Socialized Medicine the myths and the facts

[madwife2002]

The first and the most obvious concern is the cost to the patient and their family, we all know how devastating an illness can be for patients and their family many times I have witnessed the despair when a diagnoses meant further treatment which insurances question and in some cases wont cover. I have seen patients needing costly drugs to keep them alive and being unable to afford them, causing repeated admissions to repair the damage so called none compliance has caused. The first question in none compliance is were the pts actually refusing to take their medication or was it simply they could not afford to buy their medication because they don't have enough money and other bills need to be paid first? If the real reason is the cost then surely it would be more simple of we provided these medications at a more effective price or that all medications cost $5 no matter what they had? Outrageous I hear you shout but the cost of the repeated admission is far more costly than by helping prevent a repeat admission, by providing medicine they can afford.

How about blood tests could these not be done in the doctors office before the pt leaves for home and forgets to go and have a blood draw, or simply cannot get to the lab to have them drawn. I have personally waited in doctors office hours (and paid for the privilege) then been sent to the lab, miles away to sit and wait for blood work to be done. Why could the doctors not employ somebody to be at the office to draw blood on patients?

We should be looking at improving preventative medicine rather than patch it up and see.

Many times I have seen patients discharged with a new diagnoses of diabetes, no follow up at home can be organised because in my city nothing exists to assist these people. There should be a diabetic home nurse who monitors these patients in their own home-rationale, this would again help prevent admissions for diabetic complications, and none compliance.

So you wonder what has this got to do with socialized medicine. Well, in the UK if you have...

• Children
• Over 60 for women and over 65 for men
• Diabetes
• Asthma
• Thyroid problems, etc...

...then you get all your medicines for free.

There are in place specialized RN's who focus is on preventative care in the community. There are telephone help lines which anybody can utilize for free.

Maternity care is free a midwife will be assigned to you for the duration of your pregnancy and up to 6 weeks later. The cost of the birth-nothing no matter how you deliver.

I have been asked what kind of care do you receive in a socialized medicine country and I ask them, I am a product of socialized medicine you tell me how my care differs from nurses who have paid outrageous amounts of money to train as a nurse?

Of course even in the UK you can have private care if you chose to pay, this is an advantage if you need hip replacements, knee replacements, eye surgeries-other wise you may have to wait. There are initiatives in place to reduce waiting times for surgeries in the NHS and I hear that dr's can now book surgeries from their office at hospitals all over the UK which helps reduce waiting times, plus hospitals get fined if they don't meet their quota.

I agree MRI's and CT's are not as freely available, but again initiatives are in place to improve the waiting times. Emergency care no different all patients will receive emergency care.

Poor conditions yes there are poor hospitals and there are excellent hospitals, no different to Phoenix AZ.

Questions??

[Ginger's Mom, MSN, RN]

What state do you live in? Just curious? We just had to get our own and it was $300+ a month for a family with a $10,000 deductible per person. Which is kind of crappy IMO though I am grateful we can afford it.

I agree about the fragmented care though, I read an article (I think in healthcare traveler) that said one of the huge wastes in our healthcare system is massive over ordering of tests which in part is because people see too many people without any continuity of care.

I live in the state of MA, the $98/month policy had high deductible ( $2500 and only 50% coverage), the $168 had 80/20 plan with max of $1500 per year, but the plan was written in NJ.

[talaxandra]

With all due respect, this is a biased recounting. I work in the ER and patients with non-urgent complaints can sometimes wait for several hours just to be seen. However, when any employee presents to the ER with even a minor complaint, he or she will be seen almost immediately. I would be suspicious if you told me that employees at your hospital don't get that same preferential treatment.

I didn't identify myself as a staff member until I saw the intern, at which stage I'd already been sent to fast track, seen by the nurse practitioner and x-rayed. This may in no small part be due to the fact that I went to ED on a weekday int he early afternoon, when fast track's fully staffed and the ED is as quiet as it gets - that's an awareness of time but not preferential treatment.

Since I wrote the post that this is in response to, I've broken bones in my other hand. Once again I presented to my hospital - I was fast tracked after a five minute wait, saw the nurse practitioner and was x-rayed as speedily as before, but not seen by plastics because they were in clinic. In retrospect I should have been sent up to clinic but instead had a backslab made by a medical student (supervised by the NP) and was seen in clinic several days later - time from presentation to D/C: 45 minutes. Once again, I did not identify myself as staff at the outset. I had surgery on the next operating day after clinic, and was taken in last (not so preferential). I would have loved preferential treatment in outpatient's, but with both incidents had to wait like everyone else.

Colleagues have presented at peak times and certainly had to wait for more emergent cases. One nurse with a work-related back injury was in ED for five hours before being seen, and was left in the corridor on a trolley (except for her exam) because the department was slammed.

[Rebel Yell]

http://www.edmontonjournal.com/health/Disabled+infant+gets+reprieve/2460161/story.html

So is this what socialized medicine is to bring us? The government decides. And we scream about ethics, personal freedom to make our own decisions and those that support socialized medicine fail to see the other side. There are pros and cons to each, but to force someone to pay for or do something they don't want to, is not right. Therefore, it is not "a right" in my mind. Individuals should be left to decide.

Americans are good, and when the need arises, the hearts and wallets open. I have faith in the generosity of the American people to help those in need. And I have faith that if we can get the right people into government, we can make changes that are common sense, and changes to the system that are already in place to benefit all. I don't like the congress insulting my intellegence that they can do better. They can't and they haven't.

[MaritesaRN]

Oh yes the continuity of care. I am surprised that w/ todays technology we do not have a system where any doctor can access medical info. You see we have patients that go from one doctor to another, specially the ones seeking more drugs. But this will also help if , let us say a doctor needs to view a recent x- ray , instead of ordering another bunch of diagnostics, this will surely save money instead of the repeatetive diagnositic tests that was already done! You see I am gettign quite frustrated w/ these things, and I am more convinced than ever that this repeat diagnostic things is more of money making than the efficiency of having a system that will save money. I am sure they can set this efficient system up.....but what is the motivation for the money making providers? Until this mentality is corrected , this will remain this way , until we are totally bankrupt in health care....that is why we are here now. I do no tknow what it takes to change the direction of our health care. I beleive in capitalism --this is what America is all about, but too much of it and greediness in the middle of the system , this will fail eventually. they are taking resources that can nto be replaced------- just a one way ticket , and soon the pot runs dry, then what...... socialism? Surely, it will come to this ! :DYes, I will welcome something better than what we have now. See the healthcare reform and where it is now? It has been side tracked by oppositions , because it this new reform goes thru, there is no more sugar Daddy for the greedy profiteering !!!!

We the American people must help and protect each other! I definitely do not have any belief for a bi partisan --------- a waste of time and tax money to watch politicians play their games and forgot what the issue was all about!

[lamazeteacher]

i couldnt agree more with your last paragraph it worries me that health care is now not only unoffordable to the working class, it is now becoming unaffordable to the middle classes. it is and has been absolutely unaffordable to anyone who is unemployed. cobra is a joke!!

if it was made more affordable then more people would buy it and less people would present to the er without insurance and no chance of ever paying the bill. insurance companies don't care about that. even hospitals don't really care, as they are profit making (even when they say they're non-profit), and someone who doesn't pay is another tax deduction for them.

i think that maybe it suits the insurance companies to have the premiums so high because then they have less bills to pay because the ones who actually have insurance 'tend' to be the more healthy, younger clients.they happily sit back and let the hospitals pick up the 'bills' for the unemployed, poor, uninsured patient.

insurance companies make sure that those who are employed, are young and healthy, as they add at least $1,000/month to premiums for any employee who is 55 years of age. when that employee becomes 65, the employer's insurance coverage (unless they're self insured) won't allow medicare to be the primary insurer, and charge 4 x the premiums for those poor souls who find themselves jobless as an unexpected birthday present.

i know that because it happened to me several times (like 8 x in 10 years). friends who own their own business and had blue cross for themselves and their 40 employees told me the above. when the wife (who was in my nursing school and knew me to be a very ethical, good nurse) heard of my troubles, she told me about the 55 year old protocol. they paid the $1,000/month for 10 years, but when blue cross demanded $3500/month additional for her husband, they retired and became "consultants" for their 30 something son, who became the business's owner.

it's illegal for employers to ask the age of any employee, but the way they get around that, is to make all employees (including those who already have health insurance through their spouse) fill in an application for their health insurance carrier. they told me that the birth date necessary for completion of the application, is kept confidential when i balked....... i worked for blue cross last year, and the scenario described occurred. i left the year of my birth out, and the form was sent back to me with a demand to complete that part of it. when i did that, at least 8 different people from various deparftments (including human resources) called to inquire whether 1939 was correct as my birth year (i have genes that give me a younger looking face).

when i confirmed my birth year, i was sent to security to write my birth date under the pictures for my id, and their use. a day later, i was fired and asked to write a letter acknowledging that (?huh?). so i wrote a letter of resignation. my supervisor wanted me to rewrite it, but i refused. then i got the full treatment and was watched as i packed my things and was marched out of the building. in president obama's speech last night he mentioned the loss of dignity for those who lost their jobs, and i cried again. i miss working, and have the ability to continue doing that, but i can't stand the thought of being fired through no fault of mine again; and that stops me from actively pursuing one. i am impoverished because i thought that i'd work much longer.....

[MaritesaRN]

Oh my gosh , this information seemed to be written for me. I am an RN that works w/ medical review or UR in insurance companies and will be working until I can not anymore. Why not retire? I can not afford that really, besides my idea of a retirement is traveling all over the world , and I do not have that kind of money ...to keep my brain going and my checking account full, I need to work becaseu I am still helping my daughter and my granddaughter , otherwise they will be in one of those statistics where single moms and children are living on the streets. Single mom and kids is creeping on the top list of homeless people !!!! I am so saddened by this statistics.... why are we allowing this to happen to this vulnerable population? Is our society really that numb and callous not to care for people who needs help or can not take care of themselves? Is this society full of profit mongers or a few of the very rich people who lives inside their palatial houses and not even looking at what is happening outside of their secure, warm, huge mansions? the mentality " If they do not have bread, why not have cake instead?????? You know what I mean ?

There is no connection here and very few attempts to connect and help , and you know what happens in a fragmented society in the long run? If the body is fragmented in it's function , sooner or later the whole body is deceased and dies !

Back to the subject ...the reason why we need a health reform. With the reform the employers, should not be able to "discriminate" older or matured employees.....or refuse coverage to a patient because they are older and also have pre existence. so who is afraid of socialism????? I will embrace this vs. what we are going to have in the future if these corporate fiasco is not controlled ???

Nurses , we all should stick to a health reform. If you do not think we need one , then take your head out of the sand and look around. Not enough? do a research, be an activist for the good of all people !

[lamazeteacher]

Maritesa:

That post was for you, and all the nurses and others who plan to work into their 70s. Interestingly enough, the Presidents who allowed this travesty to grow ever worse, were old men with enough personal wealth to pay for any medical care they needed, or their families needed.

Now we have an intelligent, caring President in Barack Obama, who grew up poor in monetary wealth but rich in caring, education, and perspective. He sees what needs to be done, and despite Congress and the Senate' reluctance to do what is best for all people and the deficit, it will be done.

What is happening in Edmonton, Alberta, Canada is the result of loss of respect and trust because that province's government hired someone to manage health care there, who wasn't up to the task and ran it into the ground, financially. No matter who is in charge in the reform of health care in the USA, there will be national oversight. In Canada each province has autonomy regarding health care. Since Alberta has fewer people than other provinces, there are fewer people in their government representing them who let the health care there run out of money.

The financial backing of health care is going to be on those who make more than enough money to buy whatever they could possibly want, as well as whatever their children and their children could possibly want.. It will also come in affordable amounts, from everyone who works. Our President's advisors and he have brought us back from a depression that would have been worse than the one in 1929, had it continued. That has convinced me to place my trust in him, and his chosen advisors.

Those conservatives in both parties opposing the reform of health care and all the other changes Barack Obama endorsed, to fulfil the promises he made for us, are too short sighted and prejudiced to see what a great leader we have in him. While change takes longer than anyone wants, moving toward it in good faith is the answer to many. many prayers. He saw for himself how corrupt the insurance, pharmaceutical and hospital companies are, when his mother had breast cancer and died. Who was it said "The quality of mercy is not strained, it droppeth as the gentle rain from heaven upon the earth beneath?" Oh yes, Shakespere, whose country embraced universal health care.

No one said that the provision of health care equally would be easy, or that healthy people would pay so others might live. As has been said by many, life isn't fair, and some professionals who have been charging far more than the "traffic can bear" are going to have to accept less. Doctors in countries with universal health care live very well. They have lovely homes, great cars and take vacations that others can't afford. I have friends and family members in Canada who are physicians, so I've seen that, and yes, they want more money and charge additional fees. Canadians have to buy supplemental insurance with the insurance companies spawned here, that provide it for a nominal cost, because the government restricts the high prices that people are forced to pay here. They've also negotiated much lower prices for medications, medical equipment and DMEs. We can do that, too.

And we can abide less luxuriant settings at doctors offices and hospitals, as they have in other countries so that we can lower our morbidity and mortality rates, which are disgusting, when compared to other countries with half the wealth that is here!

So let's provide a united front and wear the badges that say, "Another Nurse for Health Care Reform". It's available at the Organizing for America website.

[kimmie4476, ASN, RN]

Is there a middle ground anywhere? I think the idea of a government run "insurance" with the option of purchasing a private insurance sounds pretty good to me, that way, if I lost my job I wouldn't have to worry about healthcare for my family.

As far as everyone worried about how much taxes will go up, how much do you currently pay in health insurance premiums and OOP costs? The poster from Australia said that they pay roughly 4500. per year in taxes, which works out to about 375.00 per month AUD. I might have the exchange down wrong, but I think that's about 330.00 per month USD which is what I was paying for premiums at my last job... That is their total income tax paid (except 1% and a couple of other things). I have more than 300.00 taken out of every check already in taxes, so that would mean I'd only be paying another 30.00 in "insurance" (yeah right lol)

but seriously I would rather pay premiums to the government. Government workers are paid extremely lower than CEOs and they do the job without bonuses that I paid for while they deny my claim. There IS accountability in the government, that's why we have the right to vote. Don't like how the universal healthcare system is run? Vote them out. We don't have that option with private insurance companies.

True story..one of my old bosses was on a sighseeing trip to Switzerland, fell, broke her leg....E.R. visit, 2 orthopaedic surgeons and everything else associated with her hospital stay. Her total bill? $60.00. I pay more than that in deductables. I'm just saying........

[jasonakaremy]

if canada can do it. why can t we...

[MaritesaRN]

I am glad to hear all these. Yes, reform we must have. Let us pray , support and act on the health reform. I know Swiss and Canada, and france take care of their people's health needs. Why can't we be like these other nations??? Too much capitalism, to the point of excessive greediness. We need to regulate the private insurance and of course the wallstreet bad guys. first , the best competetion is having a public option ----this is the best competetion you can pit against the greedy insurers. let us fight for the promotion of a health reform ....something big got to happen. If congress remains to be in a grid lock at our expense , then put this out for people to vote.....let us see how much money private insurers have to buy votes.

Nurses so good to know we are pretty much in the same cause !!!!!!!:redbeathe

[nursetony9]

Well, I noticed that many people used the words "free healthcare." Its NOT Free! Where do you think the money comes from to support such a huge healthcare obligation? TAXES!

I am opposed to the current healthcare bill propose by socialist Barack Obama, but I do support some of the ideas proposed for healthcare reform. Ideas like Tort Reform and the ability to buy health insurance over state lines. This country needs a profitable healthcare system. Why? If the system becomes socialized, there won't be extra money to create new technologies and medications or possibly cure certain diseases. The current healthcare bill that is going to be forced upon the Americans is NOT for our benefit. Out taxes will increase and those who oppose buying federally qualified health coverage will be fined a annual penalty. I find that to be a little UNconstitutional.

So.....socialized medicine is NOT FREE. TAXES PAY FOR IT and there isn't enough tax revenue to support universal healthcare along with all of the other social programs of this country. This could potentially bankrupt out capitalist system and create the next France.

[lamazeteacher]

Nursetony, you're brand new posting on allnurses. Far be it for me to get on your case!

However the balancing financial part of the Reform of Health Care bill, is the extended taxation of those who make so much money that they'll never miss the extra amount they'll pay. Of course all those who are well and working will pay according to their incomes, for the health care they'll receive at some time in their lives. At first, while young and healthy, it will seem unnecessary that the deduction toward health care is being taken from their paycheck, just as that Medicare deduction seemed unnecessarily large to me, for the 48 years I worked.

However, no one will want any longer for appropriate health care. ERs will be more reasonably busy, since earlier care will be obtained, as well as preventive measures taken. Doctors won't have the added pressure of knowing that they only have so many years to make 100s of millions, so maybe they'll relax and think more about the medicine and surgery they practice. I've never been so embaressed for coworkers, since I realised that money meant more to most of them (including those who I saw for my own care), than the satisfaction of giving the best care that can possibly be expected of them.

Doctors' greed has only been exceeded by the companies that are (hopefully were) their parasites - insurance, including the malpractice greaseballs, pharmaceutical, DME, and on and on. The addiction to money, not for what it can buy as much as who has the most, is an illness more tenacious than drug addiction or all the other addictions. I've been close to big money, and can relate that there is no greater misery (unless it's an early fatal illness), than a person with more than enough funding for a happy life, but the inability to have a happy one. There is also no greater joy than knowing the career choice you made, is the right one for you, with the bonus of making a difference for the support and wellness of others.

Now as to the unjust label you gave our most beloved President Barack Obama. It's wrong. He cares with all his being for the best that can be provided, for Americans and those of other nationalities, in need. Time will tell the story of his uncorruptable ethics, and the fury of those who seek to besmurch his reputation for their own gain, and/or unconscionable racism. One person simply can't get everything that was promised, done in one year. Others need to cooperate with his efforts to accomplish those objectives, and at least give them support. So far it's been like maiming the favorite racehorse at the starting gate!

We cannot have missed the way our government has been misled by selfish perpetrators who sell their votes, to be elevated in the opinion of their own constituents. I've always thought that elected officials should be lauded for their selfless devotion for service to others. That naivety is out the window now! The ugliness of self agrandisement is there for all to see, and hopefully guard against, come next elections. But that's kidding myself. There will always be those who want the quicker, easier way to their own financial success. That's why lotteries are so popular. Let's not give our government over to those who would abuse our trust, please. :spbox: