Socialized Medicine/Nursing

[PPL]

Hi everyone. I am especially interested in how nurses are treated in the UK and Canada. I feel the US is moving more and more toward socialism, more taxes, more regulations, more government infringement into private lives and private property. That said, I want to know if the nurses in UK and Canada are generally unhappy and are coming to the US, and if they are or aren't happy, why not? I know they are heavily taxed, so what are they actually able to take home of their saleries? I've heard that accessing the health care in those countries can be a nightmare and forget about it unless it's a dire emergency. I've been an RN since 1982 and there seems to be a move toward more and more regulation/documentation/cover your ass/make it look great on paper, and it's getting harder and harder to actually do quality nursing. So, unless the situation is better in the UK and Canada, why are we moving more toward a socialized system here in the US? Please, I welcome all comments.

[bunky, BSN, RN]

PS Oh Ya PPL! Should Snickers win the lottery there, and correct me if it's changed Snickers, it's tax free for a YEAR! No one coming in to meet you as you get your big fat lottery check to take 40% of it off the bat!

[LRM]

Don't beleive this, just spent half hour writing a post now I have lost it all!!

Well lets start again, been away for a week (escaped kids on our motorbike) so am trying to catch up with all the posts.

With my wage down here, I am working casual & will earn less than Aus$10,000 this financial year so I will get ALL my tax back about $2,500 (Aus$1 = USA 0.59c approx). Along with my wage, my employer (agency at moment, gives me flexibility with study) must pay equivalent of min. 5% of my wage into superanuation fund of MY choice. This money is taxed at low rate on retirement when it is accessed & will supplement aged pension or if I have enough super I will be financially independant of gov assistance. This is law for everyone, some companies pay higher than 5% but that is the minimim.

I don't pay any medicare tax as hubby has this deducted from his wage (only one pays per family). I receive discounted parking, uniform allowance & free tea, coffe, biscuits & bread in most hospitals plus subsidised hot meals if I wanted ($2 for hot meat & vegies).

Most of my shifts as EN saw me with 1:4 - 6 pts, I mainly do day shifts. So a ward with 30 pts would have between 5-6 nurses (RNs & some ENs) with pt allocations & usually one nurse floating. Evenings & nights saw fewer nurses but I can say the exact ratios. The ratios depended on the type of ward, generally surgical saw 4 pts allocated & medical 5-6, ICU is always 1:1. The work load is usually ok but ofcourse it can have very busy periods & agency staff are called in if needed or nurses shifted between wards. We are also coming into a nursing shortage in oz now so things may change here as well.

Our tax system in oz is under huge review. As of 1st July, goods & services tax was introduced (10% GST on everything except fresh food) & all income taxes have been lowered. I will get these bew benefits thru hubbie & when I work regularly next year as 1st year grad.

Thousands more people have joined private health insurance this month (gov dangles carrot) so the impact on services is yet to be seen but things are changing. Report in yesterday's paper "insurance company (one of the biggest in oz) has set guidelines on how many outpatient visits a client with lymphodema can claim for in one year". So managed care is creeping in.

I am a union member & feel that with all the changes I will continue to support the union to ensure these changes don't disadvantage those with lower income & also prevent our health care system by being taken over for profit. The unions will demand that the insurance comp. justify their policies & will help to ensure that nurses are not exploited in the process (you can be a union member in a private hospital although public hospitals are more receptive to union demands).

After reading the posts, it is evident that the 'socialised' systems pay more tax but we also receive more resources from gov, whether these resources are managed well depends on the gov in office at the time. Where as the folks in USA have more autonomy over where they spend their money but I guess these resources are subject to economic fluctuations & managerial decisions also.

The USA staff ratios seem higher with exploitation apparent in some places, this may also happen in oz with a shortage so maybe it is a sign of the times. But again, as nurses we can advocate for safe staff levels & conditions with union support down here & I assume Canada. Our paper work seems less down here too, will this change now also? How do you fight this in USA & make it safe & equitable for all involved?

[bunky, BSN, RN]

You can't really fight it in the USA LRM. You can get mad, rant and rave, bang your head against a wall, but to no avail. After a while it feels good to stop. They kind of have us by the ..., well, you can finish that one.

We have GST in Canada too. I thought you guys got it before we did, but I guess that was New Zealand I am thinking of. Taxes, taxes and more taxes.

I guess what we can surmise by all of our discussions is that they take it from you no matter where you work. No one system stands head and shoulers above the others, but some seem more just and fairer to the employee than others.

[LRM]

Yes it was NZ first with GST bunky. I have really enjoyed this discussion, so often we have been told here "we don't want our health service becoming like the american system' . Hear, hear! would say but did we really understand 'the american system' Even now I don't profess to understand it but these posts have given me an insight into some problems within the system (and some advantages) & also showed me the nurses' perspective when working within the USA system.

Personally, I prefer the oz system (comfort in what I know & no-one likes too much change) but as I have said this is definatley changing.

Combining the views of the USA nurses with some other posts (BSN vs ADN, nursing as a career?) has given me food for thought.

Thanks to all for your insight!!

[PPL, BSN, RN]

Bunky! All that head banging! No WONDER you're so funny! No need for me to post my check stub, as it looks as though the more socialized systems are paying more taxes, but maybe we ARE more exploited here. Still, if it comes down to who decides how to spend my money, I prefer it's me and NOT the government. There's so much intrusion already, and yes, maybe you're getting more from your government, but it also makes you more dependent on them, if they should decide to spend your money unwisely, dig? That's the part that scares me. One thing for sure, I've enjoyed this topic and everyone's posts. It's after 2:30a.m. and my hubby is in snoozville, but I'm sittin' here dreaming about the perfect cup of coffee from Tim Horton's. Mmmmm.

[bunky, BSN, RN]

Yes PPL I do feel punch drunk some days. It's actually a personal philosophy of mine. If I don't laugh at it I'm gonna cry so I'd rather see the funny side to it, and I do see it as hysterically funny some times. Not everyone likes that though. Ha! Ha!

PPL I'd be afraid to give YOUR government that kind of cash too! Ha! Ha! It's all what your used to and brought up believing in I guess. All I can say is that the government actually helped me there. People seemed to have more of an impact or influence on the government there too. What else did we have to do there all day during those cold winters eh?

[PPL, BSN, RN]

Bunky, you are a true goofball! Promise me that when and if you go back to Canada, you'll give us the scoop from that side of the border too! You know, any changes, or improvements, and/or decline in the situation.

[bunky, BSN, RN]

I take that as a compliment!

[fergus51]

I am a nursing student in BC and can relate to what snickers was talking about. I can't believe the doctors (whose average take home pay was 150 000 a year) were willing to walk out. Nurses had to strike to get a measly few dollars.

I have to disagree with what was said about a decrease in the number of students going into nursing. Our class is the largest ever at our Uni. Septembers new group will be even bigger because the gov't gave some extra money for more seats. The reason it doesn't seem like there are many students is because it's only recently that nursing has become a good profession to enter. 3 years ago I had people telling me I was crazy to be considering it, now I'm guaranteed a job when I graduate.

The government does need to make more spaces for university students (almost 300 applied for the 60 seats this year) and start keeping them. The brain drain is taking a lot of nurses because we need the money.

BUT, I lived in the States and I don't want to have a system like that here. With nurses as underpaid as they are I'm surprised so many like for profit care. I make about

12000 a year at my after school job. If we didn't have the system we do I'd be broke paying for meds that I need to take for the rest of my life.

ps

I really like this site. Good info and interesting ideas

[Iam46yearsold]

Outlooks toward health care financing is an ever going discussion

[Pepper The Cat, BSN, RN]

Here's my take on it. Yes, I pay higher taxes than someone in the States does.

But - if I get hit by a bus on my way home from work today, and need hospitalization, I don't have to worry about huge hospital bills.

I have a medical condition that requires frequent surgeries - they would cost me a fortune in the States, because from what I understand of your insurance plans, I probably would not be covered. I would have to choose- high medical bills or risk losing use of one of my eyes.

we get pts who have required hospitalization in the States and have had to return home to Canada for rehab,etc. They tell me that the care is much different there, because the hospitals are run for profit so the staffing levels are much different and even the whole approach to nursing is different.

As for your question about why nurses go down - some go down to get away from our lovely Canadian winters :), others go because they can make more money with less taxes. However, I know several nurses who went to the States and couldn't wait to get back home because they couldn't deal with having to charge their pts for everything.

Oops - didn't realize this was such an old thread. My bad

[loriangel14, RN]

The government funds the health care up here but they don't run it.