The United States National Health Insurance Act establishes an American-styled national insurance program.
The bill would create a publicly financed, privately delivered health care program that uses the already existing Medicare program by expanding and improving it to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans, guaranteed by law, will have access to the highest quality and cost effective health care services regardless of ones employment, income, or health care status.
Let's face it folks; the whole shebang is all about $$$$. Doctors, lawyers, insurance companies, HCF administrators and CEOs, and politicians - they all want their slice of the pie, regardless of who else gets screwed in the end.
I believe we have two major challenges to cost-efficient healthcare delivery. The first is the need for Tort Reform. So much money is wasted because providers fear lawsuits. We should all be realizing a sense of gradification from the good we all do, but we have been reduced to whining, negative paranoia waiting for the next personal injury attorney to appear. Until we can do our jobs without fear of reprisal, we will continue to complain and burn out.
The second problem is a bit more sensitive, yet closely related to the first. I ask myself every day if we are not keeping people alive just for the sake of proving we can do it. My dear 94 year-old aunt died last month, and her last year was a rough one. I saw her through one inpatient stay after another for diagnostics that brought her pain and discomfort. Apart from her physical complaints, she had dementia and knew none of us. I was finally able to convince my uncle that he should let her go. He admitted her to hospice and she died 3 days later. I loved my aunt, but I think she lost her will to live 5 years ago, but was afraid to say so. What purpose is served to spend thousands of dollars on a MRI to R/O brain tumor? At 94, she was entitled to forget who we are........
Yep, exactly. That's why we need to get rid of the profit motive in medical insurance and adopt a single-payer plan. I've got no problem if that's contracted out to a non-profit entity rather than created as a government bureaucracy. Probably better that way.
I worked for one of the biggest nonprofits in US healthcare and I have to say, it was still about the money. Bottom line, someone has to pay the bills - need infrastructure, need latest equipment, need manpower, need to pay for those who can't. Then if you run a University, need to pay for the school and the research. Need money, money, money, and I can't fault them for that....
If so why not figure out how to do so efficiently?
Safe, effective, therapeutic health care for everyone?
I have Tricare and I have no complaints about my care. The DOD hires Tricare to administer healthcare to eligible beneficiaries. I am capitated to a local Naval Hospital, but am referred to civilian docs as needed. I pay nothing for the meds I get on base and $9./month for those I get in town because they are not formulary. It is no frills, I cannot go to my PCP and demand a MRI because I have a sinus infection, and I don't expect to be given antibiotics for every sniffle. They don't scrimp where care is necessary - I need ear surgery and they are sending me to one of the best ENT surgeons on the East Coast. For this, my husband and I pay $240/year. Could they deliver this care to the entire country? Never.... For one thing, the DOD has deep pockets and understands the need to keep the workforce and their families healthy. Then there are those millions who think they need a MRI to diagnose a sinus infection. Who would be able to say no without sending folks scrambling to their Congressperson?
I worked for one of the biggest nonprofits in US healthcare and I have to say, it was still about the money. Bottom line, someone has to pay the bills - need infrastructure, need latest equipment, need manpower, need to pay for those who can't. Then if you run a University, need to pay for the school and the research. Need money, money, money, and I can't fault them for that....
Of course it takes money, lots of it. Yes, cost containment is crucial to any entity.
The issue is whether you want to add the profit motive on top of that. Any for-profit entity puts their shareholders first. Their shareholders demand not just a return on their investment but a growing return.
Also, I was specifically addressing the payer side of the equation, not the provider side. There, too, though, I believe that they should be not-for-profit.
I paid full FICCA for more then ten years. By full, I had no employer contribution from my employer. I have collected SSDI for fifteen years. I lost my IRA, 47% to pay fines and penalties for early withdrawal because I tried to save my condo from foreclosure. I receive Medicare. I don't have any retirement program because mine was wiped out, through no fault of my own. Yes, Medicare and SSDI are essential an entitlement program. An entitlement program that without its existance I would be living on the street. Perhaps that is where people like me belong rather then taking precious tax money from working nurses.
Grannynurse:balloons:
Grannynurse, If you have been around since the 60s I think you can agree that you are not a typical consumer of the Medicare?Medicaid system to which Kevin is referring. SSDI and Medicaid are meant to be available for folks like you, those who have needs as a result of unfortunate circumstances. I see from your UserID that you have not accepted your current status as your role in life and are making an effort to move on. Most on these Programs do not..... I have worked with Public Health and then Medicaid for the past 18 years and I can tell you the system is littered with people who think the government (and the taxpayers) owes them something for doing nothing - and they will tell you so with a great deal of attitude. I treat all my patients with respect, and have always been an advocate for them. I refuse to lecture a 60 year old woman who has Diabetes, CHF, and COPD while raising three grandchildren on what she receives from the state. It is too late for lectures,all I can do for her is help her stay alive. But I have a different attitude for a 20 year old single mom with 3 children who refuses to take care of herself or her kids because she thinks that is my job....2 years from now, she will join the ranks of the uninsured when her MA runs out, and she will complain that it is the government's fault...... Not!!!!
Unless they have changed the rules in the last year, it is mandatory. If you do not select a plan within their timeframe, one will be selected for you, and it may not be one compatable with the meds you take. I spent a lot of time counseling seniors about Part D. Most State Office on Aging personnel have had to be trained to help folks select the right program. It is a nightmare, and the plans are not only expensive, most have outrageously high copays. THe government's arguement is that Medicare was never meant to pay for everything, folks need to have a nest egg to help defray the expenses. But few people realize this. They think Medicare will take care of them.
I think a lot of people blame insurance carriers for failure to cover or adding unnecessary layers to approval when the real blame lies with employers. Larger companies will sit down and tell an insurance company what coverages they want their employees to have. Most of these large plans are custom written, and there is a method to their madness. A friend of mine once complained that his plan covered infertility treatment and not chiropractic visits. He thought the insurance company was being ridiculous since the average age of his workforce was 43 and predominatly male. What he never realized was until he asked was that his HR dept negotiated the coverage for him. Now who has their eyes on the profits???
Katie82, RN
642 Posts
I believe we have two major challenges to cost-efficient healthcare delivery. The first is the need for Tort Reform. So much money is wasted because providers fear lawsuits. We should all be realizing a sense of gradification from the good we all do, but we have been reduced to whining, negative paranoia waiting for the next personal injury attorney to appear. Until we can do our jobs without fear of reprisal, we will continue to complain and burn out.
The second problem is a bit more sensitive, yet closely related to the first. I ask myself every day if we are not keeping people alive just for the sake of proving we can do it. My dear 94 year-old aunt died last month, and her last year was a rough one. I saw her through one inpatient stay after another for diagnostics that brought her pain and discomfort. Apart from her physical complaints, she had dementia and knew none of us. I was finally able to convince my uncle that he should let her go. He admitted her to hospice and she died 3 days later. I loved my aunt, but I think she lost her will to live 5 years ago, but was afraid to say so. What purpose is served to spend thousands of dollars on a MRI to R/O brain tumor? At 94, she was entitled to forget who we are........