Guaranteed Healthcare

Please refrain from sending me any of your literature. I did not want and was appalled to receive a mailing touting Michael Moore's latest attempt at "documentary moviemaking". If you people think that the Workers Paradise of Cuba has such wonderful healthcare, you are welcome to leave this great country and live there.

The first comment is from a person who has not seen the movie and is telling others who see it and approve of it to leave the USA and move to Cuba.

America was founded on the freedom to think and belive what we want to think and belive. We have the right to say and think what we want without being told we have to leave the country if we don't agree with the writer.

The writer could at least see the movie and form her own opinion before telling those who don't "see it her way" to move to another country. Please read the definition of democracy.

See the movie, then decide. I will be interested to see your comments after you have seen the film. And I will be there on opening night to pass out flyers.

Anne Lewis RN

People who refuse to see the movie are not that interesting. Eventually, they will be convinced through other avenues. Let's not waste our efforts on unproductive activities.

The take action part in this campaign is to support the spreading of the movie and also to support congressional legislative changes to create a national health system. But, I am not sure it is enough to go through the legislature. We must prepare as a movement for greater action.

To me this greater action is the necessary catalyst that will empower the legislation to go through and a national healthcare system to be a reality in America.

The greater action is simple. Just like insurance companies do not refuse care but refuse payment so too can the American people refuse to pay. They can refuse to pay their current bills as well as their insurance premiums. When enough people are willing to sacrifice their current horrible system for a new this action will be effective.

With the film and some good organizing, conditions will be ripe to refuse to cooperate with the insurance companies and for profit health care companies. Also, those people who work within the health care field are encouraged to refuse to work for an unjust system. These types of actions are what is necessary to overcome the power of the healthcare industry and push this legislation through congress and make American universal health care a reality in the United States.

Eileen, Please let us know the basis for your statement that the U.S. has the best medical care possible. The steadily rising costs of health care is a worldwide problem. In the other industrial nations where costs are rationally managed, the total burden on the economy is half as much as ours because they have a single-payer system either managed by the government or smaller governmental units. The overall quality of care in these countries, measured by life expectancy, infant mortality rates, patient satisfaction and other parameters, is better than ours.
Here's my sources:

Health Affairs: How Does The Quality Of Care Compare In Five Countries?:
http://content.healthaffairs.org/cgi/content/abstract/23/3/89

Rand Corporation: The First National Report Card on Quality of Health Care in America:
http://www.rand.org/publications/RB/RB9053/

Health Affairs: Medicare Spending, The Physician Workforce, And Beneficiaries’ Quality Of Care (An alarming report that finds that “states with higher Medicare spending have lower-quality care.”):z
http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w4.184v1
Read them and weep. Then, go see the movie and get to work on fixing our system!

As far as the CNA/NNOC mailer you received, I believe it contains factual and candid information, written with the assumption that nurses share a common commitment to fairness, truth, evidence, good sense, courtesy, professional and patient advocacy. You have the right to be different. God Bless America.

Dear Rn4mercy,

I took the time to read the articles you provided. They were interesting, however, the only article that I could say held merit was the first one, namely because it provided empirical data. The second two articles were purely subjective and can not provide conclusions worthy enough to substantiate the initiation of socialized medicine. The articles do state that the observers of the studies do not altogether attribute higher morbidity and mortality rates in any specific disease entity to lesser quality of care compared to other countries. Many other factors can contribute to M/M. The evidence is strong, however, to suggest that the outcome of care in this country, compared to the four other countries was slighlty less in some areas and BETTER in others.

Now, if you would, please read this article:

http://en.wikipedia.org/wiki/Canadian_and_American_health_care_systems_c...

By reading this article, you will learn what socialized medicine has done to Canada's economy. Notably, you will find that the U.S., while having higher incidence of disease entities (why?), experience better outcomes. You will also note that the opportunities in Canada for nurses and physicians to earn a respectable salary is poor, at best. Many nurses and physicians have fled to our wonderful country to earn a fair wage, leaving Canada with limited and poor access to health care. Is this what you want for America?

Last but not least, this article states that Canada's taxes are HIGHER than ours. Our citizens are screaming now about taxes - what do you think will happen when taxes increase due to implementation of socialized medicine in the United States?

There has to be a better answer, and I can admit, I don't have that answer. We as professionals need dialogue amongst other professionals and our government, to improve what is lacking in our system. Allowing Michael Moore to be our spokesman is neither effective nor professional. We are professionals, so let's start acting like it.

This movie is great, and so is this website. I'm posting a link to your site on my blogroll.

Mother Jones, RN

Ss if OT..but the medical community's lack of coverage or caring about this situation below furstates me so much that I had to post about it here. Why is THIS woman's death not being discussed about by every med oriented blog on the internet DAILY? I perused as many blogs as I possibly could yesterday and found hardly any mention of this situation. Or worse..no mention at all.

Instead..I read mostly whines, complaints and docs and nurses being so "dismissive" of patients..many resorting to calling other human beings every horrendous word imaginable. Some seem more concerned with two docs shutting down their blogs..going so far as calling that Black Wednesday!

How are we the patients (who sadly are the end of the line for all of the medical professional's furstation and angst) supposed to help with change IF THE ENTIRE MEDICAL COMMUNITY does NOT come together and start changing things from within. How many more of us have to die before you all INSIST upon change BY ANY MEANS NECESSARY?

A more comprehensive report on ALL of this one hospital's problems can be found here if more information is needed....

http://www.latimes.com/news/local/la-kingdrew-gallery,0,5651209.storygal...

Did Mrs. Rodriguez die for nothing? According to what I found on the blogs..apparently. Many bloggers got mad that I "bothered" them with this off-topic comment. Excuse me..but IMHO,people dying like this poor woman should be the main topic. How many more of us have to die before something is done?

TALE OF LAST NINETY MINUTES OF WOMAN'S LIFE
County officials express dismay at the events surrounding the recent controversial death at King-Harbor hospital. One nurse has resigned.
By Charles Ornstein, Times Staff Writer
May 20, 2007

In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer.

"Thanks a lot, officers," an emergency room nurse told Los Angeles County police who brought in Rodriguez early May 9 after finding her in front of the Willowbrook hospital yelling for help. "This is her third time here."

The 43-year-old mother of three had been released from the emergency room hours earlier, her third visit in three days for abdominal pain. She'd been given prescription medication and a doctor's appointment.

Turning to Rodriguez, the nurse said, "You have already been seen, and there is nothing we can do," according to a report by the county office of public safety, which provides security at the hospital.

Parked in the emergency room lobby in a wheelchair after police left, she fell to the floor. She lay on the linoleum, writhing in pain, for 45 minutes, as staffers worked at their desks and numerous patients looked on.

Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone's apparent indifference.

Arriving to find Rodriguez on the floor, her boyfriend unsuccessfully tried to enlist help from the medical staff and county police — even a 911 dispatcher, who balked at sending rescuers to a hospital.

Alerted to the "disturbance" in the lobby, police stepped in — by running Rodriguez's record. They found an outstanding warrant and prepared to take her to jail. She died before she could be put into a squad car.

How Rodriguez came to die at a public hospital, without help from the many people around her, is now the subject of much public hand-wringing. The county chief administrative office has launched an investigation, as has the Sheriff's Department homicide division and state and federal health regulators.

The triage nurse involved has resigned, and the emergency room supervisor has been reassigned. Additional disciplinary actions could come this week.

The incident has brought renewed attention to King-Harbor, a long-troubled hospital formerly known as King/Drew.

The Times reconstructed the last 90 minutes of Rodriguez's life based on accounts by three people who have seen the confidential videotape, a detailed police report, interviews with relatives and an account of the boyfriend's 911 call.

"I am completely dumbfounded," said county Supervisor Zev Yaroslavsky, who has seen the video recording.

"It's an indictment of everybody," he said. "If this woman was in pain, which she appears to be, if she was writhing in pain, which she appears to be, why did nobody bother … to take the most minimal interest in her, in her welfare? It's just shocking. It really is."

The story of Rodriguez's demise began at 12:34 a.m. when two county police officers received a radio call of a "female down" and yelling for help near the front entrance of King-Harbor, according to the police report.

When they approached Rodriguez to ask what was wrong, she responded in a "loud and belligerent voice that her stomach was hurting," the report states. She said she had 10 gallstones and that one of them had burst.

A staff member summoned by the police arrived with a wheelchair and rolled her into the emergency room. Among her belongings, one officer found her latest discharge slip from the hospital, which instructed her to "return to ER if nausea, vomit, more pain or any worse."

When the officers talked to the emergency room nurse, she "did not show any concern" for Rodriguez, the police report said. The report identifies the nurse as Linda Witland, but county officials confirmed that her name is Linda Ruttlen, who began working for the county in July 1992.

Ruttlen could not be reached for comment.

During that initial discussion with Ruttlen, Rodriguez slipped off her wheelchair onto the floor and curled into a fetal position, screaming in pain, the report said.

Ruttlen told her to "get off the floor and onto a chair," the police report said. Two officers and a different nurse helped her back to the wheelchair and brought her close to the reception counter, where a staff member asked her to remain seated.

The officers left and Rodriguez again pitched forward onto the floor, apparently unable to get up, according to people who saw the videotape and spoke on the condition of anonymity.

Because the tape does not have sound, it is not possible to determine whether Rodriguez was screaming or what she was saying, the viewers said. Because of the camera's angle, in most scenes, she is but a grainy blob, sometimes obstructed, moving around on the floor.

When Rodriguez's boyfriend, Jose Prado, returned to the hospital after an errand and saw her on the floor, he alerted nurses and then called 911.

According to Sheriff's Capt. Ray Peavy, the dispatcher said, "Look, sir, it indicates you're already in a hospital setting. We cannot send emergency equipment out there to take you to a hospital you're already at."

Prado then knocked on the door of the county police, near the emergency room, and said, "My girlfriend needs help and they don't want to help her," according to the police report. A sergeant told him to consult the medical staff, the report said. Minutes later, Prado came back to the sergeant and said, "They don't want to help her." Again, he was told to see the medical staff.

Within minutes, police began taking Rodriguez into custody. When they told Prado that there was a warrant for Rodriguez's arrest, he asked if she would get medical care wherever she was taken. They assured him that she would. He then kissed her and left, the police report said.

She was wheeled to the patrol vehicle and the door was opened so that she could get into the back. When officers asked her to get up, she did not respond. An officer tried to revive her with an ammonia inhalant, then checked for a pulse and found none. She died in the emergency room after resuscitation efforts failed.

According to preliminary coroner's findings, the cause was a perforated large bowel, which caused an infection. Experts say the condition can bring about death fairly suddenly.

Hours after her death, county Department of Health Services spokesman Michael Wilson sent a note informing county supervisors' offices about the incident but saying that that police had been called because Rodriguez's boyfriend became disruptive.

Health services Director Dr. Bruce Chernof said Friday that subsequent information showed Prado was not, in fact, disruptive. Chernof otherwise refused to comment, citing the open investigation, patient privacy and "other issues."

Peavy, who supervises the sheriff's homicide unit, said that although his investigation is not complete, "the county police did absolutely, absolutely nothing wrong as far as we're concerned."

The coroner's office may relay its final findings to the district attorney's office for consideration of criminal charges against hospital staff members, Peavy said.

"I can't speak for the coroner and I can't speak for the D.A., but that is certainly a possibility," he added.

Marcela Sanchez, Rodriguez's sister, said she has been making tamales and selling them to raise money for her sister's funeral and burial. Her family has been called by attorneys seeking to represent them, but they do not know whom to trust.

She said the latest revelations, which she learned from The Times, are very troubling.

"Wow," she said. "If she was on the floor for that long, how in the heck did nobody help her then?

"Where was their heart? Where was their humanity? … When Jose came in, everybody was just sitting, looking. Where were they?"

Sanchez said her sister was a giving person who always took an interest in people in need, unlike those who watched her suffer. "She would have taken her shoes to give to somebody with no shoes," she said. Rodriguez, a California native, performed odd jobs and lived alternately with different relatives.

David Janssen, the county's chief administrative officer, said the incident is being taken very seriously. In a rare move, his office took over control of the inquiry from the county health department and the office of public safety.

"There's no excuse — and I don't think anybody believes that there is," Janssen said.

Over the last 3 1/2 years, King-Harbor has reeled from crisis to crisis.

Based on serious patient-care lapses, it has lost its national accreditation and federal funding. Hundreds of staff members have been disciplined and services cut.

Janssen said he was concerned that the incident would divert attention from preparing the hospital for a crucial review in six weeks that is to determine whether it can regain federal funding.

If the hospital fails, it could be forced to close.

"It certainly isn't going to help," Janssen said.

At the same time, he said, the preliminary investigation suggests that the fault primarily rests with the nurse who resigned. "I think it's a tragic, tragic incident, but it's not a systemic one."

Supervisor Gloria Molina, who hadn't seen the videotape, said she wasn't sure the hospital had reformed.

"What's so discouraging and disappointing for me is that it seems that this hospital at this point in time hasn't really transformed itself — and I'm worried about it," she said.

Supervisor Mike Antonovich said he believed care had improved at the hospital overall, but added, "It's unconscionable that anyone would ignore a patient in obvious distress."

Rodriguez's son, Edmundo, 25, said he still couldn't understand why his mother died. "It's more than negligence. I can't even think of the word."

His 24-year-old sister, Christina, said, "It just makes it so much harder to grieve. It's so painful."

*

If we can all be honest..this one hospital is NOT the exception. As a former nurse (who left the profession when ethically I could not pratice anymore and still be able to look at myself in the mirror without feeling that to continue would be comprising everything I believe a nurse stood for rather than staying in it for the money)..I have watched this situation in medicine erode rapidly downhill over that last ten years.

WE ARE IN CRISIS. PEOPLE ARE DYING.

If the med blogging community will not discuss this..who will?

Hello,

We're an advocacy group for the disability community, and we're currently running a campaign for HR676 (universal, single-payer healthcare). With just a few clicks you can urge your rep to co-sponsor the bill or thank them for their support of this important legislation.

The link is: http://hr676.theunderrepresented.com/

E. Spivak wrote.."Are there abuses by hospital systems and insurance companies? You bet there are. This is the bottom line, though - we still have the very best healthcare system in the world - and to disgrace our system by supporting this trash by Michael Moore, is abominable. " (END)

No we do NOT have the best healthcare system in the world..what has happened in medicine in ALL areas (and the disparity of care between the have and the have nots) is appaling.

If you are wealthy...well perhaps you can get the best care. Do you know some privitized doctors are now assigining their patients their own private duty nurse whenever they admit one of their "pay for care clients" into the hospital due to the severe conditions nurses are being forced to work under?

Do you know that dual-eligibles under 65 got dumped into restrictive Medicare Advantage Special Needs plan with such strict gate keepership (and outsourcing of MH/DA to the cheapest bidder, often states on the other side of the country who have no idea about the area or the clients they serve) that pysicians have stopped seeing those clients? Meanwhile..the HMO's that won the rights to own those dual-eligibles got paid millions of dollars just because? Studies are now finally beginning to prove that these SNP plans are causing more harm than good ? You think?

Washington knows this clientele has no voice, nor are they cared about. States bailed due to political infighting when their efforts to force Bush into NOT going ahead with the massive Medicare mess he insisted begin on Jan 1st,1996 failed. "You want seniors? Well here ~ take our dual-eligbles as well." DC responded by paying off these unprepared and cold blooded HMO's with the only language that seems to matter these days..money.

People are dying not just because of their choices..but primarily because they have NO choice in their own care in MANY instances.

I have to laugh when I see a "10 things to ask a doctor before you choose him or her for xyz" when my MAHMO has perhaps 2 providers in my large urban area to serve a population of over 100,000. Acording to Ms. Spivak I should feel blessed. Perhaps I should, as some counties in my state have no providers in certain specialty's.

Ms. Spivak..can you honestly see me beginning to ask those 10 important questions (such as board certification, experience,etc.) to the lone two providers who might see me on thier first available appointment...10 months from now? I'd be called indignent, unappreciative, and on and on. Think about that.

If I was Paris Hilton however..I am sure I could go anywhere and get a doctor to hold the kleenex for me so I could blow my nose.

I do not know how you were raised, but in my home, the golden rule was the norm - NOT the exception.

In today's medical crisis..the golden rule has literally been thrown out of the equation. Money (or lack of it) is ALL that matters.

We have sunk so low we have forgotten that we are all human beings...each of us special and deserving of the best "just because" we are. It is our inherit responsibilty to treat everyone equally and NOT just give quality care to those who have the right income or insurance.

You really need to spend a day in a poor chronically ill person's shoes before you make a statement that ALL OF US who are in America get the best care in the world.

to Eileen Spevak - please pause long enough to listen to yourself. You rave about the great gov't funded care that your family rcv'd when you were young and being raised by a single Mom with 3 kids (my exact experience, btw) - can't you understand that that is precisely what we're advocacting for everyone to contribute to and to benefit from?

It's not a far stretch from the healthcare financing models we already have in practice: Medicare and Medicaid.

Thanks to so many nurses and other healthcare justice activists, there's a huge activist community that currently exists and is working together, both where I am here in MA and across the country. Certainly there's always room for more participation and for tighter coordination but overall there's a wonderfully large and growing infrastructure of activists who are working for guaranteed coverage for all healthcare reform (not to be confused with the largely fake reform that the recent MA law represents).

the websites at this link http://bluemassgroup.com/showComment.do?commentId=75708 are a mere sample of the HC activist infrastructure that exists here and now, today. These sites and the activists who created them and maintain them are representative of a thriving activist infrastructure; tens of thousands - perhaps millions - of individual activists and thousands of organizations working together. how to best use the film SiCKO as a tool in our movement-building work calls for lots of input, participation, and creative thinking and we welcome new activists to this work.

please check out the websites for factual and useful data about US health care reform and ways you can get involved to make positive change and do post others that i've left out! - thanks.

peace, Ann

Will a doctor or nurse please explain to me why they are so sure they will fare better under nationalized health care? Right now Medicare, Medicaid and other goverment programs pay doctors LESS, often far less, than the reimbursement they get from private insurance companies. In fact, one of the big reasons private health insurance premiums go up so fast is because doctors and hospitals demand that private payers SUBSIDIZE the loss in revenue they see from Medicare payments. This is absolutely true, ask any doctor you know that will be honest about it.
Further, Even if the American public would swallow the massive tax hike to take over the system, does anyone really think that the public would stand for 15% annual increases in that tax? Health care costs go up 15% every year right now. That is cost of care, not insurance comapany profits. The only way that tax would be under control is through sever limitation of services provided and caps on doctor payments.
Finally, if the government is so great at running health care systems, why is the VA system consistently underfunded? Why do vets prefer non VA hospitals? Don't get me wrong, VA doctors and nurses are heroes. They do their best, they're underpaid, overworked and unsupported by the exact same people this web site proposes to run our entire health care system. IT DOESN'T MAKE SENSE.

To Eileen -

Thank you...I stand corrected on the VA issue. Frankly that makes my point even stronger. All I can speak to is several family members that had less than stellar experiences - but it was the beaurocracy that was the issue, not the people. And their frustration was in the system's controls on the care and treatments they could receive - worse than the old HMO days! THAT's governemnt healthcare - the same people that brought you the tax code in charge of health care?

Your points on nursing pay is outstanding. There was nearly a strike at a local hospital recently of nursing pay. I worked in a hospital and I can tell that nurses are the backbone of the hospital - far, far more critical to the success of your surgery or procedure than most people know. I also think you're dead on: nurses will be the very first to suffer under a system run by legislators that swing with the political wind. The first time their constituents cry out over annual tax increases to support the government run health system, nursing salaries will be the first to get frozen.

Bottom line: We do need to fix part of the health care system and deal with so many people falling through the cracks, but a) I just do not see insurance companies as the main villan in a very complex problem; b) American taxpayers will never support a tax (and annual increase) that it would take to truly implement socialized medicine; c) doctors, nurses and hospitals would be financially HURT by such a system; and d) Americans will not stand for the lack of choice and self-control such a system will feature.

Thanks for the response Eileen, great points.

I am an Emergency Department RN-BSN, and I do not want the US to go to socialized medicine.
1: Longer waits to see doctors and have surgical procedures done. I have friends in the UK whose mother had to wait 18 MONTHS to have a hip replacement. People end up spending their personal money out of pocket to hire surgeons to avoid waits.
2: Skyrocketing taxes. One doctor I work with said that Canada's income tax is 50% just to cover healthcare.
3: Unfair coverage. Healthy people, like me, who exercise and eat right, will have to cover costs for people who have COPD due to smoking, get hospitalized for alcoholism, and to cover Diabetic supplies for obese individuals. There will be no reward for being healthy (which many insurance companies offer discounts for having a healthier lifestyle). And diabetes will affect 1 in every 4 people within 20 years at the rate it is going right now. There will not be an incentive for people to prevent getting it because all their expenses will be covered.
4: Increased abuse of Emergency Departments. Right now our nation's ED's are overcrowded, especially due to Medicaid patients who do not take responsibility for their own health care. They don't show up for doctors visits, get kicked out of the office, and end up in our ED's for every cough, cold and STD check. That is sickening cuz then we pay for it! THey don't care cuz they don't have to pay a single penny! Now imagine anyone can go to the ED without paying a penny, and we will be even more crowded!
5: More hospitals will be shut down due to financial problems. Medicaid and Medicare provide crap for financial compensation. Already our country has shut down multiple hospitals in the past few years (www.ena.org). Expect to see more if we get universal healthcare. And there will be less doctors and nurses as they won't get paid as well; there will be no competition to increase salaries and provide "magnet" status for hospitals.

Ms. Spivak..you obviously did not really "hear" what I wrote about NOT having any choice!! If there are only two specialists for over 100,000 patients and their wait times for an appointment are ten months from now and you get very ill...where are you supposed to go?

My state's PCP's ran from the new Medicare/Medicaid reimbursement system..not enrolling any new patients and the specialists downright refused the secondary payee( staight Medicaid).. even though theorectically [due to the BBA] it is illegal. Doctors do not get punished because in truth in logic, they will just say," Ok, well I will not even see just straight Medicare patients then if I have to see Medicare AND Medicaid patients." The politicians who cater to seniors are not going to force doctors to abide by the federal law that says if you accept Medicare, you also must accept Medicaid as well.

So please tell me... where are people on my insurance.this horrid Medicare/Medicaid system supposed to go if no one wants to see me? I have no choice..I have to go to an ER.

Yet you continually are blaming the patient!!! It is the doctors who refuse to accept the insurance as payments are so low and the SNP's set it up that primaries must get authorization for just about everything..like they have the time or staff to do that. Nor are there even any specialists who will take this insurance. Trust me.I am living this nightmare.

How is that the patients fault? I hope you never become chronically ill someday. Your hostitly towards those with less resources than you can be HEARD very loudly.

You wrote..
"Increased abuse of Emergency Departments. Right now our nation's ED's are overcrowded, especially due to Medicaid patients who do not take responsibility for their own health care. They don't show up for doctors visits, get kicked out of the office, and end up in our ED's for every cough, cold and STD check. That is sickening cuz then we pay for it! THey don't care cuz they don't have to pay a single penny! Now imagine anyone can go to the ED without paying a penny, and we will be even more crowded!(END)

WHO in thier right mind would want to go to an ER as thier first choice. You MUST understand that for many.they simply have no other choice!! Please do not lump all of us together like that.

Previously..before Bush rushed the new Medicare plan in effect.Medicare was my primary and my state had a Medicaid HMO very well run that was my secondary. I had fairly good access to services like an ordinary person. The doctors got paid. Now I am stuck in an Medicare Advantage HMO SNP who severely restricts coverage and has barely ANY providers who want to take this plan. The state has bailed out and threw all of us dual eligibles out of their system..leaving us with no clear secondary payee. Studies are now coming out clearly showing that these Medicare Advantage Special Needs Plan are the worst at actually providing services to those who need them the most.

One wonders if triple-chinned filmmaker Michael Moore, when his own arteries finally clog shut from trying to personally rid the world of donuts, will seriously consider a Cuban hospital for his bypass surgery? Pinkco is just another left wing propaganda stunt. If you made the wrong chooses in life(didn't choose to get a good education , choose to take drugs, commit crimes, had more children then you could afford, purchased more of a home then you could afford, refuses to work hard) then don't expect me to pay your way.