Universal Health Care... what would this mean...

[nurseyNJNYC]

hypothetically, how would universal healthcare affect us as nurses? the demand? our salaries? ive had a taste of the whole universal healthcare thing with the movie Sicko coming out and the upcoming election... but i dont know enough to say anything... any ideas?

:cheers:

[fronkey bean]

This graph shows how increasing numbers of un and underinsureds increase the cost of health care for everyone....

not as much as in countries w/ UHC where my taxes would go through the roof.

[fronkey bean]

I think our peers in the OECD have been doing a better job in restraining health cost growth.

So they're spending less on their citizens than americans spend on themselves-- does that mean they're getting a better deal or does it mean that their citizens are getting fewer services?

In the interest of clarity I want to point out that Medicare is NOT allowed to negotiate for bulk price discounts while DOD/VA can negotiate. As a result the DOD/VA system obtains significant cost savings.

I have pointed out in the past in other threads that other countries can learn from us in the "right care" dimension but we can also learn significant lessons from what they do better. Our system is horribly broken and in need of repair.

I don't agree that our system is " horribly broken". There is certainly room for improvement but it works very well in a majority of the cases.

The argument that American government is uniquely incompetent, and cannot do things that every other nation in the world can do, is simply nonsense. Not only has America, and the American government achieved many things that other countries have not, America has so many resources and the improvement in care and cost from moving to UHC is so large that even with incredible inefficiencies it would still be a good idea.

The American gov't isn't uniquely incompetent -- other governments are just as incompetent. That is why taxes in these countries go up and services become harder and harder to come by. I have a friend who takes regular trips to Romania and under there UHC program if you go to have a baby you had better have a "gift" for the MD if you want him/her to show up at the hospital to deliver your baby.

:bugeyes:Is there not something that is a balance of the 2 systems. Private sector and universal health care?* I can see both sides of the issue, also. But if this means that baby boomers do not have to work until they are to old to enjoy life then this might be the only answer?

Of course there are compromises. It is just in the current political environment compromise is considered traitorous by both sides.

[bradleau]

I am not sure what would happen to my pay. But I do know that the medical tests that I am currently scheduled to have done, WOULD NOT HAPPEN. So what if I am having apparent seizure activity, or weakness on one side that would indicate a stroke. I am not critical, I am taking Plavix. I still work full time. I feel fine most of the time. Right now I get very good followup and intervention on chronic health issues. THAT WOULD NOT HAPPEN with a Universal Health Plan. My backup health plan is with my husbands retired military service. Last year my insurance thru work paid for his Lap band surgery. Now the military/TRICARE will pay for it. And will refund back to Feb. of 2007. His was done Dec.20,2006. I truly doubt he would be alive if we had waited, and if we had known it would be covered. So I am out a few hundred dollars out of pocket, plus the cost of carrying the insurance.

[ZippyGBR, BSN, RN]

in theory, universal healthcare sounds good.

but i think pt outcomes would suffer drastically.

i'd have a look at the MINAP data from the UK ( looking at pain to needle for MIs whether thromblysis or PCI is the method of choice in a locality) among other measures before stating that socialised medicine has poorer outcomes

plus of course the numbers that aren't measured becasue chronic disease is managed effectively in primary care - other posters have suggested that reduced levles ofcomplications from diabetes etc is a probable outcome

much longer wait times, regardless of acuity level.

ED visits concluded in under 4 hours?

Primary care appointment within 48 hours with your 'own ' doctor or walk in service via WIC

none -acute ? cardiac chest pain and possible cancer diagnoses seen in secondary care in under 14 days even if there is no acute factor presenting ( and some two week rule referrals have been 'how quick can you get to where the consultant is working at the moment?') ( acute cardiac chest pain will get you same day admission and if necessary in patient angio in a day or three)

free at the point of delivery treatment for non urgent and elective procedures end to end in 18 weeks or less ?

[ZippyGBR, BSN, RN]

Letting the government run our healthcare system is a bad idea. Canada and

England both have "Universal Healthcare" and many of their residents come to the

United States to receive healthcare.

just like the 'many' none UK citizens who come to the UL to recieve specialist care from internationally renowned highly specialist treams based in the Uk

also there are a proprtion of the peopel who travell from the Uk for healthcare becasue their wants will not be met by Practitioners based in the Uk becasue they don't feel it an approrpaite use of their time or expertise ( mainly cosmetic procedures etc)

Adding more government control to our lives

and our healthcare system will most certainley cause even more problems.

despite the the fact the US business based ystem has the highest none clinical running costs i nthe world and has huige gaps in coverage ...

Nurse

to patient ratios will get worse, nursing pay will get worse, and patient care will get

worse.

can you substantiate those accusations ...

becasue prolonged ED holds aren't good care, neither is ED waiting times running into days ... all things the UK got rid of many years ago ...

There needs to be a concerted effort to educate people on how to use the

healthcare system, instead of going to the ER when you have a cold; learn to treat

it your self. I am sure a " How to properly utilize the healthcare sysyem for

DUMMIES" book could be written. Look at the VA healthcare system, or MEDICARE,

both are basically "Universal healthcare" and the care that the patients get is often

sub-standare by normal consumer standards.

define substandard ... becasue the US has become used to a fee for service system peopel assume that if you are not minus a hancock or two of blood and been extensively irradiated you haven't been adequately investigated... diagnosis is based on clinical skills investigatiosn are to confirm that diagnosis or to allow the practitioner to see things that can't be seen with the naked eye ...

If you or I want lower healthcare

costs the first place to demand change will be at the state level in the form of Tort Reform laws. I for one just want the government to leave me alone, no taxes, let me choose my own healthcare or not, stop giving handouts to people who make bad choices, and represent the people like they're supposed to.

despite the fact that an absence of good healthcare leads to greater morbidity and mortality...

[ZippyGBR, BSN, RN]

Perhaps you could find some statistics from countries with similar populations to the United states.

I just took a look at the website where you are getting your graphs from, and it surely doen not look like there is an agenda.

www.commonwealthfund.org

what does 'per capita' mean ?

[ZippyGBR, BSN, RN]

Actually, Americans spend more on health care as a proportion of income, not as a general proportion. This figure does not take into account that the NHS is heavily funded in the UK by VAT, a 17.5% tax that is included in the price of every good sold in the UK. (Essentially, it means sales tax in the UK is 17.5%.)

VAT is not applied to everything sold in the UK

notable exceptiuons include many foods, childrens clothes, workwear ...

domestic fuels / energy is subject ot VAT at 5%

We spend the most because we have no nationalized health system (as opposed to just about the rest of the developed world). Speaking as the wife of a Brit, I can tell you that completely socialized medicine is definitely NOT what we need here; I was in an NHS hospital and unless you want to go back to putting patients in eight-bed wards (to save costs) and pulling your eye teeth out to get a GP appointment (seen that firsthand more than once) - you don't want it.

odd then that all the new builds over the past 10 years or more have had not patient area bigger than 4 beds , and the new build for the trust i currently work for is 50% single rooms and 50% 4 bed bays (single rooms all ensuite, 4 bed bays all have shower +toilet for the bay.. )

new builds in the past 30 -40 years have been 4- 6 bed bays with a side room for each bay...

8 bedded bays / nightingale wards is prewar accomodation

GP appointments - odd then that the standard is primary care appointments within 48 hours and theren of course there;s the walk -in -centres - and out of hours GP services which provide additional capacity

In addition, NHS nurses make squat. LESS than squat. Try living in the UK on the equivalent of $35K a year

19683 gbp = 38755 usd at todays exchange rate according to google

19683 is the basic wage of a newly qualifed RN in the UK, it excludes

unsocial hours payment,

registration expenses payment

and convieniently forgets that there are 8 incremental progression points in band 5 to a BASIC salary

which means after 7 or 8 years depending if you get the accelerated first incremental progession your BASIC salary is 25424 GBP = 50060 USD excluding unsocial hours

when your gas is ELEVEN BUCKS A GALLON (yes, that was the going rate there when I was there from December 10 to January 15).

imperial gallons... and don;'t forget many UK cars do 40 + miles to the imperial gallon and a lot of distances to travel are much shorter...

To fill a Ford Focus, my DH and I spent almost one hundred dollars a tank. My brother-in-law spends $160 to fill a VOLVO. My house is half-over as big as my brother-in-law's (he lives about 40 minutes outside of London in a nice subdivision - probably comparable to how a good many of us live here in the States) and his cost just shy of four times as much as mine.

Land prices i nthe Uk are high but then again look at areas ofthe USA with simialr density over a significant area ...

you might be able to buy a 10000 sq ft house for 50c and a hershey bar in podunk hollow... but what if podunk hollow is 200 miles from where the jobs are...

Grocery shopping weekly (you have to go weekly because the average house has a refrigerator that fits UNDER the kitchen counter)

the 'average' Uk house doesn't have a fridge that fits under the counter, peopel choose to have fridges that size

can cost as much as $100 a week - depending on what you need to buy and where you buy it. (Just as an example, Bounce dryer sheets - which I couldn't live without! - are seven dollars for a box of fifty. I pay eight dollars for a box of 250 at Sam's.

it's all aobut where you shop .. also land values and the national minimum wage have an impact on prices ...

200 GBP/ month on shopping - for how many people?

i generally spend 100 -150 gbp / month for two of us plus visitors and that is not economising ...

A Coke in a restaurant is four bucks - two pounds a pop. And NO REFILLS - you want a refill, you pay. 17.5% of each price is VAT -

not sure if off the top of my drinks in restaurants are VATable ... the market charges what the market will stand ...

to be honest given most fizzy pop served in restaurants is postmix anything morethan about 20 p / pint is pure profit

and gas is taxed at something like 62%.)

Funny I mentioned dryer sheets - a good number of homes over there don't even have dryers

which are expensive, noisy and dedcidedly un eco friendly - given that you also have good 'drying days' outside year round in the UK

- unless you have a few bucks and either have the room for one [read: a house big enough to have one],

other than when i lived in a small flat i've had space where i could have a drier not always had one ... and the one i've got at the minute is a small one which gets used for laziness - most drying goes o nthe washing line or on airers - outside if it's fit or on the airers in the consveratory if it's not fit

or can afford one of those combo washer/dryers - yes, a combo - that fits again under the kitchen counter. No lie - the washers are often in the kitchen!

plumbing, power (kitchens have their own ring main in many uk installations), outside wall ...

plenty of people do have laundry/ utility rooms

a dryer i nthe bathroom wouldn't fit with Uk wiring regs

Many of the houses are too old or are built in such a way that the pipework can't be altered (lots of plaster walls), and where are the pipes easily accessible? In the kitchen, of course.

So no - we don't want a completely socialized system. It would bankrupt the nation - I don't even know that it's possible.

and the relevance

And remember, the Brits also pay about 40% in income tax.

no we don't

http://en.wikipedia.org/wiki/Image:UK_Tax.svg

http://en.wikipedia.org/wiki/Image:UK_Tax_%28percent%29.svg

even including NI as well as income tax it;s well below 30% of income until you earn over 50 K gbp (98450 USD)

[ZippyGBR, BSN, RN]

There are lots of different types of UHC.

These are the three main types:

In a fully public system, there is no or little private healthcare, and the health insurance industry is not a significant one. Medical service providers are government employees, and the education of doctors is also subsidised. The most well known example of a fully public system is the original English NHS, although a private sector is now developing in the U.K. as well.

there always has been and remains to be an outside the NHS service in the Uk ...

particularly for investigations, elective surgery and up to a point for matenrity services, however for chronic disease management there is a ongoing market for private provision in the UK , snmall becasue of the service provided by the NHS...

NHs primary care is still predominately provided by private contractors as GMS contract GPs are contractors not employees

[ZippyGBR, BSN, RN]

Perhaps in Australia it is irrelevant. But here in the Unites States of America, where the Constitution guarantees citizens certain freedoms, socialism is most certainly not irrelevant.

in relation to what?

i think that once again the ignorance of leftpondia strikes again confusing ideology with systems of government.. the warsaw pact and it's systems of control of the population does not equate with socialisit, especially given the number of other counties which ahve socialist governments elected in free and fair elections

[ZippyGBR, BSN, RN]

has anyone else also lived in europe?

as a uk resident by choice and british citizen by birth, i think i can comment here ...

in france, germany, and great britain, the populations are largely homogenous (despite the recent influx of immigrants, who are largely considered second class citizens),

depends on what you define as homogenous ...

geographical areas are much smaller, and has been previously addressed, there is a 17.5% tax on every purchase (it was 15% when i lived there, before the euro),

there is not a a tax on every purchase as in the uk at least some products are zero rated and others 5 % vat...

in additon to the sky-high income taxes.

see my previous posts , sub 30 % of total income including ni contribution is hardly 'sky high'

many posters appear to be comparing apples to avacados in looking at spending, income, and wait times. (yes, a cabg is "elective", would you care to have your family member wait six weeks for same?)

and if you actually need something as a clinical emergency you will get it

:offtopic:btw-if you are in an auto crash in germany and not belted, it is contributory negligence and your insurance has the option not to pay. there is a strong set of social mores to "encourage" compliance to all the rules--the anthisis of the american spirit of self-reliance and independence. just food for thought.

and contributory negligence is bad in some way?

i'm suprised that someone claiming to exppund the values of self reliance criticises a system which penalises those who impose themselves on others ...

[ZippyGBR, BSN, RN]

Americans don't go to Canada to seek healthcare b/c we can't. Their system is free for their citizens but not for Americans b/c we don't pay taxes there.

same situation in the UK - those with a right of residence in the UK get services free at the point of delivery - everyone else pays, what confuses people is that to the average american tourist who has a boo-boo and is seen by the Ambulance service and /or the emergency department doesn't get billed ( unless they are in an RTC - where it's rebilled to the motor insurer) because the NHS doesn't charge people for services until they are admitted to hospital...

[BlueRidgeHomeRN]

and contributory negligence is bad in some way?

quote]

not at all, and perhaps not having lived in the us you completely miss the point being directed primarily at my fellow countrymen.

unfortunately, the u.s. populace tends to be extremely lititagous. burglers sue and win for damages from an injury during a home invasion, parents sue physicans and hospitals for newborns with congential defects..i'm sure this trend is common knowledge internationally.

many americans have abdicated personal responsibility, and would be horrified to learn that there are parts of the world where one's own actions or lack thereof have impact on outcomes. lack of or wait for availabilty of our current high-tech interventions would not be widely acceptable to american health care consumers, who are apt to sue a hospital if their breakfast is cold (yes, exageration for point.)

and, to bring it all back to topic, the discussion is how universal health care would impact the usa, and whether or not european models are appropriate for comparison. the point is and remains that european models are not appropriate for comparison due to the points already listed.

ps-we americans have an aversion to both taxes and lack of freedom to choose our own destinies, in case the 1700's have slipped your mind.:usarm: vet, wife, and mom