Libertarian Nurses View on Core Measures

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I am wondering if there exists any opposition to core measure standards and what Libertarian Nurses think? I have been a nurse for several years and I am currently a core measure abstractor. There are huge manuals that guide what we do and they site studies at the end of them. I am starting to lean politically Libertarian after years of believing health care has been ruined by the private sector and that there needs to be more private sector control over it. After 20+ years in the biz I've come to see that medicine is the most heavily regulated industry along with banking, and things have just gotten worse. Even the studies from these manuals that I have been able to trace funding back to either are directly done by the govt or directly funded by the govt. I come to also realize we haven't had a free market in health care in decades. I am not completely against many of the core measure standards, but Ive seen too many cookie cutter scenarios that seem too punitive. Through my lens, we have govt trying to solve problems that are main caused by govt involvement.

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Specializes in Emergency.

So...you'd rather have things "run" by a corporate entity that cares only about profit motive, nothing about pt. care-except when it bolsters the monies gained via false advertising-and certainly cares nothing about workers rights....a run to the bottom...this is my libertarian/"free market" thought: Remember. ...just cause its the cheapest (insert anything) does not make it the best...

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Specializes in Epic Trainer, Med/Surg, Psych.

If you are working in any hospital system in the US you are working for a "corporate entity" with the level of caring you describe. Healthcare in America is oligarchic, nearly monopolistic the way it stands now. None of this psuedo-fascist corporatism is acceptable under libertarian values.

As a libertarian I believe a decentralized health care system would serve everyone better, especially the lower economic classes.

It is pretty clear that you do not know what libertarians think. That's fine, as it goes, but please refrain from commenting until you do. Questions are welcome.

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Government is pretty much in control of healthcare in this country. We don't need to worry about socialized healthcare because we have had govt run healthcare for years. Please do t tell me what a libertarian believes...I know we are for decentralization of govt. most of you do not realize that the corporate structure is a govt invention. When you speak about corporate control of healthcare without holding the govt culpable for its poor management and subsidization of big pharma and many large corporate insurances you miss the root of the problem altogether. That is not decentralization. Many of use work in the system because there is little choice but tend to volunteer our time for charities. I'm not quite sure if you were referring to my comment tedwood, but it's clear you must have been referring to another poster. There is nothing in that statement that was not clear as to libertarian thought. I'm not sure where I gave support for the current system. I will continue commenting and YOUR questions as always are quite welcome.

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Specializes in Hospice.

Two brief points:

1. So far, the performance of the private sector over the last 50 years has been a dismal failure. It has not inproved efficiency, controlled costs, maintained quality or increased accessibility. The more privatized our healthcare has become, the worse it gets.

2. I haven't crunched national numbers but I can tell you that the majority of the regulations put in place in the areas where I have experience were responses to abuses and poor quality care by - you guessed it - the private sector.

You are suggesting that we continue doing the same thing and hoping for different results. Not gonna happen.

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I agree...the govt has done an awful job of the last few decades running healthcare. Because of this we have big pharma and insurance...it's hard to know if I free market would have done better in the last few decades but the problems we have in healthcare rival that of big biz...and that is they got big from cronyism. Regulations are truly needed in our line of work but not one that put too many barriers to entry and participation in smaller markets. These small markets are being swallowed up by big government crony biz's and hence our current healthcare system. We may want to try some free market as we haven't had one in the U.S. In decades

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Specializes in Hospice.

Please don't change what I said. The government does not "run" healthcare. The private sector does, and it's control has been tightening over the decades since health insurance companies were first allowed to operate as for-profit businesses.

The problem with the free market fantasy is that gaining a competitive advantage incentivizes behavior that makes a "free" market impossible.

Consider, for instance, the act of selling something. Theoretically, a successful sale depends on convincing a customer that one's product is superior and worth the price charged. In actuality, it's about convincing the customer to think the product is superior. A very different thing that involves as much - or more - psychological manipulation as it does factual information.

Lying, being easier and cheaper than actually producing a superior product, becomes an essential part of the process. From there, it's easy to progress to fraud and unethical/immoral business practices. When profit is the only acceptable motivation, there's no reason not to.

In my view, turning our healthcare system over to the private sector has already been tried and the mess we have now is the outcome of that experiment.

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This is probably where we part. Good day! There is no way I agree that the govt is not the root. Most hate that thought because it makes them feel helpless as THEY elected these clowns. Truth is there is much less chance of a monopoly in a free market than in what we have or had in the past. Sorry....good luck!

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Truth is there is much less chance of a monopoly in a free market than in what we have or had in the past. Sorry....good luck!

How is that the "truth"? I seem to recall that the only reason there is so much government intrusion into the US "free" market is because, back in the Gilded Age when the markets really were free, we had large monopolies operating to the detriment of the general public. That's why all that pesky antitrust legislation was passed, to rein in the destructive excesses of the free market. For-profit businesses don't want competition, they want to control a market and not have to deal with competition.

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Specializes in Critical Care.

I'm not sure how you're making the jump from libertarianism to Core measures, but the general premise of libertarianism is that the basic liberties and freedoms of all individuals should be protected.

In true capitalism, the goal is for wealth to create more wealth and more power, in other words, the opposite of libertarianism.

How we impose libertarian values against the increasing concentration of power and wealth is to give the public at large the power to influence the criteria that result in profit. That's exactly what core measures are; we as the public set forth very basic standards that those providing a product must meet, if they fail to provide a good product then they make less money, not more, which is how it should be.

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Libertarianism is not capitalism...it's a free market. If you have questions...I can answer, but. I'm not making a JUMP from core measures libertarianism...I'm not quite sure you grasped my lament that the way core measure came to "best practice"is that they have left out the free market in determining what true best practice is. We only have either govt studies or private companies where govt funded and/ or approved them to study! We don't impose...we refuse to implement a system that has messed things up from the beginning! Nullify!

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Specializes in Critical Care.
Libertarianism is not capitalism...it's a free market. If you have questions...I can answer, but. I'm not making a JUMP from core measures libertarianism...I'm not quite sure you grasped my lament that the way core measure came to "best practice"is that they have left out the free market in determining what true best practice is. We only have either govt studies or private companies where govt funded and/ or approved them to study! We don't impose...we refuse to implement a system that has messed things up from the beginning! Nullify!

In a truly free market, all participants are able to influence the market, this includes society as a whole, and how a society acts as a group is typically through their government.

Studies actually come from a variety of sources including private groups, for many core measures the majority of the evidence actually comes from these groups such as the RWJ foundation.

I personally cannot finance or oversee a large scale study by myself, I would bet the same is true for you, what makes much more sense is to join my desire research on what quality healthcare is with others who have the same desire and to form an entity that is intended to represent our interests as a group, ie a government.

I'd see your point if the evidence behind core measures was sealed or otherwise secret, but it's not, it's up for review by everyone. So what is it in particular about core measures you disagree with?

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