Jump to content

"Socialized medicine"

Posted
by Grushenka Grushenka (New) New

I am interested in your opinions about introducing a national healthcare system in the United States. What do you think about introducing free basic packet of healthcare services (e.g. emergency services and annual medical, eye, dental exams)? Do you know anything about national healthcare systems existing in other countries such as Sweden and Germany?

I would also be happy to get some information on this issue from abroad. Grushenka

gwenith, BSN, RN

Specializes in ICU.

Australia has "socialised" medicine but we don't think of it that way - it is a free health care system. I think actually it is one that would/might suit America as it is a two tier system. You have free state hospitals while GP visits are subsidized by the Federal goverment (as is pharmaceuticals) but you can also have your own private health insurance cover and go to a private hospital and not be subject to waiting lists that the public inevitably has.

begalli

Specializes in Critical Care/ICU.

I think that for any type of national/socialized/universal healthcare plan to work in the US it has to be uniquely presented as something by the US and for only the US.

Using other country's plans as models, as good as they may be, will not and does not go over well with many of the people of the US. I say that not to offend by any means or that I agree with it, but the US is the US and does things the US way. One problem lies in people seeing all the perceived "bad" within these other ways of doing things and can't see that it could be done differently, uniquely for us, and work, imo.

Respectfully, this is and always will be a hotly and deeply debated topic. Especially in regard to the often misunderstood or perceived individual astronomical costs of such plans or the notion that some will end up paying more than others. There are very strong and determined opinions on both sides.

I wonder if the OP is related to The Veridican?

ArwenEvenstar

Specializes in med-surg, teaching, cardiac, priv. duty.

....but you can also have your own private health insurance cover and go to a private hospital and not be subject to waiting lists that the public inevitably has.

I am NO expert on this issue. But I know that some Americans tend to think of socialized medicine as this practically perfect system. "Everyone gets free health care! We need that here!" But as mentioned in the above post from Australia, in socialized systems you can often have long waiting lists! And only those who can afford to pay privately or have a private health insurance policy can get immediate/prompt care. Does this seem fair? The wealthier get better care than the poor. Hey...this sounds similar to the complaints about our US system of private health care! See...there is no perfect system! Socialized medicine and privatized medicine both have problems.

I used to live near the Canadian border and we sometimes had Canadians come to our US hospitals to pay privately for care because they were on a several year long waiting list for the procedure in Canada.

And Americans seem to complain a lot about taxes... But do you know how high the tax rates are in these "cradle to grave" countries?? Most Americans would probably flip their lids. Socialized health care isn't free...they pay for it through high tax rates.

I personally prefer out US private system.

Anyhow...I better stop writing because this topic can easily head off into political issues....

I think we have to be careful about definitions. Nothing is free. Nothing. Someone always pays.

I mainly deal (at this time) with Lyme disease patients. Yes, Canadian patients can get antibiotics "free". However, they are limited to very old antibiotics that are not nearly as effective. Many come to the US to try Zithromax or an experimental drug.

I have also heard stories of patients being moved up on Canadian surgery lists by paying under the table in US dollars (cash).

begalli

Specializes in Critical Care/ICU.

So OP, what do you think so far?

Or was this thread a hit and run?

Remember Hilary R. Clinton during Bill's first term???

Fiona59

Has 18 years experience.

Hey, I had Zithromax last year on prescription(that is one nasty drug), cost me $60 cdn (well after submitting my claim it probably cost around $28) for the course. I've never had "free" antibiotics anywhere I lived in Canada. Provincial healthcare payments in the provinces I live in and "extended" benefits through employers (they pick the extra charge for private rooms in hospitals, cover 80% of our meds) But I've never had free anything.

What I have seen is Americans crossing the border to buy drugs here at cheaper prices and the seniors swamp our clinics for flu shots...

I'd love to know where you've heard stories of people "paying under the table in US $ to get bumped up the lists". The hospital wait lists are so tightly controlled that it just can't be done. I do know that if you contact the surgical booker and explain your situation they can play with the schedule.

There are private clinics for some surgeries but they are usually restricted (bad choice of words) to people on Workers Comp, RCMP or military members, or heres my fav. politicians. But they are paid in Canadian $.

something i am curious about...we have an extensive charity system here...pay is when you factor in benefits are about on par with private pay hospitals...but i hear horror stories about staffing .. ratios being through the roof etc...one new graduate was put in charge of 3 proeclampic pts...in progress mi on the floor b/c there was no room on cardiac floor or icu.

i wonder if the countries with s med have these problems

gwenith, BSN, RN

Specializes in ICU.

I am NO expert on this issue. But I know that some Americans tend to think of socialized medicine as this practically perfect system. "Everyone gets free health care! We need that here!" But as mentioned in the above post from Australia, in socialized systems you can often have long waiting lists! And only those who can afford to pay privately or have a private health insurance policy can get immediate/prompt care. Does this seem fair? The wealthier get better care than the poor. Hey...this sounds similar to the complaints about our US system of private health care! See...there is no perfect system! Socialized medicine and privatized medicine both have problems.

I used to live near the Canadian border and we sometimes had Canadians come to our US hospitals to pay privately for care because they were on a several year long waiting list for the procedure in Canada.

And Americans seem to complain a lot about taxes... But do you know how high the tax rates are in these "cradle to grave" countries?? Most Americans would probably flip their lids. Socialized health care isn't free...they pay for it through high tax rates.

I personally prefer out US private system.

Anyhow...I better stop writing because this topic can easily head off into political issues....

Let me clarify - our waiting lists are for non-urgent and elective procedures - if you are in trouble you get seen right away. Even on elective procedures if the waiting list gets too long there is a public outcry and the politicians will address the issue (kicking a screaming but the will eventually address the issue if we twist thier arms hard enough:chuckle)

As for paying for it through our taxes that is true but what people do not realise is that will we or nil we somehow we have to pay for health care. If it is not taxes then it is cost shifted to the private sector.

Our system has advantages too and one BIG one is that the drug companies do not like us. That is because of the PBS system which as a fixed list of public subsidised drugs. Which means that unless you get your drug on the PBS forget about marketing it here. Does that mean we do without? Hardly the PBS list is HUGE but it has only a handful of each group of drugs available i.e. there might be only 6 Beta Blockers out of a possible 12 on the market and 4 of those 6 are generic makes and therefor cheaper. It stops the price gouging little trick the drug companies have gotten into of bringing out a "new improved" version every couple of years that is not that new or that improved.

gwenith, BSN, RN

Specializes in ICU.

something i am curious about...we have an extensive charity system here...pay is when you factor in benefits are about on par with private pay hospitals...but i hear horror stories about staffing .. ratios being through the roof etc...one new graduate was put in charge of 3 proeclampic pts...in progress mi on the floor b/c there was no room on cardiac floor or icu.

i wonder if the countries with s med have these problems

Most hospitals here use a patient - nurse ratio system like Terndcare that works out the patient acuity for each patient and assigns the nursing workload so that you might have 7 med surg patients but they are all self -caring and about to be discharged. Or you might be allocated only 2 patients but both of those are high care requirements.

It is our observation that the PRIVATE hospitals have a worse nurse/patient ratio than the public hospitals. Most commonly throughout Australia we have a 1:1 nurse patient ratio in ICU (that is RN's only) for ventilated patients.

Let me clarify - our waiting lists are for non-urgent and elective procedures - if you are in trouble you get seen right away.

_______________

But you can have a gall bladder removal that is elective...that can turn easily non elective.

Does anyone know if in Canada you now have to bring your own pillow to the hospital? Something I heard in passing.

We already have partial "nationalized healthcare" in the USA in the forms of Medicaid and Medicare. For folks in the USA that are so opposed to national health care......remember, your sweet old grandmother has it in the form of Medicare and possibly Medicaid too.

I'm not an economist but I do know one thing....one of the largest costs of doing business in the USA is health care. I wonder how our economy would be impacted if these costs were shifted away from employers and on to the federal gov't. Yes we would probably pay more in taxes, however, would we pay less for other things? How much would goods and services costs if employers didn't have to pay for health care coverage for its employees.......which is the fastest growing cost of doing business in the USA.

The answer to this question would be very interesting and I'm sure that there must be many studies on this subject.

UM Review RN, ASN, RN

Specializes in Utilization Management.

I'd be concerned about staffing levels. I don't think patient outcomes would improve without better staffing ratios, and I just haven't seen the government as our partner in that goal.

I'm also concerned about wages. We'd suddenly be employees of the government, would we not? From what I've heard of the VA hospital situation, I don't think I'd be very happy there, and that's only a limited example of "socialized medicine" for a specific group of individuals here in the US.

Would socialized medicine really help our patient population? I am beginning to think not.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 years experience.

I am not at all smart on the issue, I readily admit. I have nothing but questions myself:

Like IF we justify spending the bucks to build bigger, better weapons systems, enough to destroy the world- 2000 times over......

And IF we can spend big bucks on charity overseas, foreign worker recruitment, etc.....

And IF we can afford mass bail-outs of failing corporations in the form of "corporate welfare"........

IF we can continue to cover illegal and undocumented immigrant/indigent care......

IF we can spend millions to celebrate the inauguration of a President (not just Bush)......

then why can't we insure the WORKING POOR?????!!!!!!! You know, the poor average sucker who DOES hold a low-paying, unbenefitted job? The ones we are seeing increase in numbers EVERY year that passes as companies just cut these benefits out from under them?????? The one whose working backs on which building a great nation's progress rests????

Anyone???? :confused:

As I said, I am not too damn smart after all. I just have that BURNING "why" question that I can't seem to get any answers to. :cool:

Fiona59

Has 18 years experience.

No, here in Canada we make our patients sleep on the floor, without blankets....:chuckle :angryfire Don't know what you do in Alabama, have you ever seen a Canadian. We don't live in igloos, mounties dont wear red to work, and I've only ever dated one lumberjack....

Now lets get real. Every bed has a pillow on it before admission. Spares are kept on the linen cart/supply area. Yes there can be pillow shortages especially when certain patients want 5 or 6. Yes, some people bring their own pillow. I've seen them take their pillows on vacation too!:chuckle Some people will bring in feather ones because they dont like the cleanable covers or whatever.

What else, oh, we supply sanitary pads in maternity and diapers for the babies...Heck, we even provide the drugs in the hospital without a bill at the end of the stay. We don't bill for dressing changes and we don't charge for kleenex....

Dixielee, BSN, RN

Specializes in ER. Has 38 years experience.

"No, here in Canada we make our patients sleep on the floor, without blankets....:chuckle :angryfire Don't know what you do in Alabama, have you ever seen a Canadian. We don't live in igloos, mounties dont wear red to work, and I've only ever dated one lumberjack"

I was just going to comment that you can tell which patients have been to our hosptal before because they come in with blankets, pillow and a book (for the wait!). We are always out of pillows in our ER. They are too uncomfortable to steal, I don't know where they go!

I do have a question about the 2 tier system though. Since we have EMTALA/COBRA here and have to see anyone who can drag themselves to the doors of the ER, how would that work in the duel system. Do people without ability to pay get stabalized and shipped to the public hospitals? Or do they stay where they started. I agree that the health care system as it is in this country is severely in need of an overhaul. I don't have the answers. My husband had emergency CABG last year and the bill was about $50,000 for an uneventful course and 4 days in the hospital. If we had not had insurance, we would be forever paying that back. We spend countless dollars every day in the ER doing CAT scans, MRI's, labs etc on every belly pain that comes in the door. If we don't do everything that is available and miss something, we are open to huge law suits. So we send someone home with a Rx for vicodin for a belly ache that turned out to be nothing, and a huge bill for someone to absorb.

Another problem is of course patient compliance. We have folks come to the triage window complaining of nausea and vomiting but they are eating a big box of fried rice (true!!). Last week I had a woman complaining of 10/10 abd pain, yet she consumed an entire fried chicken dinner between doses of oral contrast prior to CT. I give up!!!

I don't have answers, but I do know something has to give eventually.

Guest
This topic is now closed to further replies.