Interesting article on Obama health care plan - page 2

as i was reading the article i came across the following line... "and hospitals and doctors are concerned the government could dictate what they get paid to care for any patient, not only the... Read More

  1. by   Koyaanisqatsi-RN
    Quote from markuskristian
    The fear is over the potential waiting lists that may come from universal health care. It's a very real possibility as it has happened in Canada and Britain, however we can't be certain if it will in fact happen in America. We can only wait until it comes to fruition to find out. IMHO, with the general shortage of health care staff, it will happen.

    The second fear may or may not happen. Will there be an option to purchase private insurance for private health care. If not, it seems unjust to limit one's ability to receive better and/or quicker health care when they have the willingness to pay for it. If it is allowed, those that will pay for private insurance will also be paying for the universal care, and no one likes paying twice for the same thing.

    I resent your leftist coined term of "fear-mongering." It a legitimate fear. The true outcome of universal health care in America will just have to be seen firsthand.
    Yes, you might have to wait for some things longer than you do now. So what? We already have people dropping dead in the emergency room all over the country. For most NON ESSENTIAL SERVICES, a little wait isn't going to kill anyone. I know we are used to getting immediate treatment every single time our little tummy hurts, but this has spoiled us, and as a result we pay exponentially more for health care, and get LESS than every other country.

    Learn to set some priorities. Getting care RIGHT NOW when it can wait 3 days isn't a big priority on my list. Neither, as Sue said, is spending a ridiculous amount of money on heroic, wasteful end-of-life measures that do no good.
  2. by   Junebugfairy
    waiting lists for services are not 3 'days' though, there are waiting lists for months for services..

    i like the idea of a dual system! i love my personally purchased health plan and i would like to keep it, but i would love to see an option for those who cannot afford it.

    i am a libertarian, i do not see health care as a 'right'.
  3. by   SuesquatchRN
    Quote from fairycari
    i am a libertarian, i do not see health care as a 'right'.
    y'know, i don't, either, but i also clothe, feed and nurture some neighbor kids whose parents are a little, well, negligent, and now have six cats because another stray found our back door and food.

    it's not a matter of whether it's a "right." it isn't. however, i will never be able to understand how someone with a compassionate heart can see another person suffer or do without and not want to help, even if that person may have contributed to his own lousy status in life.

    each other. we're all we've got.
  4. by   azhiker96
    I like the idea of a government system with supplemental insurance available through private companies. Hopefully the government would ration and refuse futile treatments so that more could be spent on prevention and wellness. I've seen a pt with multisystem failure in a rotation bed that could not be rotated or moved from the device because any motion caused her to decompensate. The family insisted that she be a full code and she was on ACCESS so the taxpayers get to foot the bill. I wouldn't begrudge the treatments if they were paying for it but when we pay we should have a say.
  5. by   SharonH, RN
    Quote from whoknows56
    One of the last things I want to see is doctors being salaried. I think having salaried doctors would be a real bad thing. I don't have time to elaborate on the reasons right now.

    Are you familiar with Kaiser? The docs there work on salary. It's not the end of the world....
  6. by   Hushdawg
    Quote from classicdame
    one of the reasons Americans are leery of universal healthcare is the fear of "big government". We like to have some independence and choice.
    The problem is that we DO NOT have any choice in the current situation, corporate heads and insurance companies decide what procedures we are allowed to have based on financial cost/benefit matrix conclusions rather than allowing real medical care to take place.

    In the USA we WOULD have better control because we elect people to the positions of power which would affect the universal healthcare directly.

    Quote from classicdame
    Another is that in universal healthcare the providers (MDs, Nurses, everyone) are not paid as well as in USA.
    Untrue. The net pay versus cost of living is practically the same in an overwhelming majority.

    Quote from classicdame
    I have had the opportunity to visit many countries and have learned that nurses in USA do a lot of procedures and make decisions that only MDs are allowed to do elsewhere. In other words, there are fewer people to ACT and advocate for the patient.
    This has far less to do with the universal healthcare concept and more to do with the medical culture of a given country. There are many countries which do not have Universal Heathcare wherein the procedure/decision format is as you describe above.
  7. by   Hushdawg
    Quote from markuskristian
    The fear is over the potential waiting lists that may come from universal health care.
    You are implying that there are no waiting lists in our current corporate run healthcare system.
    Nothing could be further from the truth.

    At least in universal healthcare the waiting list is prioritized on the basis of urgent need and first-come first-served as opposed to who has the better health insurance or can pay the most money.
  8. by   Hushdawg
    Quote from SuesquatchRN
    Y'know, I don't, either, but I also clothe, feed and nurture some neighbor kids whose parents are a little, well, negligent, and now have SIX cats because another stray found our back door and food.
    Just want to comment... that mentality is why you became a nurse, isn't it?


    We need more like you.
  9. by   Hushdawg
    Quote from SharonH, RN
    Are you familiar with Kaiser? The docs there work on salary. It's not the end of the world....
    I was going to say the same thing.

    Also, salaried doctors would not do the tricks that I have seen dozens of times.. that is a doctor randomly walking through a hospital, poking his head in a patient's door and signing the chart to get a slice of the pie.

    In working with a charity several years to help poverty-stricken people in the USA you would be amazed at the number of cases I turned up going over medical bills trying to negotiate the payoff for the hospital. We investigated the charges when we noted multiple doctors in a short period of time. One case I was able to prove that 3 of the 6 doctors had never actually administered care to the patient or had provided insight for a diagnosis and we got those charges dropped from the invoice.

    Imagine how many cases around the country are going unchecked.

    Universal healthcare with salaried doctors will eliminate this kind of problem and also the serious problem of unnecessary testing and other things that corporate doctors do to pad the bill and bring more income for the hospital and themselves.
    Last edit by Hushdawg on May 11, '09 : Reason: misspelling
  10. by   Jolie
    Quote from SuesquatchRN
    Y'know, I don't, either, but I also clothe, feed and nurture some neighbor kids whose parents are a little, well, negligent, and now have SIX cats because another stray found our back door and food.

    It's not a matter of whether it's a "right." It isn't. However, I will never be able to understand how someone with a compassionate heart can see another person suffer or do without and not want to help, even if that person may have contributed to his own lousy status in life.

    Each other. We're all we've got.
    Sue,

    There are plenty of us who do the same who oppose mandatory taxpayer-funded healthcare.

    It is hardly a sign of lack of compassion that people oppose further government intrusion into their pocketbooks and lives.
  11. by   phylotea
    all the mony obama is talking about is gona come from nurses and probably doctors pay . nurses seems to be a little be" to expensive" for obama socialist era .
  12. by   Jolie
    Interesting piece on the possible effects of Obama's proposal:

    How ObamaCare Will Affect Your Doctor
    Expect longer waits for appointments as physicians get pinched on reimbursements.

    At the heart of President Barack Obama's health-care plan is an insurance program funded by taxpayers, administered by Washington, and open to everyone. Modeled on Medicare, this "public option" will soon become the single dominant health plan, which is its political purpose. It will restructure the practice of medicine in the process.

    Republicans and Democrats agree that the government's Medicare scheme for compensating doctors is deeply flawed. Yet Mr. Obama's plan for a centrally managed government insurance program exacerbates Medicare's problems by redistributing even more income away from lower-paid primary care providers and misaligning doctors' financial incentives.

    Like Medicare, the "public option" will control spending by using its purchasing clout and political leverage to dictate low prices to doctors. (Medicare pays doctors 20% to 30% less than private plans, on average.) While the public option is meant for the uninsured, employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage.

    The Lewin Group, a health-care policy research and consulting firm, estimates that enrollment in the public option will reach 131 million people if it's open to everyone and pays Medicare rates, as many expect. Fully two-thirds of the privately insured will move out of or lose coverage. As patients shift to a lower-paying government plan, doctors' incomes will decline by as much as 15% to 20% depending on their specialty.

    Physician income declines will be accompanied by regulations that will make practicing medicine more costly, creating a double whammy of lower revenue and higher practice costs, especially for primary-care doctors who generally operate busy practices and work on thinner margins. For example, doctors will face expenses to deploy pricey electronic prescribing tools and computerized health records that are mandated under the Obama plan. For most doctors these capital costs won't be fully covered by the subsidies provided by the plan.

    Government insurance programs also shift compliance costs directly onto doctors by encumbering them with rules requiring expensive staffing and documentation. It's a way for government health programs like Medicare to control charges. The rules are backed up with threats of arbitrary probes targeting documentation infractions. There will also be disproportionate fines, giving doctors and hospitals reason to overspend on their back offices to avoid reprisals....

    Right or wrong, more doctors will close their practices to new patients, especially patients carrying lower paying insurance such as Medicaid. Some doctors will opt out of the system entirely, going "cash only." If too many doctors take this route the government could step in -- as in Canada, for example -- to effectively outlaw private-only medical practice....

    So how should we reform our broken health-care system? Rather than redistribute physician income as a way to subsidize an expansion of government control, Mr. Obama should fix the payment system to align incentives with improved care. After years of working on this problem, Medicare has only a few token demonstration programs to show for its efforts. Medicare's failure underscores why an inherently local undertaking like a medical practice is badly managed by a remote and political bureaucracy....

    Private plans already pay doctors more than Medicare because they compete to attract higher quality providers into their networks. This gives them every incentive, as well as added leverage, to reward good clinicians while penalizing or excluding bad ones. A recent report by PriceWaterhouse Coopers that examined 10 of the nation's largest commercial health plans found that eight had implemented performance-based pay measures for doctors. All 10 plans are expanding efforts to monitor quality improvement at the provider level....

    There are plenty of alternatives to Mr. Obama's plan that expand coverage to the uninsured, give them the chance to buy private coverage like Congress enjoys, and limit government management over what are inherently personal transactions between doctors and patients....

    full piece: http://online.wsj.com/article/SB124208383695408513.html
  13. by   herring_RN
    when a family member gets cancer or is an accident premiums will be raised. those people too will join the elderly and permanently disabled in medicare.
    healthy people will pay for their insurance and then join the public system when they need the most healthcare.

    if we achieve single payer everyone with an income will pay and all americans will have the same insurance. coverage.
    i doubt congress will vote for low quality care when they will have the same.

    opinion
    how obamacare will affect your doctor expect longer waits for appointments as physicians get pinched on reimbursements.

    at the heart of president barack obama's health-care plan is an insurance program funded by taxpayers, administered by washington, and open to everyone. modeled on medicare, this "public option" will soon become the single dominant health plan, which is its political purpose. it will restructure the practice of medicine in the process
    http://online.wsj.com/article/sb124208383695408513.html


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