How Will Universal Health Care Change Nursing?

[arelle68]

How will universal health care change the Nursing profession? Will we finally get ratios? Will our pay go up, or down? What about benefits? Will the quality of care improve, slide, or stay the same? How would a "single-payer" system be structured? Would this be the end of the insurance industry as we know it? I would like to hear from everyone who has an opinion about any of these questions.

[leslie :-D]

here is the link for the quote

http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2006/Sep/U-S--Health-System-Performance--A-National-Scorecard.aspx

and an impressive 51 for efficiency.

shameful.

absolutely shameful.

leslie

[lamazeteacher]

"Strange, so if health care is so good in Canada why do so many cross the border to get treatment? And why is the news so loud now about the Canadians wanting change in their health care? Odd, the rosy picture you paint is not what the facts describe." Quote from RNBBAMBA

Very few Canadians cross to the USA for healthcare, yet that's been publicized for propaganda reasons, here. Those who have health care in the USA have done so, because they dislike waiting - and they're rich and can afford to pay up front for it.

My sister who is 80, had laser treatments in Tampa, FLA for her spine, as that's a new treatment there, that was unavailable in Canada, when she had it. She had become addicted to oxycodone, and was desperate for something else that would relieve the pain. Because the cost of having it was so high, she had it done on one side only, obtaining relief for about a year. Just as she was sure she'd have to have the other side of her spine laser'd, her palliative care physician started her on a regimine of less addictive analgesics, that is working. Now Canadian physicians have been trained in the procedure, and she can have it there.

My brother-in-law had both his knees replaced in Canada, within 2 weeks of each diagnosis (that those surgeries were necessary). Here, people wait until that point, too (readiness).

However, with my right knee hurting for years here, I was immediately scheduled for a knee replacement when I saw an orthopedic surgeon who was about to retire. I got a second opinion, and was told that my knee wasn't at the point where replacement is appropriate.

I went for P.T., and the therapist did a very thorough examination of it, and suggested that I try a knee band (available at most pharmacies for under $5.). I got that, and the pain was gone, and as long as I wear that, I'm comfortable - unless I've been on my feet a long time (like all day). Then tylenol with a bit of codeine takes care of it, along with putting my foot up. (By the way, the tylenol with codeine is available OTC in Canada...... I keep it handy for headaches.) Allegra (for allergies) is also OTC there. That keeps physician visits down, there - and there are fewer addicts to codeine there, than there are, here.

The changes in the healthcare program in Canada that are taking place now, are for the doctors who are demanding more money. It seems that having less of it, means they're on unequal footing with American doctors. So Canadians who want those doctors, buy extra insurance that will pay their surcharge.

It's clear that meaningful employment isn't the goal of all nurses. Real Estate and investing may interest some, but I prefer the sheer joy of knowing that I made a difference in someone's life through my nursing care, and/or I was able to track down a nosocomial infection to its source and eliminate it. To each, his/her own way of creating their happiness.

[talaxandra]

Interesting. My MBA is in Health Care Administration. I have a Post Graduate certificate in managed health care. I was the President of an HMO. What qualifications do you have other than "I worked in UHC?"

I have studied other systems of health care including UHC in depth for over 25 years. So, how do you dispute all of the evidence that UHC has rationing and endless horror stories? The evidence was given to us by previous posters, no need for me to repeat it.

It's interesting that you're happy to accept annecdotal evidence to support your position but deny ghillbert's statements validity because of your qualifications. This is particularly interesting because ghillbert's post:

1) asked you what you based your position on;

2) suggested that a different scheme might mean a lower in costs of currently exorbitant investigations (like MRIs) because there isn't a third party getting a cut; and

3) gave factual information about the Australian system, including the undisputable fact that taxes here are nothing like the scare figure of 54%.

Ghillbert concluded "I think it's interesting that the people who are most against UHC are the people with no actual experience of it." As this thread began with questions about how the introduction of a UHC system in the US would change nursing, the opinions of a nurse working in a country that's had such a system in place for several decades now is highly relevant. I would think nurses like ghillbert and I are in a better position to discuss what the experience is actually like, and perhaps counter claims of vastly inflated taxes, rationed health care, impoverished choice and lowered wages, than a someone with theoretical knowledge.

Of course, all of this is only of any use if you're actually interested in hearing from people with different opinions than yours.

[talaxandra]

To respond to the OP - the Australian system:

Ratios - the rest of the country uses a variety of other staffing models, while Victoria has legally mandated ratios. This was the result of lobbying and industrial action.

Pay rates - obviously it's impossible to say. Salaries may go down but I would imagine that nurses working in a country with UHC have more money to spend, because insurance is both optional and cheaper.

Insurance - For example, the most expensive cover I could find for a family, (including reproductive assistance and major dental) cost around $Au300 ($US245) a month. There's still a thriving private health insurance industry here, in no small part because the insured get a tax break on two fronts - reimbursement of some of their costs and a exemption from the surcharge levy (and additional 1% tax). There's also a perception, from those who work outside the system, that care is better in the private sector; those of us working in health care generally believe that the private system is prettier and great for minor elective problems, but the public sector is where the sick people and the expertise are.

[It'sMe, RN, BBA, MBA]

There are people trying to get into Canada to get treatment as well.

The thing is, with freemarket healthcare, more people suffer and die than not. Look at the facts as you so sweetly put it.

"Among 19 industrialized countries, the U.S. ranked 15th on "mortality from conditions amenable to health care," or deaths before age 75 that are potentially preventable with timely, effective care. The U.S. rate was more than 30 percent worse than the benchmark—the top three countries. The U.S. also ranks at the bottom for healthy life expectancy and last on infant mortality."

Every single industrialized country before us on that list has a universal healthcare plan in place.

That is a staggering fact. And yet, people in HMO's such as yourself, struggle to rationalize your own existence. It would be funny if it weren't so immoral and outrageous.

First, I am not in an HMO, in fact I have traditional health insurance. Second, always quote your source of information to validate it. Third, present the facts in their entirety. Many of the deaths related to mortality in the US would still occured because those people would not have sought health care anyway. Those were life style issues. And there are many studies by unbiased groups that not only dispute these numbers but also the number of uninsured people in America.

So I assume you believe that it is okay to take from those that can pay according to their ability and give to those that can't pay according to their need? Well, I don't. I also don't believe that Americans will "not mind being taxed to pay for health care services" as you said in your previous post. I don't believe in the federal income tax in the first place. I believe in the Fair Tax. We need to move to a national consumption tax. If you buy something, you pay a tax. Don't want to be taxed? Then don't buy it. Very simple. However the left and some of the right will not institute a fair tax because they can't shape social policy without being able to tax it. And shaping social policy is what the current government is all about.

Oh, by the way do you know said "let every person pay based on their ability and evey person receive based on their need?" Karl Marx, the father of Socialism and Communism. Is that what you want the USA to become? Every person should get up off their butt and get a job and provide for themself. I came from dirt poor roots, worked my way through college, got 3 college degrees and became a self made millionaire. And I lost it all. I didn't cry about it or ask the government to bail me out. I simply got up the next day, went to work and started all over again. Am I happy that I make 10% of what I use to make working as a nurse? No. Do I plan to take my income and rebuild my business? Yes. Will I leave nursing again. I don't know. I am also working on a MSN and have been looking at Director positions. But the best thing is that this is America where you have a choice. You can sit on your butt, drink PBR and watch Jerry Springer if you want to. You don't have to buy insurance. Or you can get a job, get insurance and make something of your self. And millions of people from around the world are dying to get here because of that. And no, I don't want to change to a socialist or communist form of government such as the one you are proposing. Anyone that has owned a small business like myself will tell you we need less government, not more. Yet people that have never been nothing more than wage slaves (W2) try to push us toward the socialist agenda. Well who the heck do you think is going to pay the bill when all of us entreprenuers close our business and just stay home?

Now, since you think you have all the answers, how do you plan to pay the $2,000,000,000,000.00 bill for UHC? Bama has spent all of the money and we don't have any left. So where does it come from?

[It'sMe, RN, BBA, MBA]

To respond to the OP - the Australian system:

Ratios - the rest of the country uses a variety of other staffing models, while Victoria has legally mandated ratios. This was the result of lobbying and industrial action.

Pay rates - obviously it's impossible to say. Salaries may go down but I would imagine that nurses working in a country with UHC have more money to spend, because insurance is both optional and cheaper.

Insurance - For example, the most expensive cover I could find for a family, (including reproductive assistance and major dental) cost around $Au300 ($US245) a month. There's still a thriving private health insurance industry here, in no small part because the insured get a tax break on two fronts - reimbursement of some of their costs and a exemption from the surcharge levy (and additional 1% tax). There's also a perception, from those who work outside the system, that care is better in the private sector; those of us working in health care generally believe that the private system is prettier and great for minor elective problems, but the public sector is where the sick people and the expertise are.

Good information. And can you tell me what is the overall tax rate paid there? That includes Federal, State, Local and Sales tax if any apply?

[OR Dude]

First, I am not in an HMO, in fact I have traditional health insurance. Second, always quote your source of information to validate it. Third, present the facts in their entirety. Many of the deaths related to mortality in the US would still occured because those people would not have sought health care anyway. Those were life style issues. And there are many studies by unbiased groups that not only dispute these numbers but also the number of uninsured people in America.

So I assume you believe that it is okay to take from those that can pay according to their ability and give to those that can't pay according to their need? Well, I don't. I also don't believe that Americans will "not mind being taxed to pay for health care services" as you said in your previous post. I don't believe in the federal income tax in the first place. I believe in the Fair Tax. We need to move to a national consumption tax. If you buy something, you pay a tax. Don't want to be taxed? Then don't buy it. Very simple. However the left and some of the right will not institute a fair tax because they can't shape social policy without being able to tax it. And shaping social policy is what the current government is all about.

Oh, by the way do you know said "let every person pay based on their ability and evey person receive based on their need?" Karl Marx, the father of Socialism and Communism. Is that what you want the USA to become? Every person should get up off their butt and get a job and provide for themself. I came from dirt poor roots, worked my way through college, got 3 college degrees and became a self made millionaire. And I lost it all. I didn't cry about it or ask the government to bail me out. I simply got up the next day, went to work and started all over again. Am I happy that I make 10% of what I use to make working as a nurse? No. Do I plan to take my income and rebuild my business? Yes. Will I leave nursing again. I don't know. I am also working on a MSN and have been looking at Director positions. But the best thing is that this is America where you have a choice. You can sit on your butt, drink PBR and watch Jerry Springer if you want to. You don't have to buy insurance. Or you can get a job, get insurance and make something of your self. And millions of people from around the world are dying to get here because of that. And no, I don't want to change to a socialist or communist form of government such as the one you are proposing. Anyone that has owned a small business like myself will tell you we need less government, not more. Yet people that have never been nothing more than wage slaves (W2) try to push us toward the socialist agenda. Well who the heck do you think is going to pay the bill when all of us entreprenuers close our business and just stay home?

Now, since you think you have all the answers, how do you plan to pay the $2,000,000,000,000.00 bill for UHC? Bama has spent all of the money and we don't have any left. So where does it come from?

You are so RIGHT! Having a background in Quantum Statistical Analysis, a BS in Nursing, years of study at one of the country's premier business schools, leading to an MBA, over 30 years in the business world, which includes years abroad, navigating the seas of international finance, and working at a hospital which serves the indigent, I can clearly attest to all you have offered. Thank God there are those of us who have the intelligence and experience in dealing with empirical statistical data, which clearly advocates the capitalist monetary theories, which have driven our economic engine to become the greatest country in the world!

Unfortunately, there are those who stand in our way, and aim for our ultimate downfall. Some are motivated for political gain, but sadly, most are motivated out of blind ignorance. The burden is heavy, but we are the ones who must stand together to ensure that our great country does not suffer the failings of our European predecessors by succumbing to the false teachings and policies espoused by their former leader, Karl Marx.

I for one agree, government bean-counters are in no position to dictate the health care needs of our citizens. Our system of health care is superior to any other country in the world! This is because at the heart of our health care system lies the motivating factor of competition based upon private enterprise. I would much rather deal with a private insurance company, wherein I knew that the service they were offering was based upon the idea of, "The best money can buy."

Like you, I started from humble beginnings. A veritable Horatio Alger, Jr. rising from the ashes of the slums to become a self-made millionaire. The empire I acquired in the health care industry was vast, within my niche. But, like you, through no fault of my own, I was struck down by this economic upheaval. I too have returned to nursing, albeit temporarily, until I also have the resources to rebuild my vast financial enterprise, and return to the position of being one of the titans of industry.

As I have said, we have been forged by similar forces, and have attained the lofty heights to see what those below us fail to perceive, since, metaphorically, they are unable to distinguish the forest from the trees. As a country, we need to rely on the priniciples that have made us the greatest country in the world. Profit drives business, and competition promotes the greater good. This competition ultimately weeds out the poor performers.

The wealthy will always be able to afford the benefits of excellent health care, because they have the money to afford the best care, and should receive the best care, since they have been the most successful in life. It may seem Darwinian to some, but survival of the fittest uplifts the whole of society and purges the weak.

Recently, I had a patient in her mid to late 40's. She was receiving care at our facility for cancer. She told me her story of having worked at a local, private hospital for over 20 years. Sadly, she developed cancer, and became too ill to work, which led to her termination of employment. Unable and too ill to find other work, she could no longer afford her private insurance. Finally, she sought care from my hospital, which serves the indigent. As she confided in me, this tragic tale, I comforted her with the knowledge that she had served her country, her community, and her private employer with dignity and respect. Her service was well appreciated, I assured her, and that this misfortune was no fault of her own. Thankfully, she agreed that she had served her purpose in life, and dutifully fulfilled her obligations.

After her death, my co-workers and I reflected upon her circumstances. Some suggested that the government should have intervened sooner, and that such a creature as universal health care could have possibly prevented her early demise. Of course, I countered their argument with various economic research data that demonstrated the pitfalls of their thinking. Not being swayed, I finally offered the explanation that her demise was simply her lot in life. Had she attained the personal wealth and fortune to continue making payments to her private insurance company, then perhaps her outcome may have been different. However, I would argue that even in her situation, the system worked remarkably well. Her level of health care was commensurate with her level of income, and hence her value in society. Had she attained a higher level of value in society, then the level of health care would have met her needs, and society's needs, to retain her as a valued member and resource of our society.

Some may say this is Darwinian Economics. Yet, as a country, we should come to the realization that scientific research, statistical data, and captialism serves the greater good.

Years ago, there was another man, like us, who saw the benefits of science, and believed a society based upon such ideas would ultimately lead to the perfect society with the perfect citizens.

Therefore, I salute you comrade, and I stand ready to shoulder your burden as we continue to lead this great nation to becoming that perfect society!

[MAISY, RN-ER, BSN, RN]

Any recent wasteful money spent by this government started with George W and his BS weapons of mass destruction. So much better for the little man to "walk with a big stick", then to take care of its hard working citizens.

Anyway, it's easy to say healthcare is a privilage, not a right (like a driver's license) as long as you, yourself are covered, or have made your millions and can afford to go anywhere for services.

As for statistical information and budgetary information, having spent many years in business prior to becoming a nurse, I know as do any of you who are business minded that numbers can be skewed to present the picture most pleasing to the group using them. Unfortunately the American public is not necessarily educated in the ways of the greedy. They think they know, but they don't have a clue.

Furthermore as articles are written by any authority real data is used, but in snippets. Like the articles that are written for any higher education classes or by any researcher, the support data only consists of what the author chooses to use to support "their idea". Not the whole truth, sometimes not even the truth at all-just whatever works with a reference point.

Overall, business people want to see immediate reactions to their actions as opposed to LONG TERM FORECASTING in other words "tell me what will give me the most for the dollar, NOW!" Laws become bad, because their sponsors play tit for tat. Ridiculous addendums are added so that those idiots elected by us get what they want for their constituents. BUT is it really for their voters or for their political contributors?

I say limit all political contributions to $100.00 per person, cap all political spending to $100,000.00 and finally kick all the damn lobbyists out of Washington. Then maybe we'd get people worth serving and some honesty and transparency. In an interesting term that everybody better get used to.

No system is perfect and I am not sure a blanket coverage for all is the way to go, however primary care and patient education are sorely lacking in this country. If we prevented illness by promoting health and well-being through accessible primary, and mental healthcare-many of the expensive, exhaustive, and debilitating conditions that cost us SO MUCH MONEY, may be brought to a controllable level. Canada spends 1/2 the money and according to statistics their citizens not only live longer, but are healthier throughout their lives.

As for all or you vehemently opposed to UHC are you ready if you are kicked off of your insurance, lose your job, or have family living under these circumstances? Should your neighbors have to choose whether to eat, or take their medicines or pay for insurance? Open your eyes! The coasts are inundated with services(albeit unavailable to those without and limited), but what about the interior? If access is limited for any it is a healthcare disparity and I say UNAMERICAN.

Just my for a Sunday Morning

[It'sMe, RN, BBA, MBA]

Wow! What are the odds of finding someone that has suffered the same fates? Very small.

In your example of health care for the cancer patient I am not sure the patient would have got more treatment. I too have worked in indigent hospitals and we didn't limit the care based on payor source. Everyone got the same level of care, from the homeless man brought into ICU with AIDS and a drug overdose to the Mayor with his gallbladder stones and removal. We treated everyone with the same level of respect. So I don't see where the private insurance would have done your cancer patient any additional benefit.

The argument we are embroiled as a nation now is one over who is going to pay for health insurance. Health insurance is actually a fairly recent creation, started at the first of this century. Kaiser was the true first provider of health insurance when they created the HMO for the Hoover Dam employees. The next big significant change in health insurance occurred when unions, primarily automobile and trade unions, started demanding insurance as part of their benefit package. Some believe this thought process started because of the world wars and the rapidly evolved military health care delivery system. Soldiers reentering the workplace expected to have health care provided to them by their employer just as it was in the military. Then the great downfall of health insurance entered the picture with the introduction of Medicare. What was originally pitched as a small program with specific goals became a giant substitute for health insurance. Now it is the largest payor of health care and with its constant cutting of payments it is wrecking health care. You need to go no further than the hospital floor and see the number of staff that is not there to see the effect of Medicare.

This is and has always been a debate on who is going to pay the bill for health care. The socialist are on the left and want to tax the productive citizens to pay for the non-productive. The producers are on the right and want the taxes reduced or eliminated so they produce more jobs where people can get employment and have health insurance.

Will single payer work? I don't know. Do I think the government should control the rest of health care? No! Private enterprise is always better than central government at delivering goods and services.

There is a ground swell of people all across this country that are tired of people sitting around and picking their pockets in the form of taxes. The next election could produce one of the largest sweeping removal of incumbents ever seen in this country.

And there is no perfect society. There are only humans getting up every day and making decisions. Unfortunately, some of the humans wake up and decide that they would prefer to sit at home, smoke weed or crack or drink and watch Jerry Springer and Oprah and The Vue. And they become filled with a sense of entitlement to pick our pockets, the producers to live their life style. I for one do not want to give them a dime.

So I wish you well in rebuilding your life. Just like the Master Card commercial the cost of getting there is very measurable but the experience is priceless. Many wealthy men and women failed many times before succeeding. Take Trump for example. I don't like his attitude or his outlook on life even if it is one that is produced by capable PR folks. However, from a business standpoint you have to admire him. Do you have any idea how many times he has failed BK? Do you know how much money he has lost? But yet he bounces back and still makes millions. With that kind of track record you have to believe that you too can rebuild and master your own destiny. Best wishes.

[It'sMe, RN, BBA, MBA]

Any recent wasteful money spent by this government started with George W and his BS weapons of mass destruction. So much better for the little man to "walk with a big stick", then to take care of its hard working citizens.

Anyway, it's easy to say healthcare is a privilage, not a right (like a driver's license) as long as you, yourself are covered, or have made your millions and can afford to go anywhere for services.

As for statistical information and budgetary information, having spent many years in business prior to becoming a nurse, I know as do any of you who are business minded that numbers can be skewed to present the picture most pleasing to the group using them. Unfortunately the American public is not necessarily educated in the ways of the greedy. They think they know, but they don't have a clue.

Furthermore as articles are written by any authority real data is used, but in snippets. Like the articles that are written for any higher education classes or by any researcher, the support data only consists of what the author chooses to use to support "their idea". Not the whole truth, sometimes not even the truth at all-just whatever works with a reference point.

Overall, business people want to see immediate reactions to their actions as opposed to LONG TERM FORECASTING in other words "tell me what will give me the most for the dollar, NOW!" Laws become bad, because their sponsors play tit for tat. Ridiculous addendums are added so that those idiots elected by us get what they want for their constituents. BUT is it really for their voters or for their political contributors?

I say limit all political contributions to $100.00 per person, cap all political spending to $100,000.00 and finally kick all the damn lobbyists out of Washington. Then maybe we'd get people worth serving and some honesty and transparency. In an interesting term that everybody better get used to.

No system is perfect and I am not sure a blanket coverage for all is the way to go, however primary care and patient education are sorely lacking in this country. If we prevented illness by promoting health and well-being through accessible primary, and mental healthcare-many of the expensive, exhaustive, and debilitating conditions that cost us SO MUCH MONEY, may be brought to a controllable level. Canada spends 1/2 the money and according to statistics their citizens not only live longer, but are healthier throughout their lives.

As for all or you vehemently opposed to UHC are you ready if you are kicked off of your insurance, lose your job, or have family living under these circumstances? Should your neighbors have to choose whether to eat, or take their medicines or pay for insurance? Open your eyes! The coasts are inundated with services(albeit unavailable to those without and limited), but what about the interior? If access is limited for any it is a healthcare disparity and I say UNAMERICAN.

Just my for a Sunday Morning

So Maisy, if I understand you correctly you think people are entitled to health care in the USA, as in it is a right. And I noticed you added mental health care as well. So where do you stand on Physical Therapy? Home Health Care? Personal Care? Dental care? Should it all be free to everyone? What about the dialysis patient that can't get to dialysis? Should we pay for their transportation? Who makes that decision? Who pays? And since good health care begins at home, what about a home? Should we provide every citizen a home? And of course nutrition is the foundation of health care so should we provide their food as well? And sense you think that mental health should be covered then should we provide clothes to those that are in need to help them not be depressed? And to feel productive and well adjusted everyone needs a job, should we provide them a job as well? Where do you draw a line Maisy? And who decides what is enough? A government bureacrat? And who is going to pay for all of this? And how?

[MAISY, RN-ER, BSN, RN]

A broad base of care at the PRIMARY LEVEL tends to stave off the catastrophic level. Why are we spending so much for emergent and end of life care, when we could've through primary care service avoided many of the reasons that at least in my neck of the woods I am seeing 40-50-60 year olds debilitated by acute MI, CVA, and diabetic complications.

Many of my recent CVAs and the subject of an article I am writing on disparity in our healthcare system directly resulted from a lack of time with their provider, inability to pay for their medications(no alternatives offered), a lack of healthcare literacy and no understanding that non-compliance even through ignorance could end in disability or death! We may live here, but now must open our eyes to the possibilities other ideas may and do work in other countries. Are they perfect? No, however waiting for this failing disaster we call healthcare to collapse is not an answer either.

As for ancillary services, hell yes! Are you aware in most places stroke rehab is only one hour a day? If you have money and can afford private, it is three hours. If you donate a wing to a rehab facility, I suppose it is unlimited. Let's see, buy a physical therapist for 100k per year and actually have them work for the people, comes out to $48/hr FLAT FEE. How many low level therapists are making 100k per year? How much is insurance billed for these services? Are PT front line making 100K? I know front line OT are making approx $55K that would be $26/hr-is that affordable for rehabilitation? In my opinion based on the outcomes for those I see without the means for rehab, I'd say yes. STABILITY =

Mental health care is part of the Canadian package and again how many illnesses involve mental illness? How about end of life with CA and the elderly? Don't they deserve to have the right care for some quality of life? If these issues along with medication control were addressed, would we have the same homeless problem? Would our prisons be bursting at the seams? There are so many problems caused by this area alone, that I'd propose starting with basic care for all, focus on diabetes, and a mental health model first as part of UHC!

When hospitals went from the medical model of care to a business model they tried to squeeze us into the same mold, all of our illnesses and problems a number to be counted. BUT that isn't the way it is. If cost savings are part of the goal, lose the CEO making $30 million-cap salaries at the top (like Wall Street and anyone else taking money from the government), and make profits transparent.

As nurses we may not always have the same experiences, but we do eventually touch the same patients in a hospital system. The business part has made us adversaries by creating a an environment that is not nurse friendly and keeps us so busy that time with the patient becomes less and less. For those of you who do not perform patient care, if you don't here the whys, you can't know the answers of how they got there.

Unfortunately, here like everywhere else we are governed by our opinions and our research or lack thereof. I have no doubt this will be very difficult to implement, and the AMA although appearing to play nice will do everything they can to get their piece of the pie. The only reason insurance companies are at the table is because they realize the American public is tired of them saying they are failing, when in fact they make profits year after year on our backs! Advocates, advocate for their patients and those in need. I thought that's what nurses do....

M

Happy Father's Day everyone!

[ghillbert, MSN, NP]

Interesting. My MBA is in Health Care Administration. I have a Post Graduate certificate in managed health care. I was the President of an HMO. What qualifications do you have other than "I worked in UHC?"

I did not question your qualifications, and I don't know that they are relevant. I said it is interesting that those most against UHC have never worked in it - you can have all the theories you like, but practical/lived experience trumps it in my book.

I have studied other systems of health care including UHC in depth for over 25 years. So, how do you dispute all of the evidence that UHC has rationing and endless horror stories? The evidence was given to us by previous posters, no need for me to repeat it.

What evidence that there is rationing? I have never heard of such a thing in my healthcare system, which is all I can speak to with authority. People are treated according to medical need. Unlike the US, people are NEVER refused a procedure because they cannot afford it. I work in cardiac transplant - people here have to be fiscally cleared first! Including a 10 week old baby I've looked after, who had to come to our facility after being refused due to inadequate insurance in their home state. How can you be okay with that? People don't get to choose whether they get a cheap or expensive illness - why should they be penalized for their misfortune?

Of course there are "horror stories" - in ANY system. I can tell you stories of poor old ladies laying about on stretchers in the ED hallway because there were no beds available in the Aussie system.. but crap happens wherever you are. Of course it's not the norm. You choose to accept anecdotal "horror stories" but refuse to accept personal experience that is positive.

You are also underestimating the American people. Americans don't walk into a hospital and say "give me only what I need, I will take a Yugo instead of a Cadillac if it is available." Everybody wants the absolute best no matter what the cost will be. Rationing of health care in the USA will not be tolerated. It is not tolerated by the lowest class, just go to an any ER and you will see it, and the middle and upper class certainly will not stand for it.

Oh, does that mean the Aussies are okay with substandard care? Don't be ridiculous. It's more like you get the best care WITHOUT REGARD TO INCOME. There is no rationing - it just doesn't happen. You can say it as many times as you like, but that doesn't make it true. Judging by the comments which basically end as "I'm ok, screw everyone else" - perhaps I have overestimated some americans (not all).

Of course there are various UHC plans, and some are better than others. I truly think our system of mixed public/privatized insurance is great - it's fair AND sustainable. Those who want the fancier surroundings and nicer meals can go ahead and buy extra private insurance and use it. The care is no different - it's the same surgeons/physicians that work in both the public and private systems.

Your nice little comment about having "real" degrees - I can only assume you mean that nursing is not one? - was appreciated. As you said, once logic fails, insults are all that is left. You don't have any idea of my qualifications, and they aren't relevant - I am speaking from experience. You're not.

I'm not sure why you're even posting here because you are clearly not interested in two way discussions, but only lecturing to people about why they are stupid "sheeple".