politics & job scarcity

[Espresso girl!]

Okay, I've got two issues I'm wondering about---

Five years from now, does anyone have any insight/information to support the notion that there could actually be a glut of CRNA's on the market? Or, let's say, if all the schools doubled their entering classes this year, would there still be a shortage i five years? I've not seen any statistics on this. Perhaps those of you in class may have heard something from an instructor?

Secondly, are there any worries that legislation could drastically change/lower pay? This interest to do so rooted in the healthcare mess we are in. I would reference what happened to the home health care nursing as a result of changes in gov. reimbursement that occurred a few years ago, which made HH nursing go from somewhat rewarding in pay to not at all.

Any ideas or insights would be interesting to hear about. THANKS!

[London88]

Wintermute I do not agree with the I've got mine mentality. Disaster relief should be provided immediately to those who have suffered a disaster. However, I am being very real about the guy standing on the corner. Contrary to popular belief he was not born standing at the corner with the bottle, and did not develop alcholism overnight. I am also not a proponent of the theory that because a person is born into poverty that the cycle has to perpetuate itself. I do not object to helping others, but I do object to supporting another persons street habits. There are always choices. I also agree with Kevin in that many of us who have got this far did not have anything handed to us, So I do not agree with the "we the privileged" mentality.

[WntrMute2]

Contrary to popular belief he was not born standing at the corner with the bottle, and did not develop alcholism overnight. I am also not a proponent of the theory that because a person is born into poverty that the cycle has to perpetuate itself.

OK, so let's hear your plan to educate the children of the getto, the migrant camps, the children of the illegal aliens that flock here for those streets paved with gold. Instead of alcohol or drugs, how are you going to provide the schizophrenic on the street corner with his antipsyciotic meds. Oh, btw he'll need follow up care not ER care if he is to kick the habit he or she has spent years developing. None of you out there are addicted to chocolate, food, cigaretts, sex? Is it easy to kick those habits when things are calm and peaceful in your life? Try it homeless, and in pain with no support. I'm still waiting for an answer to the question of Do you really think that guy on the street corner in the freezing weather, hearing voices, medicating himself with ETOH really is choosing that? Do any of you really believe that person would not rather have a safe job, safe shelter and safe medical treatment, even if it is not the cutting edge. Once again, choice is available to those with options . Not all have them.

[u-r-sleeepy]

Wintermute -

You are a liberal, eh? I agree access to healthcare should (and could) be improved upon, but going at it from a socialized medicine avenue is THE wrong Rx. in my opinion.

Simply take a look at the State of Tennessee's "TennCare" program right now. It started out a bit along the lines of "Heil Hilary's" vision for "reforming" healthcare. It is currently breaking the back of the State's budget and is now in full blown crisis. Why? There are plenty of "reasons" but the simple truth is:

Easy access to FREE HEALTHCARE - Woopie!!! Tens of thousands of people got into the system that never belonged (it IS managed in the "classic" gubmint werk style) and the state never weeded them out. People who aren't from Tennessee moved here (or visited long enough) to enroll and now come back for a "visit" whenever they need to see a doctor/tests.

I personally know a guy who used to be "poor" and got his kids on it. He recently made $150k/yr and his FOUR CHILDREN are still in the program. The oldest is 14 and getting "free braces" at Tennessee Taxpayer expense. This type of "compassion" is NOT limited....

The spending (waste) is so out of control that the Tennessee State Legislature is currently trying to introduce either an income tax or else a Lottery to try and curb the runaway costs.

An economist was brought to Tennessee recently to evaluate how to solve the state's crisis. He has a great track record in solving some other state's and city's budgets so it was interesting when he came back with his analysis:

Cut the fat from the TennCare program and you will balance the budget without the need for an Income Tax or Lottery. As I recall the local Democraps in the state house & senate didn't like that advice so they decided to look for another voice to listen to.

The only time liberalism looks good to me (I used to lean that way... when I was younger) is in THEORY. The results of reality are too scary for me when you see what happens putting that kind of "compassion" into practice.

I have a quick question:

If you consider yourself a "liberal" - do you go down the street you live on everytime you get paid and dole out 50% of your paycheck to your neighbors? If not, why do you keep electing people who do that very thing?

I recognize there is room for disagreement on plenty of the "political/social" issues, but I think the lefties have pushed some things a bit too far at this stage in the game.

Sorry for my rant. As I recall, this kind of "compassion" is credited to a great degree for the fall (from within) of Rome.... Too many people on the public dole has quite a price tag. It seems to me the Russians didn't have the greatest success either with socialism. Then again - what do I know?!?

[kmchugh]

Originally posted by WntrMute2

Yup, I'll pay. It is the right thing to do. Others need our help. The I've got mine mentallity is disturbing to me.

There is no question that there are members of society who we, as a society, must support. Those, who owing to mental or physical disability, cannot work and support themselves. But, they are a very small minority of our society.

You say the "I've got mine" mentality is disturbing to you. Fair enough, it has its moments with me as well. But far more disturbing to me is the "I've got yours" mentality.

Kevin McHugh

[Qwiigley, BSN, MSN, DNP, RN, CRNA]

Health care is not a right. Period. I am sorry to offend, thee. But with rights come responsibilties. With responsibilities come action. Better to pay for the 300- 700 dollars a month for a couple to get health insurance than to have SOCIALIZED MEDICINE. Bad idea, any way around it. The market will determine the type of care you will receive. Information and education is the key.

Britain and Canada have tried it. It doesn;t work, sorry to say. The people are not happy, the workers (MD. RN etc) are not happy.

[u-r-sleeepy]

Who said the people of Oregon lack any common sense?!?

http://news.statesmanjournal.com/article.cfm?i=51274

;-)

[CoreyB]

I am not sure socialized medicine is the way to go, but the current program clearly isn't getting the job done. Everyone has been howling at the idea of deadbeats getting benefits, but the majority of uninsured Americans are working or the dependents of workers. The unemployment rate is currently about 5%, while 15% of Americans are without coverave and only 62% of Americans obtain coverage through their employer (I realize the sats aren't directly comparable. I just used them to give a general idea. Ins stats from census 2000). There are a lot of working people and their families that don't have access to health care, and that is wrong.

People who work fulltime should be entitled to health insurance, period. If paying the health insurance premium of an employee is going to hurt the employers profit margine so badly that he can't afford it, perhaps he can't afford to hire the employee in the first place.

While we're opposing wellfare, lets make sure we end corporate wellfare as well.

As for access to opportunities, I think it's obvious that some people are victims of circumstance, namely poverty and ridiculously inept parenting. If anyone doubts this, I'd invite you to ask your local nursing school if you could shadow some of the students or instructors while the do their public health home visits. I'm in the middle of completing that semester right now and it has been a real eye opener. It's a nice idea to think that even if you're severely disadvantage, all that is required to be successful is a little more hard work. After seeing the manner in which many children raised in "real" poverty grow up, I just don't think that's true.

Now I'm not in favor of spending any of my tax dollars on people that aren't willing to work for themselves. I just think it makes sense to set up a system in which working families have access to healthcare. I think that it is especially important and cost effective for example to provide preventative care, like immunizations to children. Which are likely to be cheaper than emergency room visits later. ER and trauma care happens to be some of the only care that is mandated by the feds. It's an unfunded mandate that leaves hospitals and local governments holding the bag, forces many hospitals to stop providing emergency and trauma services, and...I wonder if it limits the their ability to pay us what we're worth?

All I'm saying is the system could stand some improvement, and I felt like WntrMute shouldn't take all the heat.

[London88]

Wintermute you need to stop generalizing that everyone who is an alcoholic is hearing voices. A schizophrenic can get disability insurance. Are we discussing healthcare or the homeless? Are we discussing educating the poor migrant worker or healthcare. Do you believe that giving healthcare to all those people you mentioned above will take care of their education and them not being homeless. Keep things in perspective! I can see you and I are going to duke this one out to the end.

CoreyB,

I definitely agree with what you are saying in terms of people who are working should be entitled to healthcare, as well as others such as the young, the elderly, and the ill. However I cannot agree that I should pay for those people who have brought their own problems on themselves. However the one benefit of social medicine is that by the time many of these people reach the hospital from the ETOH induced cirrhosis of the liver they will be made DNR and we won't be wasting too much money on them. I know I sound harsh but life did not deal me an easy hand when I got to the U.S. I had to struggle to put myself in the position I am today, and I could have felt sorry for myself and made some of those choices that Wintermute and I are disputing but chose not to. I earned my healthcare.

[kmchugh]

Dave

Like you, I was once pretty liberal in my thinking, and believed that health care was a right. But, I tend to be reflective, and upon a great deal of thought, I quit being a liberal, cold turkey. The reason is simple. Liberals are long on the greater good, on caring for mankind, on making sure we all have equal access to health care. But, they are pretty short on how reasonably to get these things done. In short, long on nobility, short on cash. And, after a great deal of observation, I have come to believe that entitlement does not beget empowerment. Rather, entitlement increases dependence on government. Which is really, I believe, the ultimate goal of the liberal. Make someone dependent enough on you, and that person will vote you into office forever. To not do so is to cut your own throat.

You said "Yup, I'll pay. It is the right thing to do. Others need our help." I'll admit, that's a pretty noble sentiment. But. I want you to look at that attitude from a personal perspective.

Currently, I know you are in CRNA school. I'm sure financial considerations were not your only reason to pursue this goal, but I'm equally sure that financial considerations played at least some role. Lets round figures, just for ease of calculation. Suppose you went to school with the plan of earning $100,000 annually. You can't eat plans while in school, though, so I am assuming that student loans are necessary. Maybe you don't need loans, but certainly the average CRNA student could not get by without the loans.

If you are like me, you swallowed hard at the loans you were taking, but comforted yourself with the knowlede that you would be making up to three times what you made as a staff nurse after graduation, making the loans payable. But, lets suppose that two weeks before graduation, we pass national health care. Suddenly, your taxes will go from about 38% to 55%. So, instead of bringing home $62,000 from a $100K paycheck, you bring home $45,000 from the same paycheck. Suddenly, you are making no more than you made as a staff nurse, but you are much further in debt than you ever were as a staff nurse. And since health care providers in a national health care plan are in effect government employees, health care salaries will go down. Now, owing to your national health care plan, you make less than perhaps you have ever made in your life, and still have the school debts of a person making $100000. So, who's going to pay those debts? The government, since they were the ones to put you in this predicament? Great, where is THAT money going to come from.

Next, salaries for health care providers are going down. As a result, applications for nursing school, medical school, and advanced health care schools will go down. Why spend 8 years becoming a physician, with four more years of residency, to earn $50,000. I can do the same thing without the student loans by becoming a NYC garbage collector.

Your national health care made you significantly poorer. Still willing to ante up? Not to sound harsh or cold, I'm not. Part of the reason I followed the path I did was to improve the lot in life of myself, my family. I really don't want to compromise that by saying that every person in the US has the right to dip into my pocket to pay for their health care.

Kevin McHugh

[smiling_ru]

Why should we care? Because they are fellow human beings and we have a responsibility to help them when they are suffering.

As broken as our medical system is now, everyone does have access to health care, although that care may be in an emergency room, rather than a Dr's office.

With a national health care plan I believe there would still be differences in the level of health care services rendered to each individual, relative to their perceived value to society. How to fix our healthcare system is a question beyond my capabilities to answer.

Someone on this board said "I also agree with Kevin in that many of us who have got this far did not have anything handed to us." No one on this board made it where they are now without some type of help, what that help was depends on where they started. "everlast song, you know where it is depends on where you start".

I can promise you that the person standing on the corner high/drunk or otherwise wasting our resources did not have the opportunities that you had, did not have the support system that you had, or did not have the intelligence to acheive more, that you had. Does this truly make that person less then human, not worthy of anything from those of us that did have doors opened.

Off my soap box now.

[Roland]

rationing with another. Instead, of the free market regulating the amount of care which is given, the state is instead left with the task. Like all such socialized systems which reduce incentives, it is less efficient than the free market. While our system certainly has imperfections, many of those emanate from current governmental interference. Thus, since the advent of Medicare, and Medicaid in the 70's we have seen double digit rises in inflation (within the healthcare industry). In fact one could argue that we already HAVE a quasi socialized, health care system.

In addition, I would like to point out that I am one of those without health insurence. There are certainly times that I wish that I had more access to care for myself and my family. However, even so I wouldn't trade our current system for one which was even more socialized. Given the enourmous defeat of Oregon's plan last night, I feel that I'm probably not alone.

[London88]

Smiling_ru

you do make a valid point in terms of where we are today depends on where we started. But I know that you are not assuming that we all had a supportive start and that things just worked out nicely for us. I don't know about others but my husband and I are still trying to decide how I am going to make it through anesthesia school and keep food on the table for the four kids. The struggle is not yet over. I can agree with you that changing the healthcare system is not going to solve our problems, as there will still be disparities in healthcare.