Universal Healthcare/Nursing Salaries

HM2VikingRN, RN · May 5, 2008

In general I would venture to guess that we would see increased wages as a whole. (If not in fact increased wages. Passage of the employee free choice act would also tend to support increased presence of unions in health care.)

Miami Fla: (non UHC state) 57,000 average for a staff RN.

Minneapolis MN (UHC state): 64,000

Mn does have a state income tax but that does not really affect the base salary comparison as the property tax burden tends to be lower as a compensation.

Tweety, BSN, RN · May 5, 2008

I think our present state of affairs with cost cuts, the poor economy, lack of reimbursement and tougher standards of payment, etc. is going to keep wages depressed, do we might see this trend continue with Universal Healthcare.

We still will remain a free-market and the market should have a say so in the wages as well, even if we go to a universal healthcare. Getting better reimbursement and not having to write-off so many expenses that aren't paid for might actually leave room for an increased budget for staff.

mianders, RN · May 5, 2008

In general I would venture to guess that we would see increased wages as a whole. (If not in fact increased wages. Passage of the employee free choice act would also tend to support increased presence of unions in health care.)
Miami Fla: (non UHC state) 57,000 average for a staff RN.
Minneapolis MN (UHC state): 64,000
Mn does have a state income tax but that does not really affect the base salary comparison as the property tax burden tends to be lower as a compensation.[/quote
I would completely disagree that Universal Healthcare would increase nurses salaries. In fact I would venture to guess the exact opposite. I also do not think it will increase the presence of unions in healthcare. They are two completely different issues. The area of the country you live in is also a big factor in salaries in general more so I think than if you are in a union.

elkpark · May 5, 2008

When considering the impact of a single-payer healthcare funding system on salaries, remember that all of us who currently have healthcare insurance through a private-for-profit insurance company that is "paid for" by our employer are currently earning a few hundred dollars more a month than is reflected in our paychecks because that money is taken "off the top" to pay for our insurance -- that is earned income that we never see, so we tend to forget about it.

Jolie, BSN · May 5, 2008

When considering the impact of a single-payer healthcare funding system on salaries, remember that all of us who currently have healthcare insurance through a private-for-profit insurance company that is "paid for" by our employer are currently earning a few hundred dollars more a month than is reflected in our paychecks because that money is taken "off the top" to pay for our insurance -- that is earned income that we never see, so we tend to forget about it.

Our current premiums for private health insurance will be replaced by a government tax on all income to pay for the cost of universal healthcare. Some families would likely see a significant increase in the amount they pay for healthcare. For example, my hubby carries family insurance thru his employer, which is paid thru payroll deduction. No other member of our family elects to carry healthcare coverage, since that would simply duplicate our costs without significantly improving our coverage. With universal healthcare, there will be no choice to "opt out", so every working member of a family will see a payroll deduction for healthcare. In our family, that would amount to at least doubling, and possibly tripling the amount paid for healthcare coverage.

jjjoy, LPN · May 5, 2008

With universal healthcare, there will be no choice to "opt out", so every working member of a family will see a payroll deduction for healthcare. In our family, that would amount to at least doubling, and possibly tripling the amount paid for healthcare coverage.

On the other hand, if your husband lost his job, you wouldn't have to worry about paying astronomical COBRA fees to keep your current insurance. The fees for 2-3 working adults shouldn't be THAT big of a difference (double/triple) compared to the *total* amount of the insurance provided through your husband's employer. And don't forget that your husband's employer might at any time decide to shift more of the insurance premium to the employee making it less of a deal for you.

Back to salaries and UHC. Do keep in mind that most UHC plans on the table in the US do not propose that health care be government-owned and run. Thus, health care employees would NOT be government employees. I'd think that in some areas, salaries might go down. And in other areas, they might go up. The pay for some types of nursing might go up. And it might go down for other types. If overall, health care is more accessible and affordable to all (including nurses and their families!) and nursing can provide a *true* living wage (without horrible working conditions), then to me, potential decreases in the salary of some areas of nursing seems like a reasonable trade-off.

There's a crunch on health care budgets whether or not it's for-profit, not-for-profit, or government-paid. So I don't think there's any guarantee that nursing salaries (and working conditions) would be better without any kind of UHC.

Ruffles 1 · May 5, 2008

I think nurses salaries would not increase,but the insurance premiums would go up for everyone. Insurance compaines are out to make money and will figure a way to do it.

Jolie, BSN · May 5, 2008

Under universal healthcare, nurses and other hospital employees may not be government employees per se, but I believe it is naive to think that the government won't have significant control over salaries.

Our system of private insurance definitely has its flaws, but it does encourage competition. Hospitals will not currently accept (or participate) insurance plans that do not pay a sufficient amount for the hospital to recoup its cost of care. Not so with Medicare and Medicaid. When I worked OB in South Carolina, we were paid a grand total of $800 per Medicaid delivery, regardless of the actual costs, and we were required to allow a 48-hour stay. No early DC to save costs. At that time, private insurance paid approximately $2000 per delivery, with the actual amount depending on the insurance company, lady partsl vs. C-section, length of labor, complications, etc. Had it not been for private insurance companies making up the deficit created by Medicaid underpayment, we would have had to close our OB services. Those are certainly not circumstances under which nurses could expect to be well-paid or receive raises.

elkpark · May 5, 2008

Our system of private insurance definitely has its flaws, but it does encourage competition. Hospitals will not currently accept (or participate) insurance plans that do not pay a sufficient amount for the hospital to recoup its cost of care.

This statement just isn't true. I have worked for more than one major medical center in a large city which had a contract with the insurance company that provided coverage for some of the major employers in the area, and I know for a fact that the hospitals lost money on every person they admitted who had insurance with that company -- but the insurer was such a major "player" in the area that the medical centers didn't feel they had any choice but to accept the insurance company's terms (demands!), because refusing them would have cut the medical centers off from such a large proportion of the local population ... I'm not saying that happens everywhere, but it does go in plenty of cities all over the country. It's not at all uncommon for hospitals to lose money on the insured clients from particular insurance companies, and try to make up that money by charging the "self-pay" clients much more than the insurance companies pay for the same procedures/services.

jjjoy, LPN · May 5, 2008

Hospitals will not currently accept (or participate) insurance plans that do not pay a sufficient amount for the hospital to recoup its cost of care. Not so with Medicare and Medicaid.

It's my understanding that private health insurance reimbursement rates don't always cover all hospital costs. Hospitals are willing to accept low reimbursement rates because they fear that if they don't accept the insurance company's patients that their only patients will be those without insurance - for whom they end up getting no reimbursement at all. Hospitals are competing for insurance company patients and thus will accept a lower reimbursement to keep the contract. Insurance companies are NOT competing for hospital space for their patients. That would involve bidding up reimbursement rates in order to make their contract more appealing. The only way for insurance companies to bid up their reimbursement rates would be if there weren't enough hospital beds for patient needs. That would be good for hospital's bottom lines and nursing salaries, too, but it wouldn't be good for us as patients who may be denied a hospital bed due to lack of space.

By the way, I'm not necessarily pro-UHC. There would most certainly be drawbacks. But there are also many drawbacks of the status quo that often aren't acknowledged by those who are against any kind of UHC.

Since there are major drawbacks to any option, I want the option that offers what's best for society as a whole and for the majority of individuals. Thus, slightly lower quality of care for most might be better than the best quality of care for a smaller proportion who can afford it (and there will always be those with SO much money that they will always be able to afford the best regardless of what is offered to the rest of society). However, if the overall quality of care offered is so lowthat no one benefits, then that's not worth paying for (as a society & as individuals) either.

But again, I'm off-topic here. Salaries and UHC...

HM2VikingRN, RN · May 5, 2008

I think the simplest way to think about one benefit of UHC is that it will get providers in the habit of competing for patients NOT insurance contracts.

The employee free choice act is part of this debate in the sense that almost any proposal for UHC will call for a strengthening of collective bargaining rights for health care workers. Sort of a Davis-Bacon act for nurses. Requiring a prevailing wage minimum would tend to raise the base for all.