Having worked in a country which has socialized medicine I can certainly see the pit falls and the benefits. What I don't understand is the fear behind having socialized medicine In my opinion socialized medicine has more positive benefits than negative benefits.
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.
My personnal belief is we had to start somewhere-I doubt anybody in the country would agree that the bill is perfect in fact it is far from perfect but it is an excellent starting point.
I think we should look to it as the stepping stone to the future, after all what we have is not working but I doubt those dusty old insurance companies would ever change what is working for them, unless their hands were forced.
the old system is unsustainable, but the new one is also quite unsustainable. Of course, you can always sustain it with higher taxes, I suppose. The new bill doesn't address the reason for high costs. What you are doing is replacing a system w/ another one that isn't quite likely to work either. If we really wanted to cover everyone, then just cover everyone that doesn't have coverage and don't try to fix what isn't broken.
Insurance companies have always been profitable. That's why they are in it. You think Blue Cross provides insurance so they can lose money? Obviously they are making money. They don't care how the cost rises. they already negotiated their lower rates. Next yr, they know they have to raise premiums to account for rising costs.
As a businessman, if you can't make money off one business, you usually get out of it. So costs are rising, but they are raising their premiums to maintain profitability. either that or cut benefits, which is what some of them will do. Either way, someone will pay. This is what I mean.
Your posts ramble a good bit. I'm not exactly sure what your point is, but of course insurers are in business to make a profit. All businesses have a profit motive. I guess my question to you is, what do you think is the driver of the high costs. You seem to think that you have it figured out, but you don't tell us who the culprit is. What do you mean insurance companies have already negotiated their lower rates, and what do you mean next year they know they have to raise premiums to account for rising costs? There are other options, you know? They can go back to the providers and negotiate a cut in reimbursement. That is what I expect to see happen in response to this bill. Costs are rising? I don't think so. Not double digit cost increases while inflation is almost non-existent in other segments of the economy. Someone is putting all of that money in their pocket. Nobody has any increased costs in the healthcare arena these days. What we should be seeing is prices coming down.
A private company can always dictate their price. And that price will be HIGH because they can no longer deny anyone to keep their costs low.
Of course, if there's no money to be made, why stay in that business? I think they will get out and offer a plan to cover what the govt won't cover. that would be the way to go. That way, they can call it something else -- supplemental insurance (not health insurance).
And if competition is really what we're after to lower prices...we have just eliminated the competition. Smaller insurance companies will get out or be gobbled by bigger ones. (that's competition?)
And there's always concierge doctors for the rich. no insurance needed.
A private company can't ever dictate their price. Competition dictates the price. Your posts are very telling about your lack of business knowledge. You have no understanding of the insurance or the healthcare market.
For me, the bill only means more taxes for me since my state has implemented all the features, so I will be paying more taxes and higher cost in healthcare. And now the federal government is controlling education.
Ok, I am factually incorrect about GPS, in Australia you can choose your own, In Canada, you will be placed on a waiting list.
In my state of MA, when universal health was enacted many people can not find a GP and the emergency room visits for non emergent issues has increased.
For those of you in other countries, when one does not get the desired service who do you appeal to ? I have mentioned the VA since it is controlled by the government and to get any action you have to appeal to your local pol.
the old system is unsustainable, but the new one is also quite unsustainable. Of course, you can always sustain it with higher taxes, I suppose. The new bill doesn't address the reason for high costs. What you are doing is replacing a system w/ another one that isn't quite likely to work either. If we really wanted to cover everyone, then just cover everyone that doesn't have coverage and don't try to fix what isn't broken.
Insurance companies have always been profitable. That's why they are in it. You think Blue Cross provides insurance so they can lose money? Obviously they are making money. They don't care how the cost rises. they already negotiated their lower rates. Next yr, they know they have to raise premiums to account for rising costs.
As a businessman, if you can't make money off one business, you usually get out of it. So costs are rising, but they are raising their premiums to maintain profitability. either that or cut benefits, which is what some of them will do. Either way, someone will pay. This is what I mean.
You are incorrect, in my state health insurance is non profit.
You are incorrect, in my state health insurance is non profit.
AFAIK, the insurance providers in MA are a mix of for-profit and not-for-profit providers. If I'm wrong about that, I'd be happy to look at some documentation that shows otherwise.
For those of you in other countries, when one does not get the desired service who do you appeal to ? I have mentioned the VA since it is controlled by the government and to get any action you have to appeal to your local pol.
In Australia you can:
- change GPs if you're not happy with the care;
- ask for a second (or third) opinion;
- inpatients and their families can contact patient liaison/representative (eg Alfred, RMH, Austin), who can negotiate on your behalf;
- contact the health services commissioner, or make a complaint through the health services commissioner;
- in significant cases, go to the relevent ombudsman;
A fuller discussion of complain options is listed here.
Our system is far from perfect, particularly for consumers outside high density areas (where there may only be one doctor servicing an area of several thousand square kilometers). However, as there is less (though certainly not no) emphasis on money, and because the system is funded by the public, there is a strong emphasis on disclosure and accountability.
for me, the bill only means more taxes for me since my state has implemented all the features, so i will be paying more taxes and higher cost in healthcare. and now the federal government is controlling education.
really!! you make more than $200,000/year as a nurse? those are the only people whose tax will increase as a result of reform of health care...........
ok, i am factually incorrect about gps, in australia you can choose your own, in canada, you will be placed on a waiting list.
you're factually incorrect about canada, too. waiting lists are for common surgeries that are elective, only. the people there are very satisfied with their health care.
it's the doctors who bad mouth it when they come to the u.s. for conferences with our physicians. the green jealousy monster gets into their eyes when they realize how much docs here make. well that is undergoing reconstruction here, and the game rules are changing, that's what the whining and crying is all about...... in the very near future we'll get doctors out of med schools who went there to learn how to take care of people, not make billions as a priority. (no matter how much their mothers think they're due that for getting into and through their schooling).
in my state of ma, when universal health was enacted many people can not find a gp and the emergency room visits for non emergent issues has increased.
there aren't many in most states, as most doctors want to specialize so they can make more money. the newly signed act to reform health care will reward doctors who choose to work as outliers.
for those of you in other countries, when one does not get the desired service who do you appeal to ? i have mentioned the va since it is controlled by the government and to get any action you have to appeal to your local pol.
that is the way our government assures fairness, no matter what the situation that is appealed, is. the appeal is heard by a committee od experts and the person who disgrees with the decision of the first level will be heard there. here, of you disagree with a decision made by your health care provider, you go to the board of medical licensure or medical association, which exists due to monies paid by doctors, and wherein there are colleagues of the person whose viewpoint is counter to your best interest.
AFAIK, the insurance providers in MA are a mix of for-profit and not-for-profit providers. If I'm wrong about that, I'd be happy to look at some documentation that shows otherwise.
Do a google search Ma Health Connector, it is not consumer friendly......I also a CCM, so am well aware of insurance products. United Health or Aneta are for profit. Rarely when a patient comes in with a commercial insurance management was happy since it meant a large paryment ( most of these patients worked out of state)......
I have also taken a 240 hour insurance course.
What are credentials? Are a CCM? Have you had extensive training? Do you live in MA?
Do a google search Ma Health Connector, it is not consumer friendly......I also a CCM, so am well aware of insurance products. United Health or Aneta are for profit. Rarely when a patient comes in with a commercial insurance management was happy since it meant a large paryment ( most of these patients worked out of state)......
I have also taken a 240 hour insurance course.
What are credentials? Are a CCM? Have you had extensive training? Do you live in MA?
I would be happy to review you credential>
I am trying to figure out exactly what this post means, but it sounds like you are agreeing with the fact that it is both for profit and not for profit and then trying to argue that you know because you took a six week course in something?
I am trying to figure out exactly what this post means, but it sounds like you are agreeing with the fact that it is both for profit and not for profit and then trying to argue that you know because you took a six week course in something?
Unlike most nurses, I have an expertise in understanding insurance issues. I was told I was wrong that I don't know what insurance products are available in my home state, Below is a list that I have copied from the state web site. But according to another member here, I have my facts wrong. I was just making a point, A. I have more understanding about insurance issues in my home state. I was asked to provide source that I listed below.
Easy to tell me I am wrong without providing any back up, I do know that some families who's home company is out of state may have a for profit ( aetna, United Health, etc). But these policies are not based in my home state.
Do a google search Ma Health Connector, it is not consumer friendly......I also a CCM, so am well aware of insurance products. United Health or Aneta are for profit. Rarely when a patient comes in with a commercial insurance management was happy since it meant a large paryment ( most of these patients worked out of state)......
I have also taken a 240 hour insurance course.
What are credentials? Are a CCM? Have you had extensive training? Do you live in MA?
I would be happy to review you credential>
Ooooooh, ya got me! I'm not a CCM, I wouldn't live in MA for love or money, and I haven't taken a "240 hour insurance course, " whatever the heck that is ...
You made a broad, vague statement, "(Y)ou are incorrect, in my state health insurance is non profit," that implied there was no such thing as for-profit insurance in MA, and I questioned that since I'm not aware of any state in the US that has no for-profit health insurance providers (indeed, in some states, there are no non-profit options available). I was already aware that there are a number of well-respected non-profit programs available in MA, but thank you for providing the links.
You have now responded with a statement that states there are at least two for-profit companies providing health insurance in MA, United Healthcare and Aetna, so it turns out my misgivings (or misunderstanding) about your initial statement were correct, so I don't see what you're kvetching at me about.
I'm not a CCM, I wouldn't live in MA for love or money, and I haven't taken a "240 hour insurance course, " whatever the heck that is ...
madwife2002, BSN, RN
26 Articles; 4,777 Posts
My personnal belief is we had to start somewhere-I doubt anybody in the country would agree that the bill is perfect in fact it is far from perfect but it is an excellent starting point.
I think we should look to it as the stepping stone to the future, after all what we have is not working but I doubt those dusty old insurance companies would ever change what is working for them, unless their hands were forced.