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Old 02-08-2008, 07:03 PM
spencer.jj
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Default Universal Health Care Questions

Mike DeWine, former Ohio state senator, will be coming to a class I'm in thiscoming Monday. Our professor wants us to have a few questions prepared for him regarding health care and politics, and I thought I would ask the fabulous members of Nursing Voices for some input.

I'd like to ask something about universal health care. One of the questions I've thought of is "Who do you think are the most underserved people, health care-wise, and what is your best solution for meeting their needs?"

I have a fairly good idea what he'll say, him being a very well-off, evangelical, Republican white male, but it never hurts to ask. And maybe it'll get some other people in class thinking about the issue.

Any other ideas?
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Old 02-10-2008, 03:35 AM
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Americans are the most under-served?
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Old 02-10-2008, 06:43 PM
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Well, not really, when considering the whole world's health care (I'm sure many people all over the world have worse health care than we do in the US), but there are about 47 million people in the US with no health insurance whatsoever (my wife and I are two of them). Since health care costs so much, it is practically impossible to have any kind of health care without being bankrupted.

I'm more curious as to who former Senator DeWine thinks are the most underserved, and how he suggests we fix that. I'm hoping he'll say universal health care, but I doubt that'll be the case.

Just out of curiosity, P/J, what sort of health care system does Australia have? Maybe we'll move down there
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Old 02-10-2008, 11:02 PM
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Universal Healthcare. I have a feeling that Canada's is based on Australia's, I know that their triage system in the ED was taken from the Australian system.

It is probably best if I just decribe what happens. We have two systems. Universal- MediCare, all tax payers pay into this system and all citizens have a card. When you go to the doctor you will either be bulk billed (pay nothing, it is payed by medicare) or you will pay a fee for example $40 and you will get a rebate of for example $28 (but you have to go and claim this, which I always forget to). When I go to the doctor I don't have to make an appointment (depending on the day), it is first in and you wait for a max 1hour. I can go and see any doctor I wish and my medical files can be transfered to the new doctor. As a student I have a Low Income health care card, I can see any doctor for free.

The second system is private health care. It applies mainly to hospital and extras such as optical, dental and alternative medicine (natropath, remedial massage etc). You don't always get unlimited extras, but up to a preset dollar amount. You pay monthly and can go to private hospitals for operations and medical issues. You have preferential treatment (if you need the knee replacement you will have it now) private hospitals usually are a bit more flash (not always) and you can choose your treating doctor. Private health insurance doesn't inital you to a private room (which most of my patients think it does).

If you don't have private health insurance you can still go into private hospitals (as most of the surgeons work in them, so if you want something now you will have to pay) you pay for the whole operation upfront. If you can wait you will be put on a waiting list at the public/general hospital and i think it is payed partially by medicare and the rest by you. But the wait can be a year.

Ambulance transport is not provided in all private health insurance, isn't covered by medicare but is covered on government pensions (veterans, aged, student). Everyone else can (not compulsory) pay yearly for ambulance membership $60 singles, $100 families. This covers you for all transport including helicopter, boat and normal ambulance. If you do not have membership the bill can be $2000 for normal road transport alone. You will be taken to the nearest public hospital for treatment (and seeing everyone is with Medicare you are covered at all public hospitals). If you walk in off the street you will be triaged (don't ask me how as it is too complicated to write now). You hear about people waiting for hours, and this is due to the lack of beds, but I haven't ever had to wait more than about half an hour. You will be charged for some things but Medicare covers most of it.

I hope that this is what you asked.
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Old 02-10-2008, 11:04 PM
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One last system. All road users (car, bike, pedestrian) are coved under car registration. I have hit off my bike and had to go into the ED as it was a road accident. All treatment and x-rays were covered by the TAC (Traffic Accident Commission).
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Old 02-11-2008, 06:46 PM
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The guy ended up canceling his visit. But! He is rescheduling, so if any one else wants to chime in, please do.

Thanks for the info re: Australia's system. I do enjoy learning about different systems and hearing other's perspectives.

I keep hoping I'll hear about the perfect system, where everyone is happy -- then I'll work there. Until I do, though, I guess we'll just have to work and make our little corner of influence as perfect as possible, huh?
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Old 02-12-2008, 02:27 AM
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I keep hoping I'll hear about the perfect system, where everyone is happy -- then I'll work there. Until I do, though, I guess we'll just have to work and make our little corner of influence as perfect as possible, huh?
Sadly there is probably no such system.

Even with the universal health system that is the NHS in the UK, where healthcare is meant to be free for those who need it at the point of access there are increasing problems. How do you fund such a system, how do you manage increasing demand, how do you decide what should be prioritised over something else and for whom?

This is an interesting topic, worthy of debate.
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Old 02-12-2008, 09:51 AM
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Excellent questions, Julie. Do you have any personal experiences with the NHS you'd like to relate (your blog URL is "lifeintheNHS" so I'm sure you do ).

How is the NHS funded? Some sort of income tax? or is there a some other way?
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Old 02-12-2008, 11:34 AM
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I have plenty of experience of working in the NHS and of course I am also from time to time a user of it too.

The NHS is funded through taxation. All employers, employees and self employed people contribute through national insurance towards not only the NHS but also state pensions, incapacity benefit, maternity allowance etc. Individuals do not have their own fund as it were, it is a 'pay as you go' service, so that what is paid in now is spent now. Even if you had never contributed, for example were disabled and unable to work or were a child then most of your healthcare remains free.

Not everything is included. Adults pay towards dental treatment, prescription drugs, eye tests etc. Children and certain other groups are likely to receive these free. If you want a treatment that is not deemed best practice, or which is thought 'exceptional' then you may not recieve this free. For example it is often difficult to obtain experimental drugs or treatment.

Please feel free to ask anything else you want.
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