I asked this question about Medicare for all before and never got a real answer

[ismnotwasm]

11. Medicare underfunds hospitals

This is a multi-layered complex problem, and why, while I definitely want universal healthcare, the Medicare system needs to be reworked. My hospital already takes more than it’s share of the underserved and indigent population,(there is extra funding for this) and has among the top third sickest peoples in the country.

You know what management tell us the most expensive part of healthcare is? Healthcare workers, in my case Registered Nurses. I work in an unionized state hospital with good management. While they fight us on wage increases, they don’t deny them completely. They watch things like incremental overtime (you stay for 15 extra minutes to get charting done etc) Washington state just passed a mandatory break law, so we have to take breaks, and we best get paid for them if we don’t. But pressure is there and we go through periods of being chronically understaffed. Do you want your nurse to be overwhelmed and overworked and overtired? No you all don’t.

So, no. Hospitals won’t.

We recently had a patient who was “kicked out” of a county hospital after a long stay because “they aren’t a charity hospital” it’s a longer story, but that’s a good summary.

Drug pricing and pharmaceutical companies are the first step. Proving enough primary care clinics is the next. Nursing leaders want to empower NPs to fill the provider gap that is happening in a lot of areas. Patient education is an absolute must. Yes, college costs play a factor in the provider shortage, but healthcare is messed up enough that less people are choosing that path in a time we need more, PCPs aren’t making tons of money. So depending where you live matters.

So housing costs/shelter matter. Food costs matter. Childcare matters. Environmental factors When you get into the hierarchy of needs, the basic have to be covered for healthcare to be as effective as possible.

M4A, as I’ve read through the plans aren’t addressing enough of the factors. They do not take into account what Medicare currently is, or isn’t. One of the things it isn’t is a Scandinavian type system of payment.

I can type this crap out with data and links and anecdotal experience and I find people still want to hear about a slogan.

Everyone needs to have a healthcare discussion. What have we done to stay healthy today? I haven’t done shit except to sit in my hottub. So later today, I’ll take my dog for a walk. (My hottub is refurbished and a friend did the electrical work for free). I *do* have health insurance so I’ll think about what preventative measures I can take. I’m healthy, no issues.

Now my spouse is chronically ill.

And here’s an ethical question

Hes On disability. He is very expensive medically wise. Partly because of drug costs. They blow my mind. I keep a healthcare spending account for him. It’s available through my work as a benefit.

What is his worth as a human being?

How about the junkies who are non compliant with procedures that keep them alive, and show up
To ERs over and over again.

Or, and this one is HARD, because as much as I hate multiple sclerosis, I hate cancer worse

The costs of stem cell transplant or chemo for cancer, when it all goes wrong and the cost burden is astronomical?

Or life long care for traumatic brain injuries? With a trach? On dialysis?

And their family wants everything done and the weeks turn into months?


How do we place costs on people? An arm costs this much, a leg that much

That’s actually a thing by the way.

So all this rambling means is in we are in more trouble then slogan politics will fix.

FWIW, I value all life equally, as part of my human family, which means if some POS like Rush Limbaugh was my patient I still would give him excellent care.