specific types of cancer

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hppygr8ful has 15 years experience and specializes in Psych, Addictions, Elder Care, L&D.

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5 hours ago, Tenebrae said:

Universal healthcare here

When mum was found to have lung cancer, she had her lung biopsy within 4 days and was in to see the oncologist within a week and started chemo within 2-3 weeks

When my brother in law got sick, he had his diagnosis withinn a week and was in for his whipples within 10 days. 

 

That said where I am, we have a brilliant oncology service. Other areas around the country are not as good. 

A few years ago I ended up with an infected axillary abcess. Required 6 days stay including surgery, plus IV antibiotics, total cost was around $12-16 for the oral antibiotics on discharge

Our system is far from perfect. Universal healthcare has its good points, it also has its not good points. That said, I am assured in the knowledge that if I get sick, or have an accident, I wont have to go bankrupt to pay the deductible on my insurance. If its an accident and I cant work for any length of time, ACC will pay 80% of my wage

I think the American insurance based healthcare system is hideous. Healthcare should be a basic human right. People shouldnt be dying for lack of a bone marrow transplant because their insurance denies the procedure on the grounds its experimental. Despite screes of actual medical evidence that stated as bone marrow transplant was a well recommended course of treatment for specific types of cancer

One of my biggest problem with the ACA is it has no provisions for providing quality mental health care. In my opinion the mentally ill are the single most underserved population when it comes to any kind of health care. In almost 20 years of taking care of this population I have seen nothing change. Yet when a mentally Ill person goes off the rails and actually hurts someone - Everyone clamors for something "to be done about these people!"  yet no one offers any solutions. 

Hppy

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

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12 hours ago, nursej22 said:

Undocumented immigrants have payroll taxes deducted from their pay, unless their employers are skirting the law, which would make the employers the "illegals ", in my opinion. And yes, depending on which party is in office, the middle class may bear more of the burden, in order that so-called job creators can buy back their stock and move money off-shore. 

Foreign students pay out-of-state tuition which is much higher that resident tuition, which goes to pay for a student health center, or they pay out of pocket. I should think that they may be taxed to cover costs. 

But even if the middle class continues to bear the cost, the over all cost should be lower, because of greater efficiency, absence of profit margins, and decreased pay for administrators.

And as for fraud, I feel like  see stories all the time of exposure of fraud schemes, like this one:

https://www.charlotteobserver.com/news/state/south-carolina/article229173659.html

 

I agree that we need to have an ongoing effort to combat the fraud in the system. If Medicare for all gets rid of private care then foreign students would also be covered, so whether at school or else where still under the medicare umbrella. I am not sure that the tuition would trickle down so far that the working middle class would not be feeling the pinch. Same for illegal immigrants even with the tax being taken out of paychecks (although not sure how that works if they have no SS number) and because many work for cash (and so do citizens). 

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