I want to know what nurses think about socialized medicine.

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I'm doing a report on Socialized medicine and dont know much about how people feel about it as I live in Idaho.What are any of you Canadian nurses feelings about it? Good or Bad?

Specializes in ICU,ANTICOAG,ACUTE STROKE,EDU,RESEARCH.

As a follow up to my post about the NHS in the UK I wanted to illustrate that there are immense financial targets in all aspects of the NHS. Even ward Sisters are expected to manage their budget (not sure how your training as a RN equips you to do that, or why it should be expected.

Bearing in mind the staffing ratios and salaries I posted -I took this info from the UK National Audit Office websitE. They are an independant body that review many government agencies, not just the NHS.

The National Health Service (NHS) had a surplus

of £1.67 billion in 2007-08, representing approximately

two per cent of total available resources. At the start of

the financial year, the Department set the NHS the target

of delivering a combined surplus and contingency of

around £0.9 billion. During the year the contingency

was not required and the surplus grew as a result of NHS

organisations exceeding savings plans and a reduction

in the price of generic medicines. The surplus has been

carried forward into 2008-09 and the Department

has committed to making it available to the NHS for

spending in future years.

I wonder how far into the future they are talking about considering nurses were given a below inflation pay rise this year because the unions stupidly agreed a 3 year deal last year when inflation was low.It was agreed with the condition that the government would review it ,but now they are refusing to review it as the hospitals are saying they can't afford to pay nurses more!This was written in th nursing press prior to the refusal to re-open pay talks.

Unions have submitted their evidence to the NHS Pay Review Body calling for a recommendation that the government reopens the talks on pay. Helen Mooney analyses the facts and figures

Evidence submitted to the NHS Pay Review Body last week made the case for an improved pay rise for nurses and other non-medical NHS staff (NT News, 28 October, p2).

As the economic downturn continues and the UK slips into a recession, unions have claimed nurses are facing tough times ahead and the original pay deal agreed earlier this year is no longer reflective of the cost of living.

The current 7.99% three-year pay deal equates to a 2.75% pay rise for nurses in the year 2008-2009. Awards for the next two years agreed between the government and the unions mean an extra 2.4% in 2009-2010 and 2.25% the following year.

However, a 'reopener clause', which was written in to the agreement, means that the Pay Review Body can be called on to make recommendations to the government, should the economy deteriorate - which it now has.

The system effectively means that nurses' pay decisions are in the hands of the independent Pay Review Body - and ultimately the government, which can decide in favour of or against a Pay Review Body recommendation.

The documents that were produced by the unions as evidence for the Pay Review Body make for depressing reading.

They warn that staff across the NHS are now facing severe hardship and for nursing a recruitment and retention crisis is predicted.

Graduate intake is down - at the end of July 2007 there were 3.7% fewer students attending undergraduate nursing courses than the year before.

In addition, more than 25% of students are dropping out of their courses and those who are already working in the profession are leaving before retirement age.

The evidence also shows that record numbers of NHS staff are now accessing help on managing severe debt and house repossessions. Many are also being forced to take second jobs and to work overtime because of the impact of inflation and the rising costs of fuel, food and childcare.

Karen Jennings, staff side chairperson and Unison's head of health, said: 'Hard-working staff across the NHS accepted a three-year pay deal six months ago believing the government and economic predictions that inflation had peaked and would start to fall.

'This clearly hasn't happened. No one then could have predicted the worldwide credit crunch or that inflation would

hit a 16-year high,' she added.

She warned that the government had to make sure that working within the NHS was an attractive career option and to do so it would need to 'pay workers decently'.

'The reopener clause was intended to be a safety net for NHS staff. They need that safety net now,' she said.

The RCN has urged the government to take action in the face of recruitment and retention warnings.

Chief executive and general secretary Peter Carter said: 'NHS staff put their faith in the government when they accepted their pay deal - now it's time for the government to honour the day-in day-out commitment of NHS staff by agreeing to reopen talks to secure a fairer pay deal across the health service.'

Heads of midwifery across the UK last week warned of a service 'buckling under the pressures of rising birthrates, inadequate funding and a lack of staff'.

The findings of a survey conducted by the RCM of all heads of midwifery across the UK reveal that as many as 75% consider they do not have enough staff to cope with the current workload, yet despite this one-third have been asked to cut their budgets and reduce expenditure.

The survey also shows a significant drop in midwives' morale with one-quarter of heads of midwifery saying their staff are unhappy.

As a consequence recruitment and retention has been hit with over one-third of survey respondents saying it has become a problem - compared with only 13% last year.

Jon Skewes, director of employment relations and development at the RCM, called on the government to make

sure that more midwives joined the profession and that those who are already in employment are retained.

'This will not happen without fair reward. Midwives are facing a double whammy of static resources at work and salaries not keeping pace with inflation so they are increasingly hard-pressed in terms of household bills,' he said.

'Better resourced and fairly paid midwives translate directly into better care for women,' he added.

Meanwhile, the union Unite has gone a step further.

It is the only union not to have accepted the original three-year pay deal, which it described as 'derisory' and last week it balloted its members on industrial action.

David Fleming, Unite's national officer for health, said: 'I appreciate that we are living through very difficult economic times but that is no excuse for dedicated and hard-working NHS staff to be penalised by derisory pay awards as a result'.

In its submission of evidence to the Pay Review Body, Unite criticised the government for its 'lack of economic rationale' in the current pay agreement.

'The economic crisis and recession should not be seen as a reason to decrease investment in the NHS and avoid tackling the problems in staffing levels,' it said.

'Previous low levels of pay for NHS staff and a lack of investment led to a decay in the service,' it added.

But despite the compelling evidence, there are doubts that the government will commit itself to improving pay for nurses during these testing economic times.

The two-stage reopener clause means that the unions have first to convince the Pay Review Body and then the Pay Review Body has to convince the government - that NHS staff should receive more pay.

The government's decision last year to stage the pay deal for nurses in England and threats earlier this year of another staged pay deal if unions rejected the multi-year package on offer, show the government is willing to ignore pressure from staff and the review body.

Key staff side recommendation

'In view of the significant and material changes in recruitment and retention and wider economic and labour market conditions, staff side organisations seek a review of the pay uplifts for 2009 and 2010. Staff side seeks revised awards for 2009 and 2010 significantly above inflation levels, that restore income lost from 1 April 2008 as a consequence of the steep rise in inflation and that recognise that the high inflation level has had greater impact on low paid staff.'

Some say that the Pay Review Body simply will not have sufficient influence to bring about change.

Mike Travis, RCN steward at Alder Hey Children's NHS Foundation Trust in Liverpool, said: 'I have complete confidence in the staff side evidence, which has been built up over time but it depends how the Pay Review Body will react when it is put under political pressure.'

But Ms Jennings was more positive about the possible outcome. 'I would be very shocked if the government did not listen to any recommendation the Pay Review Body may make to reopen talks,' she said.

NHS trusts, represented by NHS Employers, have already vowed to fight any attempt to increase pay to staff in the health service.

The Department of Health has also produced its own evidence to the Pay Review Body, which was submitted at the time of

writing and is likely to make similar arguments.

Gill Bellord, director of pay, pensions and employment relations at NHS Employers, said: 'Employers have told us that they support the three-year pay deal for Agenda for Change staff and do not think there is sufficient evidence to justify a review of the provisions agreed with unions'.

If a Pay Review Body recommendation is put forward and the government reopens talks, discussions will begin in the new year.

Any extra pay increase that is agreed on top of the existing one would come in to force in the financial year beginning

April 2009.

To read more about Pay 2008 click here.

What the evidence shows

Staff are experiencing severe hardship as a result of rising inflation. One union found that three-quarters of members needed to work overtime to meet living expenses and one-fifth could not afford to heat and maintain their homes.

More than 200,000 nurses are aged over 50 and due to retire within the next decade.

Recruitment continues to be low in the NHS and for the first time in two years there has been an increased reliance on bank and agency workers.

Hopefully this will give a picture of how nursing can suffer as a result of a government run health care system.

Specializes in Critical care, tele, Medical-Surgical.

I am not in favor of the government running the hospitals and clinics. I am in favor of We the government paying, much like Medicare does for our least healthy seniors and disabled people.

In the 1990's hospitals merged with big chains. They laid of licensed nurses, cut benefits, and called it "Patient Focused care". - http://www.calnurses.org/research/pdfs/ihsp_marketbasedhealthcare_062607.pdf

We have been through similar from our non government employers too.

The bottom line is for whatever reason a patient presents themselves in an ER without insurance , we pay for it either through taxes for the uninsured or higher premiums if privately insured.

We can argue the number of uninsured , but ,you cannot simply remove uninsured people from the total because they are not legally here or chose not to insure themselves , unfortunately when they become patients , their care has to be paid for .

The reason we need to know WHY people don't have insurance is to solve the problems of WHY.

And the answer doesn't need to be government health care.

There are other answers.

We libertarian and conservative folks just don't think the government's role is to mandate health care options.

Medicare is a huge mess. That in itself should be a warning . ..

steph

Specializes in Psych , Peds ,Nicu.
The reason we need to know WHY people don't have insurance is to solve the problems of WHY.

And the answer doesn't need to be government health care.

There are other answers.

We libertarian and conservative folks just don't think the government's role is to mandate health care options.

Medicare is a huge mess. That in itself should be a warning . ..

steph

I think here we are both in agreement , in that we believe the problem is getting everybody to pay for healthcare coverage , where we differ is how and to whom we get everybody to pay for healthcare .

In an honest attempt to compare actual costs of Healthcare insurance in the US system against single payor system , I googled average family cost USA health insurance ,averaged the numbers provided by the Association of Healthcare Plans ( R)$5800, The Coalition for Healthcare (L)$12000 , The Center for Budget and Policy Priorities ( C)$7000 , this gave a figure of $8266 / family .In this or another thread a UK contributor said the National Insurance contribution ( the way the NHS is financed )is 6.5% of income , that % of the average US family income (2007) is $3265 . So ,( admittedly in my quick analysis ) it would appear that there is a possibility of a major savings to famillies if we were to use a single payor system ie.$8266 - $3265 = $5001

Conservatives / libertarians such as youself appear to believe the free market is the best selfregulatory system and most efficient in providing services . While I feel that self regulation does not work ( there are many causes for the present economic crisis , but certainly the foxes were watching the hen house when it came to regulating the financial system )and the profit motive have always worked against provision of healthcare to all at a price all can afford.

I think you could argue that HM2Vikings post of the WHO report appears to show that our present hybrid system somehow creats the most expensive halthcare system in the world .

I think you could argue that HM2Vikings post of the WHO report appears to show that our present hybrid system somehow creats the most expensive halthcare system in the world .

As I mentioned regarding infant mortality stats - the way they get stats is questionable.

http://www.cato.org/pub_display.php?pub_id=9236

WHO's Fooling Who? The World Health Organization's Problematic Ranking of Health Care Systems

by Glen Whitman

The World Health Report 2000, prepared by the World Health Organization, presented performance rankings of 191 nations' health care systems. These rankings have been widely cited in public debates about health care, particularly by those interested in reforming the U.S. health care system to resemble more closely those of other countries. Michael Moore, for instance, famously stated in his film SiCKO that the United States placed only 37th in the WHO report. CNN.com, in verifying Moore's claim, noted that France and Canada both placed in the top 10.

Those who cite the WHO rankings typically present them as an objective measure of the relative performance of national health care systems. They are not. The WHO rankings depend crucially on a number of underlying assumptions— some of them logically incoherent, some characterized by substantial uncertainty, and some rooted in ideological beliefs and values that not everyone shares.

The analysts behind the WHO rankings express the hope that their framework "will lay the basis for a shift from ideological discourse on health policy to a more empirical one." Yet the WHO rankings themselves have a strong ideological component. They include factors that are arguably unrelated to actual health performance, some of which could even improve in response to worse health performance. Even setting those concerns aside, the rankings are still highly sensitive to both measurement error and assumptions about the relative importance of the components. And finally, the WHO rankings reflect implicit value judgments and lifestyle preferences that differ among individuals and across countries.

steph

Specializes in Psych , Peds ,Nicu.
As I mentioned regarding infant mortality stats - the way they get stats is questionable.

steph

I think we would both agree when it comes to statistics and sources to attack or defend a position caveat emptor applies . While I may think WHO is a fairly unimpechable source , as it has no vested interest in this subject . Glen Whitman and you obviously disagree .

Of course health insurance companies are wasting 1.4 million a day lobbying congress WITH OUR PREMIUM DOLLARS.

Specializes in He who hesitates is probably right....
Of course health insurance companies are wasting 1.4 million a day lobbying congress WITH OUR PREMIUM DOLLARS.

That should buy enough votes to save us from government-run health care :yeah:.

Specializes in Critical care, tele, Medical-Surgical.
That should buy enough votes to save us from government-run health care :yeah:.

I think that since I pay my insurance company they have a moral and ethical obligation to use the money to ensure I am not deneyed the healthcare I'm paying for.

Specializes in LTC.
That should buy enough votes to save us from government-run health care :yeah:.

So then, it's okay for lobbyist to influence our government? You must consider, one of the big platforms for Dems in Congress and Obama was health care reform. If they do not do something about it, then they are going to have a lot of problems with accountability.

Bottom line, Obama (and Many Dem Congressman ) ran and won on the health care reform wagon, if they don't deliver, there will be problems to say the least.

So then, it's okay for lobbyist to influence our government? You must consider, one of the big platforms for Dems in Congress and Obama was health care reform. If they do not do something about it, then they are going to have a lot of problems with accountability.

Bottom line, Obama (and Many Dem Congressman ) ran and won on the health care reform wagon, if they don't deliver, there will be problems to say the least.

Lobbyists are lining Obama's and Dem's coat pockets with . .. . influence. ;) And Republicans too.

steph

Specializes in LTC.
Lobbyists are lining Obama's and Dem's coat pockets with . .. . influence. ;) And Republicans too.

steph

Yes, that's true. My questions to K98 was whether or not he thought that was a good thing. Apparently he does.

Does anyone else think lobbyists are good for our Democracy?

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