Socialized medicine and nurses pay...

elkpark · Mar 4, 2009

The people who complain about "higher taxes" if a universal system were implemented in the US never take into account the hundreds of dollars they are paying each month now for their health insurance -- they never see it because their employer takes it "off the top" of their salary and it doesn't show up on their paycheck, but it's income that they have earned but are not getting. I'm always shocked at the number of people I encounter who believe that the small percentage of their health insurance premium that they are charged directly, that shows up on their paycheck stub, is the full cost of their coverage. Sure, we'd pay more in taxes, but we wouldn't be paying hundreds or thousands of $$ a month to a private-for-profit insurance company.

I, too, am v. disappointed that "even" the Dems are talking about some kind of public/private partnership plan that would keep the current insurance companies in the game. We need to get the private-for-profit insurance companies OUT of healthcare entirely -- they are bleeding all of us dry for their own (humongous) profits, and then, when it's time to pay for a claim, they fight tooth and nail to avoid doing so.

I am a long-time supporter of a single-payer, Canadian style, "Medicare for all" system, but there are many different models that are possible that would still exclude private-for-profit insurance companies. For instance, in the rural area in which I live, I bank with a non-profit, member-owned/directed credit union, and I get my electricity from a non-profit, member-owned/directed electric cooperative. Why couldn't we have similar non-profit organizations, separate from state or federal government, that offered healthcare coverage? There could be a variety of groups that offered different programs, so that you could choose to pay a lower premium to belong to a group that offered basic, "bare bones" coverage, or join a group that offered more extensive, "cushier" benefits but charged a higher premium. But all the groups would exist to serve the members' needs, not to make profits for shareholders, and would answer to the members of the group. That is, after all, how health insurance (all the state Blue Cross Blue Shield organizations) started out in the US, decades ago, before the private insurance companies got into the game (and eventually bought out all the BCBS groups, turning them into for-profit businesses).

Chico David, BSN, RN · Mar 4, 2009

Interesting how the source of information can produce different results:

From the Wall Street Journal ( a conservative business paper) in an article written by an employee of a right-wing think tank, we get this:

"The experiences of these Canadians -- along with the untold stories of the 750,794 citizens waiting a median of 17.3 weeks from mandatory general-practitioner referrals to treatment in 2008 -- show how miserable things can get when government is put in charge of managing health insurance."

"Canada's system comes at the cost of pain and suffering for patients who find themselves stuck on waiting lists with nowhere to go."

On the other hand, from the American Journal of Public Health (a peer-reviewed medical journal) we get this:

http://www.pnhp.org/canadastudy/CanadaUSStudy.pdf

Results.

In multivariate analyses, US respondents (compared with Canadians)

were less likely to have a regular doctor, more likely to have unmet health needs,

and more likely to forgo needed medicines. Disparities on the basis of race, income,

and immigrant status were present in both countries, but were more extreme

in the United States.

Conclusions.

United States residents are less able to access care than are Canadians.

Universal coverage appears to reduce most disparities in access to care.

Here's another interesting comparative study (the link goes to an online press release summarizing the study, but it links from there to the original)

http://www.pnhp.org/news/2007/may/quality_of_healthcar.php

A key quote from the article:

Dr. Gordon Guyatt, Professor of Medicine at McMaster University and lead author of the study said "These results should be a wake up call to Americans. Canadian-style universal health care can deliver as good or better health outcomes at half the price." Dr. Guyatt, who coined the term "evidence based medicine" is a leading expert on research methodology.

We hear all these scare stories about long waits - and there are some waits in the Canadian system, since they only spend half what we spend, which is actually too low - but I just keep coming back to the same bottom line: equal or better results, everyone covered, half the cost. On most of our purchasing decisions, we'd be happy enough to take that. By the way, for the system that really works, the model to look at is not the Canadian but the French - they get the best results in the world for about 60% of our cost (probably about the right level of spending), no waits, no restrictions on what doctor you can see or what the doctor can prescribe.

RochesterRN-BSN, BSN, RN · Mar 4, 2009

Thanks so much for all the feedback!! I thought there might be a number of smart people here that know a heck of a lot more about this stuff then me! I don't know much about how any of it works....and really hadn't given it much thought until watching the movie SICKO-- it got me thinking and wanting to move!!! lol (not that I can realistically but....lo)..... I think that unfortunately the US is famous for doing things their way and thinking the way WE do things is always the best way.....when sometimes this is NOT the case! If maybe the people in the goverment would open up their eyes and look around at how other countries are doing things and maybe try to learn from those who maybe have figured out something we have not!

I see this with our national problem of obesity.....americans spend Billions every year on weight loss products and yet we just keep getting fatter. Ummmm.....gee maybe looking at how places like France and some of the Asian countries do things might help. They have not even a quarter of the problems we have related to obesity!!

Don't get me wrong I am proud to be an American but sometimes the closed mindedness and "we know best, we are the best" attitude is just out of control.

Koyaanisqatsi-RN · Mar 4, 2009

http://online.wsj.com/article/SB123413701032661445.html
"The experiences of these Canadians -- along with the untold stories of the 750,794 citizens waiting a median of 17.3 weeks from mandatory general-practitioner referrals to treatment in 2008 -- show how miserable things can get when government is put in charge of managing health insurance."
"Canada's system comes at the cost of pain and suffering for patients who find themselves stuck on waiting lists with nowhere to go."
We're going to get universal health care. Then all of our troubles will melt like lemon drops.

Wow, a guy who works for the Fraser Institute writing an article against universal health care? The same Fraser Institute that is nothing more than a crappy libertarian think tank? :rolleyes:

Quelle surprise.

He manages to come up with a small handful of unsourced cases that don't prove any single thing. I know and can name a small handful of Canadians who have had great success with their healthcare system, with no such horrible waiting times.

So who does that make right? Hmm?

How about we acknowledge that NO SYSTEM IS PERFECT. I know it, you all know it. However, that doesn't mean that some systems aren't better than others. And, considering literally every metric that is measured says that the US lags behind in health care, let's give the blind patriotism and adherence a rest, huh?Capitalism is a great thing, but it utterly caused our healthcare crisis, and asking capitalism to solve that same crisis is actually one of the most hilarious things I have heard so far this week.

dnp2004 · Mar 5, 2009

I too believe the Universal Health Care system cannot be administered by insurance companies profit. This creates a conflict of interest. Now I believe the German system is managed by insurance companies but they are non-profits under strict government control and audits. My favorite system is the Taiwanese. My least favorite system, among the industrialized nations, is in the United States:scrying: Sadly, if I were sick, old, poor and unemployed I would fair better off overseas. I also would not have to declare "medical bankruptcy" because it simple does not exist in most industrialized countries.

dnp2004 · Mar 5, 2009

Wow, a guy who works for the Fraser Institute writing an article against universal health care? The same Fraser Institute that is nothing more than a crappy libertarian think tank?
Quelle surprise.
He manages to come up with a small handful of unsourced cases that don't prove any single thing. I know and can name a small handful of Canadians who have had great success with their healthcare system, with no such horrible waiting times.
So who does that make right? Hmm?
How about we acknowledge that NO SYSTEM IS PERFECT. I know it, you all know it. However, that doesn't mean that some systems aren't better than others. And, considering literally every metric that is measured says that the US lags behind in health care, let's give the blind patriotism and adherence a rest, huh?Capitalism is a great thing, but it utterly caused our healthcare crisis, and asking capitalism to solve that same crisis is actually one of the most hilarious things I have heard so far this week.

Oh remember a few years when President Bush and the Republicans were saying people should invest their retirement money in the Wall Street instead of the government based Social Security system? We saw what happened with Wall Street! So why should Wall Street be trusted to handle our health insurance needs?!

Koyaanisqatsi-RN · Mar 5, 2009

Here's an article to further drive the point home. Look at some of these comments from someone in our own government!

http://firstread.msnbc.msn.com/archive/2009/03/05/1821956.aspx

These are the same idiots who are usually pro-life...but once you're born, screw you pal. No help for you. :rolleyes:

RN4MERCY · Mar 7, 2009

Oh remember a few years when President Bush and the Republicans were saying people should invest their retirement money in the Wall Street instead of the government based Social Security system? We saw what happened with Wall Street! So why should Wall Street be trusted to handle our health insurance needs?!

I was thinking the same thing about the plans for incentivising Health Savings Accounts--HSAs. Why should 'we the people' continue to subsidize failure and pay our precious health care dollars to insurers who turn around and fight us with it? I'd be careful about laying all the blame at the feet of Republicans though. There are a lot of Dems who've been complicit advocates for the health insurance industry at the expense of the people's needs for health care. Both Baucus and the failed Clinton plans make the mistake of leaving insurers in a position to control our access to health care. Even the venerable Democratic Senator Ted Kennedy, has been largely silent on the failed mandate model introduced in his home state of Massachusetts. It's failed to control costs or extend coverage.

Early on in Obama's presidency, and in particular, judging from the approach his team has taken leading up to the recent Health Care Summit, I've been concerned that he's been surrounding himself with a barrel full of bad apples in the name of "inclusiveness." Let's hope they don't "spoil" him. We just can't let that happen. Due to the fact that thousands of single payer grass roots organizers were ready to stage an all out protest of the fact that 'Medicare for All' reform was "off the table," Obama's team issued an 11th hour invitation to only two advocates for single payer: Dr. Oliver Fein, PNHP President, and Rep. John Conyers, D-MI.

You can read Dr. Oliver Fein's prepared statement here.

With regards to nurses pay, nurses are once again being laid off by hospitals and beds are unstaffed because of decreased reimbursements, claims denials, and insurance company recissions. For profit health care is a failure and disinvestment in the public system is causing hazardous and immoral consequences for our patients, not to mention being a factor in rising unemployement of all workers. We need a nationalized, single-payer health plan. Profit has no place when it comes to the provision of vital services. Public health and safe is a government responsibility.

dnp2004 · Mar 9, 2009

Yes, single payer would be the most efficient, cost effective way to deliver health care. I see no need to have "for-profit" middlemen we their hands out.

Germany uses several insurance companies to manage their health care system. The difference there is that those companies are non-profits. So you don't have the whole "Wall Street-Quarterly Sales Report" contamination from the U.S. insurance companies that effects our whole claims process.

neurorn6 · Mar 16, 2009

Universal Healthcare, Socialized Medicine, I really don't care what you call it. I am personally against it. I have worked in Federal Access Hospitals ( these are rural hospitals that are maintained by the federal government) and the conditions were not good. First the pay was extremely low (with experience), they did not pay into SSI, or if you didn't have the 40 quarters necessary, you would lose all that you have paid into it.

I have talked with several nurses from Canada, and many nurses have to work more then 1 job to make enough money to pay their bills. I have researched the differences in the different models used and personally don't like any of them.

While it might work in the short term, what about the long term? Will we still have the number of physicians that we will need to care for the aging polulation? I have been in this industry since I was 19 years old and have seen many changes, some good and some not so good.

As nurses, we need to research this issue and come together as a group, to benefit our fellow nurses and to benefit our future patients.

HM2VikingRN, RN · Mar 17, 2009

pay scales reflect the surrounding economy...I have no experience regarding federal access hospitals (although medicare reimbursement is tied in some way to the average income of a community...)...I do know that if we use the VA system as a model to restructure the system we can deliver better care at lower prices...

tencat · Mar 17, 2009

I think we need to remember that lawsuits have completely gotten out of hand, as well, and need to be taken into consideration when deciding to go to a nationalized system. I agree we should try to take the profiteering out of medical care, but we'll have to overhaul the malpractice laws as well. I don't know much about Canada or Australia's systems, but I'm willing to be that it's a lot harder to sue healthcare providers in these countries, which really would be a blessing to this country, I think. The 'capitalism at all costs' mentality has gotten the US into the economic pickle we're currently in. It's time to look at other ways of doing things.