What would a single payer system look like?

SororAKS, ADN, RN · Feb 5, 2016

Perhaps the higher taxes might not be so noticeable if we don't have to pay high monthly costs for insurance that we do now?

Eru IlÃºvatar · Feb 6, 2016

Perhaps the higher taxes might not be so noticeable if we don't have to pay high monthly costs for insurance that we do now?

But since having insurance was not mandatory (until the Health Care Reform law) people could choose not to have insurance so it would had been cheaper to be like that instead of having higher taxes. Now that if I am correct it is mandatory to have insurance that does not longer applies, so instead of having to pay premiums they could just get it taxed from their income. But the word tax its a dirty word to many in the US so I see it hard to happen here. I still believe that cutting the middleman and kind of forcing everyone to have medical insurance would be a good thing. Imagine if hospitals didnt had to loose money in ER visits by the uninsured. And if people could get primary care before certain conditions worsened, that would be golden.

Tenebrae, BSN, RN · Feb 6, 2016

I had a patient undergo surgery less than 24 hours after being diagnosed with a brain tumor. Radiation in less than 10 days. And she won't lose her house.

My mum was diagnosed with small cell carcinoma of the lung.

She was in for the diagnostic bronchoscopy within the week, in for palliative chemo within three weeks.

She gets to keep her house, and doesn't have to sell a vital organ just to pay the deductible

Alisonisayoshi, LVN · Feb 6, 2016

Well I think I wouldn't spend my a big part of my day arguing with insurance companies about why my pt with a 9 Gleason and a ridiculous PSA might need a bone scan to check for mets. That's probably what it would look like. I wouldn't have to argue with some insurance rep to get people appropriate treatment, I could actually spend my time caring for pts. I think I'd like that. Personally.

Hollybobs · Feb 10, 2016

Well I think I wouldn't spend my a big part of my day arguing with insurance companies about why my pt with a 9 Gleason and a ridiculous PSA might need a bone scan to check for mets. That's probably what it would look like. I wouldn't have to argue with some insurance rep to get people appropriate treatment, I could actually spend my time caring for pts. I think I'd like that. Personally.

It does look like that. I'm from the UK so it is universal access and different to single-payer but reading these boards, time and time again you guys are angry because of the emphasis upon customer satisfaction getting in the way of giving the best quality care you can. We don't have that.

(We have other challenges, our staffing ratios are a joke in comparison to yours, 1:12, 1:14 in acute care isn't unusual. And our government is trying to dismantle what he have currently by running our resources low and vilifying us in the national press. Our Doctors are having national strikes).

Personal thoughts about advantages and disadvantages of our tax-funded system:

-It can be taken advantage of. People with poor lifestyle choices who don't pay taxes can access free services whenever they want for treatment and surgeries. This makes some people who pay taxes in this country very angry. it can make nurses angry.

-There is no incentive to be more healthy. I don't know whether this makes a difference to people's lifestyle choices in reality- are people in the USA more healthy as a result of sometimes needing to pay for care?

-We are expected to do more with less. We were recently told by our government "better care, lower cost".

-We do NOT have fancy lobbies but sometimes money is wasted, for example in rebranding. It is taxpayers money that is wasted by poor government decision making. It means less money goes to the frontline.

-It is more humane, more civilised, more fair. The poor and disadvantaged should not be penalised or receive less of a standard of care because they were born with less.

-We are resource conscious, we try to not waste resources and to use them well.

-The standard of care is very high but waiting lists can be a few days to a few months depending on the problem. We do prioritise and fast-track more urgent cases.

-We are not "wait staff" and not expected to be so. We are not, if meds need to be given out or someone is unwell, expected to get extra pillows or drinks etc and we can, politely, explain this without fear of reprisal. We are nurses and a hospital is not a hotel. Relatives are not routinely offered refreshments (obviously when in dire straits, extremely worried, palliative care situations) and generally there is a 2 to a bed policy for them to follow.

-We are not paid as well but cannot be fired for jumped-up reasons because hospitals want to hire cheaper people. I was horrified when I read about this happening.

-We do spend a lot of time caring for patients. The rest is charting and often we have our own problems with the system to navigate. There are a lot of frustrating conversations about resource management in terms of a lack of beds, patients waiting in ED, patients waiting for discharge and lack of staff.

-We have an optional private system for those who want it. It is faster and more "nice".

-I think the cost in taxes is cheaper than insurance. There other benefits to making healthcare free at the point of care for all. Catching a problem earlier and treating it is cheaper. Are healthier citizens are cheaper for society overall?

-We do have targets to meet and customer satisfaction surveys to achieve if our hospital wants more funding. It isn't generally too intrusive when delivering care.

I know universal access is different to single-payer and some of the above won't apply but I think there is overlap.

Hoosier_RN, MSN · Feb 10, 2016

But since having insurance was not mandatory (until the Health Care Reform law) people could choose not to have insurance so it would had been cheaper to be like that instead of having higher taxes. Now that if I am correct it is mandatory to have insurance that does not longer applies, so instead of having to pay premiums they could just get it taxed from their income. But the word tax its a dirty word to many in the US so I see it hard to happen here. I still believe that cutting the middleman and kind of forcing everyone to have medical insurance would be a good thing. Imagine if hospitals didnt had to loose money in ER visits by the uninsured. And if people could get primary care before certain conditions worsened, that would be golden.

We may not have been paying a higher tax or been mandated insurance, but paid higher premiums and rates due to having to make up for the uninsured. It's all the same, call it whatever you wish, but I say cut out the middleman, insure all US citizens, and go from there!

Fiona59 · Feb 10, 2016

I had a GI bleed a few years ago, got in for the urgent gastroscopy within the week.
I had a patient who needed urgent surgery, first for a fractured long bone, secondly for the wash out out the dehisced wound.
Not bad for a single payer system.

My coworker got hers the same day she presented to emerg

Tenebrae, BSN, RN · Feb 11, 2016

My coworker got hers the same day she presented to emerg

I would have too most likely. I spent a week before I went to the doctor trying to ignore it, hope it would stop, trying not to pass out, trying to carry on as normal, blame it on eating too much licorice, blueberries etc

How much did your co worker end up paying?

Me: $0.00

Tenebrae, BSN, RN · Feb 11, 2016

My coworker got hers the same day she presented to emerg

The patient who needed surgery to fix a fractured long bone, got it within the day, also got the eigh weeks rehab and didnt cost them or their family a cent

Fiona59 · Feb 11, 2016

I would have too most likely. I spent a week before I went to the doctor trying to ignore it, hope it would stop, trying not to pass out, trying to carry on as normal, blame it on eating too much licorice, blueberries etc
How much did your co worker end up paying?
Me: $0.00

Nada. Canadian as well.

emtb2rn, BSN, RN, EMT-B · Feb 11, 2016

I'm feeling the bern with the last bunch of posts.

CryssyD · Feb 28, 2016

Worse. This is the same system Canada uses and sometimes you have to wait for years for surgery or necessary procedures. Government red tape will come into play as someone up there in Washington decides if you need or do not need a procedure. Yes, there will be little to no cost. Yes, you will sacrifice quality and quantity.
Teri, RN, BSN

With all due respect, that is nonsense. Our health-care statistics in this country (USA) are abysmal, and you can't blame it on personal irresponsibility, smoking, or stupidity. Other countries have populations that smoke much more than we do (France is one,although they do generally eat much healthier) but have much, much better overall health and health statistics. Healthcare may be excellent for people with money and good insurance, but it is and has always been much, much worse for those without. And that isn't fair. It's time we levelled the playing field so that everyone is guaranteed access to decent care. Quality won't suffer--it couldn't get a whole lot worse than it recently was. It's long been true that the best of American medicine (which is very good indeed) was not available to all; the worst of American medicine has too often been the best that far too many of us could get.

Profit has no place in something as vital as healthcare. It pits money-making against taking care of other human beings, and let's face it, not all people know how to make the right choice in that particular dogfight.