Universal healthcare grassroots movement

RNed · Jul 31, 2001

Fiestynurse I reviewed your posting and read information on the Web site you shared regarding HCA. I am not totally against a universal system designed to improve the heatlh and care given in this country.

Like many I have lost faith in our government processes to make the necessary changes to accomplish a very difficult task.

There is a substantial problem in distribution of funds rather than an absence of funds.

We are not getting the funds (healthcare) to the people that would benefit the most. Repeatedly I care for alcoholics, drug addicts and others who are using subsidized healthcare dollars, yet, as soon as able to stand vertical, they return to unhealthy habits. While at the same time we are unable to provide bone marrow transplants, etc. to our children who would have a full life ahead of them if healthcare was timely and appropriate.

Our goals are the same, it is our paths that are different. I can support a review (HCA), however, as I read the information, my concern is that it has developed a solution and therefore will be more prone to find data supporting that solution rather than reviewing other options or thinking "outside the box".

A single payer system will not change the fact - that the rich and educated will receive better care then the poor and uneducated. In our society if the rich have the money there will be a medical market designed to access that money and it will be better care because the rich will not buy average or less care. We are unable to level the playing field in a supply and demand economy even if it is a noble plan.

Once the data and review is completed would (HCA) review a single payer system for the uninsured, indigent, poor and working poor and can this review include all subsidized services including housing and food and leave the private market as is?

If we consolidate all services thru one clearinghouse we could increase efficency, lessen adminstrative expenses and have better followup and outcomes. It seems to me good healthcare needs to include shelter and food and it is appropriate that we include those items now rather than later. The current support systems are fragmented and allow abuses and duplications in service.

Yes, it would recognise and define a two tier system, but there is a two tier system in play now. We can deny it or we can accept it. This has been one of the major failures impeding healthcare improvement and many other programs.

We continue to strive for a fair system in an unfair world. When we have the wisdom to accept - it is unfair, we will be another step closer to developing an acceptable plan.

fiestynurse · Aug 1, 2001

I understand the loss of faith in our government. I am skeptical and discouraged at times, too. Why should we trust our health care dollars to the government, when they do such a poor job managing the rest of the money they get from us?

However, it is untrue that government managed health care financing is more expensive or inefficient than the current private insurance system. Medicare, consumes only 2.2% of its revenue for administration. The Canadian health insurance system consumes only 2.5% for administration. If you include all other administrative costs, hospital and clinic administration, billing, marketing, insurance profits, the U.S. spends 35-30% of all health care revenues for bureaucracy, contrasted with 8-12% in Canada.

Moreover, a government controlled system allows us access to

information about the way decisions are made. In private corporations this is considered "proprietary" and not open to public view. There are scandals in government, but these pale in comparison to those in health care. Have you ever heard of a government official getting away with the $1 billion Leonard Abramson got for the Aetna-U.S. Health-care merger?

In addition, the single payer system is equitable. Everyone has access to personalized care with a local primary care physician. Hopefully, we would finally remedy the racial and ethic disparity in health care with better access. The 44 million uninsured would be covered. Discrimination of any kind would be strictly prohibited.

Finally, the study that HCA helped to pass is being done by an independent facilitator. Three systems will be studied, including single payer. All this information will be presented to a task force that will consist of all the stakeholders whose buy-in will be crucial during the legislative debates expected in 2002.

Mijourney · Aug 2, 2001

Hi feistynurse and fergus51. As an FYI, I have learned that the American Public Health Association plans to have a conference in Atlanta, GA in October. I briefly reviewed the schedule for that event in their website and discovered that there are supposed to be presentations on single payor systems or universal health care. I also just read my local newspaper and noted a prominent doctor in the area who wrote a letter to the editor strongly endorsing a single payor system.

http://www.apha.org

I am still concerned about doctors dictating the tenor of a single payor system. We do not need representatives (ie doctors and administrators) from the narrowly focused medical-industrial-complex model solely dictating all the funding or care in a reformed system.

fiestynurse · Aug 7, 2001

The American Medical Association

Newly Adopted Principles of Medical Ethics, June, 2001

Principle IX: "A physician shall support access to medical care for all people."

The greatest impediment to access is the lack of adequate health insurance. Although access problems related to our health care infrastructure must be addressed, truly universal access is impossible without comprehensive, universal insurance. Creating a universal health insurance program is the greatest and most urgent priority if we are to realize this goal of universal access. Let's start the process now. After all, the House of Delegates of the American Medical Association has declared it to be unethical not to do so!

P.S. Thanks for the info Mijourney

Mijourney · Aug 8, 2001

Hi. One thing I think we should acknowledge with physicians is that they became part of the problem instead of the solution when it came to skyrocketing medical costs. They made the decision to get in bed with insurance companies and the government with the various indemnity plans. Most physicians, especially specialists, that have been in practice for over five to ten years can attribute their wealth to insurance and Medicare. They made the decision to sleep with pharmaceuticals and other biotechnology entities. In fact, pharmaceuticals and biotechnology entities increasingly invade the territory of nurses and allied health professionals regularly in person and print and you see their advertisements on TV. With the increased health and medical needs and demands by an aging and more sophisticated population, something had to be done to control what was turning into abuse of the health care system. Unfortunately, managed care has in many cases done more damage than good.

What will be interesting about universal health care is to see how it is executed. It seems to me the physicians want to regain what power they had prior to managed care through universal health care and they feel they have justifiable reasons. Hospital and health care executives want to attach themselves to physicians so that they can have a commanding voice at the table. However, this go round, nurses and other groups typically left out of the fray must force their voices to be heard as loudly as physicians and administrators so that we don't get bogged down with one group's model of patient care and health care delivery. We nurses want control of our destiny just as the physicians do.

RNed · Aug 9, 2001

Mijourney makes a good point related to the physcians being in bed with the money managers. I think most physicans support universal heatlh care becasue they desire this hugh funding source for care "they" deem necessary.

The most crucial decision is who is the "gatekeeper". We have tried the insurance companys, HMO's, etc and with little, if any success in reducing costs.

A unviersal heatlh care system is prime for increased acceleration of healthcare expenses without stringent controls and gatekeepers on services.

Just because they are doctors or legislatures does not mean they define what is or is not "ethical". Everyones' values are different and ethical issues are wide open for interpetation. The controversy surrounding healthcare's ethical positon is as varied as there are people. Example:

Do we pay for abortions, circumcisions, birthcontol?

Do we pay for 89 y.o. bypass surgeries?

Do we pay for the eighth pregnancy of a non-working single mom?

How many drug rehab stays do our addicts get?

Who determines if this MI shall be treated medically or surgically?

The best research is being done at the Mayo clinic, I wish to go to the Mayo clinic for my therapy?

We must answer these questions before we decide how much funding is required. We can not afford a system without limitations of services and we can not afford a system where those who decide are also those who reap?

We need to define what we are going to provide for services and what we are "not" going to provide for services, then we need to determine cost, affordablity and value.

Society is not going to accept, "Universal Healthcare" until these type of decisions, controls and issues are answered.

fiestynurse · Aug 11, 2001

I completely agree with you mijourney!!

In regards to the American public wanting a health care system that has double-digit inflation. Some say that people are just expecting the world. But I think that the American people have been programmed to "expect the world" by some interest groups that will profit from the expectation.

How about the Sunday magazine ads for the toenail fungus medication that only costs $800 for a course of therapy (the ads don't mention the price)? And the $5000 a dose drugs to keep your cardiac stent open -- should we use anything but the best? We glamorize (and the media and corporations glamorize for us) the ultra-expensive off-the-wall technologies while who cares about promoting life-style changes? How much space in the media did the new mechanical heart get, compared with the news that exercise and minimal weight loss could prevent diabetes?

The neonatologist earns $750M a year compared to the family practice doc who earns $120M. The AMA protects the interests of the highly paid specialists by bashing the Canadian system. And despite all their (really) good new drugs, the pharmaceutical industry has probably created the largest image of "the hell with costs" with its promotion of such items as "the toenail fungus pill" (above), the purple pill for heartburn that costs $100 a month, items like Claritin , which cost 50 times as much as an OTC drug which is just as effective, etc.

How about the waterfalls in the hospital lobbies? Our system seems to embrace the ideals of "personal responsibility" for the poor but "personal opportunity" for the rich. Community benefit? That would be socialism. So "personal opportunity," with its double-digit inflation result, has set the tone for American health care. We can see that with the direction our system is taking, the poor and near-poor will be increasingly left out, priced out of the market, by the "opportunists" who will then continue to lecture the less well-off about "personal responsibility."

Yes, we have created a monster, but some folks are more to blame than others.

RNed writes:

"I think most physicans support universal health care because they desire this high funding source for care "they" deem necessary."

I THINK THE OPPOSITE IS TRUE!! I think physicians are hanging on to the present system because they think universal health care will hold them more accountable!

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