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So do you disagree that we need better public health system? better education, better preventative measures? Do we not need to tell those what could afford insurance to buy insurance rather than buying other non essentials? We are not in disagreement. I guess I'm in the field and I know that unless we make some changes, the problems will continue to grow, and we will continue to throw more and more money at it.
No, I"ve spent most of my career as a public health nurse, and I am in full agreement with PH principles. But you can't just push preventive (that is the word, BTW) measures. People are always going to get sick.
Most people w/o insurance are from working families whose employers don't offer it. There are also some self-employed who don't buy insurance. Have you looked at prices of individual policies? Very expensive for very little coverage. "Throwing money at it" could include such things as a tax credit for the self-employed and subsidies for those whose companies don't offer it.
No, I"ve spent most of my career as a public health nurse, and I am in full agreement with PH principles. But you can't just push preventive (that is the word, BTW) measures. People are always going to get sick.
Most people w/o insurance are from working families whose employers don't offer it. There are also some self-employed who don't buy insurance. Have you looked at prices of individual policies? Very expensive for very little coverage. "Throwing money at it" could include such things as a tax credit for the self-employed and subsidies for those whose companies don't offer it.
I'm glad I'm talking to a nurse. Someone with true insight
Think of a typical compliant patient with DM. What care is needed? Education, medicine, labs twice a year, sees a doc or a nurse 2-3x a year?
Now think of your last poorly controlled DM patient. How much more does this patient cost the system? You and I know that genetics we can't control, but motivation and compliance is a HUGE problem!!
The fundamental cost of our system is cost, since cost is what prevent people from getting insurance.
I don't see how building more hospitals, hiring more nurse, docs would help. We need education above anything.
I'm glad I'm talking to a nurse. Someone with true insight
Think of a typical compliant patient with DM. What care is needed? Education, medicine, labs twice a year, sees a doc or a nurse 2-3x a year?
Now think of your last poorly controlled DM patient. How much more does this patient cost the system? You and I know that genetics we can't control, but motivation and compliance is a HUGE problem!!
The fundamental cost of our system is cost, since cost is what prevent people from getting insurance.
I don't see how building more hospitals, hiring more nurse, docs would help. We need education above anything.
There are many things that can throw diabetes out of control; illness, stress, pregnancy, etc. To blame all this on the pt. is wrong. Yes, I've seen diabetics who don't follow their diets, take their meds, but you have to keep plugging away and hope that one day they will. Teens especially have a hard time being "compliant".
Who is going to do this education you propose? Health care professionals. Where are they going to do it? In an office. And if more people have insurance, more people are going to be diagnosed in the first place, and need all the care that is initially required, which will require more personnel and space.
There are many things that can throw diabetes out of control; illness, stress, pregnancy, etc. To blame all this on the pt. is wrong. Yes, I've seen diabetics who don't follow their diets, take their meds, but you have to keep plugging away and hope that one day they will. Teens especially have a hard time being "compliant".
Who is going to do this education? Health care professionals. Where are they going to do it? In an office. And if more people have insurance, more people are going to be diagnosed in the first place, and need all the care that is initially required.
No one is blaming ALL of that on patients. If you do primary care at all, you know that motivation is the main reason. What percent of patients are compliant with a plan? This is not exclusive to DM.
OK. See it your way. We make insurance available for everyone. Who pays? No matter how you disguise it, it's the tax payers. Can't keep printing money at this rate! So you hire 10% more docs and nurses and administrators and techs and office space etc. So do you think this will solve the problem? Of course not. It's a bandage that makes you feel better.
One of the fundamental problem is that we are getting less and less healthy as a society. For what ever reason. We are more dependent on medicine to save us.
So how long will it take for us to run through the funding?
One of the fundamental problem is that we are getting less and less healthy as a society. For what ever reason. We are more dependent on medicine to save us.
So how long will it take for us to run through the funding?
This is simply untrue. Death rates from virutally all causes are down.
Most people no longer get tuberculosis and/or a lot of other communicable diseases any more. We don't get diseases from dirty public water, etc. Women rarely die in childbirth any more. We get more chronic disease b/c people live longer.
Most people no longer get tuberculosis and/or a lot of other communicable diseases any more. We don't get diseases from dirty public water, etc. WE get more chornic disease b/c people live longer to begin with.
Maybe you haven't heard of drug resistant TB making a come back? MRSA?
"People from regions with high rates of TB — especially sub-Saharan Africa, India, China, the islands of Southeast Asia and Micronesia, and parts of the former Soviet Union — are more likely to develop TB. In the United States, more than half the people with TB were born in a different country."
Last edited by Katarina Witt; 03-01-2009 at 06:12 PM..
Reason: add info about TB
Yes, but there are no TB epidemics like there were in the 50s. MRSA is a new problem, but it is treatable.
Both are very close to an epidemic.
They are not a huge problem from a cost perspecitve anywyas. The incidence of diabetes, htn, heart disease, cancer, joint disease are all on the rise. What percent of the health care cost do you think they represent?
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