Reply #159: I think we also have a collective head up our ass as a country

[Heddi]

People overwhelmingly want social programs...until you tell them that they'll have to pay for these social programs. Then suddenly there will be this new influx of "those people" sucking the teat dry for the rest of us, etc.

I'm a nurse. I work at the largest community hospital in my part of the country. We are also the largest level-1 trauma center in this part of the country. 80% of our clientelle are poor, homeless, immigrant, underserved, underserviced, no insurance.

What people don't "get" is that we are *already* paying for "those people" to get services in the health care community. However, we are paying MORE because we only give them the option of the already under-staffed and over-crowded emergency rooms as their PCP. They have very limited in a few cases, and absolutely NO access in the majority of cases to any kind of preventative care. There is no reason to come to the ER at 2am because of an ear infection, but for millions of people in this country, that's the only place they CAN go because they don't have insurance, don't have a way to go to a doctor's office to be seen where they will have to pay the office fee up front. Then add to that the cost of medications. God forbid it's more serious than an ear infection....diabetes? Hardly an inexpensive illness. Kidney failure? Heart or Lung Disease??? There is no other place for "those people" to go to get treatment for these problems other than the ER.

We already ARE paying for the care, at a much inflated cost than we should be paying because emergency room RN's and MD's shouldn't be treating ear infections. And when they do, the service rendered is going to be SIGNIFICANTLY higher than the cost if the person could have been seen by a doctor, gotten a prescription, and gone home.

We have an I ME MINE attitude in this country. I see it when "normal" people are my patients---they were on an alaskan cruise and have a headache,so they come to my ER and get admitted because they have A-fib (very common heart rhythm) THey're affluent, or at least not homeless. They don't have addictions to multiple substances, but they're sharing a room with someone who is. They get all adamant about "those people" clogging up the emergency rooms and my thought is "you are one of "those people" too" But because the don't SEE themselves as one of "those people", they feel that they have more of a right to social services, regardless of who "Those people" are. Citizens, non citizens, drug addicts, prostitutes, single mothers, battered women, prisoners, working homeless---this is who my patients are. These are the people I work with and treat 14 hours a night, 3-4 nights a week.

"those people" are not a drain to our society and to our health care. What is a drain to the health care system is the health care system itself. We are beheld to the insurance companies. They OWN healthcare. I see it every day, where MD's and RN's come up with clever ways to diagnose certain problems, or describe procedures a certain way so that they are paid for by insurance, medicare, medicaid, the VA, whatever. WE (healthcare workers) are quite aware of this problem in a very intimate way. I have had patients who have refused life-extending procedures because they could not afford the deductable. They don't take certain meds because they can't afford the every-other-month blood test that's required to be on the med.

If the general public realized that WE ARE GIVING FREE HEALTH CARE to many people, I think their heads would explode. Why not take out the middle-man---get rid of insurance companies. Just come out and say "Look, we subsidize Billions of dollars in health care costs through pro-bono and charity as it is. Let's just go ahead and extend that to everyone. We're already paying for it anyways so now EVERYONE can get coverage for whatever they need, at any time" and just fucking kick insurance companies out. YOu need to go to the dr, you go to the doctor. Simple as that.