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.
Specializes in Mental Health, Gerontology, Palliative.
BeenThere2012 said:
I...
The CEO of our medical system earned over $11 million dollars last year, but they wouldn't pay a decent wage for staff and most felt it wasn't worth the stress.
I'm on a SN4. My current yearly income is about to go to just on $100,000 annually. We have just had a nation wide ruling refered to as pay equity. Based on the idea that because nursing is primarily a female dominated field it should be paid based on male dominated professions.
We also get good differentials including afternoon and night allowances as well as weekend rate which is time and a half and double time on public holidays.
This is IMO a result of having a national MECA. We advised a strike just recently and you could tell the managers were packing it based on how many requests for volunteers for strike 24/7 coverage.
In the last few years I've seen a few cases of people with a serious illness that have gone to the US for treatment. However thats because the medical tech is not avaliable elsewhere and it cost them hundreds of thousands. They didn't go because America has a superior health care system. If they could have gotten the needed medical treatment in subsaharan africa they would have gone there
I never said we had a far superior system, but the folks that come, are coming because the treatment is available, so that is what makes a differencein those cases. That's what I'm getting at as far as balance. Many in the US think that if we went to socialized medicine, we would still have all of the bells and whistles available to everyone, but for free, etc. Nope. Socialized medicine does an accounting of what the lowest cost treatment exist for every condition, and allocates accordingly. I don't have any problem with that whatsoever, but the general public needs to understand that, which they don't. They wrongly believe that everything will be the same carewise (like a hotel with concierge care). Also, my cousin has been a nurse 6 years longer than I have. She makes way less than what I do, though our cost of living is fairly comparable. Wages are lower to keep overall costs lower. Again, no system is perfect, and I wouldn't mind socialized medicine, but the US population would need to be prepared for what it truly means, not some lofty dream of perfection all the way around
Specializes in Mental Health, Gerontology, Palliative.
Hoosier_RN said:
Nope. Socialized medicine does an accounting of what the lowest cost treatment exist for every condition, and allocates accordingly.
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
If our patients need stuff, they get it and I'm talking top of the line most up to date treatments. We arent talking 30 year old med tech thats been dragged out of a cupboard somewhere,.
The system isn't perfect. However if I had a choice between working in my system and moving to the US and working in the land of milk and honey. I'll stay where I am.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
...
Wages are lower to keep overall costs lower. Again, no system is perfect, and I wouldn't mind socialized medicine, but the US population would need to be prepared for what it truly means, not some lofty dream of perfection all the way around
It seems that the strategy of keeping health care costs down by over working and under paying healthcare workers isn't working very well. The USA enjoys the most expensive care and now has terrible health outcomes too. The collapse will continue, whether or not we acknowledge that our capitalist health system is broken and unsustainable.
It's not clear what "lofty goals" you are referencing unless you mean universal access to basic preventative health care or basic treatment without budget breaking copay and hidden costs. In 2022 roughly 40% of Americans delayed needed health care because of financial cost. Tens of millions have little to no access and 4 in 10 have access but can't afford the care when they need it. Why are we defending this?
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
If our patients need stuff, they get it and I'm talking top of the line most up to date treatments. We arent talking 30 year old med tech thats been dragged out of a cupboard somewhere,.
The system isn't perfect. However if I had a choice between working in my system and moving to the US and working in the land of milk and honey. I'll stay where I am.
But, some treatments are not available. Costs are contained. That's why some travel. It is what it is
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
But, some treatments are not available. Costs are contained. That's why some travel. It is what it is
Some treatments are not available here in the USA unless you have lots of money.
AND, unlike the other countries, tens of millions of Americans have limited or no access to affordable Healthcare. And millions access care every year that they can't afford and suffer financial devastation in their attempts to make themselves well.
It is what it is because the American voter has been convinced that our failing capitalist system is the best and their votes perpetuate the status quo. Unfortunately, this system is not sustainable. It is too expensive and does not promote the health and well being of we the people. We can either work to change it now or wait until it is completely dysfunctional.
Some treatments are not available here in the USA unless you have lots of money.
AND, unlike the other countries, tens of millions of Americans have limited or no access to affordable Healthcare. And millions access care every year that they can't afford and suffer financial devastation in their attempts to make themselves well.
It is what it is because the American voter has been convinced that our failing capitalist system is the best and their votes perpetuate the status quo. Unfortunately, this system is not sustainable. It is too expensive and does not promote the health and well being of we the people. We can either work to change it now or wait until it is completely dysfunctional.
TMB, go back and read my other comments. I have not made any comments that say socialized medicine is awful, so your attack on my comments is unwarranted. I'm simply pointing out that the US has some treatments/meds more readily available. Yes, at a higher cost, and many cannot afford. But, they aren't even available or offered in other countries is my point. Case in point, a NP that recently started working for our nephrology group after coming from the NHS, stated that some common meds in the US couldn't be ordered for patients across the pond without jumping through multiple hoops, if at all. She named off some common BP meds as an example. Now, do I know this to be gospel truth? No, but I don't know why she would lie. She did say she missed the lower cost of healthcare, but not the higher taxes and lower pay rates...she says she feels her quality of life is much better in the US than overseas (she's a native of GB, married a US citizen). I guess we all have our own perspective, but in the end, no system is anywhere near perfect
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
TMB, go back and read my other comments. I have not made any comments that say socialized medicine is awful, so your attack on my comments is unwarranted. I'm simply pointing out that the US has some treatments/meds more readily available. Yes, at a higher cost, and many cannot afford. But, they aren't even available or offered in other countries is my point. Case in point, a NP that recently started working for our nephrology group after coming from the NHS, stated that some common meds in the US couldn't be ordered for patients across the pond without jumping through multiple hoops, if at all. She named off some common BP meds as an example. Now, do I know this to be gospel truth? No, but I don't know why she would lie. She did say she missed the lower cost of healthcare, but not the higher taxes and lower pay rates...she says she feels her quality of life is much better in the US than overseas (she's a native of GB, married a US citizen). I guess we all have our own perspective, but in the end, no system is anywhere near perfect
Attack? This is a discussion, not an attack.
Sure there are new and novel and expensive treatments available in this capitalist health system. There's money in that line of healthcare. The problem is that our system isn't meeting basic expectations for health care of the residents of this country while costing us somewhere around 18% of our GDP. At the same time, Americans are falling in many of the measurable health outcomes and our life expectancy is decreasing.
That is simply not sustainable.
No person had suggested that any system is perfect. This system of ours, however, is broken.
No person had suggested that any system is perfect. This system of ours, however, is broken.
I agree, I'd love nothing more than to kiss the insurers goodbye, because that's where many problems lie. Then bloated admin at the top could be gone. Too many other fixes needed to even start listing. Lastly, the American consumer is to blame as well, we want what we want, when we want, etc. Unending life support for grandma, 98, because the family would be sad etc, you get my point. The American consumer's whole attitude towards health needs to change, not everything can be, or even should be, fixed with a pill/treatment. I don't know as a nation that we're there yet, but it seems like we may have to be sooner than later
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
I agree, I'd love nothing more than to kiss the insurers goodbye, because that's where many problems lie. Then bloated admin at the top could be gone. Too many other fixes needed to even start listing. Lastly, the American consumer is to blame as well, we want what we want, when we want, etc. Unending life support for grandma, 98, because the family would be sad etc, you get my point. The American consumer's whole attitude towards health needs to change, not everything can be, or even should be, fixed with a pill/treatment. I don't know as a nation that we're there yet, but it seems like we may have to be sooner than later
At this point in time, insurers make our system more expensive, more complicated, more inequitable, and add zero value to our health system while siphoning millions of dollars for their own profit stream. They are a portion of the reason our system is so fractured and dangerous. IMV insurers in the USA have too much power.
I don't blame people for wanting basic healthcare and the ability to access health professionals outside of the acute care or emergency room setting. In my view, that's the largest expectation, that American citizens can get basic but necessary care when they need it
The health professionals and for profit industry created the expectations for care. There's lots of money to be made on treatments and devices, even when they don't improve quality of life or increase life expectancy. In my professional lifetime I've seen just as many unrealistic providers making unrealistic care recommendations to family at end of life as I have seen families demanding unrealistic care. Maybe more. Observing the health system from a Hospice and palliative care perspective near the end of my career, in several states, was enlightening in that regard.
At this point in time, insurers make our system more expensive, more complicated, more inequitable, and add zero value to our health system while siphoning millions of dollars for their own profit stream. They are a portion of the reason our system is so fractured and dangerous. IMV insurers in the USA have too much power.
I don't blame people for wanting basic healthcare and the ability to access health professionals outside of the acute care or emergency room setting. In my view, that's the largest expectation, that American citizens can get basic but necessary care when they need it
The health professionals and for profit industry created the expectations for care. There's lots of money to be made on treatments and devices, even when they don't improve quality of life or increase life expectancy. In my professional lifetime I've seen just as many unrealistic providers making unrealistic care recommendations to family at end of life as I have seen families demanding unrealistic care. Maybe more. Observing the health system from a Hospice and palliative care perspective near the end of my career, in several states, was enlightening in that regard.
I may be reading between the lines here but I am coming to understand your basic stance is improve basic levels of care, rationalize care, and eliminate healthcare related profits? Is that fair to say?
In my professional lifetime I've seen just as many unrealistic providers making unrealistic care recommendations to family at end of life as I have seen families demanding unrealistic care. Maybe more. Observing the health system from a Hospice and palliative care perspective near the end of my career, in several states, was enlightening in that regard.
I agree, but want to add that pharmaceutical advertising also adds to the expectations as well. As a child of the 60s/70s, I don't remember prescription medications being marketed, much less at the at the intensity at which the marketing occurs now.
I'm really tired of admins who expect us to provide hotel level service, with barebones staffing and supplies. "It's my pleasure to serve you, because I have the time" ??
Tenebrae, BSN, RN
2,021 Posts
I'm on a SN4. My current yearly income is about to go to just on $100,000 annually. We have just had a nation wide ruling refered to as pay equity. Based on the idea that because nursing is primarily a female dominated field it should be paid based on male dominated professions.
We also get good differentials including afternoon and night allowances as well as weekend rate which is time and a half and double time on public holidays.
This is IMO a result of having a national MECA. We advised a strike just recently and you could tell the managers were packing it based on how many requests for volunteers for strike 24/7 coverage.