After posting the piece about Nurses traveling to Germany and reading the feedback. I would like to open up a debate on this BB about "Universal Health Care" or "Single Payor Systems"
In doing this I hope to learn more about each side of the issue. I do not want to turn this into a heated horrific debate that ends in belittling one another as some other charged topics have ended, but a genuine debate about the Pros and Cons of proposed "Universal Health Care or Single Payor systems" I believe we can all agree to debate and we can all learn things we might not otherwise have the time to research.
I am going to begin by placing an article that discusses the cons of Universal Health Care with some statistics, and if anyone is willing please come in and try to debate some of the key points this brings up. With stats not hyped up words or hot air. I am truly interested in seeing the different sides of this issue. This effects us all, and in order to make an informed decision we need to see "all" sides of the issue. Thanks in advance for participating.
Michele
I am going to have to post the article in several pieces because the bulletin board only will allow 3000 characters.So see the next posts.
Britain's National Health Service reaches middle age.
How is Its Health?
by Gerard Brogan, RN
Long waits in the ER, nursing and other staff shortages, well-publicized medical mistakes. It's an all-too-familiar picture for Americans living under managed care. But this is also a picture of England's National Health Service (NHS) three years after its 50th anniversary.
Two different health care systems facing similar challenges: aging populations, greater demands and heated funding debates. Since its inception the NHS has been a sacred part of English public life.
Polls show that, across the social spectrum, it is a concept held dear to the hearts of the British people. Successive governments have effected changes and improvements, but none have dared to seriously question it as the method of health care delivery in the UK.
The NHS was conceived in 1942 when World War II was at its bleakest for the British and the need for a robust public health system to deal with mass casualties was deemed paramount. Implementation of the NHS began in 1945 and was finished by 1948.
A new politic was sweeping the nation, fueled by the optimism of the returning soldiers who, after defeating fascism in Europe, were eager to right social inequities at home. A new welfare state was the goal, with cradle-to-grave social services for all. The NHS would be the cornerstone of this new state. Tax supported, the service would be free to all at point of use, based on community care with general practitioners and community health centers at its core.
The NHS proved to be a success in dramatically improving the health of the nation. As services were utilized more and new technologies and treatments introduced, the NHS continued to grow. It is now the largest organization in Europe and employs more than 1 million people. Now, more than half a century after its birth, its critics claim the NHS is expensive, unfair and inefficient. Yet this is said about the health systems in many countries both in the developed and undeveloped world.
The private sector has made inroads into the system, and brought with its entry some spectacular, well-publicized financial disasters. Some conservatives call for more public-private partnership and/or competition to break down the NHS "monopoly."
The British public does not seem to share this opinion. In a recent poll conducted by Market and Opinion Research International (MORI), England's largest polling firm, nine out of 10 citizens said privatization is not the answer to the problems now facing the NHS. What the public does believe is that the cause of problems within the NHS is underfunding, and that an increase in funding would improve service. Figures back up this perception.
Britain currently spends a total of £67 billion (or more than $93 billion in U.S. currency) on health care for a population of 58 million people. This represents 7.1 percent of the gross domestic product. The European Union average for its 14 nations is 9.2 percent.
In the United States, health care spending accounts for about 14 percent of the GDP.
In terms of quality of care, the World Health Organization, in its report, "The World Health Report 2000 Health Systems: Improving Performance," ranked France first in quality with the United Kingdom at 18th and the United States at 37th.
Defenders of the NHS say these results demonstrate that the system is working well, given current funding levels, and could improve tremendously with extra funding. The last government election campaign reflected this public pressure. Both major parties promised NHS reform and increased funding as part of their manifestos. The Labor Party led by Tony Blair prevailed in the election.
A measure of the importance of the NHS is that it shared center stage with the recent terrorist attacks during the Prime Minister's speech on Oct. 2 at the first Labor Party conference since its re-election. Blair stressed how the NHS had been underfunded for years and pledged to increase funding.
The government has since added some hard numbers to the rhetoric, pledging to increase funding by 5 percent a year until 2003, with projected increases of 3.9 percent a year thereafter until 2006. Government ministers say this would increase funding to 8 percent of the GDP by 2006, a figure they claim is in line with the European Union average. Critics say that the European Union average is actually 9 percent and that further funding increases are necessary. What the final funding figures will be after 2003 are still in question.
What is not in question is that the NHS will prevail as the health care system of choice for the British people. "We have without doubt the best health care system in the developed world," said Jim Devine, RGN, Senior Health Officer of Unison, the United Kingdom's largest trade union. "Despite the attempts of the Tories [Conservative party] over 19 years to privatize the National Health Service both wholesale and piecemeal, polls show the British public want the NHS to remain tax-supported and free at point of access. The labor party is hopefully listening to the British public."
Unison's surveys of Registered General Nurses (RGN), the equivalent to U.S. RNs, and other health care workers demonstrate that workloads have doubled over the last 15 years. Devine stated that £45,000 (or roughly $65,000) is spent on training each nurse. "We are giving them the skills and then failing to provide them with the environment in which to properly use those skills. This obviously leads to low morale and high turnover of nurses.
"We [unison] believe that spending on the NHS should be brought up to the average of the European Community in terms of Gross National Product. This would lead to a very significant change in the provision of care in terms of more nurses, more support staff and more beds. It is precisely these shortages that are preventing the NHS from living up to its full potential."
Gerard Brogan, RN, has extensive nursing experience in both Britain and the United States.
NHS quality and performance: the issue explained /story/0,8150,728530,00.html>
The government's reputation rests partly on its ability to improve NHS performance, delivering speedier access to safer, more dependable, higher quality services.
At a glance: what's in this big issue? /story/0,8150,724678,00.html>
Web review: the most useful sites on NHS performance /page/0,8149,649180,00.html>
Timeline: a brief history of NHS inspection /comment/0,8146,848297,00.html>
Big issue: Alder Hey organs scandal /0,7989,430964,00.html>
Big issue: the NHS plan /0,7995,392018,00.html>
Latest
Doubts over hospital performance bonus cash /story/0,8150,1137282,00.html>
Feb 2: NHS leaders question plans to pay hospitals bonuses of up to £500,000 for improvements in emergency care.
01.02.04: Hospitals to collect efficiency bonuses /story/0,8150,1136995,00.html>
'Whistleblower' wins tribunal case /story/0,8150,1135642,00.html>
Jan 31: Hospital finance director was unfairly dismissed, an employment tribunal has found.
Doctors punished for kidney blunder /story/0,8150,1130246,00.html>
Jan 24: Two doctors who wrongly removed a patient's only healthy kidney found guilty of serious professional misconduct.
13.01.04: Surgeons accused of kidney blunder deny misconduct /story/0,8150,1121945,00.html>
I love how people always critique the NHS to say that universal care is worse, but never mention the fact that they spend HALF of what we do on health care.
What about the notion mentioned in the first article about ingenuity and invention? What about the idea that we are motivated by money? We sure are movitated by money, as RN's, come contract time, aren't we? If in a universal healthcare Doctors and nurses make what a bus driver makes, then where is the incentive? Where is the incentive for pharmaceutical companies to invent new drugs to treat cancer and autoimmune disease and HIV and come up with new antibiotics or anti-virals or new vaccines. Has Canada been inventive? Have government run universal healthcare systems displayed ingenuity? When one in 8 of us females develop breast cancer, do we want there to be a newly developed treatment, so that we can survive to raise our children?
Now I am throwing down the gauntlet on this one. I challenge you to find, within the US an institute/facility dedicated to performing systematic reviews of research for the develoment of evidence based practice guidelines for NURSING!!!! Can you equal the Joanna Briggs Institute???
BTW WE have free mamograms for all women over the age of 50 and they send out regular reminders too. We actually have mobile breast screening clinics (that is the clinics are mobile not the breasts)
Okay, lets see. Kitkat, in my limited knowledge of the phrase "bible thumper", I consider it to mean "one who forces religion down your throat". I do not think you did that and I did not ever call you that--I only mentioned them. I do not resent christians at all. I am not religious and I think that religion causes more problems than it solves, but I was baptised protestant, I had a jewish foster family, and I studied eastern philosophy (nearly one in the same with religion in the east) in college. I was merely demonstrating a rather irrelevant point to the actual healthcare discussion that I think most conservatives don't understand how non-religious people can have morals.
I do not think its wrong in any way that some people have more money or can afford more of whatever than others, I think that its wrong that many of these people with more are on a mission to obtain more at all costs, to the detriment of others, and with no regard for who they are trampling on their way up. It is wrong that that is their main goal and that they don't care about anyone else. Lets put it this way: you've probably heard someone say before (or you've read) that "with power comes an awesome responsibility" and certainly money is a huge indicator of power. Now what do you suppose is meant by this quote? It seems to me that it refers to things like integrity, justice, fairness, consideration, beneficence, etc.
As I said earlier, I understand that you should have your taxes go where you want them to--so should I. I would love it if my taxes went to health, education, crime prevention, etc and I was assured that those are the only placed that it would go. But since our representatives in this country don't actually represent what we want, other than throwing us little crumbs here and there even for those of us who voted, I am in the same situation that you wish to avoid. Oh, I am not an athiest, I am an agnostic, if a label must be applied. I realized a long time ago that one could not be sure of the existence of God, nor could they be sure that "their" religion is the "right" one.
I guess I am not articulate enough to make my point since you don't seem to understand it. I think everyone should work hard and be accountable. I think everyone should be tolerant, kind, and as knowledgeable as they can possibly be. I think everone should constantly be trying to improve themselves and I think everyone should be willing to lend a hand when needed. I think everyone's goal should be to further the human race and to enjoy ourselves while doing it. I think most liberals think that most of these goals are low on most conservative's priority list, hence the apprehension to trust their line of thinking especially when it comes to something really important like healthcare. I would love it if somehow we were wrong in our assumptions, but never mind having proof that we are wrong, I can't even get a nurse of all people ( I mean you) to even hint that these are the types of things that are at the top of your list. I think it is more important to protect the rights and needs of everyone than to protect the right of the few to retain the autonomy not to help out. Though I am trying, I cannot understand why you do not consider this sort of thinking a good thing.
Discussions can become heated--please do not consider my replies an insult--it is not intended that way. I know that I basically keep responding to Kitkat, but please feel free to join in all, if you wish. Again, Kitkat, please do not regard my replies as insults--I am sorry if I offended you.
MPs query Pounds 70m spent on structure and pay-offs NATIONAL HEALTH SERVICE.
NICHOLAS TIMMINS
The National Health Service has spent more than Pounds 70m on redundancy and restructuring in the past two years, the Department of Health has told MPs.
The sum is equivalent to the cost of refurbishing a big hospital or two-thirds of what the National Institute for Clinical Excellence added to NHS spending in its full year as it recommended the use of better drugs.
The costs, resulting from re-organisations ordered by Alan Milburn when he was health secretary, have been revealed to the Commons health select committee.
According to the department, closing regional offices cost Pounds 15m, and replacing community health councils with the patient liaison service cost Pounds 12m in redundancy pay. Replacing 100 health authorities with 28 strategic bodies across England cost Pounds 45.3m. The bill is likely to rise as the Commission for Healthcare Audit and Inspection replaces the Commission for Healthcare Improvement next April.
David Hinchliffe, the committee chairman, said: "Every time we get a major restructuring - and we have had 18 in the past 20 years - we get these huge restructuring and redundancy costs.
"It makes the argument against yet further changes in the NHS. We also lose a lot of experienced people," said the Labour MP.
It was probably one factor, he said, that explained "why some of us think an awful lot of money is going into the NHS but not enough is coming out in terms of results". And it was far from clear the changes had yielded better performance.
NHS officials struggled to defend the costs before the committee. Richard Douglas, finance director, said it was hoped the Pounds 12m cost of scrapping CHCs was a "maximum". John Bacon, who is in effect chief operating officer, said: "Clearly, the belief is that the structural changes ...will deliver a more efficient and effective service, so there is a gain to be had."
MPs challenged the scale of some redundancy packages. Making a chief executive in their early 50s redundant can cost up to Pounds 250,000 once payments into the pension fund are included.
Mr Douglas said the two large restructurings affected 20,000 staff, and the department had worked to redeploy people. "In the end there was only a relatively small number of people that we could not find places for . . .We are dealing with some very major change."
Some redundancy costs look very high, he told MPs, but "have to be seen in the context of a pay bill in excess of Pounds 20m. So in percentage terms they are absolutely tiny."
i have decided to step out of the debate - i feel that i am not accomplishing anything here.
however i will continue to peruse any material coming from australia and will remind posters of the terms of service for the bulletin board
you will not use this bb to post free advertising or solicitations, any material which is knowingly false and/or defamatory, inaccurate, abusive, vulgar, hateful, harassing, obscene, profane, sexually oriented, threatening, invasive of a person's privacy, or otherwise violative of any law.
Now I am throwing down the gauntlet on this one. I challenge you to find, within the US an institute/facility dedicated to performing systematic reviews of research for the develoment of evidence based practice guidelines for NURSING!!!! Can you equal the Joanna Briggs Institute???
BTW WE have free mamograms for all women over the age of 50 and they send out regular reminders too. We actually have mobile breast screening clinics (that is the clinics are mobile not the breasts)
My comment was a reference to Canada.... so how do I comment? I don't know how to comment when what I type is taken out of context.
I think it is interesting that the poll at the top of this thread show a 55% are pro universal health care.
Actually, I think that the poll that I posted is very interesting. This site is I would have to guess, 75% or more liberal left dominated posters. I would have thought the poll would show that 90% of polled BB posters were pro-universal healthcare.
And as far as innovation and research, I have also already given you proof of that. Go to Sick Kid's website, go to Mount Sinai's website, look at the Samuel Luenfeld research institute.... But obviously I have no knowledge of the system here....
If you just think the Canadian system is what's bad, then do you think the Australian universal system is superior? It seems like you think they are all bad.
pickledpepperRN
4,491 Posts
http://www.revolutionmag.com/newrev7/nhsart.html
Britain's National Health Service reaches middle age.
How is Its Health?
by Gerard Brogan, RN
Long waits in the ER, nursing and other staff shortages, well-publicized medical mistakes. It's an all-too-familiar picture for Americans living under managed care. But this is also a picture of England's National Health Service (NHS) three years after its 50th anniversary.
Two different health care systems facing similar challenges: aging populations, greater demands and heated funding debates. Since its inception the NHS has been a sacred part of English public life.
Polls show that, across the social spectrum, it is a concept held dear to the hearts of the British people. Successive governments have effected changes and improvements, but none have dared to seriously question it as the method of health care delivery in the UK.
The NHS was conceived in 1942 when World War II was at its bleakest for the British and the need for a robust public health system to deal with mass casualties was deemed paramount. Implementation of the NHS began in 1945 and was finished by 1948.
A new politic was sweeping the nation, fueled by the optimism of the returning soldiers who, after defeating fascism in Europe, were eager to right social inequities at home. A new welfare state was the goal, with cradle-to-grave social services for all. The NHS would be the cornerstone of this new state. Tax supported, the service would be free to all at point of use, based on community care with general practitioners and community health centers at its core.
The NHS proved to be a success in dramatically improving the health of the nation. As services were utilized more and new technologies and treatments introduced, the NHS continued to grow. It is now the largest organization in Europe and employs more than 1 million people. Now, more than half a century after its birth, its critics claim the NHS is expensive, unfair and inefficient. Yet this is said about the health systems in many countries both in the developed and undeveloped world.
The private sector has made inroads into the system, and brought with its entry some spectacular, well-publicized financial disasters. Some conservatives call for more public-private partnership and/or competition to break down the NHS "monopoly."
The British public does not seem to share this opinion. In a recent poll conducted by Market and Opinion Research International (MORI), England's largest polling firm, nine out of 10 citizens said privatization is not the answer to the problems now facing the NHS. What the public does believe is that the cause of problems within the NHS is underfunding, and that an increase in funding would improve service. Figures back up this perception.
Britain currently spends a total of £67 billion (or more than $93 billion in U.S. currency) on health care for a population of 58 million people. This represents 7.1 percent of the gross domestic product. The European Union average for its 14 nations is 9.2 percent.
In the United States, health care spending accounts for about 14 percent of the GDP.
In terms of quality of care, the World Health Organization, in its report, "The World Health Report 2000 Health Systems: Improving Performance," ranked France first in quality with the United Kingdom at 18th and the United States at 37th.
Defenders of the NHS say these results demonstrate that the system is working well, given current funding levels, and could improve tremendously with extra funding. The last government election campaign reflected this public pressure. Both major parties promised NHS reform and increased funding as part of their manifestos. The Labor Party led by Tony Blair prevailed in the election.
A measure of the importance of the NHS is that it shared center stage with the recent terrorist attacks during the Prime Minister's speech on Oct. 2 at the first Labor Party conference since its re-election. Blair stressed how the NHS had been underfunded for years and pledged to increase funding.
The government has since added some hard numbers to the rhetoric, pledging to increase funding by 5 percent a year until 2003, with projected increases of 3.9 percent a year thereafter until 2006. Government ministers say this would increase funding to 8 percent of the GDP by 2006, a figure they claim is in line with the European Union average. Critics say that the European Union average is actually 9 percent and that further funding increases are necessary. What the final funding figures will be after 2003 are still in question.
What is not in question is that the NHS will prevail as the health care system of choice for the British people. "We have without doubt the best health care system in the developed world," said Jim Devine, RGN, Senior Health Officer of Unison, the United Kingdom's largest trade union. "Despite the attempts of the Tories [Conservative party] over 19 years to privatize the National Health Service both wholesale and piecemeal, polls show the British public want the NHS to remain tax-supported and free at point of access. The labor party is hopefully listening to the British public."
Unison's surveys of Registered General Nurses (RGN), the equivalent to U.S. RNs, and other health care workers demonstrate that workloads have doubled over the last 15 years. Devine stated that £45,000 (or roughly $65,000) is spent on training each nurse. "We are giving them the skills and then failing to provide them with the environment in which to properly use those skills. This obviously leads to low morale and high turnover of nurses.
"We [unison] believe that spending on the NHS should be brought up to the average of the European Community in terms of Gross National Product. This would lead to a very significant change in the provision of care in terms of more nurses, more support staff and more beds. It is precisely these shortages that are preventing the NHS from living up to its full potential."
Gerard Brogan, RN, has extensive nursing experience in both Britain and the United States.