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??

[dlatimer]

jynxa17, (hope I spelled that right)

I agree that state, so called insurance, has a lot of problems. That is why the need for a national policy is needed. This could be administered by any competent provider-payer system and if it was done with the wide and large population that is available, the payments should be less with greater coverage. Also, if the profit part of insurance was removed and the system worked solely for the people who have the insurance, then the cost should come down greatly. The insurance companies have a great scam going. When they sign up to provide a employer with insurance - the employees have a limited choice. All the things you mentioned could be deleted coverage by any insurance company, as long as they do so to all insured. If you depend on your employer to provide your insurance, then that gives them some leverage if they decide you need to be disciplined or provide an incentive to work overtime or to see patient care from their viewpoint. This is a very complex and important issue. The US is the only industrialized nation without a national plan. The insurance companies, pharmaceuticals and other health care providers have a lot to lose. That is why you see commercials telling you how their plans are affordable.

Everyone should have access to affordable health insurance. How can you expect to have a healthy workforce? That is not influenced by outside forces and can concentrate on doing their job well?

[MaritesaRN]

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?

:wink2: I do not know much about socialized medicine either....but observing other nations such as UK, France, Holland , Switzerland .... and I have heard there is a few more--------the system is possibly more efficient thatn ours, otherwise why woudl they continue using it , and still serves it's purpose. Our health system for however it started definitely does not work anymore...it's for profit now. If you notice employers even send their employees overseas for a surgery that woudl cost them less than here in the USA. Just like our bigt itme corporates , that are now bankrupt, this current system of our country have and will continue to cause some problems. The onesthat will fall thru the cracks are the children and elderly ---these are our precious treasures ( Alpha and Omega), not a disposable item. They need to have coverage no matter what and the only way to do it is socialized medicine. Now, I share your concern w/ some of the government office and workers and your fear of them handling the socialized medicine. Nope, this is a relevant overhaul of the government offices that must happen. These socialized medicine offices must be run by qualified personnel, not some dead wood employees that have been in gov't services too long and just putting in their time for a bountiful retirement ! No, we need to change that scenario , and a complete overhaul as to who runs it and who works in these offices, along with an outsider that does the QA and QI to make sure they are working efficiently.

Bottom line is our system is not working now, so don't you think we need to find something else if what we have is not efficient, and barely working for all of us? Health care should not be a privilege for the few, but for all

of us!! Profit should not come first before the health of the people. Sure the greedy ones will not like this, and they will use their money to lobby their greedy propositions.

[Eishouse]

to jynxa17

I understand your distress. I have experienced everything you discussed, only I was covered by my employer's private insurance, for which I was paying a very large premium, deductible and copay. I had to go 200 miles from home to be hospitalized for depression because that was the nearest inpt treatment unit located with the walls of a full service hospital. Being separated from family and friends during severe depression is not therapeutic. All of the bureaucracy and red tape you had to deal with in the state insurance plan also exists in private insurance. I sincerely hope that insurance reform will result in better coverage, better services, and more human treatment for both of us.

[jynxa17]

jynxa17, (hope I spelled that right)

I agree that state, so called insurance, has a lot of problems. That is why the need for a national policy is needed. This could be administered by any competent provider-payer system and if it was done with the wide and large population that is available, the payments should be less with greater coverage. Also, if the profit part of insurance was removed and the system worked solely for the people who have the insurance, then the cost should come down greatly.

The US is the only industrialized nation without a national plan. The insurance companies, pharmaceuticals and other health care providers have a lot to lose. That is why you see commercials telling you how their plans are affordable.

Everyone should have access to affordable health insurance.

i agree that the insurance companies are shady as can be, and yes everyone should have affordable insurance. i really wish that we could do something to fix the problem, but i truly don't believe the socialized medicine theory is it. our government is so ineffectual it's pathetic. and a national plan is great in theory, but i'm telling you in practice it would never work. how would checks and balances work? if the gov. runs the program, how do we as citizens complain, make changes, etc... i apologize because i am quite the cynic and distrust the gov on almost every level. but honestly look at state insurance programs, the whole FEMA/ red cross/ katrina disaster, the inability to give halfway decent care to vets, the amount of people who can't into rehab programs, etc ad nauseum. anytime a large chunk of the government tries to help people they usually just make a mess. i think a national plan would make it even worse than it is now. and even if the gov were competent enough to pull this off (which they aren't) there are so many other big questions...

how would we fund this? raise taxes? whose taxes and by how much?

would people without citizenship get access even if they don't contribute the same to american society?

what about people that increase their risk of needing medical treatment? drug users, alcoholics, etc...

what about smokers? are they covered even though they engage in behavior that is all but guaranteed to run up medical bills and cause complications?

and what about politicians? are they going to same doctors as us common folk?

again, i apologize for my cynicism, but i come from chicago.... a place where tollways were supposed to be temporary, yet still exist and the rates keep increasing, where they cut funding to schools, while our aldermen make make 6 figures, and where we engage in 'pay to play' politics which has left us in so much debt we have to raise taxes (again) while our senators get paid overtime to figure out how to balance the budget, and the money we didn't have to start with is now going to be paying to send yet another governor (4 of the last 8) to jail. and on top of that the b.s. and corruption, and waste of dollars, our current president came from this political background. not saying he's a crook, but just about everyone else here in illinois is, so i am even more paranoid about him trying pass something like this.... the gov couldn't pull it off as it is, but an illinois politician pulling it off is just scary...

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

: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 ".

I guess it would depend on what your GP felt, but it would be unlikely to be covered. Having said that more and more alternative therapies are being offered by the NHS so it may just be a matter of time.

[talaxandra]

our government is so ineffectual it's pathetic. and a national plan is great in theory, but i'm telling you in practice it would never work. how would checks and balances work? if the gov. runs the program, how do we as citizens complain, make changes, etc... how would we fund this? raise taxes? whose taxes and by how much?

would people without citizenship get access even if they don't contribute the same to american society?

what about people that increase their risk of needing medical treatment? drug users, alcoholics, etc...

what about smokers? are they covered even though they engage in behavior that is all but guaranteed to run up medical bills and cause complications?

and what about politicians? are they going to same doctors as us common folk?

It's always amazing to me how many of you distrust your government. I'm not saying it's without cause - I don't know enough about how things work there. It's just such a strong contract with Australian attitudes toward our elected officials, which is more benign.

Anyway, back to the thread. In Australia there are health ombudsmen who manage complaints. My hospital has a complaints officer who's independent of the chain of command and certainly takes the most ridiculous complaints seriously. I know this because the other day I saw a letter about a patient who complained because he'd been woken up overnight when he thought he needed to rest. We had gone with the antibiotic-therapy-and-observations approach... I imagine all public hospitals have a similar office for this purpose.

The US health care system consumes a vastly bigger percentage of GDP than any other country. Though all health care systems are costing more every year, it seems unlikely that replacing your current system with a universal program would cost more than the current combination of tax revenue and private insurance (employer paid or privately finded). I have previously posted how much health care costs me each year, both in percentage of tax and actual examples, with or without optional private health insurance.

Only permanent residents and citizens of Australia, and citizens of countries where we have a reciprocal agreement, have access to Medicare. We certainly don't have the same issues with illegal inhabitants as you do, so that's significantly less an issue here, but I know it's a problem in the UK.

Everyone has equal access, regardless of participation in risky activity, be in unprotected sex, drug use (including tobacco and alcohol) or hang gliding. I suspect the majority of poiticians ahve private insurance, if only because they earn over the additional levy threshold. However, as most consultants work in both the public and private systems they do see the same doctors at that level. In addition the biggest hospitals are public, and we take the sickest patients. It's not uncommon for private hsopitals to send their sick patients to us, and I've looked after a number of wealthy patients as well as a couple of politicians.

[jynxa17]

Anyway, back to the thread. In Australia there are health ombudsmen who manage complaints. My hospital has a complaints officer who's independent of the chain of command and certainly takes the most ridiculous complaints seriously. I know this because the other day I saw a letter about a patient who complained because he'd been woken up overnight when he thought he needed to rest. We had gone with the antibiotic-therapy-and-observations approach... I imagine all public hospitals have a similar office for this purpose.

The US health care system consumes a vastly bigger percentage of GDP than any other country. Though all health care systems are costing more every year, it seems unlikely that replacing your current system with a universal program would cost more than the current combination of tax revenue and private insurance (employer paid or privately finded). I have previously posted how much health care costs me each year, both in percentage of tax and actual examples, with or without optional private health insurance.

Only permanent residents and citizens of Australia, and citizens of countries where we have a reciprocal agreement, have access to Medicare. We certainly don't have the same issues with illegal inhabitants as you do, so that's significantly less an issue here, but I know it's a problem in the UK.

Everyone has equal access, regardless of participation in risky activity, be in unprotected sex, drug use (including tobacco and alcohol) or hang gliding. I suspect the majority of poiticians ahve private insurance, if only because they earn over the additional levy threshold. However, as most consultants work in both the public and private systems they do see the same doctors at that level. In addition the biggest hospitals are public, and we take the sickest patients. It's not uncommon for private hsopitals to send their sick patients to us, and I've looked after a number of wealthy patients as well as a couple of politicians.

but that still leaves a lot of concerns to me...

and i should clarify about my question about complaints, i have heard (don't know if it's true) that doctors in a universal program may make recommendations you don't like, but you don't get to have other options. something like a different course of treatment, different meds, etc... so if you want something different than what your doc reccomended, you have to really struggle to get what you want instead. and i am also curious about malpractice... how would cases be handled? who handles cases, the waiting time, etc... i would fear that if the gov is in charge a person would have to wait forever for some resolution, provided they got anything resolved at all... and sorry for my earlier rant about the gov, but i just wanted to let everyone know why i'm so distrustful.

about the immigrant thing... so what happens if someone who doesn't have papers gets hit by a car, and rushed to the e.r.? are they not treated? or if they are, who pays for it? i can't figure out how that cost isn't passed on to the rest of the population some way or another.

i would have to think that a universal program would cost more, because there would have to be a major increase in taxes to fund this type of program. not only would taxpayers continue to pay for the unemployed and underemployed (and the rates are really high right now, which would put an even bigger strain on tax payers), they would also continue to pay for seniors, the disabled who can't work, and in addition to that pay for millions of illegal immigrants, and then get around to paying more for themselves, their families, and everyone else. it seems like such a huge burden! especially if you include problems we have in america other countries don't have. i think we have the highest rates of obesity and that shoots up our other diseases and costs... heart disease, diabetes, etc... as well as secondary problems due to weight, bad knees, back pain, all the kinds of things people see doctors for. even if these people were covered, i can guarantee there will be a huge chunk of the population who will be livid about having to pay tax money to cover people who have what may be considered "self induced" illnesses... obesity esp. if it leads to diabetes, liver disease brought on by alcholism, lung cancer brought on by smoking... i am not saying that people don't deserve treatment, but it also seems unfair to make other people who live healthy lives pay for bad choices by others. it's a sticky issue with no clear answers!

[MaritesaRN]

i agree that the insurance companies are shady as can be, and yes everyone should have affordable insurance. i really wish that we could do something to fix the problem, but i truly don't believe the socialized medicine theory is it. our government is so ineffectual it's pathetic. and a national plan is great in theory, but i'm telling you in practice it would never work. how would checks and balances work? if the gov. runs the program, how do we as citizens complain, make changes, etc... i apologize because i am quite the cynic and distrust the gov on almost every level. but honestly look at state insurance programs, the whole FEMA/ red cross/ katrina disaster, the inability to give halfway decent care to vets, the amount of people who can't into rehab programs, etc ad nauseum. anytime a large chunk of the government tries to help people they usually just make a mess. i think a national plan would make it even worse than it is now. and even if the gov were competent enough to pull this off (which they aren't) there are so many other big questions...

how would we fund this? raise taxes? whose taxes and by how much?

would people without citizenship get access even if they don't contribute the same to american society?

what about people that increase their risk of needing medical treatment? drug users, alcoholics, etc...

what about smokers? are they covered even though they engage in behavior that is all but guaranteed to run up medical bills and cause complications?

and what about politicians? are they going to same doctors as us common folk?

again, i apologize for my cynicism, but i come from chicago.... a place where tollways were supposed to be temporary, yet still exist and the rates keep increasing, where they cut funding to schools, while our aldermen make make 6 figures, and where we engage in 'pay to play' politics which has left us in so much debt we have to raise taxes (again) while our senators get paid overtime to figure out how to balance the budget, and the money we didn't have to start with is now going to be paying to send yet another governor (4 of the last 8) to jail. and on top of that the b.s. and corruption, and waste of dollars, our current president came from this political background. not saying he's a crook, but just about everyone else here in illinois is, so i am even more paranoid about him trying pass something like this.... the gov couldn't pull it off as it is, but an illinois politician pulling it off is just scary...

Hi I feel the same way as you do . Here in California, we are so much in debt....and the governor is trying to cancel a health safety net for those who do not have any means of insurance, including some children health program and school grant for those who can not afford to get an education....I can see a state w/ lots of illiterates and very sick people. The CDC will be very busy trying to take care of all kinds of plague. Crayz huh? Especially at this time ? Dear Lord, where are we getting this politicians? Most of them do not even know how we, the ordinary people live? What was that saying about royalty not understanding as to why the french people revolted? " If they have no bread then why not eat cake?" ---- this is the mentality of some of these rich politicians who have no idea what it is like to be the ordinary people--- the people who have paid the big majority of the taxes, and is now burdeing the economy meltdown. Where is my certificate of shares for the automobile

companies? That was my money, your money, our money. They have relief, how about giving that money to the people? You will see economy improve; they can pay mortgage, they have purchasing power, credit cards will be paid, etc. We need change, and I think us nurses need to participate and not passive anymore. Nursing associations need to instigate this and support the rights of nurses, including descent pay and a discounted education in this area----this is what must be done!

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

I may be able to help with some of these questions

but that still leaves a lot of concerns to me...

and i should clarify about my question about complaints, i have heard (don't know if it's true) that doctors in a universal program may make recommendations you don't like, but you don't get to have other options. something like a different course of treatment, different meds, etc... so if you want something different than what your doc reccomended, you have to really struggle to get what you want instead.

In the UK you are entitled to a second opinion or third opinion if you don't like the options that you are offered, as long as the course of treatment is recognised for your condition there would be no reason that it would be denied. I guess if your going to question your doctors rationale for offering treatment options then your going to have researched and will be able to provide evidence to support your preferred choice of treatment in which case you can discuss it with your physician.

and i am also curious about malpractice... how would cases be handled? who handles cases, the waiting time, etc... i would fear that if the gov is in charge a person would have to wait forever for some resolution, provided they got anything resolved at all... and sorry for my earlier rant about the gov, but i just wanted to let everyone know why i'm so distrustful.

Complaints have to be dealt with within a specified time, you will receive a acknowledgement of your complaint within 2 working days and then you receive monthly reports of progress until your complaint is resolved, this should be within 6 months. I have been in a position where responding to complaints was part of my job and most were resolved within 3 months. There is also the patient ombudsman that patients can get assistance from whos remit is to oversea and investigate hospitals response to complaints, this organsiation is independent of the hospital and the government.

about the immigrant thing... so what happens if someone who doesn't have papers gets hit by a car, and rushed to the e.r.? are they not treated? or if they are, who pays for it? i can't figure out how that cost isn't passed on to the rest of the population some way or another.

Everyone who attends the emergency unit will be treated regardless of thier nationality or ability to pay. Hospitals have an overseas pateints departments who will then deal with the financial aspects of this care once the patient is in a position to be able to deal with it. Having said that of course there are those that can't pay and who abuse the system, I have had patients pitch up in the EU from another country with a 2 year history of abdominal pain wanting to have thier cholecystecomy on the NHS because they happened to be "visiting" family here

i would have to think that a universal program would cost more, because there would have to be a major increase in taxes to fund this type of program. not only would taxpayers continue to pay for the unemployed and underemployed (and the rates are really high right now, which would put an even bigger strain on tax payers), they would also continue to pay for seniors, the disabled who can't work, and in addition to that pay for millions of illegal immigrants, and then get around to paying more for themselves, their families, and everyone else. it seems like such a huge burden! especially if you include problems we have in america other countries don't have. i think we have the highest rates of obesity and that shoots up our other diseases and costs... heart disease, diabetes, etc... as well as secondary problems due to weight, bad knees, back pain, all the kinds of things people see doctors for. even if these people were covered, i can guarantee there will be a huge chunk of the population who will be livid about having to pay tax money to cover people who have what may be considered "self induced" illnesses... obesity esp. if it leads to diabetes, liver disease brought on by alcoholism, lung cancer brought on by smoking... i am not saying that people don't deserve treatment, but it also seems unfair to make other people who live healthy lives pay for bad choices by others. it's a sticky issue with no clear answers!

The NHS in the UK is by no means perfect, there are so many things I would like to change and I don't for one minute think that we have the perfect system, having said that I wouldn't want to be without healthcare that is free at point of delivery. I don't mind paying the taxes that I pay to get that benefit or even subsidising those who abuse the system (because in truth those that abuse are in a minority) and to me personally the benefits are greater

[dlatimer]

Thanks for the info from UK, Aus.

I just want to make one point. If the profit was taken out of healthcare would it be more affordable and more inclusive? Insurance companies are publicly held companies and therefore are in business to make money for shareholders. If insurance companies, and lots of healthcare companies, are stating they put patients first, I it hard to accept their sincerity since their stated airm is to make profit for their shareholders.

[dlatimer]

We elect our officials and therefore (if the electing system is not fraudulent) we get what we deserve. We are all responsible for our own society.

[Fourhundred27]

Wow Ambermichelle! That is awful and sad. We need the option in this country to have state covered medical care. If that doesn't happen did you and your family consider moving to Canada? His quality of life would greatly improve, given that their government cares enough about it's people to offer medical coverage. Good luck to you and your son. I am angry after reading your post. You shouldn't be placed in that situation.