By design, a monopoly produces a different kind of worker. Unwilling to have their wages capped and freedoms restricted, the best inevitably leave. Mediocrity, unfortunately, gives rise to fewer malcontents and thus is a prerequisite for stability in the system. Put it this way: if a socialized system wants to survive, it must expunge the most driven and gifted from its midst. When wages, moreover, are tied to a negotiated deal with labour, rather than, in the case of a competitive market, to the individual physician's performance, the position of the mediocre practitioner is further reinforced.
My cousins are volunteer firefighters. They used to cary beepers when om call. Now have cell phones.
One cousin is on call 12 hours a day for the two weeks he is 'home' in Oklahome from California. He does go in for a couple hours the first day.
In almost 40 years none of my cousins has actually fought a fire. The paid career firefighters get there first. They are waiting around.
I didn't know emergency workers talk like that but am not surprised.
After all they are the ones who see all the injuries and illness, not the times everything went OK.
That does not make it OK.
That is the point that I am trying to make...there is a skill level in everything...sometimes it's reflected in a paycheck, sometimes it's not, sometimes you have to go to school forever, sometimes you don't.
I cannot imagine a world without paramedics...but hospitals aren't much good if doctors and nurses aren't there to catch the pass.
There is a place for everyone in healthcare...and everyone's job, from the smallest to the biggest, is very valuable.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
This is probably going to be an unpopular post, but I'm going to post it anyway. There is a very, very good reason why most fire departments, etc. are mostly volunteer...is because of the downtime involved in the job.
Every fire department, ambulance service, etc that I have been to...usually has some type of recreation room, kitchen, pool tables, you name it. I've had to stop by these places from time to time and usually alot of guys sitting around and playing cards or board games.
I am NOT saying, that they don't work...but this is what they do in between calls...and I'm ok with that...after all, most of them only get paid for the hours that they are out on a call.
I also have 5 paramedics in my Anatomy and Physiology class right now. Every single one of them "down" the nursing program, talk about how paramedic's job is more skilled, more challenging, how nursing is pretty much an "office job with healthcare aspects" to it.
Anytime anyone brings up any subject during class breaks...one of them always relays it back to being a paramedic...one person mentioned he liked to ride sidewalks, the paramedic commented, "It's fun until you call me to scrape your brains off the sidewalk," another girl talked about how her and her husband liked to go hunting, and another paramedic said, "Yeah, we have alot of people that think they know how to use guns until they get into trouble and call us."
Can you imagine having a conversation with a nurse or a doctor with that kind of "elitest" attitude?
These folks are not popular members of our class...they are constantly trying to correct our instructor, and so far haven't won any arguments, and they always talk about how doctors and nurses don't know anything.
We have several LPN's in our class that have worked in hospitals for years, and they actually contribute to the discussion...not find something negative or tell "war stories" about what goes on in the hospital.
Nurses don't downgrade their profession, who why do they downgrade nurses?
The paramedic occupation is not a reasonable representation of the fire service, because a much larger percentage of paramedics work in private EMS, or are actually the only paid employees of an otherwise all-volunteer fire dept. For example, I worked as a paramedic in a fire dept for five years before becoming a nurse; the paramedics and EMT's were the only paid people. The entire fire suppression division was volunteer.
And the volunteerism is not driven from down time, but because of the innate function of charity that prompts so many people to provide this service for free.
As far as the medics in your classes; they are right about a lot of stuff, and likely chafed about the fact that they have spent time in the trenches dealing with the most unpleasant of society for very little pay. During my years as a medic, I made about 1/3 of what I make now, was assaulted twice, requiring medical care, and there was a high expectation of my clinical skills (both personally and professionally). I also found that my nursing instructors left a lot to be desired, putting EKG overheads on the projector upside down, making blatantly incorrect statements about medical conditions, etc. There was also so much contradiction, it was challenging to know what to expect next. For example, given a scenario of a freshly admitted acute abdominal pain patient, what would be the priority. The expected answer was psychosocial (how does the patient feel about their condition), but IMO two better answers were either safety and pain management and safety (both listed options). Imagine my surprise when I was check "wrong." I asked if safety conditions could only be implied, and what good does it to talk about the abdominal pain if there is a safety issue going on; i.e. the other patient in the room is violent or the room is on fire.
These medics are way off base, and they are in for a big surprise when they enter professional nursing practice. They do have remarkable skills and probably have developed great coping mechanisms, but they probably have no skills when it comes to the acuity they are about to see in many ICU's, managing two critical patients for 12 hour stretch. They will see the light.
In contrast, these medics have specific skills and knowledge for dealing with prehospital events; if we had another thread, I could share so many stories of nurses who showed up on calls and tried to tell me how to do my job...often saying the dumbest things and making a downright nusiance of themselves.
Not every municipality provides the service for free...my neighbors accidently started a fire (they tore down a 80 year-old outbuilding, not realizing the floors had been coated with oil over the years), and the blaze was huge and much hotter than it normally would have been.
They also got a $400 bill from the fire department because we live outside the corporate limits of the town (yeah, town, not city).
So the service isn't free.
Sorry, I disagree that downtime of a job doesn't have anything to do with whether or not it's a paid position...that might be your opinion, but if you ask our Town Management, they'll tell you that is EXACTLY why they have never budgeted for an obviously valuable service.
Also...the last time I took an ambulance...I got a bill for that too.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
Darren,
Not every municipality provides the service for free...my neighbors accidently started a fire (they tore down a 80 year-old outbuilding, not realizing the floors had been coated with oil over the years), and the blaze was huge and much hotter than it normally would have been.
They also got a $400 bill from the fire department because we live outside the corporate limits of the town (yeah, town, not city).
So the service isn't free.
Sorry, I disagree that downtime of a job doesn't have anything to do with whether or not it's a paid position...that might be your opinion, but if you ask our Town Management, they'll tell you that is EXACTLY why they have never budgeted for an obviously valuable service.
Also...the last time I took an ambulance...I got a bill for that too.
Whether or not you got a bill has absolutely nothing to do with this discussion, or in any way supports the comparison people have made of the Fire Dept. to socialized medicine. Additionally, I've already pointed out that volunteer fire dept's bill for services. It' still doesn't make a supporting argument for socialized medicine. It also doesn't change the fact that 73% of the nation's fire fighters are volunteers.
Additionally, there are far fewer volunteer ambulances, and even fewer run by the fire dept. Again, not relevant, especially when the volunteer services bill for service. Just because someone paid a bill, it doesn't mean a firefighter or EMT received a paycheck.
So, I never said it's free. I do make a point that it's 1. a viable services because so much payroll expense is spared, and 2. the only way you can make a viable comparison to socialized medicine (as has been attempted several times in this discussion), is to have a 73% volunteer work force in health care.
And since I've assisted in starting an ambulance service, managed EMS operations, worked as an educator, served as a volunteer paramedic and V. Pres. of a volunteer ambulance service, and worked for a fire dept, I think I bring a bit of experience to this discussion. Additionally, my first college degree is in EMS, and there are two reasons your Town Management might say what they did. 1. They don't understand the function of public safety, or 2. They were blowing smoke up someone's behind. Do they provide police service? I'd like to know how many arrests one of their officers makes in a shift, because when he's not engaged in a police incident, he's essentially in "down time." Do they take that into account? I seriously doubt it.
The real reason these folks don't choose to provide this service is because they CAN'T AFFORD THE SALARY...which is exactly why the Fire Service is a terrible comparison. To say that it's because of down time makes absolutely no sense.
And just how much expense do you think that $400 covered for the fire dept? A drop in the bucket compared to the operating expenses of the dept without even considering the time spent training OR possible payroll.
The main point no one has brought up here is that in socialized medicine, services are rationed. Example: in the UK dialysis is withheld after 55 yoa, in Canada if your doctor suspects a brain tumor, your wait for an MRI can be as long as 6 months. Here in the US, whether or not you can pay you can get these services very quickly and for as long as you need them. No, our system is not perfect, but it is the best in the world. And though some posters believe making a profit is inherently evil, it is an incentive for providers and systems to deliver better care. Putting our healthcare in the hands of government would be disastrous. Most of the problems we have today result from their manipulation of the market through medicare & medicaid and regulations requiring hospitals to treat people who have no way of paying. Before medicare and medicaid, people were treated quickly and more cheaply. Yes not everyone can afford good care, but forcing healthcare entities to care for everyone without payment will only degrade everyone's care.
The main point no one has brought up here is that in socialized medicine, services are rationed. Example: in the UK dialysis is withheld after 55 yoa, in Canada if your doctor suspects a brain tumor, your wait for an MRI can be as long as 6 months. Here in the US, whether or not you can pay you can get these services very quickly and for as long as you need them. No, our system is not perfect, but it is the best in the world. And though some posters believe making a profit is inherently evil, it is an incentive for providers and systems to deliver better care. Putting our healthcare in the hands of government would be disastrous. Most of the problems we have today result from their manipulation of the market through medicare & medicaid and regulations requiring hospitals to treat people who have no way of paying. Before medicare and medicaid, people were treated quickly and more cheaply. Yes not everyone can afford good care, but forcing healthcare entities to care for everyone without payment will only degrade everyone's care.
Where do you get your 'facts' from?? There is no point throwing out random statements unless you can back them up.
Further, what makes you think the US 'has the best healthcare in the world'? The World Health Organization puts the US at 37th place.
Further, the US has wait time problems.
And finally, where on earth did you hear that if you are suspected of a brain tumour you must wait 6 months?? One of our employees had headaches and was not feeling well - dizzy spells. He was booked immediately after seeing a doctor...and yes. He has a malignant brain tumour. It is a very sad situation. He is only 52 with teenagers in the house.
I do not know what the answer is for the United States, but disparaging other systems that DO work well and pretending that the US system is the BEST when it most obviously is not, is just plain denial.
Specializes in Cardiac Surg, IR, Peds ICU, Emergency.
62% of the U.S. population is protected by paid career firefighters
Once again, this would be relevant to the comparison of socialized health care only if 38% if the nation's population was also protected by volunteer nurses, physicians, and all other medical staff.
BTW, a certain percentage of those paid firefighters are working for private fire departments; this doesn't even include the number of private corporations (i.e. Boeing, Allekiski Steel), that run their own paid fire departments.
Emergency departments, operating rooms, laboratory services, radiology, and other services need to be ready at all times.
Many communities rarely need the services of their volunteer firefighters.
Single payer is not socialized medicine.
Great Britian has socialized medicine. The National Health Service owns and runs the hospitals and clinics. Physicians, nurses, other caregivers, and support staff are employed by the government.
Single payer means the government insures it's people.
pickledpepperRN
4,491 Posts
I was thinking avout the down time too.
My cousins are volunteer firefighters. They used to cary beepers when om call. Now have cell phones.
One cousin is on call 12 hours a day for the two weeks he is 'home' in Oklahome from California. He does go in for a couple hours the first day.
In almost 40 years none of my cousins has actually fought a fire. The paid career firefighters get there first. They are waiting around.
I didn't know emergency workers talk like that but am not surprised.
After all they are the ones who see all the injuries and illness, not the times everything went OK.
That does not make it OK.