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 NICU, PICU, Transport, L&D, Hospice.
Asystole RN said:
I agree. I am a little torn on what the best policy is to control drug prices in the United States. In the UK the government regulates profits to be a max of just under 30% for a drug. This is problematic in controlling since most of the drug companies are multinationals, making auditing challenging. Like Australia, they also mandate prices be decreased over a period of time so that the older the drug the cheaper it becomes. The thing I think I like the best is that there is an assessment and negotiation regarding the clinical benefit of a medication. The more clinically beneficial the higher the price can be.
Currently in the U.S. there is no federal regulation on the price of medications. The primary pushback to regulating prices is that the less profitable a drug becomes, the less incentive there is to develop something new. Personally I think there should be a balance between incentivizing drug development and regulating prices.
The USA needs to create an outline for healthcare in the USA which identifies successful solutions in other countries with better everyday care and better outcomes at lower cost per person.
We can do this as soon as we stop letting our elected representatives sell us out to capitalists and oligarchs.
The USA needs to create an outline for healthcare in the USA which identifies successful solutions in other countries with better everyday care and better outcomes at lower cost per person.
We can do this as soon as we stop letting our elected representatives sell us out to capitalists and oligarchs.
I agree we need to identify better solutions. I think those discussions can start with us. It is easy to identify a problem, much harder to identify specific actionable solutions.
Personally, I think the first step is understanding why U.S. healthcare is the way it is and developing attainable goals for the system with clinically relevant and measurable metrics.
Specializes in NICU, PICU, Transport, L&D, Hospice.
Asystole RN said:
I agree we need to identify better solutions. I think those discussions can start with us. It is easy to identify a problem, much harder to identify specific actionable solutions.
Personally, I think the first step is understanding why U.S. healthcare is the way it is and developing attainable goals for the system with clinically relevant and measurable metrics.
Our current congressional members appear incapable of undertaking such a task. They are too busy.
Specializes in Mental Health, Gerontology, Palliative.
Asystole RN said:
Why would we as professionals, subject matter experts, rely upon a lay person to determine the best healthcare system?
As healthcare professionals we should be able to articulate clear and actionable goals to improve the healthcare system.
This arose in my first degree.
The reason why those in charge don't let the systemic healthcare decision be made by the health professionals, they believe the health professionals would give all the people the healthcare that they need
Far more kinder on the bottom line if those decisions are made by accountants with algorithms.
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
I'm talking about those who refuse to participate in basic self care (diet, exercise, hygiene, etc) then want to blame the system when it blows up on them, or wants the newest magic pill that they've seen in an ad, heard from a friend, or pushed by a Dr
Specializes in NICU, PICU, Transport, L&D, Hospice.
Hoosier_RN said:
I'm talking about those who refuse to participate in basic self care (diet, exercise, hygiene, etc) then want to blame the system when it blows up on them, or wants the newest magic pill that they've seen in an ad, heard from a friend, or pushed by a Dr
I know what and who you are talking about. I don't blame the American people for their lack of access to health care or their slow poisoning by the corporate food industry. The people are victims here with increasingly poor health, terrible access to care and falling life expectancies. It's not their fault that they are targets for pharmaceutical marketing in a country where actual health care may not even be available to them.
I'm talking about those who refuse to participate in basic self care (diet, exercise, hygiene, etc) then want to blame the system when it blows up on them, or wants the newest magic pill that they've seen in an ad, heard from a friend, or pushed by a Dr
Petit rationing. I only worked with a single orthopod over decades of orthopedic anesthesia, who demanded that his obese patients demonstrate that they can lose weight before they replace a joint. In fairness, the last time I was in an orthopod's office, about 4 years ago, there was a sign on the wall that they wouldn't consider joint replacements in patients with a BMI higher than 30, Amen.
I know what and who you are talking about. I don't blame the American people for their lack of access to health care or their slow poisoning by the corporate food industry. The people are victims here with increasingly poor health, terrible access to care and falling life expectancies. It's not their fault that they are targets for pharmaceutical marketing in a country where actual health care may not even be available to them.
I mostly agree with you. But, the behaviors described also are part of our general societal decline into entitlement and victimhood. And, there is a free will element. These people encounter the Healthcare System over and over, they are given good sound advice, but they continue to ignore it.
Petit rationing. I only worked with a single orthopod over decades of orthopedic anesthesia, who demanded that his obese patients demonstrate that they can lose weight before they replace a joint. In fairness, the last time I was in an orthopod's office, about 4 years ago, there was a sign on the wall that they wouldn't consider joint replacements in patients with a BMI higher than 30, Amen.
The fat acceptance movement is ultimately a negative one for health. I see obesity as a health issue, but many people see it as a vanity issue. I agree that people of all types should be loved and honored for who they are. But to ignore the massive health risks associated with obesity, or any other controllable risk factor, is just dishonest and ludicrous.
toomuchbaloney
16,033 Posts
The USA needs to create an outline for healthcare in the USA which identifies successful solutions in other countries with better everyday care and better outcomes at lower cost per person.
We can do this as soon as we stop letting our elected representatives sell us out to capitalists and oligarchs.