Obama health care law upheld.

Nurses Activism

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

There will always be people that are believed to be too fat, or too addicted, or too stupid to be saved from themselves. And there will always be members of our society that believe that society and government have no obligation to help them.

That does not change the fact that more than 20000 people die each year, in this great and wealthy country, simply because they do not have access to our superior technology and skill.

The fact that there are medical errors that cause death is not a reason to ignore another preventable causes...like lack of access. I would disagree that our biggest problem is "ourselves", because we "ourselves" are not always responsible for our illnesses. I, for instance, am not responsible for my adenocarcinoma...unless you know something that my oncologist doesn't. Similarly, my daughter is not responsible for her congenital heart defect, or her PCOS. Without access to adequate medical care, however, her life will be significantly affected by those conditions.

Our biggest problem right now is that there are too many people who cannot afford our current system and therefore must access it in the least efficient, least comprehensive, and most expensive way...primarily through the emergency departments. Our biggest problem is that although we spend 17% of our national GDP on health care, we have the worst health outcomes of any modern industrialized nation. It may be the wealthiest system, but it is not the most effective...at least when it comes to measureable health outcomes.

We can agree to disagree..and that is fine with me. My research and professional experience has just led me to a different conclusion than yours when it comes to health care in the US.

Specializes in cardiac, ICU, education.
We can agree to disagree..and that is fine with me. My research and professional experience has just led me to a different conclusion than yours when it comes to health care in the US.

I am sorry for your family's pain, but don't you think the healthcare system would have more money and procedures/treatments would be cheaper if it wasn't inundated with people who had more self responsibility? I couldn't of prevented my husband and children from getting Celiac disease, it is a genetic auto-immune disorder. But I make sure their weight is maintained and that they eat the right foods for their conditions.

There will always be people that are believed to be too fat, or too addicted, or too stupid to be saved from themselves

Absolutely, but the problem isn't that there are "some," the problem is that there are way too many. "Too fat" - 60% of the U.S. is overweight. "Too stupid" - We went from #1 in the 80's to #25 in country rank for math and reading - why? "Too addicted" - Forget the regular drugs for adults, our kids take more Ritalin and pain killers than in any other country.

Again, our biggest problem is ourselves. When we figure out how to change our culture and self-entitlement than we can also help others like you who didn't bring on an illness themselves.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Fat people, stupid people deserve to have healthcare as well......not disrespected and belitteld.

There but for the Grace of God go I......

Specializes in cardiac, ICU, education.
Fat people, stupid people deserve to have healthcare as well......not disrespected and belitteld.

Not sure where on this thread they are being belittled. Simply stating the fact that being overweight or having literacy or addiction issues can impair or destroy your health and those issues must be addressed and prevented if we are going to be a healthy nation. A healthcare program that does nothing to promote personal responsibility will not solve our problems.

Specializes in PICU, NICU, L&D, Public Health, Hospice.

This program is promoting personal responsibility...you must have insurance to pay for your health needs or pay a penalty (tax)

Specializes in cardiac, ICU, education.
This program is promoting personal responsibility...you must have insurance to pay for your health needs or pay a penalty (tax)

That isn't personal responsibility, that is a penalty for not doing what the government is forcing you to do. Don't get me wrong, I think people should be required to have some type of minimal coverage, but personal responsibility is deciding not to have 3 children with 3 different fathers who don't pay a cent for the child or maybe to stop smoking around said children.

Again, we there are going to be some people who just don't get it because of cognitive impairments, but there are too many people who are refusing to take responsibility for themselves and their families and want the rest of us to pay for their choices.

Specializes in PICU, NICU, L&D, Public Health, Hospice.

So, we want people to have personal responsibility, but we don't want the government to encourage that with a tax or penalty?

How do we "promote" personal responsibility then?

Or do we simply identify that some are irresponsible and throw up our hands and continue to pay for health care the same way we have been? Of course, it is important to acknowledge that our current system is not sustainable either financially or professionally (it costs too much with poor measureable outcomes).

Specializes in cardiac, ICU, education.
How do we "promote" personal responsibility then?

Stop being a nanny state for everyone.

I gave my ideas before and I said I was in favor of everyone having to have insurance.

it costs too much with poor measureable outcomes)

That is mostly because of our country's newest culture or more takers than makers.

Specializes in PICU, NICU, L&D, Public Health, Hospice.
Stop being a nanny state for everyone.

I gave my ideas before and I said I was in favor of everyone having to have insurance.

That is mostly because of our country's newest culture or more takers than makers.[/QUOTE]

I am not certain that this is the conclusion of the studies on our health outcomes. It seems that the statistics reflect that our poor outcomes are more related to the reduced access, high referral rate to multiple specialties, ineffective communication and fractured continuum of care. However, if you have other insight, I would be interested...

So we are on the same page in terms of requiring health insurance...that is a big part of ACA, yes?

Specializes in cardiac, ICU, education.

Yes, I am a proponent of everyone having health insurance, but again, what will the reimbursement rates be like? Medicare or Medicaid rates? Than a large number of MD's and NP's will not provide services, not because they don't want to, but because they won't be able to afford to. Look at countries like Taiwan where the universal healthcare system has MD's working a minimum of 6 12-hour days a week while seeing an average of 200 patients per day and make a 1/2 to 1/3 of what they make in this country. Or look at Italy's or Greece's system (while it lasts as the countries are now bankrupt) and you will see how the entitlement culture has largely led to their demise. You say there are studies about health outcomes being related to access, specialties, communication, etc. While some of that is true, how can you divorce those statistics from our nations dismal 'cultural' statistics?

1 out of 3 girls will be pregnant in the US by time they are 20 years old. Think about that for a second. Why would girls in this country stop having more children? More education? We have educated girls and boys to death with very few positive changes. That has more to do with culture than healthcare.

Our war on drugs has gone nowhere in the last 30 years. The D.A.R.E. program has been proven in numerous studies to be a big failure, however, our government still funds it.

More than 60% of our country is overweight. We are just getting bigger. The majority of people know how to loose weight and keep it off except the majority of the country is overweight.

We have the highest mortality rate from gunshots and drunk driving accidents than anywhere else in the world (civilized countries) yet we let murders leave jail after an average of 5 years and a first time drunk driver gets probation.

My point again is that we are our own biggest problem in healthcare. I am not saying there aren't healthcare issues that need to be addressed and I am not saying we should deny treatment to people but the proposed 'Obamacare' does nothing to promote self responsibility. We need to start having some boundaries.

Specializes in PICU, NICU, L&D, Public Health, Hospice.

You and I agree on a number of things. Yes we do have issues with teen pregnancies, obesity, substance abuse, etc. Where we differ is in consideration of the ACA. I believe that the ACA helps to improve access for those people who currently have limited access to the health system. I also believe that the increased access for routine and preventative care will help us to have a greater impact on the lives of these people.

I believe that nursing is, in large part, what is missing in the health relationships of patients and they system. Currently, nurses are the health educators for patients, yet, many times the ONLY access that people have to nurses is in the acute care setting. Either because the medical offices do not employ nurses or because the patient does not have a medical home. In the absence of nursing intervention, and ongoing nursing guidance and education about health behaviors and outcomes we will continue to see exponential increases in poor health behaviors in the general population. IMHO

I certainly do not feel or believe that the ACA is a magic bullet to fix all of our ills, I believe that it is a step in the right direction and forces the country to examine the health processes we have in place with the intent of improving access, affordability, and accountibility. I tend not to be fearful of change, but rather to embrace change as part of the natural progression of things. To me, ACA simply represents a beginning of needed revisions.

Specializes in cardiac, ICU, education.
I believe that nursing is, in large part, what is missing in the health relationships of patients and they system. Currently, nurses are the health educators for patients, yet, many times the ONLY access that people have to nurses is in the acute care setting. Either because the medical offices do not employ nurses or because the patient does not have a medical home. In the absence of nursing intervention, and ongoing nursing guidance and education about health behaviors and outcomes we will continue to see exponential increases in poor health behaviors in the general population.

I completely agree with you.

I tend not to be fearful of change, but rather to embrace change as part of the natural progression of things. To me, ACA simply represents a beginning of needed revisions.

I actually love change, however, we aren't changing our culture in a positive way. The ACA doesn't change behaviors and if the reimbursements are going to be as low as they are in every other universal health care system (every system pays physicians, NP's and RN's lower even with a COL conversion) that we won't be able to do the wonderful things you stated above. Almost every time insurance reimbursement or Medicare rates go down, hospitals cut staff. In the long run, it will be interesting to see who stays in the new ACA system and who leave and what care will be rationed. Getting back to a point I said before, there is few ideas on what should change, but very little consideration on who is going to pay for it.

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