I feel like we are rapidly reaching jump ship level. My own sister (in her 40s with 4 kids and natural born Texas/US citizen) is actively migrating her family to Canada next year. Her daughter with a clef pallet cost her family 90K last year WITH insurance. Her husband makes $150K a year, so they managed...but Christ! My sister is so serious that she already submitted all her immigration papers and is waiting to hear back.
I work in a clinic. The ER at the hospital I work for has sent critical patients to our clinic because they 1) apparently have no staff that know how to evaluate for a emergency (I say this having 8 years ER experience under my belt). I had a patient go to the ER twice in 24 hours for urinary pain, bleeding 1 week post op. They sent him to the clinic pale AF, orthostatic blood pressure 80/40, bladder scan showed 330 after voiding (ended up being a giant number of clots that I got to try to hand irrigate in the OFFICE!). The ER did a UA at both visits and NOTHING ELSE.
You might want to say this is my institution in particular...however I haven't held a job at 1 institution for more than 3 years. I've traveled. So, yes, there are better and worse.....but they are ALL getting worse. Process improvement usually involve trying to make up care gaps with unlicensed, under educated, unqualified people OR have one qualified person do the work of 3-4 people (both of which create gross care gaps).
I wish I could go with my sister. This has only gotten worse in the 15 years I've been a nurse. I'm not proud of my field.
In regards to insurance and government regulation of care....I'm not so sure I find the latter all that unappealing. As someone who moved from a state with high taxes due to a robust Medicaid program (Illinois) to a state that has low taxes and a next to nothing Medicaid program (Texas); I am now even more sure that a national healthcare system is needed and the next step for US healthcare.
What I can see now that I didn't fully appreciate before moving to another state, is how much medicaid affects the standards of care for all patients....even those with insurance.
Examples:
43 year old female goes to the ER with shortness of breath, a CT is done and several masses are found.
In Texas: They discharge the patient from the ER instructing her to follow up with breast specialist as soon as she can afford to. It took her a month to be able to see the doctor because you can't schedule an appointment without being able to pay up front. Texas Medicaid does not cover many cancers so this lady needed a biopsy to have proof that her cancer was breast cancer before she can possibly get Medicaid. Took another 2 weeks to get her biopsy and then 2 more weeks to get the results. So she had stage 4 cancer before she even got approved to get Medicaid and possibly organize treatment.
In Illinois: This case would have been admitted to the hospital, biopsy preformed and oncology/radiation plan established and set up before discharge. Because in Illinois they can back date Medicaid coverage they go ahead and establish care ASAP which leads to better outcomes.
A 60 year old female presents to the ED with abdominal pain, back pain and lady partsl bleeding x 2 days. She hasn't had a period in 10 years. She tried to make an appointment with her OBGYN but was told the soonest available appointment was 1 month away (that's some *** but a different issue). She has an excellent insurance plan (This is my Aunt so I know her coverage.)
In Texas:
To my flabbergasted dismay, they did a UA and a CBC. They told her that was all they "had" to do and that she should continue to follow up with her OBGYN as soon as possible.
In Illinois:
What would have happened is she would have gotten a UA, CBC, CMP, and some sort of imaging (lady partsl ultrasound or CT) and a stat referral to her OBGYN.
I think both of these demonstrate how little incentive Texas has to provide complete care because they "don't have to" aka there is no funding ensured by the state so ALL patients are given a minimal amount of care. The policy isn't care for the patients and then address funding in Texas. It is address if their insurance will cover the care and then provide care, leading to delayed care and poorer outcomes.
I think this is a part of Abbott's plan to just eliminate some of the population.......no, really!
Texas has the highest uninsured rate in the nation. In 2019, they had some of the worst health ranking in the country.
On top of that, Texas also has an alternative Workers Comp program that other states are moving toward like Oklahoma where the employers hire private companies and make their own rules that basically harm the employees and limit their rights. These second rate private programs leave many injured workers in the dust, unless they are able to find a lawyer to sue and then have to wait for it to play out in the court system, with all the delays, not to mention if arbitration isn't mandated which once again favors the employer!
It was honestly a miracle that Nina Pham got a settlement against Texas Health Presbyterian when she contracted Ebola after not being given adequate safety PPE and had to Google it herself and use tape to try to cover the flimsy gown she had! They wanted her to accept workers comp instead. But they had literally violated her rights to privacy by videotaping her while she was in the ICU for a cheap PR stunt! I hope she is doing OK now.
Is this something the DOJ would take up or is workman's comp entirely a state program? Well at least these two states have put the rest of the country on notice that they are not friendly to workers. But, of course, these two states aren't very friendly in general to their citizens.
no and a thousand times no except perhaps in Russia.
I've noticed over the years, US citizens are absolutely brilliant and blatantly misrepresenting the reality of single payer health and will argue it with people who do have first hand single payer health.
I work in a single payer system. If we need equipment that is not on the ward, we go to our CNM who files a rec and we get it by the end of business. Worst case scenario it might take a solid 24 hours
My point. In US, most folks think all treatments will be there at the snap of the fingers, no wait. Also, I was talking more along the lines of medications. The "latest/greatest" isn't what's being used in socialized systems either. Many Americans are served a beyond healthy dose of pharmaceutical ads, and expect the latest/greatest at any cost. Socialized medicine doesn't work that way. I have no problem using "oldie but goodie" meds that are tried and true, but again, many Americans have a falsely lofty set of expectations. Case in point, one of my patients at dialysis uses a regular wheelchair, no need for anything beyond. He thinks he would have a Steven Hawking style wheelchair that takes voice commands. Another thinks she'll get x,y,z meds, when she's doing fine on a,b,c meds, but she's "seen all the commercials". I bite my tongue often with these conversations. Again, it's an expectation vs reality that I'm not sure many are ready for. But I hope it comes around soon, as no one should have to suffer waiting for basics in healthcare
Specializes in NICU, PICU, Transport, L&D, Hospice.
FolksBtrippin said:
It's spelled cleft palate and does not cost 90k to repair.
The ongoing care of patients with cleft pallet too often includes multiple surgeries (including cosmetic surgery) and other therapies that can total in the hundreds of thousands of dollars in the USA.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
toomuchbaloney said:
The ongoing care of patients with cleft pallet too often includes multiple surgeries (including cosmetic surgery) and other therapies that can total in the hundreds of thousands of dollars in the USA.
Again, it's "cleft palate". If you can't spell it, it's hard to believe you know much about it.
Specializes in NICU, PICU, Transport, L&D, Hospice.
FolksBtrippin said:
Again, it's "cleft palate". If you can't spell it, it's hard to believe you know much about it.
Sorry. I post exclusively from my phone in the interior of Alaska and Samsung too often second guesses me when I'm not taking my time.
I spent a bunch of years running a good sized PICU after spending the beginnings of my long and fulfilling nursing journey in a large NICU. That means that rather than speak to the information that I shared, you opted to use a misspelled word to jump to a very negative and wrong assumption about me. That says something about you, although neither one of us is the topic.
Why not dispute my claim rather than trying to make personal insults because I offered a different POV? Do you think there's a possibility that the cost of ongoing and related care for these congenital anomalies can accumulate into the hundreds of thousands of dollars in the USA?
Do you think there's a possibility that the cost of ongoing and related care for these congenital anomalies can accumulate into the hundreds of thousands of dollars in the USA?
I only pulled this part of your post because your were responding to somebody else and I don't want to appear like I am also trying to jump into an argument so please don't take it that way.
But sadly yes, with the inflated health care costs in the USA I can indeed see the cost of care for cleft palate and other congenital anomalies reaching 6 figures easily.
Specializes in NICU, PICU, Transport, L&D, Hospice.
kbrn2002 said:
I only pulled this part of your post because your were responding to somebody else and I don't want to appear like I am also trying to jump into an argument so please don't take it that way.
But sadly yes, with the inflated health care costs in the USA I can indeed see the cost of care for cleft palate and other congenital anomalies reaching 6 figures easily.
Thank you for plucking my larger point from the comment. I don't consider it an argument.
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subee, MSN, CRNA
1 Article; 6,118 Posts
I think this is a part of Abbott's plan to just eliminate some of the population.......no, really!