Universal Deathcare.

[Kyrshamarks]

So those that support Universal Healthcare and how great it is care to explain to us how it was great for Alfie Evans? Hopefully not coming soon to the America near you.

[Rocknurse, MSN, APRN, NP]

I worked for the NHS for over 12 years having been trained in an NHS hospital. I have never seen any patient care held because of financial issues. Quite the contrary in fact. I was part of a very famous and lengthy court case that involved a patient who sued the NHS for the right to die because they wanted to keep on treating while she wanted to die with dignity. She won and I was there when she took her last breath. How many people have died in this country because they can't afford treatment and how many times has an insurance company denied someone care because they didn't want to pay up on an insurance policy that had been correctly paid into? In this instance the decision was the correct one. In England the converse is true in that private care is NOT superior to NHS care. NHS hospitals are some of the finest in the world, and it's well known that the only thing private hospitals do better is waiting list times. I've worked in both and I'd always send my family member to an NHS hospital.

I'd like to share a post from a doctor in the UK. This was taken from a friends post and written by Matt Mayer...

"So far I've been quiet over the tragic case of Alfie Evans, but as a doctor, a father of four and a former intensive care doctor I feel I have a duty to speak.

Firstly, no child is the property of their parents. As parents our own anguish, emotion and needs are entirely and utterly secondary to the best interests of our children. We do not own them. We can't make demands on what happens to them like a piece of furniture. Furthermore, as parents we are naturally conflicted in deciding what is best for them in times of dire crisis. Because of the unconditional love we have for our children we will naturally cling to hope even where there is none. Despite being a doctor I find it impossible to objectively medically assess my own children, because I'm their Daddy, not their doctor.

Secondly, doctors and nurses act in the best interests of their patients - not the parents, not the press, not some feral "army," not politicians, not the Pope, the PATIENT. The first line of the modern Hippocratic Oath is "Make the care of your patient your first concern." The staff at Alder Hey were working under incredibly difficult conditions even before a mob started accusing them of murder. Now their job is impossible.

Thirdly, Alfie Evans has an irreversible, catastrophic degenerative neurological disorder with no hope of recovery. The brain does not regenerate. Respiratory function and other basic physiological reflexes are literally, neurologically nothing whatsoever to do with sentience, consciousness or self awareness. Death, surrounded by those who love Alfie, peacefully, quietly, in dignity is in his best interests, this has been affirmed not just by his doctors but by the highest Court in the land. Having pictures of him in intensive care plastered all over the press, or being used as a political and religious football, or having people scream outside his hospital room is NOT in his best interests.

Finally, the behaviour of "Alfie's Army" is, to be frank, disgusting. Threatening doctors and nurses by name such that they fear for their lives is disgusting. Threatening to storm a children's hospital is disgusting. Threatening to pull fire alarms when other children are on the operating table having life saving surgery is worse than disgusting. Piggy-backing onto the grief of the parents of a baby you have never even met is flagrant grief tourism and an ultimate act of selfishness. Furthermore, veiling such aggressive and malignant behaviour behind a pretense of faith could not be further from what it means to be a Christian.

If you believe there is a conspiracy among the medical profession, or a cover up, or you believe parents own their children, or that the parents' feelings are more important than the dignity of their child, or if you are a member of Alfie's army then please do me a favour and remove yourself from my friends list."

[Guest219794]

The NHS costs a fortune. Importantly, it is "free at the point of service," not free. A 21% VAT tax on almost everything you buy means it seriously impacts what you spend every day. That percentage will likely continue to go up as costs continue to rise. The VAT tax was 17% not that many years ago. The UK government also takes money out of your paycheck for National Insurance (National Insurance helps to fund the NHS as well as pay for unemployment+disability benefits and state pensions).

Despite massive taxation and fees, the NHS is broke. Nurse patient ratios, outside of the ICU's, are often *much* worse than the U.S., and they are certainly not better. There is often a waiting time of many, many months for non emergent surgeries (hysterectomy, joint replacement), psychiatric care, and even to get a CT. Doctors are generally poorly paid and nurses with 20+ years experience --top pay-- is about the equivalent of 25 dollars an hour, and that's if you are willing to float all over, and work in London. In rural areas experienced nurses make the equivalent of 14 to 16 dollars or so. (Of note, it matters not what the exchange rate is to the U.S. dollar. If you live in England 20 pounds spends about like 20 dollars does in the U.S., but probably a little less due to higher costs of living due to the housing shortage). We can't afford the nightmare of Obamacare, and we certainly can't afford anything like the NHS. Partly because a large portion of our population would end up not paying for any of it, while the rest of us would pick up the tab, unless we had a substantial VAT tax, which I doubt would happen here. Seeing how we have over 5x as many people than the U.K., the financial burden for the average worker would be incredible. Thanks but no thanks.

I am some ways not a huge fan of the UK NHS. I have two relatives who had cancer missed that would certainly have been caught in the US. My anecdotal experience not withstanding, it still seems to be a more efficient, effective system.

They spend less.

They have better outcomes.

I am pretty sure those points are well supported. While I hear many people criticize that system, I never hear the claim that the UK spends more or has worse outcomes- at least not from rational people.

So, to what do you attribute the positive differences?

I am on my way to 12 hrs in the ER where I will be providing horribly expensive, inefficient, and sometimes harmful care. But, at least I earn enough to pay my health insurance.

[KatieMI, BSN, MSN, RN]

Rocknurse,

THANK YOU!

BTW, I like the expression "grief tourism".

[Kyrshamarks, BSN, RN]

I found a well written piece from a nursing perspective on wrongfully prolonging death and suffering in out modern medical system.

Very relevant to this case.

"These are many of the people that are kept in that state between alive and dead in my ICU. These are the people that death would be a comforting end to their struggles and problems, would bring an end to the pain and suffering they have. But yet, we as a society deny this to these people. "

It is kind of funny that you would chose "this well written piece" as a source. Look at the author of the piece. Me. lol. I am against prolonging suffering but I also am against the government and hospitals deciding when it is time. Families are the final decision maker. Not committees or groups or courts.

[LibraSunCNM, BSN, MSN, CNM]

It is kind of funny that you would chose "this well written piece" as a source. Look at the author of the piece. Me. lol. I am against prolonging suffering but I also am against the government and hospitals deciding when it is time. Families are the final decision maker. Not committees or groups or courts.

But what if the family's decision is actually more harmful to the patient? What then?

[OldDude]

It is kind of funny that you would chose "this well written piece" as a source. Look at the author of the piece. Me. lol. I am against prolonging suffering but I also am against the government and hospitals deciding when it is time. Families are the final decision maker. Not committees or groups or courts.

You've opened up quite the spirited debate on a tender and emotional subject. I believe the posters have been enlightened to some degree; whether their mind has been changed or not. But this definitely has been a thread worth reading...I learned a few things.

Thank You!

And yes, your piece was well written!

[Neats, BSN]

Oh one of my favorite soap boxes.

I have lived in Europe and grew up in Canada. I have experienced socialized insurance first hand. I also have worked in the geriatric setting so again have experienced socialized insurance in the US first hand (think Medicare/Medicaid).

To me what could have been a real simple healthcare coverage (include mental and dental) has turned in a cluster of muddy policies/protocols that are making this more difficult in which to gain access and to work in.

We are going down a slippery road in which we will be taken over by our government much like what happening the development of the TSA. We will all be government workers perhaps in the future.

We have no universal electronic health record, payment system and what is being charged can fluctuate greatly, medication expenses, the patient expectations/and the reimbursement attached, and then fraud occurrences (includes un-necessary procedures). Theses all contribute to our cost of health care. The one item we do not discuss is the US lawsuits verses other countries.

I am not sure of the answer but I would like to see actual medical professional representation that include a multidisplinary team from each state/territory based on population, members of the community who are interested in the development of a basic healthcare system, and really come up with a thoughtful bare bones healthcare delivery system that our supposed leadership will enact. These decisions should not come from congress but come from medical professionals who are experts in their chosen field.

My experience when we assist patient is that simple interventions can make the best outcome's, sadly we have made our out comes, more and more complicated. We should not have to lose what we have worked so hard for due to our medical issues, nor should we as a country have to have such a high burden of healthcare costs compared to other countries after all, anatomy and physiology remains the same no matter where you go (some exception apply).

[morte, LPN, LVN]

(I've been waiting for her to pop up ...)

?pun intended?

[Hoosier_RN, MSN]

It is kind of funny that you would chose "this well written piece" as a source. Look at the author of the piece. Me. lol. I am against prolonging suffering but I also am against the government and hospitals deciding when it is time. Families are the final decision maker. Not committees or groups or courts.

In the US, many times it is the insurance companies who decides when treatment ends, not the family. I've seen treatments delayed for ridiculous paperwork. In many ways, it sounds like our system no better than the system we are bashing. Insurance companies deny lifesaving treatments everyday, over the bottom line. It's sad, but it is what it is

[elkpark]

In the US, many times it is the insurance companies who decides when treatment ends, not the family. I've seen treatments delayed for ridiculous paperwork. In many ways, it sounds like our system no better than the system we are bashing. Insurance companies deny lifesaving treatments everyday, over the bottom line. It's sad, but it is what it is

Many would argue that our "system" is a lot worse than the British system.

[OldDude]

In the US, many times it is the insurance companies who decides when treatment ends, not the family. I've seen treatments delayed for ridiculous paperwork. In many ways, it sounds like our system no better than the system we are bashing. Insurance companies deny lifesaving treatments everyday, over the bottom line. It's sad, but it is what it is

Now THIS is a true statement. I've seen it explicitly on display in Home Health. First, it's my opinion, patients are dumped out of the hospital way too soon; especially on Friday. Second, the number of Homecare visits is "decided" by the insurance carrier. Good observation Hoosier.

[OldDude]

Many would argue that our "system" is a lot worse than the British system.

I'll guarantee you it's the most expensive; top to bottom.