I want to know what nurses think about socialized medicine.

HM2VikingRN, RN · Jul 2, 2009

Respect is earned. I don't receive insurance through my employer. You must have missed that part. The bottom line is this. We all pay our own way. You take care of yours, I'll take care of mine. I don't need the government dipping into my paycheck any deeper than they are now. All of the costs for this proposed nonsense are ESTIMATED. The actual cost will be higher, much higher. You think our for-profit system is inefficient? Give it to the government and stand back. Even my left leaning union buddies are starting to balk at El Presidente's proposals. Please, somebody name ONE cost efficient government program. Just one.

Behaving badly is not going to win points in any debate. Dignity and respect is one of those basic behavioral sets that makes society function well.

WE TAKE CARE OF OUR OWN WHEN WE HELP TAKE CARE OF OTHERS.

Social Security runs at an administrative cost on the order of something like 0.3 %

Contrast that with 401 k systems that cost about 1-2% on average. These costs eat up 30% of expected returns for participants.

One of the things government does do very well is transfer money from point A to B at low cost. If we don't fix health care administrative costs that puts all health care plans at risk. I would not be complacent about the survivability of employer paid retiree health care without real health care reform.

The HELP act looks like it is going to put true competition into the finance end of health care.

New Dem health plan has public option, lower cost
By DAVID ESPO - 13 hours ago
WASHINGTON (AP)-Democrats on a key Senate Committee outlined a revised and far less costly health care plan Wednesday night that includes a government-run insurance option and an annual fee on employers who do not offer coverage to their workers.
The plan carries a 10-year price tag of slightly over $600 billion, and would lead toward an estimated 97 percent of all Americans having coverage, according to the Congressional Budget Office, Sens. Edward M. Kennedy and Chris Dodd said in a letter to other members of the Senate Health, Education, Labor and Pensions Committee. The AP obtained a copy.

http://www.google.com/hostednews/ap/article/ALeqM5jlMpJGn28kqCcgU-aGcYE_ZHW-ywD99612R00

allnurses Guide · Jul 2, 2009

Elkpark,
You support government efficiency with government documents? Please. Of course government administration is less expensive, they can mandate costs. The government can mandate access. The government can mandate everything.
My brother is married to an English woman. Her parents live in the UK. Her father developed prostate cancer at age 65, and the NHS allowed him medication for comfort. Period. He died two years later. If he was here in the US, he'd still be with us.
There is much talk of the 45-47 million Americans without insurance. What about the rest of us who are satisfied with our coverage? My daughter is 22, a recent college grad. Most of her friends are uninsured, by choice. They could easily pay for it, they choose not to. Foolish? I think so. Should I pay for it? No. They have the means and the choice.

My father made the mistake of giving up his Medicare and signing up for the CareAmerica HMO. He trusted his "gatekeeper" because the MD was also a musician.

His PSA was elevated and rose every year.

I told him to go to a urologist. His primary physician (AKA Gatekeeper) said it was not necessary. He tried a needle biopsy which was negative. (wrong location?). He had enough money to see a urologist but trusted the gatekeeper.

Then my Dad fell and hurt his shoulder. The X ray showed metastisis to the bone.

He then got an oncologist. The primary cancer was prostate.

Four months later he died on Christmas eve.

With single payer your daughter and her friends would have their premiums deducted from their checks. If the live on dividents or a trust fund it would be paid with their yearly taxes.

Then in the event of a terrible accident or rare csatastrophic illness they would be insured.

As it is now we taxpayers pay for the ones unlucky to get hit by a car or develop cancer. But the ones who remain healthy don't pay.

It will be more fair when everybody is in. And nobody is out.

We ALL pay and we ALL are covered.

Then we can work on prevention and other ways to improve our health instead of billing the myriad of different pland with their different rules.

HM2VikingRN, RN · Jul 2, 2009

Elkpark,
There is much talk of the 45-47 million Americans without insurance. What about the rest of us who are satisfied with our coverage? My daughter is 22, a recent college grad. Most of her friends are uninsured, by choice. They could easily pay for it, they choose not to. Foolish? I think so. Should I pay for it? No. They have the means and the choice.

I think what you are missing about the goals of health care reform are that we get everyone paying into the system. That doesn't mean your costs will go up. Actually the goal is to get everyone paying into the system.

allnurses Guide · Jul 2, 2009

We had a physician come speak to our econ class last night (I love this class). He talked about how we must do a better job of educating the public about the myth of 47, 48, 49, 50 million uninsured.

There are truly just about 8 million. (I've linked to the myth stuff before).

Just some notes I made on the fly from last night:

There are 33 millions Canadians (California has 37 mil).

Average wait to see doc for 1st visit - 9.3 weeks in 1993 / 18.3 weeks today.

1.7 mil Canadians could not access a family physician.

77 day wait for non-urgent cardiac care.

#2 leading cause of death in Canada is colorectal cancer.

Colorectal cancer rates in Canada are 6.7 per 100,000 and 41% fatal.

Colorectal cancer rates in America are 4.8 per 100,000 and 34% fatal.

The standard treatment for colorectal cancer in the US is Avastin and it is not available in Canada.

We got the pdf of this book . . . It is called "The Top Ten Myths Of American Health Care".

Review

"Before you do anything else, make a note to read "The Top Ten Myths of American Health Care" by Sally C. Pipes. It might literally save your life, by checking the political stampede toward a government-controlled medical profession usually presented politically as 'universal health care.'" Thomas Sowell --Creators Syndicate

Product Description

The Top Ten Myths of American Health Care: A Citizen's Guide, is the latest book from health care scholar, and Pacific Research Institute President and CEO Sally C. Pipes. The book's foreword is by Steve Forbes: For anyone interested in getting to the core of America's health care troubles, this is the perfect book, he writes. And for health care policy makers, it should be required reading. In her 182-page book, Ms. Pipes takes on ten popular myths about the state of health care in America. The final chapter lays out several patient-centered prescriptions for reform.

http://www.amazon.com/Top-Myths-American-Health-Care/dp/1934276111

I appreciate my professor - he has had speakers from all sides come to speak to us. I think it behooves us to read up on the issues from all perspectives. Also, for the folks who say those of us who supposedly don't come up with alternatives . . there are many in the book and we've been mentioning them on allnurses and I've heard them spoken of on the news too.

steph

HM2VikingRN, RN · Jul 2, 2009

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http://www.commonwealthfund.org/Content/Charts/Testimony/Learning-from-High-Performance-Health-Systems-Around-the-Globe/W/Waiting-Time-to-See-Doctor-When-Sick-or-Need-Medical-Attention--Sicker-Adults-in-Six-Countries--2005.aspx

We should be looking to implement best practices based on lessons learned from other countries.

Ms. Pipes book is a thinly disguised op-ed that attempts to present itself as research based.

5% of Canadians don't have a regular doctor. Americans have greater access problems with roughly 1 in 5 lacking access to regular care:

Nearly 20 percent of Americans between the ages of 18 and 64 did not have a regular source for health care in 2004 and 2005, a strong indication many Americans may not be receiving needed care, according to a study recently released by the CDC.
"Literature shows having health insurance and a usual source of care are associated with more medical visits, visits when you need them, and possibly better quality of care and better continuity of care," said Amy Bernstein, Sc.D., chief of the CDC's analytic studies branch at the Office of Analysis and Epidemiology and director of the study reported in Health, United States, 2007. (567-page PDF; About PDFs)

at http://www.aafp.org/online/en/home/publications/news/news-now/health-of-the-public/20071218cdcstudy.html

more at http://www.graham-center.org/online/graham/home/news-releases/2007/mar16-nachc-access-denied.html

HM2VikingRN, RN · Jul 2, 2009

http://www.cbpp.org/cms/?fa=view&id=628

46 million is still 46 million.

K98 · Jul 2, 2009

I think what you are missing about the goals of health care reform are that we get everyone paying into the system. That doesn't mean your costs will go up. Actually the goal is to get everyone paying into the system.

Ah yes, get EVERYONE paying into the system. That has made quite a few folks question the costs of this proposed mess. Thank heavens it will never come to pass. It will remain something to debate on http://www.leftnurses.com .

HM2VikingRN, RN · Jul 3, 2009

You complained about 20 somethings who choose not to purchase health care insurance. Reform will get them paying into the system. The current sytem of using the ER for care drives up direct costs to you because it raises your premiums and copayments to cover uncollected medical bills.

What is lost in the noise about reform is that it will lower costs by 2 trillion dollars depending on the structure of the reform package.

at http://www.commonwealthfund.org/Content/Charts/Report/Fork-in-the-Road-Alternative-Paths-to-a-High-Performance-US-Health-System/Three-Insurance-Exchange-Scenarios-Cumulative-11-Year-Savings-in-National-Health-Expenditures.aspx

misswoosie · Jul 3, 2009

Hi

I am a RN in the UK and have been for 23 years. I am also in the process of moving to the US (WITH VISA FROM MY HUSBANDS JOB AS ALTHOUGH I HAVE PASSED NCLEX AND HAVE JOB OFFER, GC WAIT IS 3-4 YEARS)

I will do this in bullet points so hopefull clearer

COST

We pay 6.5% of our salary for health care
If you don't work you don't pay
everything,except maybe some cosmetic surgery,is covered
We don't pay for visits to GP,clinic appointments or anything else,unless you choose to pay privately to be seen either in a NHS hospital or private hospital.
We pay $12 per prescription item, unless for a child, over 65,or on benefits-then it' free.Also insulin and some other meds (but not many) are free.
We pay $27 for a dental check up,clean-again not if on benefits a child, but no upper age cut off for dentistry charges.
Basic dental work-extraction,filling is $75 per extraction/filling
$324 for a crown or bridge
cosmetic dentistry ie wightening, veneers not covered by NHS. I think things like replacing silver fillings, or having a white filling rather than a silver one cost about $75 a shot

I also wanted to say that our contributions over there will be about 4% plus the co pays etc.

RN salaries

Don't vary according to size/location of hospital except for London and surrounding areas
Are set by the government
Start at $16 per hour up to $21 after 9 years for staff nurse
Clinical nurse specialists get from $15 per hour up to $32 as not all Clinical nurse specialists are on the same pay band
a recent survey showed that on average nurse work 20 hrs per month of UNPAID overtime
GPs earn more than many hospital consultants ie $150-200,000 per year.

Patient ratios

on ICU RNs care for only 1 vented pt,BUT we have no techs for monitors or vents, we do all the setting and calibrations ourselves.
We aslo do all patient transport, cleaning of equipment ,beds and bed areas,ordering of pharmacy supplies,stores etc
most ICUs don't have many nursing assistants
on med/surg RNs will have 9-15 patients to look after on days and 15 on nights.There will probably be 2 healthcare assistants on as well, but we don't have equiv to LPNs in the UK-most have either retired or converted to RN and training is no longer available for your equivalent LPN

Private Health insurance

Private health insurance is available but will not cover you for any conditions you already have! Soem people get it through company they work for, not sure how much premiums are otherwise.

Wait times

are driven by government targets
money and resources will be pumped into the specialty wher the targets are (ie overtime available for theater nurses etc but not usually anything for ward staff)
other areas that don't have targets will suffer as a consequence (robbing Peter to pay Paul) Good eg is infection control at the moment
My father-in-law had severe knee pain (waking at night, only able to walk 200yds, NSAIDS and codeine not working) and he waited 3 weeks for consultation and then 6 weeks after that for surgery.

Funding

Is confusing!
Primary care services pay for secondary care services
government gives a hospital a yearly budget. If they overspend then the overspend is taken off next years budget-really helpful
So even though it is a nationalised system it has to be run like a business, so it is neither one thing or another!

Hope this helps:down:

misswoosie · Jul 3, 2009

Should have said these are USD -and our cost of living is ridiculous. You cannot buy a home for much less than $200,000, gas is around $8 per gallon and we pay $2000 per year property tax for a 1100 sq ft town home.(just some examples, and we live in the cheapest North east in london you cannot buy a house for less than around $400,000)

allnurses Guide · Jul 3, 2009

http://www.cbpp.org/cms/?fa=view&id=628
46 million is still 46 million.

Well, that's not true. 46 (or 47 or 50) million minus (17 million + 10 million) = 19 million.

And that doesn't count the 20-somethings who opt out of buying medical insurance.

The '40 Million Uninsured' Myth

By Julia A. Seymour (Bio | Archive)

July 18, 2007 - 18:45 ET

Michael Moore claimed in his movie “SiCKO” that there are 50 million uninsured Americans, according to his own Web site.

But he’s wrong.

He’s certainly not alone though. So were President Bush, Sens. Barack Obama (D-Ill.) and Hillary Clinton (D-N.Y.) as well as The Washington Post, New York Times, Los Angeles Times, CNN, CBS and ABC just to name a few.

“It’s really indefensible that we now have more than 45 million uninsured Americans, 9 million of whom are children, and the vast majority of whom are from working families,” said Sen. Hillary Clinton in a May 31 speech.

ABC medical expert Dr. Tim Johnson cited the incorrect data as he praised a "bold" and "politically brilliant" universal coverage plan on the April 26 “Good Morning America.”

“It’s bold because it does propose to cover all Americans, including the 47 million now who are uninsured, within five years,” said Johnson.

Each of these people and media outlets incorrectly claimed the number of uninsured to be between 40 and 50 million Americans. But the number of the uninsured who aren’t citizens is nearly 10 million on its own according to the Census Bureau, invalidating all the claims of 40+ million “Americans” without health insurance.

Moore should have paid attention to that fact, since he agrees that being “an American” matters to get health insurance.

“That’s the only preexisting condition that should exist. I am an American. That’s it,” said Moore in footage aired by ABC’s “Nightline” on June 13.

But that isn’t the only problem with the numbers being used to stir up support for socialized medicine. There are also roughly 17 million people who can afford their own insurance – they make $50,000 or more a year. Journalists and politicians also frequently neglect to mention that 45 percent of the uninsured will be insured again within four months, according to the Congressional Budget Office.

It seems to me Michael Moore (and quite a few others) have

“fudged” some facts.

http://newsbusters.org/stories/40-million-uninsured-myth

This is from 2007 . . . .and the doc who spoke to us the other night is right that the myth of how many people don't have medical insurance has been addressed for years and YET that number keeps being bandied about.

steph

allnurses Guide · Jul 3, 2009

http://www.americanthinker.com/2009/06/a_real_free_market_health_care_1.html

. . ."Well, there you have it. The savings for taxpayers over three years: Nearly $5 trillion. Not requiring bills hundreds of pages long: Priceless! A few short regulations and we have a viable health care system for the future covering over 99% of the population, devoid of the treachery of Medicare and without dependence on the federal government. It's very simple, very sensible, and so easy even a government official can understand it. It's even short enough for Congress members to read fully, though some may require several days. Oh, yes, Mr. Obama, I want our $600 billion back."

:up: