Richard Titmus wrote in his concept of social policy about what he called the 'stranger'. He said the ultimate in social policy is to give to the stranger because you recognise that she or he is the same as you. You don't give to the stranger because they are hungry or because they are tired but because you recognise the problems of hunger and tiredness. In other words you see them as part of yourself and part of what you are responsible for. If you see them as 'the Other, you don't get that sense of responsibility.
John Rawls, who talks about justice, also uses a similar sort of model by saying that if you punish other people you always have to work on the basis that it might happen to you, which is another formulation in a slightly different format.
It is a fact in the USA that 64 million people do not have health insurance, which means there is a third world country within a country that boasts to the world that it is apparently the best.
So how do you explain queues of people waiting for hours, starting at 4am, to get an appointment to see a physician for something as simple as a sore throat? How about the 60-year old man with heart problems, who needs a heart transplant being told 'sorry, you're 60, so you don't qualify'? How about being told 'sure, you can see a doctor for a suspected UTI, come back in four weeks (this happened to me, back in 1985 while I lived in Winchester)? The health system in the UK is a mess, no matter how you slice it (no pun intended).
When I lived in N. Idaho, we had doctors leaving Canada to open practices in the US, since they literally couldn't afford to feed their families with the ridiculous taxes they had to pay, not to mention the reams and reams of paperwork they had to deal with. Socialized medicine is not the answer.
At the hospitals I did my clinicals in, EVERYONE was treated, regardless of whether they had insurance or not.
You appear to have overlooked preventative management - breast screening:
Accoring to Watts T et al(2004) Breast health information needs of women from minority ethnic groups. Journal of Advanced Nursing 47(5)526-535
Studies from North America have demonstrated that while women from minority ethnic groups (particularly African American women) experience a lower incidence of breast cancer as compared with white women, they have poorer 5-year survival and higher mortality rates (Champion & Menon 1997, Bailey et al. 2000). Several factors might explain this difference, including poor or incorrect knowledge and practices relating to early detection of breast cancer as compared with white women, negative attitudes, late diagnosis, poorer access to health care, lower use of screening services, and cultural practices (Danigelis et al. 1996, Glanz et al. 1996, Champion & Menon 1997, Zabora et al. 1997, Lawson 1998, Bailey et al. 2000, Raishidi & Rajaram 2000, Zhu et al. 2000, Phillips et al. 2001).
In the United Kingdom, the incidence of cancer is thought to be lower among minority ethnic groups (Pfeffer 1996). As the ethnic minority population ages and individuals become more acculturated into the lifestyles of the indigenous population, the incidence and mortality from cancer is expected to increase (Bahl 1996, Luke 1996). Breast cancer is the commonest cancer among first generation immigrant women from minority ethnic groups (Cancer Research Campaign 1997). Although its incidence in the United Kingdom is lower in certain minority ethnic groups compared with the indigenous population, it is possible that this may rise in the future.
You appear to have overlooked preventative management - breast screening:
Accoring to Watts T et al(2004) Breast health information needs of women from minority ethnic groups. Journal of Advanced Nursing 47(5)526-535
Come on, Larry, you're grasping at straws
Breast Cancer is a Worldwide Epidemic
September, 1997
Canada: About 20,000 Canadian women will get breast cancer in 1997, and 5,000 will die of it--a rate nearly identical to that of the neighboring USA, which has 10 times as many people. The Canadian Cancer Society estimates that 99,000 potential years of life were lost to breast cancer in Canada in 1994.
USA: One in eight women in the USA will develop breast cancer in her lifetime. The US has one of the highest incidence rates in the world. New cases increased 52% from 1950-1990, with a 4% rise every year from 1982-1987. In 1997, 180,200 cases are expected with an estimated 44,190 deaths. Breast cancer is the leading cause of cancer death for women aged 15-54 and the second for women 55-74. It accounts for 39% of all cancers diagnosed in women. In 1991, the death rate for black women was 19% higher than for white women.
UK: In the United Kingdom, one in 12 women will develop breast cancer in her lifetime. There were 34,500 new cases in 1991. In 1994, 14,080 women died of breast cancer--that is 270 deaths a week. The UK has the highest breast cancer mortality rates in the world.
Doesn't look like those preventative steps afforded by national health care have done much good in Canada or the UK. Face it, the US has the best system in the world.
I can tell you from clinical experience that poor women in my country HAVE access to free breast cancer screenings. I learned at our local county health clinic that even mammograms are offered to those who qualify financially.
Sorry, but when citizens of this country have free will and are offered a CHOICE between staying on the couch at home and going to the free preventative healthcare clinic...many decide not to get off the couch. That's not our government's fault.
Canada: About 20,000 Canadian women will get breast cancer in 1997, and 5,000 will die of it--a rate nearly identical to that of the neighboring USA, which has 10 times as many people. The Canadian Cancer Society estimates that 99,000 potential years of life were lost to breast cancer in Canada in 1994.
USA: One in eight women in the USA will develop breast cancer in her lifetime. The US has one of the highest incidence rates in the world. New cases increased 52% from 1950-1990, with a 4% rise every year from 1982-1987. In 1997, 180,200 cases are expected with an estimated 44,190 deaths. Breast cancer is the leading cause of cancer death for women aged 15-54 and the second for women 55-74. It accounts for 39% of all cancers diagnosed in women. In 1991, the death rate for black women was 19% higher than for white women.
UK: In the United Kingdom, one in 12 women will develop breast cancer in her lifetime. There were 34,500 new cases in 1991. In 1994, 14,080 women died of breast cancer--that is 270 deaths a week. The UK has the highest breast cancer mortality rates in the world.
Doesn't look like those preventative steps afforded by national health care have done much good in Canada or the UK. Face it, the US has the best system in the world.
I think its normal that you should qualify your reference - incidentally the UK is a small country compared to US.
I think its normal that you should qualify your reference - incidentally the UK is a small country compared to US.
Well, you started this thread off with the claim that the US had 64 million uninsured people. Not only has that been proven to be incorrect, you failed to "qualify your reference." Then you offered us another statistic from an unqualified reference. Careful about throwing stones, particularly with all that glass around you.
Your point about the size of the countries is irrelevant. The article offered by stsdoc referred to breast cancer mortality rates, not total cases. You do recognize that you are just digging yourself in deeper, don't you?
I think its normal that you should qualify your reference - incidentally the UK is a small country compared to US.
Larry I too can tell you from personal experience that poor women do have access to all the health screening.
I was at one time a divorced single mother going to school and used the free clinics. They were good clean clinics that gave good care.
I do want to thank you though for bringing this subject up. Next time I hear one of my cohearts start talking national healthcare again.....I can say HEY!!! Look what happens when you let your government run your healthcare.
Stsdoc, since that article is talking about rates, it only proved that Canada's system is equal to the US in that matter. That's hardly an indictment against universal systems.
Pbelle, I don't know a single doc in Canada who can't afford to feed his family. That's a big line of crap. And the tax rates really aren't that different. I live in California and take home the same amount as a percentage as I did when I lived in Ontario when you include the money I spend on my health insurance. And again, if health insurance wasn't a consideration in the kind of care a person will receive, why on earth are we paying for it?
I really wish people could have these discussions and just admit that there are pros and cons to both systems rather than spread misinformation. The hype around these issues is crazy.
The mere fact that even one man, woman or child in this great country goes without health insurance is disgusting.
What's just as disgusting is that those who do have health insurance cannot get the procedures or tests they need. Rumor has it that HMOs have been known to literally kill people. http://boxer.senate.gov/hmo_stories/stories.html
Nor do doctors have the free will to treat their patients as they deem fit or necessary fearing the repercussions of going againt the payor.
Those of us who do have insurance and/or our employers are paying twice for health insurance in this country. Once for ourselves (or our employer pays for us) and once in taxes to pay for those who don't have health insurance through their employer or otherwise.
The talking in circles that goes on in the type of debate that's happening in this thread does absolutely nothing to solve this problem.
No one can deny that healthcare is a HUGE problem in the US. Nothing will change unitl the system itself changes, and changes dramatically.
Specializes in Education, Acute, Med/Surg, Tele, etc.
Hey well talk liablity here...all patients can sue, therefore all must be treated equal! That is the mandate of the old mighty health care dollar..so it shall be writen and done!
Sounds horrid, but it is true...and that is why non-insured patients are treated equal...and therefore a good thing, just sad it came to that huh? I would rather take it from a nurses standpoint...all patients deserve quality treatment period!
Now, as far as insurance effecting me...I tried to turn a blind eye, and failed! You see, in my facility one is charged by 15 minute increments for even talking to me (RN), charged for meal monitoring, bowel monitoring, and I/O, pay for med administration, pay for any treatment, pay for their treatment supplies covered or not, oh yeah that and rent for living there. They are charged for everything, which means I have to really think carefully about what I ask for in terms of monitoring/treatments because if I am not cautious, they will be broke and out of my facility to fend for themselves somewhere! Sadly, I do have to consider it...I can't hide from it anymore like I use to in Hospital.
A very ballpark figure on charges for a bowel monitor is over 200 bucks per month!!! WHAT!!!!!???? To ask a patient if they went poop and right y or n on a piece of paper???? But hello, that is the way it goes...so I think really hard before putting someone on one if they really don't need it. I use to just put everyone on one to monitor, especially if they were on narcotics...but I soon found out what I had done by doing that...and stopped...now only as a purely need to basis (and I get a doc order so insurance may cover it...lordie how stupid is that to have to do!) But if they do, I put them on one no questions asked and let my admin handle the situation from there...I didn't get into nursing to handle my patients finances like that!
Don't even ask what a 15 minute RN service costs, feeding by staff, hoyer lift or complicated transfers, CBG's, injections, or med admin by staff costs...your eyeballs will pop out!!! I was shocked, and accidentally added to the probelm by not knowing the costs by ordering things I didn't know were so expensive ...now I know, and am more aware of it before I order things.
Kinda funny that this topic is on here.... and right when I've come off work with a story to tell.
First my Background. I'm from Canada and am living in the States (have been for 2 years) on a Visa. I have always feared to leave the "safety" of the Canadian system. I love it. I love how even the down and out can have physiotherapy for their outpatient care, and there are several social/health programs that people are put into that support whatever ailments they have... it's really quite relieving. Yes, we do have the problem of time there, but patients (whether they are upper or lower class) are taken care of as equals. The difference I noticed with people here with no insurance is that they are left to fend for themselves with dressing changes and supplies until the next follow up appointment...
until now...
I dicharged a patient 3 hours ago who had jaw surgery for cancer. This patient had no insurance. He would require Tube feedings every 6 hours at home through his PEG (not to mention the care that goes with having one), dressing changes to his old Tracheostomy site, and his donor site from his skin graft. He was spanish/english speaking and working on a visa permit. He would have to receive radiation, chemotherapy. After teaching him administration of Tubefeeding, dressing changes and care of PEG's, this person was given a (HUGE) supply of dressings from the hospital as well as solution to clean each site. syringes to flush, tube feeding bags. the Dietician came up and gave him a crate of tube feeding product and the Social worker came up to help arrange for the Chemotherapy to take place, stating that he would have rides to the hospital for all these appointments, and could obtain more supplies there. Not only that, but because he had contributed to Social Security (I think it's called that here) he may be eligible for a disability claim.
All this for a guy with no insurance.... Amazing eh? Anyways I felt very comfortable dicharging him, knowing that he'd be followed up by all these people here...
Despite the scary rumors/concerns that exist.... American healthcare system is doing a fine job there.
...now I know, and am more aware of it before I order things.
Larry
88 Posts
You appear to have overlooked preventative management - breast screening:
Accoring to Watts T et al(2004) Breast health information needs of women from minority ethnic groups. Journal of Advanced Nursing 47(5)526-535