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??

[madwife2002, BSN, RN]

Re the gas prices in the UK

Yes the gas prices, alcohol prices and the cigerette prices are high due to taxes.

The cars are smaller most people drive cars under 2.0 litre to keep the gas consumption down. You drive shorter distances, there is public transport. Car insurance is much cheaper.

[MaritesaRN]

Taxes.....hummm, good question.

When I worked in Germany the tax rate was roughly something like this for a middle income couple.

One paid 50% taxes.

One paid 33% taxes.

Of course, the one with the HIGHER income would pay the 33% tax, if possible.

Therefore, I made 2400 D-Marks a month. But I took home 1200 D-Marks.

(This was in the 80es, and D-Marks no longer exist nowdays, this currency merged into the Euro.)

At least I got something for my taxes. In those days the health insurance also included a pair of glasses a year, and the most a person could be charged for a Rx was 5 D-Marks.

What do we get for our tax money in the USA? Are they even going to send us our shares of General Motors so we can frame them and hang them on the wall?

I read that the 'new' health plan that Obama is letting Congress craft will include 'taxes' on health benifits provided by employers, something that Obama was opposed to during the campainge, and the other guy favored.

I am telling you, these people who run our government are so 'in bed' wiht the Special Intrests groups that 'we the people' will not win, no matter which of the two groups are holding the reins.

The admisistration and Congress expect the health care system to 'save' the economy', in the report I read today on NBC.

How is that supposed to happen?

I thought health care was supposed to 'save' the health of the populance!

Why does no one DO something about a total overhaul of this broken, disfunctional system?

A thousand kudos to you my dear! You hit it right on the sore spot.......unless the people will do something about this special interests group influencing the government for favors that will return great profit to ehm at the expense of the rest of the population................that is you and me. Tax money?? Well we carry the rich and of course we have to help the poor....so the whole tax thing is on our back !!!! We need to be assertive evn aggressive if need be to change this .

[dlatimer]

Taxes.....hummm, good question.

When I worked in Germany the tax rate was roughly something like this for a middle income couple.

One paid 50% taxes.

One paid 33% taxes.

Of course, the one with the HIGHER income would pay the 33% tax, if possible.

Therefore, I made 2400 D-Marks a month. But I took home 1200 D-Marks.

(This was in the 80es, and D-Marks no longer exist nowdays, this currency merged into the Euro.)

At least I got something for my taxes. In those days the health insurance also included a pair of glasses a year, and the most a person could be charged for a Rx was 5 D-Marks.

What do we get for our tax money in the USA? Are they even going to send us our shares of General Motors so we can frame them and hang them on the wall?

I read that the 'new' health plan that Obama is letting Congress craft will include 'taxes' on health benifits provided by employers, something that Obama was opposed to during the campainge, and the other guy favored.

I am telling you, these people who run our government are so 'in bed' wiht the Special Intrests groups that 'we the people' will not win, no matter which of the two groups are holding the reins.

The admisistration and Congress expect the health care system to 'save' the economy', in the report I read today on NBC.

How is that supposed to happen?

I thought health care was supposed to 'save' the health of the populance!

Why does no one DO something about a total overhaul of this broken, disfunctional system?

I understood the money saved by individuals (not having their premiums on insurance increased and planned increases in health care cost) will increase the amount of money available to save or spend.

The taxing of health care insurance premiums is another question. Instead of me quoting - here is a link to the NYTimes article.(if you believe them) http://www.nytimes.com/2009/06/03/us/politics/03health.html?th&emc=th

Write your congressperson/senator! Please, let them know what you think.

[Eishouse]

My doctor insists that with universal coverage she would be unable to offer her patients alternative therapies. So far, I've had lab testing and dietary management of the findings which my insurance covered as well as they cover anything (60/40 I think).

Another set of lab testing which may or may not be covered, long courses of expensive antibiotics and antivirals which my insurance does cover, a grocery sack full of nutritional supplements which my insurance doesn't touch, compounded pharmaceuticals for which I get reimbursed 50% and I do the paperwork. I have to drive 250 miles every 4 weeks to see the doctor, while I'm there I get an IV treatment for which insurance covers about half of the cost of the visit, half of the cost of the IV components, and none of the nursing care is covered. I need to get an infrared sauna for chronic pain. The DME expert at the:no: insurance company just laughed when I asked about that. There's nothing great about this insurance, it's expensive and has a high deductible. What are we worried about?

[talaxandra]

In Australia all prescription drugs, including IV treatments, would definitely be covered. You have to pay a small charge per script until you reach the threshold and then it drops (if you earns an income) or is free (if you're on a pension) for the rest of the financial year. I don't know what a compounded pharmaceutical is but if it needs a prescription it's covered. In the UK even non-prescription drugs are free if your doctor writes a script saying you need them.

Dieticians amy or may not be cvoered depending on the case and location - all in-hospital (including outpateint) consultations are covered.

I don't know about infra-red saunas but I had a variety of physio treatments when I did my back and it was all free.

The supplements almost certainly wouldn't be covered under Medicare, though a private insurer may cover some of them, but you'd probably still come out ahead.

[XB9S, BSN, MSN, EdD, RN, APN]

My doctor insists that with universal coverage she would be unable to offer her patients alternative therapies. So far, I've had lab testing and dietary management of the findings which my insurance covered as well as they cover anything (60/40 I think).

Another set of lab testing which may or may not be covered, long courses of expensive antibiotics and antivirals which my insurance does cover, a grocery sack full of nutritional supplements which my insurance doesn't touch, compounded pharmaceuticals for which I get reimbursed 50% and I do the paperwork. I have to drive 250 miles every 4 weeks to see the doctor, while I'm there I get an IV treatment for which insurance covers about half of the cost of the visit, half of the cost of the IV components, and none of the nursing care is covered. I need to get an infrared sauna for chronic pain. The DME expert at the:no: insurance company just laughed when I asked about that. There's nothing great about this insurance, it's expensive and has a high deductible. What are we worried about?

In the UK you would get full access to all investigations your GP felt necessary to diagnose and treat, in Wales and Scotland your prescription medication would be free and would cover antibiotics, antivirals. As far as the alternative therapies, it would depend on what you'd need and if your GP felt it was necessary for your treatment. There has been some reluctance to cover alternative therapies on the NHS but more and more GP practices are including it as part of treatment plans

NHS directory of Alternative thearapists

[lamazeteacher]

What do we get for our tax money in the USA? Are they even going to send us our shares of General Motors so we can frame them and hang them on the wall?

I read that the "new" health plan that Obama is letting Congress craft will include taxes on health benefits provided by employers, something that Obama was opposed to during the campaign, and the other guy favored.

I am telling you, these people who run our government are so 'in bed' with the "Special Intrest" groups that we the people will not win, no matter which of the two groups are holding the reins. The administration and Congress expect the health care system to save the economy, in the report I read today on NBC.

How is that supposed to happen?

I thought health care was supposed to save the health of the populance!

Why does no one DO something about a total overhaul of this broken, disfunctional system?

with apologies for corrections I made, based on rules of grammar and spelling. It's my mission in life to assist in the appropriate use of English, what can I tell you?

I get the anger you're expressing, quezen, which is probably why you're perpetuating myths that just aren't based in fact. First of all, the "new" health care plan is a work in progress, not as congress constructs it, but as doctors who have been working on it for years, who know how things aren't working now, and who care more about their fellow human beings' welfare than making billions for themselves. I think we can all agree that health care as it is now, isn't in the best interest of the people; and as the "wealthiest country in the world", our morbidity and mortality stats are intolerable.

The greatest problem in health care today, is that it's run by private insurance companies who have their own best interest at heart (money). They have convinced employers that they have the most economically feasable plan. Any involvement with employers, predicts the doom of any health care plan, as it depends on people being employed which statistics revealed today, leaves 9.4% of the adult workforce without coverage.

We all know that reports made by the media are largely fiction, for the purpose of getting people to read/watch what they do. You didn't leave a website for the report you wrote about, from NBC, so I can't read it to see if your take on that was accurate - or if what they reported was really the case as proven by reliable research.

Nothing is for nothing, a fact proven by pharmaceutical companies that give all those freebies to physicians and others who might influence physicians with whom they work, in return for their prescribing the medications named on the freebie. Then physicians inappropriately feel bad, they say, when their patients then can't afford said medication...... Representatives who visit physicians at their offices, deliver gourmet meals, etc. don't come cheap! Those practises have to be banned! (Just as lobbying congress also needs banishing, too. Are our representatives and senators so ignorant that they need proposed legislation explained to them by biased sources?) They have to do their own research about issues, and that would take their time, most of which isn't spent in their respective "houses", as bills are approved or turned down.

As far as bedding with the practitioners/producers of things that are not in the best interest of their constituency, it's more like being vulnerable to bribes - not in money, necessarily (and we all know that's been done), but in "I'll scratch your back if you scratch mine". In other words, I'll get "X" number of government representatives to back your bill, if you back such and such........... unfortunately those who are vulnerable to that approach to wrecking fair government, come in both red and blue party colors.

That's why it's so important for voters to make the effort to go to presentations of the competition and read their positions they write, as well as those of the candidate we support for whatever reason. What others say who might not be as informed as you are, should not be believed. Trust your gut when weighing the proposals of both, especially those with no proposals, or those who appear not to care about anything but getting into office.

Any health care program involves the outflow of money, it is not a means of saving anything other than people, from extensions of their diseases - the prevention of which is accomplished through educational programs and individual counseling. The ideal for that, is to perform services accurately, promptly and efficiently, which will definitely save lives. For anyone to say that other universal healthcare programs haven't that goal, is ridiculous. No one profits from them!

Calling those systems "socialized" is a means of creating a "bad smell" in their regard. We've all grown up in an atmosphere of the dread of socialism/communism (propaganda), so anything called that, won't be popular. Think chocolate, or if you don't like that, the smell of your choice. Let's make it work! YES, WE CAN!!!!

[Eishouse]

Hello, quezen -

I think I understand your point. However, I disagree that anybody's health care is free. The VAHS and the IHS are funded with federal monies (taxpayer funded). Medicare is federally funded through a direct payroll tax. Medicaid is funded by state monies (taxpayer), supplemented by federal funds (taxpayer, again). Indigent care, at least where I live, is funded by the county government (taxpayer). One health care entitlement you did not mention is correctional medicine, funded by county, state, and federal monies (taxpayer). My insurance is funded by me and my coworkers. My taxes have increased every year for the past 10 years. (This includes federal income tax, property taxes, excise tax on the fuel I purchase, sales tax on everything I purchase except grocery items and prescription drugs, and who knows how many more hidden taxes, such as automobile licenses, and those add-ons on utility bills - access fees, etc). While my taxes have been going up, my insurance premiums have been going up more, as has my deductible and my pharmacy copay. My insurance pays 80% of "reasonable and customary" fees for an office visit, leaving me to pay the balance out of my pocket, which is sometimes twice as much as the insurance has covered. Medicare and Medicaid payments to providers are about what my insurance company calls "reasonable and customary". Therefore, the price of an office visit increases every year so the physician can realize a profit in spite of poor reimbursement, and that comes out of my pocket because government programs pay what they pay and nobody gets billed for the coverage gap. Many of the things I need to treat a chronic illness are not covered at all, and I pay for them out of my pocket. So, I am paying for Veteran's Administration healthcare, Indian Health Service care, Medicare, Medicaid, indigent care, correctional care, my own private insurance, and most of my own care and treatment, as well as paying for the entitlement funding gap.

I do not begrudge any person's right (and I firmly believe it is a right, not a privilege) to the care they need, but I know that a lot of times I am not as well cared for as the people receiving entitlement funding for their healthcare, because I do not have the resources to cover what my insurance does not. That is the real flaw in our system.

I don't have the answer. I believe this problem is much bigger than we think it is, and I think it's wrong to talk about "Health Care Reform". The reform needs to address incompetent goverment at all levels, corporate (insurance, durable medical goods manufacturers, pharmaceutical companies, for-profit healthcare empires) greed and abuse of power, and abuse of the "system" by consumers. However we choose to address it, it needs to be equitable and affordable. Whoever the payer will be needs to pay for what providers think their patients need, preferably with a minimal amount of paperwork. There needs to be much more focus on wellness. And there should be no way any person or entity can get rich out of healthcare dollars.

[Eishouse]

Sharrie - Thanks for the information. How's the job situation for aging RNs over there?

[XB9S, BSN, MSN, EdD, RN, APN]

Sharrie - Thanks for the information. How's the job situation for aging RNs over there?

Many areas have recruitment freezes at the moment, but it's the new grads that are stuggling. Experienced nurses are sought after. In fact one of our most senior nurse specialists retired last year and has come back to work part time for us

[MaritesaRN]

In the UK you would get full access to all investigations your GP felt necessary to diagnose and treat, in Wales and Scotland your prescription medication would be free and would cover antibiotics, antivirals. As far as the alternative therapies, it would depend on what you'd need and if your GP felt it was necessary for your treatment. There has been some reluctance to cover alternative therapies on the NHS but more and more GP practices are including it as part of treatment plans

NHS directory of Alternative thearapists

:wink2: I looked up infrared sauna------ this sounds investigational or no back up research, except it simply does not have the suns "harmful" rays. I do not feel comfortable w/ this claim. they had no back up research to support the claim. If it is like the sun, then why not use the sun ( use a sunscreen ) , instead of this "infra red " sauna. fo detox , you sweat , and thus is the reason for the "CLEANSING" of which the regualr sauna does the same thing. I could be wrong , but this will not be covered whether government or private insurance as , " investigational ".

[jynxa17]

hey there, i found your blog insightful, but i have to say i disagree, from the perspective of a patient, not healthcare worker. i have had the insurance from my state, and while it is better than no insurance, and it was free, but there were some major nightmares i had to deal with.

1. my doctor who had a family practice and i had seen since i was 4, stopped taking me when i got the state's insurance. apparently the state hadn't been paying bills for several patients statewide, so several doctors in the area stopped taking the insurance all together, even if you had been a patient for 20+ years.

2. i couldn't find any hospital programs that accepted me for an outpatient program for depression. i was told that unless the building the programs took place at were physically attached to the hospital, the insurance wouldn't pay. despite the fact i needed to be hospitalized for post partum depression, i had to struggle to find somewhere to go. several local hospitals had mental health centers across the street, somewhere else on campus... but the insurance would not cover treatment there.

3. several times i had to get samples from the psychiatrist because the insurance wouldn't cover my meds completely. they would only cover a certain dosage and of course you can't exceed that dosage, so i had to get samples. and btw, the way the only psychatrist i could get worked for the county so i had to wait anywhere from 2-3 months to get in to see her, so if i needed to adjust my meds i was screwed, and generally had to do it myself.

4. couldn't get a pap smear. the law just changed (thank god) but until about a year ago, a woman could only get a pap smear/exam if she was under 21 or pregnant. so then i had to pay out of pocket for that as well.

and after all this, the general attitude was "well, you aren't paying for it, therefore, you don't get to be mad about a lack of coverage"

that really concerns me. if 1 state can't manage to get adequate coverage for women between 22-60, meaning no pap smears, proper psychological care before and after pregnancy, incorrect meds, insanely long waits, etc... due too much red tape, budget defecits, or whatever excuse they have, how on earth can the federal government afford to give better care to everyone of both sexes and all ages in all 50 states? or treat conditions that are more gender neutral? there are a lot of women who get PPD, but that has to be a small number in comparison to the amount of people who have heart disease, or cancer, etc... the socialized medicine concept really freaks me out. if the state can't do much for me when i'm depressed, i am terrified about having to rely on their program if i need major surgery.

and most importantly, if a person is unhappy, what recourse do they have? now if i don't like a plan, i can switch, but if there is one major plan for everyone, can there be valid options?