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.
As far as universal health care; we already have a form of universal health care. Government-directed programs such as medicaid already exist, and they are not run well. There are hundreds of thousands of dollars misappropriated through the medicaid system each year...
UHC is about affordable (and not necessarily "free") health care for all, not just those who qualify for programs like Medicaid. It's a concern for working people that they may lose their health insurance if they lose or change their job. It's a concern for working people that a pre-existing health condition can mean prohibitive costs for health insurance. It's concern for working people that the bad luck of getting ill could easily deplete all of their hard-earned assets.
I'm sure there are other solutions besides some kind of UHC for these issues. But the way things are currently leads to many wasted health care dollars as well. I've had to spend hours on the phone with insurance reps & billing departments & health care providers tracking down bills and figuring out what services were and were not covered. How much of my health care dollars ends up paying for that? That's a waste of money as well.
The issues of second and third generation able-bodied adults living off of government subsidies is a problem. I see that as a separate issue from the general concept of UHC.
before writing a rant i think it is always a good idea to do a little research and engage in critical thinking. there is plenty of data available that questions the validity of your statements.
viking-
we don't usually agree, but i really do appreciate your documentation, however dubious i may consider the source.
i have a request, though----can you get these graphs and tables in a readable font for us over 40-types , or perhaps get the "prose" version? i'm a reasonably smart lady, but too many tiny [blurry] graphs and i'm seeing chi-squares from "stat" class and my eyes roll back--thanks!!
I lost my health insurance after a series of medical problems (chemo, knee replacement, fractured femur, and Iron deficiency anemia from G.A.V.E. all in 3 years). All just bad luck, not from bad health habits or substance abuse
No insurance and not enough money means no health care. No health care means deteriorating health making it harder to work. Decreased work performance leads to unemployment. I'm only 55 and afraid I'll be homeless by summer if I don't get a job with better insurance. I could work full time for 10 or more years with adequate healthcare. Without it I'd be lucky to live that long.
I hope some lawyer will latch onto the "right to life" and take it into the courts. Right to healthcare seems like it's clearly implied to me.
I'm not only pro universal health care, I'm praying for it daily.
As have I...The difference in our positions is that I happen to worry about a dysfunctional/overly expensive system with 48 million uninsured of which the vast majority are working but hold jobs that either provide NO benefits or the benefits are unaffordable....
I've been seemlessly enrolled in health insurance my entire working life.
I was too while I was WORKING as an LPN,I now have to go to a free clinic, I cannot get Medicaid in WI, until SSDI approval, then Medicare. Most of the CNAs had to use Badger Care for their children, because they could not afford the private health insurance offered by the employer.
As far as universal health care; we already have a form of universal health care. Government-directed programs such as medicaid already exist, and they are not run well. There are hundreds of thousands of dollars misappropriated through the medicaid system each year - they don't have any system for keeping track of users and abusers - they can go from hospital to hospital, for example, obtain prescription medications, and then sell them on the street. (Or take them themselves) My point is, why do we think we can trust our government to create a cost effective and manageable program, when they can't balance their own budgets, or police the programs we already have? I also don't believe everyone "deserves" the right to free health care. If you are capable of working, and you are, you should receive adequate health care, no matter who you are or what you do. But if you are an able-bodied citizen, and you have been a second or third generation welfare recipient, I don't believe you "deserve" free health care. Someone has to pay for this care, and I am tired of busting my butt to cover so many others who can't get off of theirs. Don't get me wrong - I don't want to deprive people from basic care, I just think we have a whole lot of work to do before we can consider this! Look at how many elderly people, who put their time and money into the system for years, are now experiencing so much trouble receiving appropriate care. It is government mismanagement that created that mess, and I don't trust that they can do any better now. :angryfire
I couldn't have said it better myself. My main problem with universal healthcare is how do we pay for it? It is paid for by taxing the people. Though I would love to live in a world where everyone receives adequate healthcare I'm not willing to pay for the healthcare of the bum down the street who won't get a job b/c they feel they are entitled to a better one. It doesn't give those w/o a job any more motivation to find one. B/c now they are virtually recieving free healthcare from everyone who works and pays taxes. Nice thought, but no thanks.
Specializes in ICU, Paeds ICU, Correctional, Education.
my nursing practice is driven by my professionalism: i work because i get paid to do so. i wouldn't work without renumeration because, no matter the noble cause, that's slavery.
i'm very good at what i do. i'm an expert. i'm a professional. i deserve to be paid as a professional.
if individual responsibility in health promotion and care is a dismal failure, then no amount of gov't subsidy will or can change that.
there are no rights absent responsibility. the two concepts are inter-related. they are intricately linked. to suggest otherwise means you don't understand the definition of a 'right'.
you say i lack insight into the human condition. i disagree. socialism lacks insight into the basic motivations of the human condition. that is why it always fails. even if it's just in health care.
gov't does nothing better. it never has.
i'm not trying to antagonize you. i'm really not. look, if health care is a right, then why aren't all other basic necessities? explain to me how food, shelter, clothing, and transportation aren't also rights, regardless of responsibility. shouldn't the gov't provide all those things to everybody, regardless of need? after all, aren't they equal 'rights' as health care? shouldn't we not trust the average person to be individually responsible for those things, as well?
~faith,
timothy.
of course you are not trying to antagonise me and i very much support the "right" (there's that word again) to free speech. i also recognise differences in people and how they often come to form their ideas and philosophies.
i have been an intensive care nurse in adults, paeds and neonates in total for 30 years. i have worked in other countries, in different settings and have been on two overseas tours with cardiac teams, setting up intensive care units and nursing adults and children post operatively in our portable intensive care units. i was unpaid in the monetary sense but richly rewarded. i now teach others.......but i will never consider myself an expert on anything. i don't place any more value on the work that i do than any other vocation.
for the past two days, i have been attending a paediatric palliative care symposium where i have been reminded of the dedication and the non-judgemental ethos of nursing practice that feeds and sustains the spirituality of those that make the lives of humans who suffer better. now that's professionalism.
"man [sic] thinks he amounts to a lot, but to a louse he is merely something to eat." don marquis, the life and times of archie and mehetabel
as far as universal health care; we already have a form of universal health care. government-directed programs such as medicaid already exist, and they are not run well. there are hundreds of thousands of dollars misappropriated through the medicaid system each year - they don't have any system for keeping track of users and abusers - they can go from hospital to hospital, for example, obtain prescription medications, and then sell them on the street. (or take them themselves) my point is, why do we think we can trust our government to create a cost effective and manageable program, when they can't balance their own budgets, or police the programs we already have? i also don't believe everyone "deserves" the right to free health care. if you are capable of working, and you are, you should receive adequate health care, no matter who you are or what you do. but if you are an able-bodied citizen, and you have been a second or third generation welfare recipient, i don't believe you "deserve" free health care. someone has to pay for this care, and i am tired of busting my butt to cover so many others who can't get off of theirs. don't get me wrong - i don't want to deprive people from basic care, i just think we have a whole lot of work to do before we can consider this! look at how many elderly people, who put their time and money into the system for years, are now experiencing so much trouble receiving appropriate care. it is government mismanagement that created that mess, and i don't trust that they can do any better now. :angryfire
i couldn't have said it better myself. my main problem with universal healthcare is how do we pay for it? it is paid for by taxing the people. though i would love to live in a world where everyone receives adequate healthcare i'm not willing to pay for the healthcare of the bum down the street who won't get a job b/c they feel they are entitled to a better one. it doesn't give those w/o a job any more motivation to find one. b/c now they are virtually recieving free healthcare from everyone who works and pays taxes. nice thought, but no thanks.
health care and insurance are by definition a shared responsibility. i have not seen a single reputable sourced article to support these types of claims about medicaid abuse. (what there is is undoubtedly surpassed by administrative costs of private insurance in the billions of dollars.)
as i have written ad nauseum any uhc plan is not going to be funded by new taxes. it will be funded by either a payroll tax (in a pure single payer system) or a system where employers and individuals have the option to purchase insurance directly from medicare (the mixed partnership model). in either case the funding streams will be in place of the current premium structure instead of new taxes. this along with administrative cost reform will bend the medical inflation cost curve towards sustainability.
there is absolutely no reason that 1 dollar of health care spending should fail to purchase 97 cents of health care instead of the current 70 cents. the private insurers should be able to manage health care financing for 3% administrative costs just like traditional medicare medicare.
the real coverage gaps are between 100-300% of poverty where working families either have no benefits or the benefits they have access to are unaffordable. lets stop the bashing of the poor and get down to the business of building a health care system that assures equitable access and is high performing.
from cepr:
to define a "good" job, cepr uses a simple definition based on three characteristics: pay, health
insurance and retirement benefits. according to this definition, a good job is one that meets all of
the following three criteria:
it pays at least $17 per hour (about $34,000 on an annual basis),
it offers employer-sponsored health insurance (where the employer pays at least part of the
monthly premium),
it offers an employer-sponsored retirement plan (either a “defined contribution plan” like a
401(k) or a “defined benefit” like a traditional pension).4
...
using this definition, cepr’s analysis finds that good jobs are a minority of current jobs, and that
bad jobs outnumber good jobs.
in 2006, just under one-fourth (23.1 percent) of u.s. jobs were good jobs, offering decent
pay, employer-sponsored health insurance, and a retirement plan.
an even greater share of workers—29 percent—is in jobs that met none of the three goodjobs
the yoyo economy is bad for workers and for the economy as a whole. there are professional value reasons (social justice etc) for us as nurses to support the idea of a good job for every american but there are also personal reasons. if we don't speak collectively on behalf of the rights of other working americans for good jobs we place our own "good" job status at risk.
when you take the time to think about it uhc is one leg of the stool to support entry into the middle class. the others are access to high quality education from preschool through college and protection of collective bargaining rights. each of these removes barriers that get in the way of people achieving their full potential and assuring a fair shake at achieving success in society.
I'm wondering--with all this reiteration of the idea of a free market, how EXACTLY does anyone stand to make a profit off of people who are both very ill and completely broke? I have the feeling that if anyone could come up with a specific answer to this question that somebody would already be out there doing it, KWIM?
I'm wondering--with all this reiteration of the idea of a free market, how EXACTLY does anyone stand to make a profit off of people who are both very ill and completely broke? I have the feeling that if anyone could come up with a specific answer to this question that somebody would already be out there doing it, KWIM?
How does anybody make a profit selling phones to people that are completely broke and phoneless? But, they do. More people in poverty have cell phones than not.
How does anybody make a profit selling cars to people that are completely broke, but carless? But, they do. More families in poverty have cars than not.
How does anybody make a profit selling television sets to people that are completely broke and tv-less? But, they do. The average poor household has a television set.
See the thing about the free market is that a competitive market will expand to capture the absolute maximum audience. Socialists think of the free market as a bunch of rich people smoking cigars and slapping themselves on the backs for how they 'got' the little guy.
Except.
In a truly free market (not the gov't protected market of health insurance), the dirty little secret is the rich cannot become rich without having a market to sell their products.
The rich can't become rich while the poor become poor if you need a growing middle class to buy your products. It's a symbiotic relationship. YOU need somebody rich to have the assets and desire (to be rich) to craft a product to sell to you. THEY need you to have enough money to BUY their products.
The market will reach out for the maximum market to compete in. It's the way it's always worked. It is the best combination of quality and price, for the absolute most people.
The gov't simply cannot provide a better price, higher quality, OR, more universal coverage. The gov't just isn't that good a competitor, much less a monopoly.
Does it matter if EVERYBODY is covered if 47 million people won't get the care they need because of wait lists? More people will stay sick and more people will DIE waiting for care under a rationed system than can access the system today.
Gov't restricted health care just isn't very compassionate.
I'm wondering--with all this reiteration of the idea of a free market, how EXACTLY does anyone stand to make a profit off of people who are both very ill and completely broke? I have the feeling that if anyone could come up with a specific answer to this question that somebody would already be out there doing it, KWIM?
The direct answer to your question is catastrophic insurance that is real 'insurance' instead of pre-paid health care under the guise of insurance (what we have now). Get the gov't rules out of the way, and such policies would be cheap enough to offer to even entry-level workers. Let the government subsidize anybody it feels can't afford such policies.
Everything else, let the consumer negotiate. I know, you CAN'T negotiate where they take you after a car accident. THAT is what catastrophic insurance covers. Routine doctor visits, medications, etc - let the consumer negotiate. The market will only pay what it will bear. I assure you, a CT scan would not be several hundred dollars if people had to pay for them, out of pocket. Your doctor wouldn't give you the latest $200 dollar anti-biotic if the $10 generic would suffice and YOU were paying for it. (If YOU were paying for it, the latest antibiotic wouldn't be $200, in the first place.)
Health care savings accounts would shield 5 grand a year, tax-free and cumulative, of your income for out-of-pocket expenses. For MOST people, when they are young and healthy, that amount will grow and grow so that, when they NEED it, it will be a considerable amount of money. For the chronically ill - add a high cap that converts their care to the catastrophic plan after a certain amount (say 20k/yr worth of care) and then - and only then - let the gov't pick up the tab (SSI) for the difference between the 5k HSA and the 20k/cap (15k).
Now, you have the gov't picking up parts of the tab to make the system more or less, universal. The gov't would pay for three things: catastrophic insurance for those it deems needs help, HSA assistance to those that can't afford to put their own 5 grand back a year (similar to the EITC - a credit to your account), and SSI gap for chronic coverage between 5k and the 20k catastrophic kick in for coverage of chronic illness. These three things, in an otherwise first party payer market, would be FAR cheaper than the tab the government currently picks up.
You have the average person negotiating his own care. Prices will plummet, making the system more and more affordable. The market will and can only charge what the market will bear. Competition will weed out inefficiency. THAT would be the best combination of the free market, and gov't, working together to bring about universality. It would do so without stealing health care choice from the masses. It would make care much cheaper.
The results: cheaper care, better care (because the combination of price and quality are the chief selling points of any product), universal care, free market care.
The market works, and works best. Even for 'broke' people.
I have just outlined for you 'universal coverage' that doesn't take away choice, from anybody. It doesn't force you to depend upon some bureaucrat for your care (whether that 'crat is from the gov't or some big gov't backed insurance company). To the contrary, getting your employer's health care provider (YOU aren't their customer), and the gov't out of your way will give the average consumer MORE choice in his/her care, for less cost.
Does it matter if EVERYBODY is covered if 47 million people won't get the care they need because of wait lists? More people will stay sick and more people will DIE waiting for care under a rationed system than can access the system today.
~faith,
Timothy.
Where does this thought come from? Now you are saying that not only will people stay sicker-more will die when receiving greater access to health care?
jjjoy, LPN
2,801 Posts
UHC is about affordable (and not necessarily "free") health care for all, not just those who qualify for programs like Medicaid. It's a concern for working people that they may lose their health insurance if they lose or change their job. It's a concern for working people that a pre-existing health condition can mean prohibitive costs for health insurance. It's concern for working people that the bad luck of getting ill could easily deplete all of their hard-earned assets.
I'm sure there are other solutions besides some kind of UHC for these issues. But the way things are currently leads to many wasted health care dollars as well. I've had to spend hours on the phone with insurance reps & billing departments & health care providers tracking down bills and figuring out what services were and were not covered. How much of my health care dollars ends up paying for that? That's a waste of money as well.
The issues of second and third generation able-bodied adults living off of government subsidies is a problem. I see that as a separate issue from the general concept of UHC.