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d!gger 3,759 Views

Joined: Oct 23, '06; Posts: 43 (60% Liked) ; Likes: 58

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  • Mar 26 '09

    1. there have been problems with cprs software but humans in the system do catch them as they have occurred and get the problems resolved. (overall va patients do get excellent care.)

    critics will say that the vha is not significantly cheaper than other american health care, but that's misleading. in fact, the vha is also proving far better than the private sector at controlling costs. as longman explains, "veterans enrolled in [the vha] are, as a group, older, sicker, poorer, and more prone to mental illness, homelessness, and substance abuse than the population as a whole. half of all vha enrollees are over age 65. more than a third smoke. one in five veterans has diabetes, compared with one in 14 u.s. residents in general." yet the vha's spending per patient in 2004 was $540 less than the national average, and the average american is healthier and younger (the nation includes children; the vha doesn't).

    2. evidence based reimbursement is hardly denying care:

    problem is, studies show that individuals are pretty bad at distinguishing necessary care from unnecessary care, and so they tend to cut down on mundane-but-important things like hypertension medicine, which leads to far costlier complications. moreover, many health problems don't lend themselves to bargain shopping. it's a little tricky to try to negotiate prices from an ambulance gurney.
    a wiser approach is to seek to separate cost-effective care from unproven treatments, and align the financial incentives to encourage the former and discourage the latter. the french have addressed this by creating what amounts to a tiered system for treatment reimbursement. as jonathan cohn explains in his new book, sick:
    in order to prevent cost sharing from penalizing people with serious medical problems -- the way health savings accounts threaten to do -- the [french] government limits every individual's out-of-pocket expenses. in addition, the government has identified thirty chronic conditions, such as diabetes and hypertension, for which there is usually no cost sharing, in order to make sure people don't skimp on preventive care that might head off future complications.
    the french do the same for pharmaceuticals, which are grouped into one of three classes and reimbursed at 35 percent, 65 percent, or 100 percent of cost, depending on whether data show their use to be cost effective. it's a wise straddle of a tricky problem, and one that other nations would do well to emulate.

  • Mar 26 '09

    Please go and READ the actualy language and healthcare legislation being proported along with stimulus spending.....

    Just don't take one newspapers /websites interpretation of pending legislation.

    For the political novice:
    Most major bills in congress contain legislation on several seemingly unrelated areas ....don't think this is the only bill to do so.

  • Mar 26 '09

    current bill language:
    . american recovery and reinvestment act of 2009 (amendment in senate)[h.r.1.as2]

    section:title viii--departments of labor, health and human services, and education, and related agencies department of labor
    under office of the national coordinator for health information technology
    (including transfer of funds)

    • for an additional amount for `office of the national coordinator for health information technology', $3,000,000,000, to carry out title xiii of this act which shall be available until expended: provided, that of this amount, the secretary of health and human services shall transfer $20,000,000 to the director of the national institute of standards and technology in the department of commerce for continued work on advancing health care information enterprise integration through activities such as technical standards analysis and establishment of conformance testing infrastructure so long as such activities are coordinated with the office of the national coordinator for health information technology: provided further, that funds available under this heading shall become available for obligation only upon submission of an annual operating plan by the secretary to the committees on appropriations of the house of representatives and the senate: provided further, that the secretary shall provide to the committees on appropriations of the house of representatives and the senate a report on the actual obligations, expenditures, and unobligated balances for each major set of activities not later than november 1, 2009 and every 6 months thereafter as long as funding under this heading is available for obligation or expenditure.
    fyi, this position been in existance for 4yrs created by president bush:

    the office of the national coordinator for health information technology (onc) provides counsel to the secretary of hhs and departmental leadership for the development and nationwide implementation of an interoperable health information technology infrastructure. use of this infrastructure will improve the quality, safety and efficiency of health care and the ability of consumers to manage their health information and health care.

    in 2004, the president issued an executive order establishing the position of the national coordinator for health information technology within the office of the secretary of hhs. the primary purpose of this position is to aid the secretary of hhs in achieving the president’s goal for most americans to have access to an interoperable electronic medical record by 2014.

    go to thomas (library of congress) , click latest daily digest to locate bills currently being voted on and latest admendment language

    then email your congress person regaring your thoughts language tweek or desire to see passage/rejection...
    they do listen to you and trust me omeone in the office is keeping scorecard on comments received.
    seen if first hand on my trips to us senators office and meetings with state senator/reps in pa's harrisbug capital bldg.

    contact info available: 2/4/09: nursing activism primer-- legislation, lobbying/ contacting elected officials

  • Mar 26 '09

    nurses blast "cruel ruse" by insurance giants to cover patients as deal for forcing americans to buy insurance

    the nation's largest organization of registered nurses today condemned the conditional offer by the insurance industry to stop denying coverage to sick people in exchange for a massive government bailout....

    ... on tuesday, the insurance trade lobby america's health insurance plans and blue cross and blue shield offered to stop denying coverage to those with pre-existing conditions - but only if the healthcare reform plan under consideration in congress contains a requirement forcing all americans to buy private insurance - and if congress rejects a proposal to include a public plan alternative for people not wanting private insurance.
    "that's not a sign of flexibility at all, it's blackmail," said geri jenkins, rn, co-president of the 85,000-member california nurses association/national nurses organizing committee.
    "they are only willing to scale back on their immoral denial of coverage for people who are sick, even those who have had minor illnesses, if they are given billions of dollars in payments from private individuals and government subsidies," said jenkins.
    the insurer's proposal "amply demonstrates what is so fundamentally wrong with our insurance-based system. decisions on whether patients can receive healthcare coverage are not based on patient need, but on how much profit the private insurers can make."
    nurses, said jenkins, were also disturbed at the response of lawmakers and others who praised the proposal.

  • Mar 26 '09

    I live in Canada, and have for all but three years of my life. While our health care system isn't perfect, it doesn't discriminate on the basis of ability to pay. Everyone has the same rights and responsibilities regarding health care from coast to coast.

    I have been a nurse for nearly 15 years. My hourly rate of pay is $40.43, with an evening premium of $2.50, a night premium of $4.25 and a weekend premium of $2.75 per hour. (So if I work Saturday night I will be paid $47.43 an hour.) I get 4 personal days, 11 statutory holidays, 20 vacation days, 3 professional development days per year and I earn sick time at the rate of 1.25 days per month. If I have to work on a statutory holiday I'm paid time and a half. Overtime is double time. My extended health benefits, dental and vision care, disability and life insurance, pension and RRSP contributions are paid 75% by the employer. Incidentally, I DO NOT work for the government. I work for the health region in which my hospital is located. The government provides the money and the legal oversight, the region provides the health care. Physicians are paid according to a fee-for-service model (which is not adequate and is subject to reform) and are not told by the government what they can do for their patients or what they can't. Hospitalists are paid a salary by the health region and believe me, they are not hurting. Access to services can be delayed due to a number of factors that are not important to this discussion, but are also not limited to the Canadain system.

    There are so many misconceptions and outright lies about what socialized health care is and isn't, most promulgated by people who don't understand it and don't want to. Thank you OP for wanting to know.

  • Mar 26 '09

    This source has a point of view

    The NCPA's goal is to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector.
    This one does too

  • Mar 26 '09

    Quote from iteachob
    Problem! You can't have one without the other.
    Take the $525 - the sum of my payment for my private insurance and my employer's contribution to the same each pay period - multiply it by 26 (pay periods in a year). That adds up to $13,650 per year that goes to cover private health insurance for my family of 3. It astounds me that there are people who seriously think this ok.

    That almost-14k...heck, even half that, or even a third, multiplied by every working American, would likely suffice to cover everybody's medical bills in the nation. So much for higher taxes...just quit paying the dang private insurers whose job it is to make a profit.

  • Mar 25 '09

    I'm fairly conservative politically, but in this one area I am unabashedly in favor of abolishing our current patchwork "system" of healthcare and allowing government to collect the funds for universal health care---NOT health "insurance". I want to see the insurance industry completely OUT of the picture. Insurance companies are why costs are out of control, why our paperwork is ridiculous, why average people don't get care until they're so sick they wind up in the ER, why so many desperately needed procedures are never done (consider weight-loss surgery) even though they would save lives and money in the long run.

    I wouldn't want politicians to oversee the actual system, especially not at the federal level. Instead I'd have panels made up of healthcare professionals (INCLUDING nurses!), financial and legal experts, and knowledgeable laypersons to administer health programs at the state level. Who better than the states themselves to determine the needs specific to their populations?

    But however we get there, we MUST establish access to basic medical services for every citizen of this nation and get the profiteers out of health care. Nothing less will suffice. And that's all I have to say about that.

  • Mar 25 '09

    I have a mouth that gets me in trouble, so sometimes I just have to count to 10, or 20, or 50, or 10,473!

    I have learned to control it (most of the time) and know (usually) when I can and can't pop off. I've found it helps to talk to someone I know will not hold my comments against me, so I pop off to my boss (unless it's about her, lol! ) or a co-worker (one I can trust who won't gossip) in a private area. But what's saved my life? Text messaging!!! I text my husband with my negativity, and he talks me off the ledge!

    As far as body language goes, try talking to yourself in a mirror. When I was a child, my mom said I never met a mirror I didn't like :imbar so I've learned to use this as a tool to see how others see me. You know what facial expressions you make. So say some things you normally say into the mirror. Practice making your facial expressions less, well, expressive. Try to learn not to wear your heart on your sleeve.

    Or learn not to care. Accept that you can be somewhat caustic and try not to let it bother you that some people are not going to like you. Because, honestly, not everyone is going to like you, no matter what you do.

    And try not to let what others do bother you. Don't take things personally. Most people are so self absorbed they think everything is about them. Usually it's not. I have a co-worker with "foot-in-the-mouth-itis." I do a job that's not traditionally nursing and she can say things sometimes that sound like she thinks she can do our job better than the RNs since she's a dietitian. I used to get offended, now I just ignore it. I know she doesn't think she's better, she just has trouble getting her point across without rubbing people the wrong way. And her personality is one that likes to be unique, so she doesn't like to be "lumped in" with the rest of us, she needs to have a role on the team that's hers alone.

    And ya know, it could be the hormones...can your doctor test your levels? Sometimes you get to where a medication dosage is not enough and needs to be increased.

    Good luck to you.

  • Mar 25 '09

    EB3 is not a loop hole to bypass immigration. EB3 is the GC category that nurses come under and at the moment this visa is actually affected by retrogression and current processing dates are 2003 unless from India and that is 2001. Many many foreign nurses are affected by retrogression

    Visa bulletin for April 09

  • Mar 25 '09

    Would still like to see/talk with real live nurses who work in these hospitals. Doubt its really happening.

  • Mar 25 '09

    I didn't read all the responses, so this may have been covered. Just something to think over... in most nursing programs you can work as a CNA after you pass your level one courses. Then you can work as a CNA without having to pay for a separate course. This is how I did it and was still able to work as a CNA for one year during school, and now I have it to put on New Grad Resumes. Just a thought!

  • Mar 25 '09

    Prednisone is activated by the liver into prednisolone. For this reason, and because it is more easily absorbed, prednisolone is the drug of choice when hepatic disease or insufficiency is present.

  • Mar 24 '09

    Quote from I love my cat!
    Programs for Nurses to Combat "Compassion Fatigue


    Well, I've always believed that if a person cannot care for themselves, how in the heck can they be expected to care for others!
    I am guilty of this.
    When I first started Nursing many years ago, I always worked through my breaks and lunches, stayed OT and picked up shifts because the facility was desperate. "Hey everyone, look at me, Martyr Mary! Look how hard I work. Look how dedicated I am! I will even let my health and personal life suffer for YOU"
    I was naive.
    I thought my co-workers and employers would have more respect for me. Pretty much the opposite happened and I soon realized I was a door-mat. I quickly learned that few people respect a person that cannot take care of and stand up for themselves.
    I now take care of ME first! No, it is not selfish. It is my life and I only get one crack at it.
    I am so much healthier and happier.
    I've always said, someday when I die and they're all standing over my casket, nobody from my place of work is going to show up and say, "She was great, she always picked up overtime, gave up her breaks, came in on her day off, etc.- wasn't she a great employee?"
    NOPE- Hopefully, what they will say about me is, "She was a great mom, sister, friend". Nobody is going to remember you for sacrificing yourself on the staffing altar, 'cause when your gone, they're just going to find another body to take your place. Rather, live so that you will be remembered for your kindness, your thoughfulness, your friendship- and you can't do that if you don't put yourself and your family/friends first.

  • Mar 24 '09

    Interesting...hospitals creating programs for nurses to help them combat compassion fatigue...How about lets get ENOUGH staffing so the nurses can do the kind of job they were educated to do and ENOUGH staffing so breaks and lunches can be taken routinely; and lets get enough supplies stocked so the nurses do not have to run around finding what they need to do their job; and lets get enough secretaries to do the phone answering and clerical duties;and let's not forget to give compassion classes to managers, doctors and administrators so they will treat the BEDSIDE NURSES WITH THE RESPECT AND COMPASSION THEY DESERVE TO BE TREATED WITH!