Where do most of the uninsured live?

tewdles, RN · Nov 15, 2009

We currently spend 16% of our GDP on healthcare in this country...all too soon it will be 20%. It is important for ALL areas of our country's prosperity that we figure out how to get control of this soon.

Jolie, BSN · Nov 15, 2009

If you weren't married, I would marry you. True story.

Aww, that made my day!

P.S. You're a guy, right?

Onekidneynurse · Nov 15, 2009

We currently spend 16% of our GDP on healthcare in this country...all too soon it will be 20%. It is important for ALL areas of our country's prosperity that we figure out how to get control of this soon.

And how do YOU propose we spend less than that? We save babies others won't. We have the highest ICU care rates for elderly in the world. Why would someone be in an ICU when they can sit up in a chair and eat real food?

And you wonder why an insurance company won't pay for that hospitalization? Would you?

SilentMind · Nov 16, 2009

Aww, that made my day!
P.S. You're a guy, right?

Yes dear, I'm a guy.

We currently spend 16% of our GDP on healthcare in this country...all too soon it will be 20%. It is important for ALL areas of our country's prosperity that we figure out how to get control of this soon.

You keep throwing that number out there. It can't be anywhere near accurate. Considering the US only takes in about 28-30% of the GDP in taxes, you're saying we spend more then half of our federal budget on healthcare? Even with medicare, that doesn't sound reasonable at all. Not even close.

tewdles, RN · Nov 16, 2009

Yes dear, I'm a guy.
You keep throwing that number out there. It can't be anywhere near accurate. Considering the US only takes in about 28-30% of the GDP in taxes, you're saying we spend more then half of our federal budget on healthcare? Even with medicare, that doesn't sound reasonable at all. Not even close.

In fact 16% is accurate...bing or google it. I know, it sounds ridiculously high...which is why I mention it often. For me, this figure is one of the things that transcends partisan politics...we simply cannot sustain a system at this level knowing that the trend is upward.

elkpark · Nov 16, 2009

You keep throwing that number out there. It can't be anywhere near accurate. Considering the US only takes in about 28-30% of the GDP in taxes, you're saying we spend more then half of our federal budget on healthcare? Even with medicare, that doesn't sound reasonable at all. Not even close.

"Doesn't sound reasonable"? The numbers have been widely reported and discussed in the media and everyone (except you, apparently) is in general agreement. People with different points of view may draw different conclusions about what the numbers mean and what, if anything, should be done about them, but no one seems to be disputing the actual figures.

"The problem of health care spending growing faster than incomes is also a problem that plagues the private sector, which explains why total spending on health care in the economy has doubled over the last 30 years to a current level of about 16% of GDP. CBO estimates that this percentage will double again over the next 25 years to 31% of GDP."

http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html

"Total health spending accounted for 16.0% of GDP in the United States in 2007, by far the highest share in the OECD."

http://www.oecd.org/dataoecd/46/2/38980580.pdf

"Health spending in 2009 is projected to account for 17.6% of GDP."

http://www.kff.org/insurance/upload/7692_02.pdf

"Over the past four decades, the share of gross domestic product (GDP) spent on health care has more than tripled from 5 percent to 16 percent."

http://www.ncpa.org/pub/ba654

"Health spending as a share of GDP is expected to grow from its 2008 level of 16.3 percent to an estimated 19.5 percent of GDP in 2017 (about $4.3 trillion)."

http://www.randcompare.org/current/dimension/spending

http://economix.blogs.nytimes.com/20...from-the-pack/ (see charts)

allnurses Guide · Nov 16, 2009

And how do YOU propose we spend less than that? We save babies others won't. We have the highest ICU care rates for elderly in the world. Why would someone be in an ICU when they can sit up in a chair and eat real food?
And you wonder why an insurance company won't pay for that hospitalization? Would you?

My open heart patients often sit in a chair and eat real food 10 hours post op.

They still have hemodynamic monitoring, chest tubes, temporary pacemeker wires.

And yes they need nearly constant assessment, intervention, evaluation, and reassessment.

Onekidneynurse · Nov 16, 2009

My open heart patients often sit in a chair and eat real food 10 hours post op.
They still have hemodynamic monitoring, chest tubes, temporary pacemeker wires.
And yes they need nearly constant assessment, intervention, evaluation, and reassessment.

CCU not ICU. We used chest tubes on M/S back in the 90's. I do HD treatments in the ICU. I'm there for 3-4 hours and never see an RN in the room.

Onekidneynurse · Nov 16, 2009

"Doesn't sound reasonable"? The numbers have been widely reported and discussed in the media and everyone (except you, apparently) is in general agreement. People with different points of view may draw different conclusions about what the numbers mean and what, if anything, should be done about them, but no one seems to be disputing the actual figures.
"The problem of health care spending growing faster than incomes is also a problem that plagues the private sector, which explains why total spending on health care in the economy has doubled over the last 30 years to a current level of about 16% of GDP. CBO estimates that this percentage will double again over the next 25 years to 31% of GDP."
http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html
"Total health spending accounted for 16.0% of GDP in the United States in 2007, by far the highest share in the OECD."
http://www.oecd.org/dataoecd/46/2/38980580.pdf
"Health spending in 2009 is projected to account for 17.6% of GDP."
http://www.kff.org/insurance/upload/7692_02.pdf
"Over the past four decades, the share of gross domestic product (GDP) spent on health care has more than tripled from 5 percent to 16 percent."
http://www.ncpa.org/pub/ba654
"Health spending as a share of GDP is expected to grow from its 2008 level of 16.3 percent to an estimated 19.5 percent of GDP in 2017 (about $4.3 trillion)."
http://www.randcompare.org/current/dimension/spending
http://economix.blogs.nytimes.com/20...from-the-pack/ (see charts)

Just listened to NPR last week . We have the lowest food costs in the world. We have some of the lowest gas prices in the world. Yes I'm not talking about Saudi or Venezula. Japan has the highest cost of living in the world. So it's still a wash.

Onekidneynurse · Nov 16, 2009

"Doesn't sound reasonable"? The numbers have been widely reported and discussed in the media and everyone (except you, apparently) is in general agreement. People with different points of view may draw different conclusions about what the numbers mean and what, if anything, should be done about them, but no one seems to be disputing the actual figures.
"The problem of health care spending growing faster than incomes is also a problem that plagues the private sector, which explains why total spending on health care in the economy has doubled over the last 30 years to a current level of about 16% of GDP. CBO estimates that this percentage will double again over the next 25 years to 31% of GDP."
http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html
"Total health spending accounted for 16.0% of GDP in the United States in 2007, by far the highest share in the OECD."
http://www.oecd.org/dataoecd/46/2/38980580.pdf
"Health spending in 2009 is projected to account for 17.6% of GDP."
http://www.kff.org/insurance/upload/7692_02.pdf
"Over the past four decades, the share of gross domestic product (GDP) spent on health care has more than tripled from 5 percent to 16 percent."
http://www.ncpa.org/pub/ba654
"Health spending as a share of GDP is expected to grow from its 2008 level of 16.3 percent to an estimated 19.5 percent of GDP in 2017 (about $4.3 trillion)."
http://www.randcompare.org/current/dimension/spending
http://economix.blogs.nytimes.com/20...from-the-pack/ (see charts)

I bought a house in 1970 for $27,500. In 2000 I bought a condo for $71,000 and an SUV for $30,000. Tell me what hasn't gone up in 30 years except newer innovations. i.e. computers..............

30 years ago we didn't have half the technology we do today. Would you like to go back to health care 30 years ago?

lamazeteacher · Nov 16, 2009

I bought a house in 1970 for $27,500. In 2000 I bought a condo for $71,000 and an SUV for $30,000. Tell me what hasn't gone up in 30 years except newer innovations. i.e. computers..............
30 years ago we didn't have half the technology we do today. Would you like to go back to health care 30 years ago?

If you're talking only about price, yes! The research for the improved technology (unlike that claimed by pharmaceutical companies as their own cost) wasn't paid for by physicians. In fact, often, for one example, laser treatments in offices take less time than earlier treatment before them, yet due to the expense of buying that equipment, more is charged, even though more patients can be seen. Like bridge tolls, the higher charges continue long after the apparatus blamed for the escalation in price, has been paid in full.

The real villain in price elevation is - AGAIN - insurance companies charging ever higher premiums for malpractise policies that physicians paid, starting 4 decades ago. Most of the blame, of course goes to insurance execs who live lives of extreme luxury because of those premiums.

The legal profession is also to blame, for not curbing gigantic awards to victims' families for malpractise; and let's admit it (as members of the health care team), the rest of the blame goes to sloppy health care practitioners. We need to talk to patients more as they move along to the OR suite. Something like, "how long has your LEFT leg been bothering you, Mr/Ms. so-and-so" would help, but of course preop sedation makes patients not the best sources of information (especially if their primary language is not ours). Now that charts are going paperless, and can be brought up on a screen in the OR, there should be no excuses for not looking at the H & P (like stacks of paper misfiled in some charts).

Insurance companies bleed small businesses and patients' bank accounts for everything they can (and even what they can't). The worst of that, I think - possibly because it's my insurance problem now, is Medicare supplemental insurance. Now, after many years of paying into Medicare, I'm expected - by AARP, the very organization formed to help seniors - to pay more for that. AARP was coaxed into becoming an insurance provider, to add that organization presumably advocating for seniors, into the insurance industry field. Granted, Medicare pays physicians, hospitals and diagnostic and treatment labs less than is charged, and those health care providers charge accordingly. On the theory that if you know you'll get less, why not charge more? Isn't that the business negotiators' credo? Love that capitalism! (No, I'm definitely NOT a socialist.)

When I get medical bills, they are "adjusted" to a slightly lesser amount than originally charged, to comply with Medicare standards, but still require 20% of the amount originally charged, to be paid by me (the elderly patient)! I've opted out of all that. I don't pay the supplemental insurance, and I don't pay the additional amount. So far, after 5 years of that, no facility or practitioner has refused me care, due to non-payment of their "20%". Now my credit score isn't the greatest, but I can buy what I can afford with my own money, rather than charging, so I use no charge cards (even though doctors and hospitals would take them, and then their patients would get hit with more outageous costs, due to the high interest charges, and the provider doesn't have to pay for bill collection companies that keep half of what was charged)........ Love that capitalism.....:angryfire

Oh, and a little known fact about Medicare and social security, is that all the spouses of higher wage earners can have their former (and present) spouse's Medicare and Social Security payment records' higher benefits, without that spouse's knowledge (that's OK with me, as I'm the ex, X2 of my former spouse). Hmmmmmm... So if someone had 2-3 spouses, their one payment into Medicare and social security pays for half of the social security money and all the benefits received by each, from his/her one contribution. In the day when Medicare and Social Security was begun, multiple (legal) marriages hadn't climbed as high as they are now.

In those times, too, removal of the wrong organ, body part, limb, wrong patient errors has many levels of care providers involved. From the unit nurse, to the transporter to the OR, the OR nurse accepting the patient, who looks at the chart (hopefully), and OR circulating nurse, anaesthesiologist, and finally to where the buck stops, the physician who should have reviewed the chart prior to surgery.

SilentMind · Nov 16, 2009

If you're talking only about price, yes! The technology (unlike that claimed by pharmaceutical companies as their own cost) wasn't paid by physicians. The villain in price elevation is - AGAIN insurance companies charging ever higher premiums for malpractise policies that physicians paid, starting 4 decades ago. Most of the blame, of course goes to insurance execs who live lives of extreme luxury because of those premiums.
The legal profession is also to blame, for not curbing gigantic awards to victims' families for malpractise; and let's admit it (as members of the health care team), the rest of the blame goes to sloppy health care practitioners. We need to talk to patients more as they move along to the OR. Something like, "how long has your LEFT leg been bothering you, Mr/Ms. so-and-so" would help, but of course preop sedation makes patients not the best sources of information (especially if their primary language is not ours). Now that charts are going paperless, and can be brought up on a screen in the OR, there should be no excuses for not looking at the H & P (like stacks of paper misfiled in some charts).

So, insurance companies...check. Medical professionals....check. Lawyers....check. Where does personal responsibility come into play again? Or do we just choose to look past that, because it's actually requires effort on our parts without complaining about how everyone with a bank account greater then ours is wronging us?

How in gods green earth is it the lawyers fault that people go out and try to sue someone frivilously? Lawyers are merely a tool, a service provided. Far as I know, most hospitals don't allow lawyers to make rounds to see if anyone was mistreated. The individual actually has to make the choice to contact one and file a lawsuit. If they don't, it won't happen.

As far as medical errors on that scale, I'd like to think they don't actually happen very often. But I'm sure they do. Far as I'm concerned, if you can't be bothered to make sure you're taking the right limb, then you don't deserve your license. It should be grounds for immediate termination. But even if it is a semi-common occurance, I doubt that it makes up a very large portion of malpractice suits.

Insurance companies bleed patients' bank accounts for everything they can (and even what they can't). The worst thing - possibly because it's my insurance problem, is Medicare supplemental insurance. Now, after many years of paying into Medicare, I'm expected - by AARP, the organization formed to help seniors, to pay more. AARP was coaxed into becoming an insurance provider, to add that organization presumably advocating for seniors, into the insurance industry field. Granted, Medicare pays physicians, hospitals and diagnostic and treatment labs less than is charged, and those health care providers charge accordingly. On the theory that if you know you'll get less, why not charge more? Isn't that the negotiators' credo?
When I get medical bills, they all are "adjusted" to a slightly lesser amount than originally charged, but still requires 20% of that amount originally charged, to be paid by the elderly patients! I've opted out of all that. I don't pay the supplemental insurance, and I don't pay the additional amount. So far, after 5 years of that no facility or practitioner has refused me care, due to non-payment of their "20%". Now my credit score isn't the greatest, but I can buy what I can afford with my own money, rather than charging, so I use no charge cards (even though doctors and hospitals would take them, and then their patients would get hit with more outageous costs, due to the high interest charges, and the provider doesn't have to pay for bill collection companies that keep half of what was charged........ Love that capitalism.....:angryfire

I read through these paragraphs, and I was following pretty well until that last line. How is it even possible that you ended that rant with "Love that capitalism.....:angryfire"? I mean, it blows my mind. You're talking about government run medicare, how it isn't enough to cover care, how it requires supplemental insurance, how it forces doctors to raise their rates, so how exactly did you pin this on capitalism? Especially when the only capitalistic factor in your situation are the doctors, who you said haven't denied you care even though you haven't been making their copays.

Bravo on not abusing credit cards though. If more people thought like you do, we'd be in a lot better shape as a nation economically.

Oh, and a little known fact about Medicare and social security, is that all the spouses of higher wage earners can have their former (and present) spouse's Medicare and Social Security payment records' higher benefits, without that spouse's knowledge (that's OK with me, as I'm the ex, X2 of my former spouse). Hmmmmmm... So if someone had 2-3 spouses, their one payment into Medicare and social security pays for half of the social security money and all the benefits received by each, from his/her one contribution. In the day when Medicare and Social Security was begun, multiple (legal) marriages hadn't climbed as high as they are now.

I'm not really sure what your point is here, or what part of the programs you're referencing. But benefits are paid by those still paying into the system to cover those who have already retired. I'm not really sure how they actually calculate how much each individual recieves, but I assume that's what you're saying? You get increased benefits based on how many times you've been married before? Or are you just trying to show how fundamentally flawed the funding for these programs is? Overall, you don't seem all too happy with them.

In those times, too, removal of the wrong organ, body part, limb, wrong patient errors has many levels of care providers involved. From the unit nurse, to the transporter to the OR, the OR nurse accepting the patient, who looks at the chart (hopefully), and OR circulating nurse, anaesthesiologist, and finally to where the buck stops, the physician who should have reviewed the chart prior to surgery.

No argument there. It's unacceptable, and as I said earlier...should be grounds for loss of licensure.