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Should the U.S. Maintain HealthCare as a For Profit System?

We've just experienced a history making election. Now it's time to come to reality. We will not be seeing a single payor system at this point if ever. The question becomes, should we expect to continue to see the wide salary and wage gap that we are experiencing between many executives, specialty physicians and most nurses, many allied health workers? Is it appropriate that many specialty physicians and high level executives receive large incomes while so many nurses and allied health workers are struggling to make ends meet and a good percentage of citizens are uninsured or underinsured? What's your take?

Yes I think it is fine to keep the system so doctors make more then nurses.... of course I do not think gov regulation will help.

Otherwise - what is the incentive to better oneself?

I think it should operate like the cardio system... muscle which work harder have a higher concentration gradient created and thus 'earn' more O2... no but seriously. Life should not be fair or people would not strive to better themselves.

HonestRN

Specializes in cardiac, ortho, med surg, oncology.

That is a tough question. Many specialty physicians spend many years in school followed by demanding residencies and fellowships before reaching full MD status and pay. Most hospital staff nurses have a BSN or ADN, a far cry from from the time and money spent on becoming a specialty MD. High level executives on the other hand I can honestly say are WAY overpaid.

Dolce, RN

Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

I hope we don't become so socialist that everyone gets paid the same regardless of education or effort. If a nursing degree required 8 years of education and surviving residency than I would demand equal pay with physicians but until that happens I think that the difference in pay is fair.

Dolce - I agree to a certain extent.

Even if a nursing degree was 10 years... I don't see why that should anyone should think that should equal a different degree.

A 4 year electrical engineer and a 4 year social worker should not be paid the same either. A 4 year electrical engineer and a 4 year civil engineer should not be paid the same either...for the sake of it. Pay should be based on demand. You should enable people to better themselves and ensure they get skills based on a mix of pay, quality of life, job satisfaction and stability that they seek.

In no way to I think a DNP and MD should be paid the same - based on years of education alone... if DNP's become competitive to MDs in all respects.. and the market deems that shift - then so be it....and thus they will feel the requirement to be just as responsible and be under the crushing weight of the insurance agency ;) time will tell ;)

Yes I think it is fine to keep the system so doctors make more then nurses.... of course I do not think gov regulation will help.

Otherwise - what is the incentive to better oneself?

I think it should operate like the cardio system... muscle which work harder have a higher concentration gradient created and thus 'earn' more O2... no but seriously. Life should not be fair or people would not strive to better themselves.

So being a doctor is "better" than being a nurse? I'm sure this attitude will set well with a lot of nurses here. Nurses who clean poo, lift heavy patients, get attacked by patients and doctors, who work 2 jobs while raising kids, who sweat blood to become nurses, and who deal with people like you who view them as not as good as doctors.

We need free medical care for all.

Down with insurers, down with our current medicine for profit system.

Too many going without care, too many have to pay for the uninsured, too many going bankrupt when the insurance runs out or the job ends (where they got their insurance). Other countries do it, we need it, too.

If there's any doubt that our country is run by a gang of thieves or that we're not socialist, just look at the redistribution of wealth via income taxes (earned income credit, for example), corporate welfare, and the recent bailout by American taxpayers of the private banks. And now we hear that those banks are going to use the bailout money to pay themselves bonuses - bonuses for the monsters who created the problem in the first place. Doth thy very blood not boil?

BTW, the income tax was supposed to be a "temporary wartime measure" - since WW2, I believe.

ZASHAGALKA, RN

Specializes in Critical Care.

We've just experienced a history making election. Now it's time to come to reality. We will not be seeing a single payor system at this point if ever. The question becomes, should we expect to continue to see the wide salary and wage gap that we are experiencing between many executives, specialty physicians and most nurses, many allied health workers? Is it appropriate that many specialty physicians and high level executives receive large incomes while so many nurses and allied health workers are struggling to make ends meet and a good percentage of citizens are uninsured or underinsured? What's your take?

The premise is wrong.

You are worth 5 dollars an hour, as a Registered Nurse, if you accept that much in pay.

No more. No less.

Let me expand. Awhile back, there was an ongoing group of threads about paramedics coming into the ED and claims that they were going to be paid much more than the nurses working there.

Here's the problem with that. Paramedics in the field do NOT get that much. IF it were the case that the money would be so much better in EDs, so many paramedics would apply for the job that the sheer glut of paramedics angling to work in the ED would bring pay back down to normal paramedic pay.

Or. Take for example, nursing. Why do non-bedside jobs pay so much less? The answer has nothing to do with skill level. It's because so many more nurses WANT those jobs.

The REASON why nobody pays 10 dollars/hr for their registered nurses IS that no RNs would work for that. The reason why McDonald's DOES pay 10/hr is because, there are people that WILL work for that amount of money.

If our hospitals could pay us 5/hr, they would. They don't because, they can't.

You get what you are worth and THAT is evidenced by what you are willing to take. No more. No less.

The government cannot change that. All the gov't can do is tweak the system and the result of those tweakings will be that the system will shake out in unintended ways.

This idea that you can egalitarianize labor so that outcomes match input is wrong. It's not wrong because its immoral; it's wrong because it just won't work. People will only accept for a job what it's worth for them to do that job. IF you make it so that some jobs aren't worth the effort to attain them, then, you will only make candidates for those jobs more scarce. Conversely, if you make other jobs worth MORE than they are intrinsically worth, then, you make those jobs more scarce as people over-fill them.

For example, would YOU work as a unit clerk, if it paid as much as an RN?

You might think that I'm being flippant, but, I'm not. This is an economic law. Congress can't change it, even if they wanted.

People earn what they are worth. They do so because, by accepting the pay offered, they concur with the assessment. People that DON'T concur with the valuation of their worth: they better themselves to find jobs that DO match their evaluation, or, they make a go of it themselves.

~faith,

Timothy.

ZASHAGALKA, RN

Specializes in Critical Care.

So. The key to nursing salaries improving is for nursing to take a higher view of what we are worth.

And.

That is happening. Every day, nurses "burn out" and leave the profession because they aren't getting paid enough to do the job they are doing, under the conditions in which they do those jobs.

There are more nurses with licenses than there are nursing positions to be filled. But. There's a shortage when more than half a million nurses drop out of the profession.

In order to combat that shortage: nurses must get paid more.

As a profession, as we re-evaluate what we are worth, individually and collectively, the market will match. It has no choice.

And nobody in government can, at the end of the day, tell YOU what YOU are worth.

Only YOU can do that.

~faith,

Timothy.

So being a doctor is "better" than being a nurse? I'm sure this attitude will set well with a lot of nurses here. Nurses who clean poo, lift heavy patients, get attacked by patients and doctors, who work 2 jobs while raising kids, who sweat blood to become nurses, and who deal with people like you who view them as not as good as doctors.

Vito - no actually what I support is that the market decides the value of a job or commodity.

If you want to earn as much as a doctor you can either become a doctor or be a nurse conducting business in a fashion where you are valued at that amount. I disagree with the previous poster stating that doctors and nurses should have equal pay as they were both in school for the same length of time. That is ridiculous statement as it has nothing to do with the 'value' of the service you provide.

I'm actually a fan of nurses as you can tell... since I aspire to be one. However, I find it dangerous when people view their salary as a basis of their age or length in school.... you should be salaried based on the value you provide - and that is not judged by us (sadly) but by others ;)

In answer to the posted question of "Should the U.S. Maintain HealthCare as a For Profit System?"

I have talked to some friends in Canada. There are advantages and disadvantages but slowness of diagnosis and treatment is one of the big disadvantages. I have even known some Canadians come to the US for treatment. I wouldn't want to see our healthcare erode and would be afraid it would with major changes i.e. if you mean government funded health care.

As far as the question of salary IMO it is more of a supply and demand causing the gap.

Vito - no actually what I support is that the market decides the value of a job or commodity.

If you want to earn as much as a doctor you can either become a doctor or be a nurse conducting business in a fashion where you are valued at that amount. I disagree with the previous poster stating that doctors and nurses should have equal pay as they were both in school for the same length of time. That is ridiculous statement as it has nothing to do with the 'value' of the service you provide.

I'm actually a fan of nurses as you can tell... since I aspire to be one. However, I find it dangerous when people view their salary as a basis of their age or length in school.... you should be salaried based on the value you provide - and that is not judged by us (sadly) but by others ;)

Noted. Actually, I couldn't tell that you want to become a nurse.

As for value, what's sad and aggravating is that nurses haven't yet universally accepted the truth that we need to unionize and get totally tough with employers. We have to do for ourselves what the UAW, Teamsters, AMA (yes, the doctors), ABA (lawyers), etc. did and do for themselves. Short of that, non-union nurses will replace us and we'll feel fortunate to work for only a meal if the economy gets bad enough.

Tim's (I think) argument above about the economics of work and the value of work - I agree, in theory. It's when the cold wind blows through the cracks in my cardboard condo and my kids' bellies are bloated from starvation that I figure I'd better work for whatever they'll pay me. When I'm sleek and fat and sassy, I can choose my pay with a little more discretion.

Thanks to everyone who has posted so far. Very interesting. I'm going to weigh in on the discussion to say that my intention of looking at the wage gap was not to say that doctors and nurses should make the same income. In my opinion, that goes without saying. What I was looking at is the fact that it is widely reported that the wage/income gap is widening between the rich and poor of this country. As a group, physicians tend to do very well in the income category and many are in the wealthy category. Nurses and allied health workers' income fall in the middle to low income category and many are struggling. Some of you have alluded to training and educational backgrounds as affecting the income. Some have also implied that physicians should be more valued than nurses. The subtitle of the question to consider is whether the U.S. should continue to place more value on physicians and high level health care executives and allow them to achieve a level of wealth that is off the charts compared to other health care workers? Can closing the income gap be achieved without a not-for profit health system?

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