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

carolinapooh, BSN, RN · Feb 15, 2008

: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.

i am sorry - but i agree with this. i am a card-carrying, flag-waving, proud-to-be-an-american, and i wouldn't want to live anywhere else - but i agree completely with the germans on this one.

paying for some schnock's decision to not wear a seatbelt, then said schnock gets tossed through his windshield and bounces on his head on the curb, then the schnock can't work and ends up on government disability while hooked up to a vent for the rest of his life - well, now i'm supporting some other yahoo who could have saved himself (and me!) a whole lot of trouble by just fastening his stupid seat belt.

that's not contributory negligence - that's asking people to (horrors!) think. where does someone get off of flying down i40 without his seatbelt fastened because he thinks his decisions don't affect others? i also think that insurance companies should refuse to pay if some idiot gets drunk, wrecks his car, and wrecks himself. i think we should do enough to keep you from dying - and then you're on your own.

in fact, the germans have it completely wrong. it's not contributory negligence - you didn't neglect to do something, you chose not to do it, even though you know doing it could have killed you. contributory stupidity is more like it.

if insurance companies refused to pay for stupid stuff like this, not only would my car insurance be cheaper, but i'd bet my health insurance premiums would go down as well, or at least not go up every seven seconds....

oh, i see the flames coming...bring them on.... :smokin:

Long Term Care Columnist / Guide · Feb 15, 2008

How absurd, of course I don't think these people "don't deserve healthcare". I just don't think that the government should use their police powers to force Peter to pay for Paul's bad choices.
You are jumping from conclusion to conclusion. No one has ever advocated that we "DENY" anyone healthcare. Just that we don't become enablers by financing the fix to bad choices.
The type of healthcare that should be "free" (or rather on the public dole) should be only those that are not precipiated by poor choices.
Will someone please tell me how not treating certain patients with certain afflictions is NOT denying them care?:uhoh21:
Oh, I get it. Under this form of social Darwinism, we'll treat low-income Mary Jones for her pneumonia, but not her COPD because she smoked 2 packs a day for 50 years. We'll amputate disabled veteran John Smith's foot because the circulation is nonexistent and gangrene is setting in, but we won't supply insulin for his diabetes because he ate himself up to 300 pounds.
I don't believe in enabling people to continue to self-destruct. I'm also not fond of paying taxes to pay for other peoples' health care when I have to work hard to earn my own. But then, I'd rather do so---even if someone, somewhere, might get something to which they aren't completely entitled---than turn my back on any human being who needs medical care, regardless of how they became ill.
Ah, what a sad state of affairs..........I'm all for personal responsibility, but attitudes like "I got mine" dishearten and disgust me, especially coming from people who are in a HELPING profession. It does not bode well for the future of health care, or of humanity in general.

KayMichelle · Feb 15, 2008

This is a very disturbing comment, coming from a healthcare professional. No one said Type II diabetics were 'victims', and I certainly don't consider myself one. Please don't judge people like me until you've walked a mile in our moccasins. It is nothing short of insulting.
If diet and exercise were as easy as you seem to think, there would be few diabetics, and certainly no fat people. No one, but no one, would CHOOSE this life.......especially not when healthcare providers are so quick to assume an air of superiority and belittle us for our alleged lack of discipline.
I have forgotten more about self-control than most people learn in a lifetime. Yet I'm still fat, and I'm still a diabetic. Guess that makes me totally worthless in some folks' estimation. :stone

Zippy, in post #208 is who called these patients "victims".

My goodness! How we have become emotional over this issue! I thought this was an academic/intellectual debate about universal heathcare.

First of all, I didn't mean at all to point anything out to you personally. I didn't insult you at all. I'm sure you're a perfectly wonderful person. DMII is only one of many, many sticking points in the overall debate of universal heath care. It is simply one of those watershed items, which are many. Universal healthcare is usually rejected because of these issues.

Let's discuss another watershed issue.... how about AIDS? The drugs needed are very, very expensive cocktails taken by the patients. You know, many in Africa are very upset that the rest of the world won't pay for these hugely expensive drugs. I saw a movie in school not too long ago about AIDS, which showed how, in Africa, men think that if they have sex with a very young virgin, it will cure their affliction. Nothing the NGOs say will change their minds. They just keep spreading this horrible disease. Are we to avoid "judging" these men? Or are we to be true to our profession by promoting good health decisions? Do we enable this risky behavior? Or do we stand firm and persist in demanding that it stop? Back in the '80s, the healthcare professionals tried to shut down the bathhouses in L.A. They were called judgmental, bigoted. After many, many unnecessary deaths, they finallly closed. It was a good movie, it gave much to think about in our tolerant society.

Or how about another issue... drug addiction and costs to rehabilitate drug addicts. Or another... STDs... Gastric band surgery.... or another... abortions... or another, after effects of attempted suicide... or what about high risk athletics? steroid abuse therapy? reckless driving? lung cancer caused by smoking? What about illegal aliens that bring into this country hepatitis and TB?

Should the cost for the care for these things come out of the pockets of those who have no choice? Backed up by the power of the police state?

These issues are true conundrums. They need to be discussed without such emotionalism. By US, the healthcare professionals, in a mature way, without name calling, without calling someone's opinion "disturbing" and such. That is nonsense. If we cannot openly discuss healthcare issues, who can? When you descend to name calling, we will never have healthcare reform, or even a shadow of it.

Discussing thorny issues doesn't make someone a 'bad' nurse. No one is judging you personally. Forums are for discussing issues, not judging anything.

There are many syndromes that will be made worse by making healthcare "free". The state should not become an enabler. If someone is noncompliant in their therapy, how can you justify forcing another citizen to pay for it?

I think a monetary fine at least should be levied for noncompliance if we had universal healthcare. Other wise, it is like someone refusing to work, but still getting a paycheck.

It could be a true nightmare.

carolinapooh, BSN, RN · Feb 15, 2008

sorry - i had to answer this. original post in purple, answer from zippygbr in black, new answers in bold. i didn't know how to "clip" a post so i could quote both myself and the second reply, so i apologize in advance.

originally posted by carolinapooh view post

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 ... in nc, our food tax in groceries is only 2 percent - but that doesn't ease my mind with our sales tax on everything else. the fact that "a few items" aren't taxed doesn't change the fact that vat on consumer goods is 17.5%. in pa, where my father was from, clothing isn't taxed, but toilet paper is. that clothing isn't taxed doesn't change the tax rate. i'll take the fact that maybe my wording is misleading - but according to my last sainsbury's bill for a week's groceries (and i don't eat a lot of junk) - 17.5% is where it's at.

domestic fuels / energy is subject ot vat at 5% the utility bill for my mils two-story, 1000 sq ft semi-detached is almost double my 2200 sq ft detached. and her house is not as warm as mine. plus, "energy" is not a "good" so much as it is a "commodity".

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...not all of them - stroll down south to southampton general...eight beds to a ward and my friend was in one of them in january...ward was built originally in the 1970s and "upgraded" in the eighties - and nothing since - although they did just get a multimillion pound grant from nhs to add/expand their peds wards.

8 bedded bays / nightingale wards is prewar accomodation not hardly - this is what i observed in southampton general in january. it's not "prewar" - it's happening now, and we americans worked like the dickens to abolish "wards" in this country and afford our patients some privacy - something i think everyone's entitled to in a hospital. one of the patients a few beds down from my friend suffered from dementia and sundowned like crazy. you can imagine what trying to rest in the midst of that was like for my friend. i felt sorry for everyone in the ward - including the poor old man who was inadvertently causing the disturbance.

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 personally, all i've witnessed there is promises that gp offices are simply too busy and too overscheduled to be able to keep.

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 which would be before taxes, right? the figure i found in my mims periodical from december quoted 17128 gbp for new nurses.

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 yeah, we have that at a lot of our hospitals - we get raises, too, but i'd hardly call them outrageous pay raises.

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 hoursyeah, here too - but the rent here isn't what it is there for similar accommodations (unless you live in midtown manhattan; i can't believe the cost of housing in southampton and camberley), and the utilities aren't what they are there - you've missed that i'm on your side in this. fifty grand in the uk is not a lot of money when your cost of living is as outrageous as it has become over there.

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...yep, bil and i have talked about this. most of the brits i know have a commute to work, and burn as much gas as i do - nearly a tank a week. the conversion is about five liters to the gallon to make it american. i know this - it's irrelevant because i did the math already. dh and i talk about this all the time, so i know how to convert to allow for the difference.

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 ...i've compared prices for similar housing in similar areas here and it's insane. plus, i would never choose (the operative word here is choose) to live crammed up next to my neighbors, and neither does my other half.

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...here, quite often, it's not - and believe me, i know what a luxury it is and am grateful for it.

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 i would disagree with this, as does my husband. they're becoming more common as people are able to afford bigger houses, but most houses not built in the last ten years do not have the room for the luxury of a free-standing fridge.

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 ...this is true.

200 gbp/ month on shopping - for how many people? four, and yes, in camberley. we have a flat there and i know what it costs all too well, having been out with my sil.

i generally spend 100 -150 gbp / month for two of us plus visitors and that is not economising ...three hundred bucks a month is suspiciously close to one hundred bucks a week.

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 ...they're vated, because they're counted as separate purchases.

to be honest given most fizzy pop served in restaurants is postmix anything morethan about 20 p / pint is pure profit that's like saying a coke here actually costs the restaurant twenty cents and they're charging you two bucks - which is irrelevant because you're still paying sales tax on it that the business then turns over to the state! regardless of profit, there is still a 17.5% tax charged on the purchase, which is turned over as tax revenue by the business. the consumer still pays the tax on the purchase and the business still has to turn it over.

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 ukis this before or after it rains? (ok, a low blow; i'm trying to lighten the mood. we'd kill for rain here!) please - this is truly irrelevant, but was the most relevant item i could think of that would drive home here how much the cost of living is over there - largely due to taxation.

- 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 sorry, but my mother-in-law has one; it's a washer-dryer combo, installed by a qualified electrician - and they can go in the kitchen under the counter d/t the way they're wired. we have one in the flat. blows my mind. trust me - i'm completely correct on this one. hop into sainsbury's or curry's and check this out. my point is the average house over there is so small, there's no room for it anywhere else.

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. i know this, but to americans it seems bizarre. we install central air and heat into houses built over one hundred years ago, so not being able to alter a home seems foreign to many of us.

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 relevanceto what? that providing uniform, universal, and fair coverage to three hundred million people wouldn't bankrupt us? that just writing that sentence makes it seem even more preposterous that it could ever be done?

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:u...percent%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) actually, my brother-in-law would disagree. i don't consider wikipedia a reliable resource; i checked british tax tables on your treasury's website and i'm pretty close. and either way, your tax rate is still higher than ours - because of a government-imposed, outrageously high sales tax - vat - that is essentially attached to everything, which you pay in addition to income taxes.

btw, we own a flat b/c we own a business there - so we pay taxes there as well! ask me about my tax rate... :lol2: :lol2: :lol2: :lol2:

thank you for allowing my rant!

my point is, what's good for the goose isn't always good for the gander. one of my comments was taken a bit out of context - i think americans would be all for some sort of preventative/primary care that's accessible to everyone and potentially socialized. we'd nip so many problems in the bud - we'd be able to stop disease before it started - we could control the disease process of so many already devastated by disease. but completely socialized? not a chance.

i'm also not saying the way the uk does things is wrong - i'm just saying that there are a lot of consequences to it. i think it's incredible that universal health care is, in theory at least, available in the uk - but i think the system, like so many of government's good intentions, has become a ba*tardization of what it was meant to be (can i say that? guess i'll find out!), and corrupt beyond imagination. it was all over the legitimate press (oxymoron?) while i was there; it's all over the press all the time. the system is in trouble and is in desperate need of help.

why pattern any reform in this country on an imperfect system? for that matter - and i'm including my own opinions, both expressed and implied - why point fingers and sing-song across the playground how much better "we" are than "they", when "everyone's" got their own skeletons in the proverbial governmental closet?

the fact of the matter is this: no one government has the answer, and i'm not sure we armchair quarterbacks do either. but i love the fact that we can all debate it here; i love seeing people so passionate about their nations, their professions, and yes even their systems of government!

carolinapooh, BSN, RN · Feb 15, 2008

Will someone please tell me how not treating certain patients with certain afflictions is NOT denying them care?:uhoh21:
Oh, I get it. Under this form of social Darwinism, we'll treat low-income Mary Jones for her pneumonia, but not her COPD because she smoked 2 packs a day for 50 years. We'll amputate disabled veteran John Smith's foot because the circulation is nonexistent and gangrene is setting in, but we won't supply insulin for his diabetes because he ate himself up to 300 pounds.
I don't believe in enabling people to continue to self-destruct. I'm also not fond of paying taxes to pay for other peoples' health care when I have to work hard to earn my own. But then, I'd rather do so---even if someone, somewhere, might get something to which they aren't completely entitled---than turn my back on any human being who needs medical care, regardless of how they became ill.
Ah, what a sad state of affairs..........I'm all for personal responsibility, but attitudes like "I got mine" dishearten and disgust me, especially coming from people who are in a HELPING profession. It does not bode well for the future of health care, or of humanity in general.
Your point is exactly why I would wholeheartedly support some sort of universal/accessible preventative/primary care. (I also sometimes find myself supporting a flat tax and no itemizations - at least if I paid 25% and Joe Bazillionaire paid 25%, we're both paying the same percentage of our income, regardless of its size. The fact that his paycheck outstrips mine is something none of us can help, but at least it's an equal share. As it is, I pay about 30% and Bazillionaire boy pays probably about ten percent, because he employs half a tax law firm for that very purpose.)
But I digress...
We all, I think, find ourselves wrapped in the moral dilemma you describe from time to time. It infuriates me when I see illegal immigrants using the ED as a Dr. office - and yet I think, what the h*ll would I do in their shoes? Being married to an immigrant doesn't help my struggle any - especially when I think of the money it's cost to do it the legal route, and some folks waltz right in...but again, what would I do? I'd get the you-know-what out of Mexico, or Honduras, or wherever I was, and head here - one way or the other, and hope the legendary generosity of the American people would extend itself to me.
I look at people with uncontrolled health problems that I know have the resources to rectify the situation, and it just drives me nuts. But at the same time - if I were in their shoes, would going to the doctor embarrass me too much, and I could only find it within myself to go when I knew the situation was beyond repair, and then hope for the best?
I find it hard sometimes to reconcile my thoughts and feelings on this. I guess that's why I'm human and not in Congress - I KNOW I don't have all the answers and don't pretend to think I do.

KayMichelle · Feb 15, 2008

Will someone please tell me how not treating certain patients with certain afflictions is NOT denying them care?:uhoh21:
Oh, I get it. Under this form of social Darwinism, we'll treat low-income Mary Jones for her pneumonia, but not her COPD because she smoked 2 packs a day for 50 years. We'll amputate disabled veteran John Smith's foot because the circulation is nonexistent and gangrene is setting in, but we won't supply insulin for his diabetes because he ate himself up to 300 pounds.
I don't believe in enabling people to continue to self-destruct. I'm also not fond of paying taxes to pay for other peoples' health care when I have to work hard to earn my own. But then, I'd rather do so---even if someone, somewhere, might get something to which they aren't completely entitled---than turn my back on any human being who needs medical care, regardless of how they became ill.
Ah, what a sad state of affairs..........I'm all for personal responsibility, but attitudes like "I got mine" dishearten and disgust me, especially coming from people who are in a HELPING profession. It does not bode well for the future of health care, or of humanity in general.
Wow.
Again, I thought we were discussing the merits of univeral health care.
I didn't think we were discussing the option of denying anyone medical care.
That doesn't actually exist here in the United States. You can go to any emergency care unit at the hospital and it is illegal for them to turn you away.
Then, you can just ignore the bill. You can give them a false name and never see a bill.
It could happen, however, if we had universal healthcare.
That is why many are against it. It would "universalize" the system, so that your particular problem could be scrutinized with a history. Denial could happen pretty easily.
Healthcare reform is probably a better idea. That way, we can continue with no one being denied care. You see, it is possible that no one would know that Mary had COPD because she smoked for 50 years if that info wasn't centralized by a huge bureaucracy.
I don't think you gave a good example, however, because there isn't much that can treat her breathing problem very well with so much damage. Also, if you already have gangrene, insulin isn't going to help very much.
You know, no matter how good a nurse you are, you are not God, and people do get chronic diseases. Many times, these people are overmedicated in nursing homes, no matter what you do - those with COPD live dismal lives - many on tracheostomies with ventilators.
You should try not to personalize these discussions. We as nurses, need to have a solid viewpoint on these issues that pertain to our profession, we need to discuss them. We might be the ones pushing for a policy that might actually harm our patients in the long run.
When you call people names and say how disgusted you are with them for their opinions, it doesn't exactly foster open discussion. It makes people not want to discuss anything at all. I have mixed feelings about universal health care. Yes, I feel sorry for those who are noncompliant, but I've had noncompliant patients myself, and think there should be some kind of predetermined sanctioning against it. It is frustrating for everyone.
I don't "got mine". I haven't had health insurance in many, many years. When I did have it, I paid $350 per month with a $3,000 deductible, of which I never once hit the top. I have a schmuck of a little sister who goes to the emergency room for every possible problem, which is quite often since she is a hypochondriac, and she has never paid a dime.
I know there could be terrible consequences for an open system, at a time when inflation is rampant, prices for gasoline, housing, food is going up at racing levels. I don't think we can afford that as a people.

Simplepleasures · Feb 15, 2008

zippy, in post #208 is who called these patients "victims".
my goodness! how we have become emotional over this issue! i thought this was an academic/intellectual debate about universal heathcare. this is condesending.
first of all, i didn't mean at all to point anything out to you personally. i didn't insult you at all. i'm sure you're a perfectly wonderful person. dmii is only one of many, many sticking points in the overall debate of universal heath care. it is simply one of those watershed items, which are many. universal healthcare is usually rejected because of these issues.rejected by whom?
let's discuss another watershed issue.... how about aids? the drugs needed are very, very expensive cocktails taken by the patients. you know, many in africa are very upset that the rest of the world won't pay for these hugely expensive drugs. i saw a movie in school not too long ago about aids, which showed how, in africa, men think that if they have sex with a very young virgin, it will cure their affliction. nothing the ngos say will change their minds. they just keep spreading this horrible disease. are we to avoid "judging" these men?if you are the nurse who is taking care of an aids patient, it is not your place to judge on the job, in front of the patient, go home and judge all you want. you are not enabling or being untrue to your profession. teach, don't preach. or are we to be true to our profession by promoting good health decisions? do we enable this risky behavior?of course not. or do we stand firm and persist in demanding that it stop? back in the '80s, the healthcare professionals tried to shut down the bathhouses in l.a. they were called judgmental, bigoted. after many, many unnecessary deaths, they finallly closed. it was a good movie, it gave much to think about in our tolerant society.are you truly going to stand in front of your patient and demand they live the lifestyle you advocate?
or how about another issue... drug addiction and costs to rehabilitate drug addicts. or another... stds... gastric band surgery.... or another... abortions... or another, after effects of attempted suicide... or what about high risk athletics? steroid abuse therapy? reckless driving? lung cancer caused by smoking? what about illegal aliens that bring into this country hepatitis and tb? you are against gastric band surgery too?, or are you saying fat people should get the surgery, if this is the case do you realize many insurance companies deny this surgery as being "cosmetic"? so all those illegal aliens are disease ridden, what should we do with them? hmmm, near suicides, what should be done with these poor devils?
should the cost for the care for these things come out of the pockets of those who have no choice? backed up by the power of the police state? police state......:uhoh21:
these issues are true conundrums. they need to be discussed without such emotionalism.i think i may have detected a bit of emotion in the police state comment. by us, the healthcare professionals, in a mature way, without name calling, without calling someone's opinion "disturbing" and such. that is nonsense. if we cannot openly discuss healthcare issues, who can? when you descend to name calling, we will never have healthcare reform, or even a shadow of it. by saying something is disturbing is a far cry from name calling. discussing thorny issues doesn't make someone a 'bad' nurse. no one is judging you personally. forums are for discussing issues, not judging anything.of course not, yes this is a forum.
there are many syndromes that will be made worse by making healthcare "free". the state should not become an enabler. if someone is noncompliant in their therapy, how can you justify forcing another citizen to pay for it? could you list some for us?
i think a monetary fine at least should be levied for noncompliance if we had universal healthcare. other wise, it is like someone refusing to work, but still getting a paycheck. so, what should we fine these folks?
it could be a true nightmare.

have a good evening.

KayMichelle · Feb 15, 2008

Your point is exactly why I would wholeheartedly support some sort of universal/accessible preventative/primary care. (I also sometimes find myself supporting a flat tax and no itemizations - at least if I paid 25% and Joe Bazillionaire paid 25%, we're both paying the same percentage of our income, regardless of its size. The fact that his paycheck outstrips mine is something none of us can help, but at least it's an equal share. As it is, I pay about 30% and Bazillionaire boy pays probably about ten percent, because he employs half a tax law firm for that very purpose.)
But I digress...
We all, I think, find ourselves wrapped in the moral dilemma you describe from time to time. It infuriates me when I see illegal immigrants using the ED as a Dr. office - and yet I think, what the h*ll would I do in their shoes? Being married to an immigrant doesn't help my struggle any - especially when I think of the money it's cost to do it the legal route, and some folks waltz right in...but again, what would I do? I'd get the you-know-what out of Mexico, or Honduras, or wherever I was, and head here - one way or the other, and hope the legendary generosity of the American people would extend itself to me.
I look at people with uncontrolled health problems that I know have the resources to rectify the situation, and it just drives me nuts. But at the same time - if I were in their shoes, would going to the doctor embarrass me too much, and I could only find it within myself to go when I knew the situation was beyond repair, and then hope for the best?
I find it hard sometimes to reconcile my thoughts and feelings on this. I guess that's why I'm human and not in Congress - I KNOW I don't have all the answers and don't pretend to think I do.
I agree that there should be SOME things that are slowly added to a list of care that is basically socialized. There are some deeply divided issues that cannot be resolved, as I mentioned earlier, so we should just start with the primary care, preventative care things.
Our problems are nothing like the mess in some countries. Some type of tort reform/insurance reform would be a great idea too. That would ease the burden on the hospital staff. It would also help to make the industry more competitive financially as well, I think socialized medicine will wreak havoc on our paychecks, if it comes to pass!

Simplepleasures · Feb 15, 2008

I agree that there should be SOME things that are slowly added to a list of care that is basically socialized. There are some deeply divided issues that cannot be resolved, as I mentioned earlier, so we should just start with the primary care, preventative care things.
Our problems are nothing like the mess in some countries. Some type of tort reform/insurance reform would be a great idea too. That would ease the burden on the hospital staff. It would also help to make the industry more competitive financially as well, I think socialized medicine will wreak havoc on our paychecks, if it comes to pass!
When you become a nurse, you can actually put into practice all your strongly held beliefs. Just don't DEMAND the crack addict in the ER to get off of drugs, it might be safer to ask nicely. When do you graduate?

KayMichelle · Feb 15, 2008

should the cost for the care for these things come out of the pockets of those who have no choice? backed up by the power of the police state? police state......:uhoh21:

these issues are true conundrums. they need to be discussed without such emotionalism.i think i may have detected a bit of emotion in the police state comment.

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methinks you missed your government classes in college. in political theory, "police state" just means that you can get thrown in jail if you don't pay the taxes government sets up.

i think you are confusing it with conspiracy theories.

it is the concept of "the social contract" which is the basis of sociology.

the contract is that we give our freedom to a government in exchange for social order.

for instance:

"...in his essay no treason, argues that a supposed social contract (of the rousseauean sort) cannot be used to justify governmental actions such as taxation, because government will initiate force against anyone who does not wish to enter into such a contract..."

this is the essence of the questioning the fairness of socialism.

can you force anyone to pay taxes for something they do not believe in?

is that tyranny?

according to aristotle, rousseau, locke, hume, among others other, especially our founding fathers, absolutely yes.

Long Term Care Columnist / Guide · Feb 15, 2008

Zippy, in post #208 is who called these patients "victims".
My goodness! How we have become emotional over this issue! I thought this was an academic/intellectual debate about universal heathcare.
First of all, I didn't mean at all to point anything out to you personally. I didn't insult you at all. I'm sure you're a perfectly wonderful person. DMII is only one of many, many sticking points in the overall debate of universal heath care. It is simply one of those watershed items, which are many. Universal healthcare is usually rejected because of these issues.
Let's discuss another watershed issue.... how about AIDS? The drugs needed are very, very expensive cocktails taken by the patients. You know, many in Africa are very upset that the rest of the world won't pay for these hugely expensive drugs. I saw a movie in school not too long ago about AIDS, which showed how, in Africa, men think that if they have sex with a very young virgin, it will cure their affliction. Nothing the NGOs say will change their minds. They just keep spreading this horrible disease. Are we to avoid "judging" these men? Or are we to be true to our profession by promoting good health decisions? Do we enable this risky behavior? Or do we stand firm and persist in demanding that it stop? Back in the '80s, the healthcare professionals tried to shut down the bathhouses in L.A. They were called judgmental, bigoted. After many, many unnecessary deaths, they finallly closed. It was a good movie, it gave much to think about in our tolerant society.
Or how about another issue... drug addiction and costs to rehabilitate drug addicts. Or another... STDs... Gastric band surgery.... or another... abortions... or another, after effects of attempted suicide... or what about high risk athletics? steroid abuse therapy? reckless driving? lung cancer caused by smoking? What about illegal aliens that bring into this country hepatitis and TB?
Should the cost for the care for these things come out of the pockets of those who have no choice? Backed up by the power of the police state?
These issues are true conundrums. They need to be discussed without such emotionalism. By US, the healthcare professionals, in a mature way, without name calling, without calling someone's opinion "disturbing" and such. That is nonsense. If we cannot openly discuss healthcare issues, who can? When you descend to name calling, we will never have healthcare reform, or even a shadow of it.
Discussing thorny issues doesn't make someone a 'bad' nurse. No one is judging you personally. Forums are for discussing issues, not judging anything.
There are many syndromes that will be made worse by making healthcare "free". The state should not become an enabler. If someone is noncompliant in their therapy, how can you justify forcing another citizen to pay for it?
I think a monetary fine at least should be levied for noncompliance if we had universal healthcare. Other wise, it is like someone refusing to work, but still getting a paycheck.
It could be a true nightmare.

Sorry, I'm a little fuzzy sometimes, but I honestly can't recall having called anyone names here.

And FWIW, the post I was referring to IS disturbing, at least to me personally, because it reflects a general shift in societal attitudes that I find objectionable. America used to be about "we're all in this together"; now it's "every man for himself". I was raised by a generation that prided itself on sticking together and seeing things through; it bothers me greatly that so many seem so willing to simply cast their fellow human beings aside when they don't conform to some ideal of right behavior. I don't apologize for that.

I used myself as an example, not because I felt insulted, but because I wanted to put a human face on "lifestyle" diseases. It's much harder to be judgmental toward a group of people when one of 'them' is someone you know, somone who works with you or lives next door to you or goes to the same church with you. Being fairly well-known here at allnurses as a frequent poster and moderator, I thought that speaking of my own struggles might help others see that those of us who have self-induced conditions are not just a bunch of weak-willed losers, we are PEOPLE who deserve health care like everyone else.

As for the scolding on the purpose and function of discussion forums: I've been a member of allnurse for five and a half years, and a moderator for two and a half. I think I may have learned a couple of things in all that time, not the least of which is how to be patient with other posters.

Good-night. :yawn:

Simplepleasures · Feb 15, 2008

Never mind, lets rock and roll!