Wisconsin has gutted Medicaid, no mandated ratios!

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So with all the craziness befuddling many Wisconsinites lately a new tightly kept secret was finally brought to light. Governor Scott Walker has not only gutted Badgercare (Wisconsin's Medicaid) which many farmers rely on as well as low income and buy ins by people who have two part time jobs for instance, Seniorcare which is an RX drug program for low income Seniors (which had a $20mil surplus), cut the end-stage chronic renal program, and Familycare which helps to pay for long term care for disabled and poor elderly individuals. Also, there is absolutely no nurse to patient mandated ratio in Wisconsin (let alone hourly mandates).

Many of our hospitals that give care to Medicaid patients are already overburdened as we have had hospitals close, not to mention the many who have lost insurance only going in when they catastrophically need emergency care. This is going to shift the costs to hospitals who will then do two things, raise rates on cash paying patients, and cut staff to the smallest possible amount even if that means 12 patients to a nurse, as I see it anyway.

Most hospital systems are non-profit but having worked for one that is supposedly religious in nature, I can assure you it is a farce in some cases as I worked on the "for-profit" side. It is hard enough as a new RN to find a job but with hospitals tightening their belts not only do I fear it hard to find a job (even at a nursing home), I fear the patient safety aspect of this.

It has been well documented that not only hourly mandates over 12 hours but high nurse to patient ratios can be directly tied to medical error and patient mortality. Is it going to even be safe to practice nursing in my state?

I love my state so dearly and if what I fear happens, I fear our world-class award winning health care system will look like one of a third-world country, little supplies, rationing care, deciding monetarily if a life is worth saving because "we cannot afford it".

What are your thoughts?

Specializes in Psychiatric.
Wisconsin already has a high income tax rate (7%). If they can't afford to provide free healthcare, they can't afford it. You can't tax people much higher than 7% to the state, plus what they pay in Federal and other taxes.

People are going to have to purchase individual policies, or go to clinics, doctors that accept cash, etc. When we were uninsured we called around and found a doctor that took cash and paid a fraction of what he would have charged if he had to bill insurance.

It's not hopeless and the state is dealing with their debt, I'm sure it will be safe to practice nursing in that state. As far as I can tell, that program only existed since 2006, so I doubt it was unsafe to practice nursing in Wisconsin at all times prior to 2006.

It is only "free" to people who are below the federal poverty line, many people pay into the system premiums because they cannot afford insurance in the marketplace. Many farmers rely on this and even some nurses who work 2 part time jobs who do not give benefits. If he was so concerned with money, he would truly share the sacrifice and not give away more tax breaks to the Corporations. This isn't about whether or not I think we need to fix our fiscal house, this is about patient safety, my license, and my freedom. We can go to jail for negligence a there is no law mandating ratios, our could go sky high as well. Think outside of the box of "taxes" please.

Here's the thing, you can make cuts but the drastic cuts that were made were not thought through. Also, why then give away tax breaks to Corporations? I find it ironic that one cannot step outside of the political points on this and see this is not shared sacrifice, this is sacrifice of the middle class. Our entitlement programs in this State are not in the red, they were raided to "balance" the budget. Many people pay into Badgercare with premiums because they cannot afford the insurance through their workplace. Many farmers rely on this as one farmer put it "I work 100 hours a week in the fields, and my wife at Wal-Mart, this will put a complete hardship on our family as we cannot afford marketplace insurance" This isn't about left vs. right. Sure we need to get our fiscal house in order but if you are okay with working in a non-mandated ratio state where your hospitals are flooded with uninsured patients then please come to Wisconsin! We ALL know uninsured patients come in when they are catastrophically ill so try taking care of 12 of those! This isn't about taxes, it is about patient safety!

Corporations provide JOBS. If they hike corporate tax, corporations will leave your state for states with lower corporate tax. What would that help? Who could afford healthcare then?

Specializes in Psychiatric.
Corporations provide JOBS. If they hike corporate tax, corporations will leave your state for states with lower corporate tax. What would that help? Who could afford healthcare then?

Please cite this because according to those who actually study Economics, small business and new businesses create jobs. You are willing to pay more taxes then? It will happen eventually, cannot kick the can of crumbling infrastructure, failing schools, and now potentially terrible health care down the road forever. Also, please look up Marginal Utility and learn that law of Economics. It hurts a middle class worker of $50K to pay 2% more of his income far more than someone making $500K. The top 25 Corporations in the U.S. took subsidies and paid no taxes. http://www.forbes.com/2010/04/01/ge-exxon-walmart-business-washington-corporate-taxes.html

http://money.cnn.com/2010/12/03/news/economy/employers_doing_more_with_less/index.htm

They are not creating jobs despite sitting on $1.6 trillion in wealth.

Please step out of your ideological box and realize I am not trying to argue Economics with you and taxes, I am trying to bring up the very real threat of patient safety. Also Wisconsin Medicaid existed before 2006, it just took the name of Badgercare around that time.

Please cite this because according to those who actually study Economics, small business and new businesses create jobs. You are willing to pay more taxes then? It will happen eventually, cannot kick the can of crumbling infrastructure, failing schools, and now potentially terrible health care down the road forever. Also, please look up Marginal Utility and learn that law of Economics. It hurts a middle class worker of $50K to pay 2% more of his income far more than someone making $500K. The top 25 Corporations in the U.S. took subsidies and paid no taxes. http://www.forbes.com/2010/04/01/ge-exxon-walmart-business-washington-corporate-taxes.html

http://money.cnn.com/2010/12/03/news/economy/employers_doing_more_with_less/index.htm

They are not creating jobs despite sitting on $1.6 trillion in wealth.

Please step out of your ideological box and realize I am not trying to argue Economics with you and taxes, I am trying to bring up the very real threat of patient safety. Also Wisconsin Medicaid existed before 2006, it just took the name of Badgercare around that time.

I don't live in Wisconsin - I live in Illinois. Our governor just raised the corporate tax and the Jimmy John's Headquarters, KMart, several large construction companies and others are now leaving the state. Your governor is welcoming them with open arms, as is Florida and another state, I believe New Jersey. So we are losing jobs down here, and for the life of me, I can't understand why you would want your state to do the same. I just named companies leaving my state because of exactly what you want, is that ideology?

Frankly, I think if you moved to Illinois and I moved to Wisconsin, we'd both be happy. At least Wisconsin is attempting to be fiscally responsible...

(And I understand you don't want to talk economics, taxes, jobs, etc, and only patient safety, but these are all closely connected - you can't have healthcare without a way to pay for it, which leads to all of the other considerations.)

Specializes in Psychiatric.
I don't live in Wisconsin - I live in Illinois. Our governor just raised the corporate tax and the Jimmy John's Headquarters, KMart, several large construction companies and others are now leaving the state. Your governor is welcoming them with open arms, as is Florida and another state, I believe New Jersey. So we are losing jobs down here, and for the life of me, I can't understand why you would want your state to do the same. I just named companies leaving my state because of exactly what you want, is that ideology?

Frankly, I think if you moved to Illinois and I moved to Wisconsin, we'd both be happy. At least Wisconsin is attempting to be fiscally responsible...

(And I understand you don't want to talk economics, taxes, jobs, etc, and only patient safety, but these are all closely connected - you can't have healthcare without a way to pay for it, which leads to all of the other considerations.)

Quick question, what is the max number of patients you have had to care for?

quick question, what is the max number of patients you have had to care for?

you have decided that wisconsin will now have unsafe staffing ratios without anything to back that up. if you think your cheap insult b/c i'm a student justifies your point, it doesn't. and btw, we have medicaid left and right down here in chicago and they are closing county hospitals (i just posted a story about this the other day in il), because they can't afford to keep them open. if you think not making medicaid cuts keeps hospitals open with low patient ratios, it doesn't. they closed st. francis, are closing mental health facilities down here now, without anywhere for the patients to go -

oh and your wisconsin hospitals are closing illinois clinics because illinois *cannot afford to pay their bills* and has stopped reimbursing them - that's what happens when you can't pay your bills and try to continue to give away services (at low cost or no cost), when there is not the money to do so -

children’s hospital of wisconsin is scaling back its presence in northern illinois with plans to close three clinics by the end of november and to consolidate two others.

the move is being done, in part, in reaction to shortfalls in the illinois medicaid program, which has stopped reimbursing children’s for its care of children who are insured through the state-run health insurance program for the poor.

Specializes in Psychiatric.
you have decided that wisconsin will now have unsafe staffing ratios without anything to back that up. if you think your cheap insult b/c i'm a student justifies your point, it doesn't. and btw, we have medicaid left and right down here in chicago and they are closing county hospitals (i just posted a story about this the other day in il), because they can't afford to keep them open. if you think not making medicaid cuts keeps hospitals open with low patient ratios, it doesn't. they closed st. francis, are closing mental health facilities down here now, without anywhere for the patients to go,

oh and your wisconsin hospitals are closing illinois clinics because illinois cannot afford to pay their bills and has stopped reimbursing them - that's what happens when you can't pay your bills and try to continue to give away services (at low cost or no cost), when there is not the money to do so -

children's hospital of wisconsin is scaling back its presence in northern illinois with plans to close three clinics by the end of november and to consolidate two others.

the move is being done, in part, in reaction to shortfalls in the illinois medicaid program, which has stopped reimbursing children's for its care of children who are insured through the state-run health insurance program for the poor.

whoa knee jerk reaction, i was trying to find out your frame of reference not insult you.

Specializes in Critical Care.

To my knowledge the only state with mandated ratios is California, you've got 49 other states where ratios are at the whim of the hospital administrators. If you are truly worried about patient safety and the chance ratios may increase, then you need to work for your state passing a safe staffing law. Quit talking about taxes while you demand that others don't talk about taxes (while you bring up that topic).

Listen, this is a dangerous time in our country. Period. The era of big spending should be over but many governments (state and federal) are having a hard time with stopping this concept. If your state goes bankrupt, they won't be able to do anything for anyone. It's not that I don't feel compassion for those that don't have...I do. But the problem is all the years of attempting to provide for all those who weren't willing to provide for themselves has put us in a position we can't recover from. The truly needy were falling by the way side then.

I deal with a patient population where many people go off on disability or medicaid then the state or federal government pays them not to work. Not all of these people are unable to work. Yet, they continue to receive payments and expect all kinds of freebies because "they don't have a job". But heaven forbid you ask them to give up 1 pack of cigarettes a month to afford their $4 a month blood pressure med. Ok, vent over on that topic.

You're going to have face the idea that times are going to get tougher for everyone. Period. And with rising gas costs, it's getting harder for people to meet some basic needs. That's going to affect us all as they have less money to spend. Prepare for belt tightening, that's what's coming. And heaven only knows when it may end.

Specializes in Psychiatric.

Sigh, I didn't bring up taxes, I also kept repeatedly saying "this isn't about taxes" so once again "this isn't about taxes" This is why I brought it up on the Patient Safety thread. Funny how my non-Nurse Economist husband can understand how I am not arguing Economics here as far as taxes go but the cause and effect of cutting funding to an already overburdened system. Is it speculation? To some degree but it isn't an unfair analysis.

Specializes in Critical Care.

FYI, your topic came up under general discussion, which is where I saw it. Again, I feel if you are worried about ratios, fight for state legislation

Specializes in Med-surg, ER, agency, rehab, oc health..

As for corps not paying enough taxes... You could do something in the nature of Texas where there is no state income tax. There is only a sales tax. As for mandated staffing ratios, as one poster stated, only one state has those ratios. I have worked at alot of different facilities, and my current facility asks us to do care on 6-8 patients a nurse. In exchange they offer RRTs for ekgs and breathing treatments, CNAs for VS and help with patient care, Lab techs to draw blood, and other ancillary services. I like that. Some hospitals in california to save costs cut out all of those and had RNs do primary care on 6 patients. According to economics it will all work out. For example if you ask nurses to practice unsafely at too high ratios, nurses will quit, and you will have to hire agency and try to keep them. Eventually the cost of nursing help will be too high for you to afford it and you will either close or get better staffing.:coollook:

Read this article for a reasoned argument and a viable approach to the problems under discussion here. Unfortunately, the suggestions in this article make far too much sense to be seriously considered. Liberals won't like this approach because it's not single payer and it makes individuals largely responsible for much of their health care. Conservatives won't like it because there is a government component and it will dramatically reduce insurance company profits.

http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/

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