Thread: Legislators and health Board: Hell / Ship of Fools.


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Posted by Schroedinger's cat (# 64) on :
 
So the US Republicans have voted to repeal the Obamacare provisions. I don't fully understand it, but, from what I can understand, it will remove health care provision from some of the poor and needy in the US.

How anyone can do that, I don't know. How they can actually vote to let people die simply for not being rich baffles me (I know, I am getting baffled by a lot of other peoples decisions these days).

Now I am watching Hospital from last night, which highlights that the government in this country are also deliberately destroying the NHS, which was the very best in the world a few year ago. It has been underfunded and damaged by this government, deliberately for profit.

I used to think we were progressing as a society. these last few years have shown me that we are not. We have had the good times, and we are now being fucked royally by our leaders.

I am utterly ashamed of my country today. I am ashamed to be in the West. In fact, I am ashamed to be a human, because humanity at its worst does not deserve to survive. At our best (also shown in Hospital and many other places) we are awesome, but I don't know if our worst is worth it.
 
Posted by lilBuddha (# 14333) on :
 
One needn't be a heartless, hypocritical lying bastard to be a politician, but it helps
 
Posted by Brenda Clough (# 18061) on :
 
They're not really interested in health care. Their constituents dying in the streets, pfui. They're only interested in their ideology. It was spearheaded by Obama, and therefore it is anathema.
 
Posted by Pigwidgeon (# 10192) on :
 
In the meantime, U.S. Congress critter have one of the best healthcare plans in the country.
[Mad]
 
Posted by Brenda Clough (# 18061) on :
 
They have a doctor on staff, on duty on Capitol Hill. Bet your place of employment doesn't have one! They also only work 170 days a year, on a six figure salary, and have exempted themselves from all labor laws and employment regs. That's what happens when you can vote your own benefits.
 
Posted by L'organist (# 17338) on :
 
posted by Schroedinger's Cat
quote:
Now I am watching Hospital from last night, which highlights that the government in this country are also deliberately destroying the NHS, which was the very best in the world a few year ago. It has been underfunded and damaged by this government, deliberately for profit.
Neither this government, nor the previous coalition, is trying to destroy the NHS: in fact, if one were to wish to level that charge at anyone it might be at the lunacy that took place in the middle Blair government which, by not thinking through the possible effects of some of its actions put in place some of the things that are causing such trouble now.

I'm referring to the GP contract and pay settlement that was reached in 2004 which managed to up the pay of GPs while reducing their patient responsibilities for out-of-hours care. This was done at a time when general practice was already starting to feel the strain with far more GPs were working part-time and so leaving gaps in surgery timetables. The result can be seen in many surgeries working very short hours, many refusing to make home visits, most out-sourcing evening and weekend out-of-hours services, many deciding not to offer ante-natal care, etc, etc, etc. This instantly brought more pressure to bear on A&E departments at the same time as the relaxation in licensing hours led to increased numbers of drunks and others being taken in by police (and others) - and police were in any case taking in more because they were finding it nigh impossible to get GPs to take on the role of part-time police duty doctor.

All of the above would be bad enough but when you add in the fact that as a nation we don't look after our health, plus the increasing number of very frail elderly - alive thanks to advances in medical science but not necessarily thriving, and a national obesity epidemic you have a recipe for disaster.

Yes, the NHS is underfunded in comparison with other European countries, but that is because in, say, France and Germany it is not only the government that is paying for health but also individuals through health insurance, which for the average worker costs far more than our NI levy which is meant to cover not only health but social care, pensions and other benefits.

Quite how you think the government is "profiting" from what you perceive to be underfunding of the NHS is a mystery: they are simply trying to do what all governments have tried to do since the NHS came into being, which is buy a £10 item for £5 - it can't be done.

As for the situation in the USA with die-hard Republicans seeking to destroy Obamacare, this is a scandal.
 
Posted by no prophet's flag is set so... (# 15560) on :
 
Canadian situation is that medicare is provincially controlled. Coverage varies province to province, but has this in common: doctor and hospital care is covered. Almost nothing else is covered. No dental, no medications, no psychotherapy, no physical therapy except right after surgery, no eye care, no crutches or walkers, some provinces cover ambulances (mine does not, average cost $500. Home care (care in the home) post hospital costs a per day fee, which is unaffordable at $20-60 per day.

It was last better here 30-40 years ago. At that time dental and eyes were covered for under 16 years, medications were always one flat price (would be about $15 per perscription in today cost), community mental health provided psychotherapy, marital/ family counselling.

The shift began when the first conservative wave occurred, Mulroney here, Thatcher, Reagan etc elsewhere. Cut corp and high earner taxes, have those with good employment have benefit plans pay for non-hospital and non-doctor care. But the good job group is a smaller proportion of the workforce.

I am a small business owner. 9 employees, 2 partners/co-owners. The costs to buy health benefits and pensions has doubled in real dollars in 35 years. We also pay a living wage, and pay out of pocket for things not covered for employees, like walkers and crutches and homecare. It is terrible that many have no options and can't afford. Sometimes we want to give up, get out and retire, but I don't see how we could leave everyone in the cold. National chains keep offering, and we say PFO. They would squeeze it all for what they could ring out. I really have come to hate conservatives who created all of this.
 
Posted by Doc Tor (# 9748) on :
 
quote:
Originally posted by L'organist:
Neither this government, nor the previous coalition, is trying to destroy the NHS

Well, that's just flat out bollocks.

Even if you consider the GP contracts botched, it was designed to prevent the haemorrhaging of GPs from the system. Which it partially did. I met a GP (friend of a friend) over the weekend - emigrated to Perth, WA eighteen months ago. 80 hour week in the UK, 40 hour week in Aus. No contest. That's why the GP network is failing - too few GPs who are grossly overworked - not for any other reason.

And then you have to explain why we lack trained nurses (met one of those over the weekend too - now a publisher), ICU beds, midwives, and everything else that goes to make a hospital. A&E is at the sharp end, but the problems are systemic, chronic, and getting worse.

You have to be the most naive thing in naiveland to wonder what the Tories would get out of it. Profit. That's what they'd get out of it. Their noses in the trough. You're welcome.
 
Posted by The Phantom Flan Flinger (# 8891) on :
 
Even if the blame can be laid at the feet of the Blair government (which, in itself is pathetic - Blair has been gone from Downing Street for 10 years), it is in the hands of the current government to put it right.

Instead, they manage to put their heads in the sand and their noses in the trough at the same time. A remarkable feat.

Bunch of fuckwits.
 
Posted by Schroedinger's cat (# 64) on :
 
I have mental health problems. If I need urgent or emergency treatment or help, I don't know that it will be there. I don't know whether I will get the help I need without having to get arrested.

I don't know if the help will be there before I take my own life. I am scared to ask, because if the answer is no, I am on my own.

I have worked most of my life, I have contributed to the welfare budget all of that time. I have done my part. Apparently, that means fuck all. If you don't understand how frightening that is for me, you can also lick your own arse as you shove your head up it.
 
Posted by ExclamationMark (# 14715) on :
 
quote:
Originally posted by Schroedinger's cat:
I have mental health problems. If I need urgent or emergency treatment or help, I don't know that it will be there. I don't know whether I will get the help I need without having to get arrested.

I don't know if the help will be there before I take my own life. I am scared to ask, because if the answer is no, I am on my own.

I have worked most of my life, I have contributed to the welfare budget all of that time. I have done my part. Apparently, that means fuck all. If you don't understand how frightening that is for me, you can also lick your own arse as you shove your head up it.

So sorry to hear that.

It's scary because in many cases the help isn't there - I'm currently fighting to help 2 people stay in secure care. The powers that be want to release them back home with community support for medicating. Last time this happened for one the meds didn't turn up. Meltdown.I had to invoke a safeguarding incident against the local council ("Negligence" in care).

Review meeting - everyone blamed apart from the people who didn't deliver the meds. Duh?

legislation in the UK has precipitated the crisis in the NHS

1. Fewer GP's, longer waiting times.
2. Adult Social Care budgets cut(tens of millions over 3 years in a growing town I know, already under pressure for child support & mental health)
3. Hospitals jammed up - see 1. and 2. above. Doctors overworked .... yet some still find time and energy for private work
4. Loss of respect for the NHS - non delivery, fudging the issues. When respect is gone people take the mickey - hence A & E is now the first port of call for many people for most illnesses. You know you must be seen.
5. Licensing laws and alcohol availability. 30% of A & E admissions on some nights are alcohol related. Never the same issues when everything shut down at midnight and alcohol not available so freely in shops etc.

[ 14. January 2017, 05:49: Message edited by: ExclamationMark ]
 
Posted by Jane R (# 331) on :
 
Exclamation Mark:
quote:
Doctors overworked .... yet some still find time and energy for private work
Senior consultants tend to be the ones who do private work alongside NHS work. GPs and junior doctors may refer you to private healthcare but don't do it themselves. They are the ones who are being overworked.

I have a friend who is a junior doctor. His shifts are long enough officially, but because he is dedicated to his job and can't bear to leave without making sure his patients are taken care of he often does unpaid overtime. I'm expecting him to emigrate to Australia any day now.

The NHS cannot run on goodwill and the dedication of its staff for much longer.
 
Posted by tessaB (# 8533) on :
 
And cutting bursaries for health-care trainees ensures that fewer people are choosing to go into those professions. As well as actively working against mature students who may have already got a degree in a different subject and then find they can't get a loan for another degree.
 
Posted by lilBuddha (# 14333) on :
 
quote:
Originally posted by Jane R:

The NHS cannot run on goodwill and the dedication of its staff for much longer.

Not only that, those long hours increase the odds of mistakes.
 
Posted by Golden Key (# 1468) on :
 
Exclamation Mark--

Re moving people from secure care to community care:

Here, in California, it was a disaster, because it was handled in an impractical way. It sounds wonderful to get someone out of a restrictive, institutional situation, but...

AIUI, meds weren't provided at the person's new home. The person had to go to a central place to get them. If the person couldn't manage that, then no meds...worsening health...low functioning...homelessness...worse functioning...encounters with police and street danger...

That's one of the major causes of the vast homelessness problems in California.

[Votive]
 
Posted by Huia (# 3473) on :
 
quote:
Originally posted by Jane R:
I have a friend who is a junior doctor. His shifts are long enough officially, but because he is dedicated to his job and can't bear to leave without making sure his patients are taken care of he often does unpaid overtime. I'm expecting him to emigrate to Australia any day now.

I would say "tell him to come to NZ, it's much nicer here" - except that Junior doctors here are going on strike next week.

Huia [Frown]
 
Posted by Kittyville (# 16106) on :
 
Ditch war!
 
Posted by Golden Key (# 1468) on :
 
Ah, "ditch" is to NZ and Oz as "pond" is to UK and US?
 
Posted by Kittyville (# 16106) on :
 
Yes - "the ditch" or "dutch", if you're a kiwi, is the Tasman Sea, which separates us.
 
Posted by Golden Key (# 1468) on :
 
Cool. Thx!
 
Posted by ExclamationMark (# 14715) on :
 
quote:
Originally posted by Jane R:
Exclamation Mark:
quote:
Doctors overworked .... yet some still find time and energy for private work

I did say "some" but take your point entirely.
FWIW Mrs M (worked until early retirement - physically worn out after 36 years on the front line) and all of our daughters work in the NHS - elderly care, mental health, cancer care, infection control - so we do see it at first hand.

My experience of social care was nursing a terminally ill parent at home - the Social Care Team promise the earth but only delivered 1/42. They didn't send a bed as promised - forgive my cynicism but I've had to support a dying individual in great pain because it's taken hours to get someone out to sort out a morphine pump with a very basic procedure.
 
Posted by jedijudy (# 333) on :
 
If it weren't for the ACA (Obamacare), I would have no health insurance. With multiple serious medical conditions, no insurance would mean no home or food.

I was listening to a Republican congressman on NPR this morning, and he was bemoaning the fact that the ACA has made health insurance unaffordable. If he would take that tinfoil head covering off and talk to actual people who have Obamacare, he would see the opposite is true. My policy without ACA for this year would be about $1000 a month. My monthly income is a few dollars more than that. Through the ACA, I'm paying less than $10 a month and have low copays and no deductible. What do the Republicans have in mind to improve that? I've heard no plan. The congressman on the radio this morning didn't give one single bit of information on what the new plan would be, just that Obamacare would be axed.

I wonder how many Shipmates here in the US are on ACA, and what they would do if it was suddenly removed from existence. I know that I personally would be in deep, deep trouble.

[ 15. January 2017, 16:06: Message edited by: jedijudy ]
 
Posted by Soror Magna (# 9881) on :
 
The Republicans keep saying that they'll have a plan based on conservative principles, including competition. They're either unwilling to admit or unable to comprehend that health care is not a free market and will never follow the same economic rules as shoes or plumbers. Nobody goes on line to find the cheapest place to get a colonoscopy. Nobody waits until there's sale on heart surgery. Doctors don't compete with each other by lowering their fees. (As if. [Killing me] ) Neither do any other health care providers. Legislation from the Reagan era requires hospitals to treat the uninsured and those costs are borne by other patients. The health care field is populated by charities and non-profits as well as for-profit actors. Insurance rates are determined by the health of the stock and bond markets, not just the health of the insured population. And so on. That's why the Republicans have never been able to come up with a universal health insurance plan. Except, of course, RommeyCare ...
 
Posted by lilBuddha (# 14333) on :
 
quote:
Originally posted by jedijudy:
If it weren't for the ACA (Obamacare), I would have no health insurance. With multiple serious medical conditions, no insurance would mean no home or food.

As I understand it, ACA did negatively affect some. However, far more people were able to have health care than previously. And despite the lies the Republicans are telling, Medicare actually benefited.
The Republicans, as a group, do not care.
 
Posted by Belle Ringer (# 13379) on :
 
This is a general comment that applies to health care too. Sociopaths. Rumored to be 4% of the public, they are much more of the bosses. They truly don't care about the "little people" even if married to them. Put on a good public show, that's all, keeps the public unsuspecting.

As long as the money is not around, little interest. Let some money show up and all bets are off.

It's a game, holder of the most toys win. If he got those toys by tricking the workers that's extra points.

Ive seen it for years but always assumed it was isolated leaders. Until recently. It's throughout the industries big enough to offer the game.

Including medicine. Not limited to it.

Next step is how shall we then live. Not sure. Stay tuned.
 
Posted by cliffdweller (# 13338) on :
 
quote:
Originally posted by lilBuddha:
quote:
Originally posted by jedijudy:
If it weren't for the ACA (Obamacare), I would have no health insurance. With multiple serious medical conditions, no insurance would mean no home or food.

As I understand it, ACA did negatively affect some.
It negatively effected the very rich-- the top 400 families in the US, which is why it's being repealed.

It arguably effected the healthy uninsured, because they were forced to purchase insurance. But I say "arguably" because it's not like they were forced to pay money for no benefit or to benefit only others, like paying for public schools if you have no kids. They were forced to pay into a system that is entirely for their benefit-- like paying into social security. They had to buy insurance (and were often subsidized to do so below market costs), and rec'd in return the benefit of health care.

What did happen is that the health insurance companies did a very good job of passing off the normal sorts of annual premium hikes that they have gouged out of consumers all along as something "caused" by ACA, simply by saying "cuz Obamacare". It was a ludicrous bit of bait-and-switch, absolutely false, but they did a very good job of selling it so that when people got their higher bills they all cried foul. Sure, if we'd been able to get single-payer we would have had better control over those premium increases, but ACA certainly didn't cause them. Irony is the insurers did a little bit too good a job cuz now they're all scared to death of the upheaval and loss of subsidized healthy customers they're going to lose if/when ACA is repealed.

My heart just bleeds for them, poor dears.
 
Posted by Brenda Clough (# 18061) on :
 
I know conservatives in the US who argue that the government should not be in health care at all. Poor people should get charity to pay for their doctors, from churches. I know a lot of pastors and priests here will be looking forward to that.

I asked whether the government should be involved in auto insurance. Which the authorities do not actually offer. What there are are laws that if you want to drive you need to get a license (ensuring that you're not blind, are of age, etc.) and auto insurance, so that when you hit someone or are hit there's some way to pay for the injuries and damage. My conservative friend at least was consistent in her beliefs; she felt the government shouldn't do this either.
 


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