LuLuW
Joined: 27 Apr 2003
Posts: 46
Posted: Wed Apr 30, 2003 11:09 pm Post subject: Awww, come on ......
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You're not seriously trying to blame the Clinton adminstration on the current state of the dialysis industry, are you? Well, he's certainly blamed for everything else, so why not this, right? Sheesh! First or all, the dialysis industry problems are looooooong in the making and are part of the overall pathetic state of healthcare/medical insurance/expense in the U.S. That's why healthcare reform was one of the first major issues Bill Clinton tackled when he was first elected in '96. He, and yes Hillary, were passionate about their medical reform bill which focused on providing comprehensive health benefits to ALL Americans and outlawing insurance company practices that discriminate against consumers and small businesses. Their objective was to make care available to everyone, no matter where they live or how old or sick they are. But we all know how that went over. The Republicans (experts at doing this) threw a socialism spin on it, and the rest, as they say, is history. So, yes, the last hearings on aging and dialysis were held during the SUMMER of 2000. So, that would have given him, what, about 3 months to fix everything up nicely? Please, give me a
eak! For all practical purposes, with the election approaching in November, his term was essentially up. So, nice try. Now, excuse my bluntness, but speaking of blind eyes and deep pockets, what exactly has this current administration done? NOTHING! What has the current adminstration done about anything on the domestic front? NOTHING! But I bet dialysis in Iraq will be improved before it will be here.:"> Now that you can count on. Truthfully, I'm really not interested in going back and forth and playing the blame game. But, the bottom line is something needs to be done, and NOW. Let's start making the current administration accountable, particularly since it sadly looks like they'll be around for another 4 years. That gives them PLENTY of time to do something.
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plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Thu May 01, 2003 12:00 am Post subject: This needs bipartisan support
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There is plenty of blame to pass around on both sides. You can't tell me the Senate hearings totally caught people in the Clinton administration by surprise. They had eight years to figure out what was going on, and did nothing. I have to admit, the Bush administration seems to be following in the same tradition. We seem to be trying the great liberal solution of throwing a lot of money at it, but it doesn't seem to be getting better.<
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>There is something here for everybody, no matter your political persuasion. Some people (like me) may like the idea of having more communtiy-based units, without the central control of a large corporation ( a more conservative theme ). Conservatives might be likely to favor the idea of home hemo, with it's promise of more freedom and invidual control. But things in the units may not change much without the enforcement of standards (a more liberal theme). I trust big business, about as much as I trust big government. And with all the board swapping seen in dialysis anyway, they are getting indistinguishable.
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aprnjam
Joined: 28 Apr 2003
Posts: 85
Posted: Thu May 01, 2003 2:29 am Post subject: Re: APRN
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It's not so much that I'm either for the Democrats or the Republicans, but I just don't happen to like Mr. Bush. Being a NP, I keep up-to-date on the laws that are passed and who puts their "John Hancock" on the bill. Mr. Bush signed the bill that reduced reimbusement for Medicare/Medicaid patients. He could have vetoed the Bill, but instead he chose to sign it. One of the papers that I always had my students write as a wake up call, was on Rationing of Health Care. What is happening, as we can all see, is that Health Care is being rationed. As you stated, we can afford to go to war, but we can't afford to provide health care to our citizens. When SS was first designed, the average life-span was 67 years. The intention was that an individual would work unitl age 62 or age 65, retire, draw SS for 2-5 years and then die. Based on that theory, then the SS system would not be in trouble. What they did not take into consideration was the advances in technology in the health care field, people taking control of their health, taking better care of themselves, and people living longer. Instead of paying attention to the statistics tht was hitting them in the face since all of us baby boomers were born, they continued to ignore it. So now, we have an excessive amount of people on SS and a reduced number of people in the workforce to pay all the baby boomers, because we didn't have 5 or 6 kids each, we only had 1 or 2. So now, the question becomes how do we solve this problem? Gee, if we ration the health care of the individuals on Medicare/Medicaid, give them inferior care, pay the provider miminal reimbursement for caring for these individuals, then they will soon refuse to see them because they can't afford to keep their doors open. Boom! We have rationing of health care and these people will die, reduce the number of people on SS, receiving Medicare/Medicaid benefits, and our problem is solved. The general public will not realize what we are really doing, because 80% of the population can only read at an 8th grade level, so they won't understand the legal mumbo jumbo. They don't care that a person is having to chose between paying their rent, buying food and buying their medication. Then they decide that the drug companies give the providers too many "bennies" (and in some instances they do, I will NOT dispute that fact at all), but in my practice, they also provided me with one extremely valuable resource. Samples that I could give to my patients who couldn't pay for their medications. I was able to eliminate one problem for them. They no longer had to make the choice if they had to give up shelter and food for the medications they so desperately needed. In my clinical practice, I always asked the patient, if I give you this prescription, can you afford to have it filled? Ninety...mind you 90% of my 4500 patients, said no. I don't know how many patients died because I didn't have antibiotic samples anymore to give them because of the new federal laws that went into effect last July 1st that limited the number of samples I could receive in my clinic. Without the medication they died, and it's even more evidence of rationing of health care. I've sat on the Executive Boards of several national nursing organizations, and this is a concern to all of us. How do we get our patients the medications they so desperately need? How do we keep the doors to our clinics open when they keep cutting our reimbursement? In some states, NP's have to have supervising physicians. They charge us anywhere from $10K to 20K year to come in once a month, look a few charts, and be available by phone if we have a question about a patient that we don't feel comfortable with. Most patient's prefer NP's because we take time with them, we educate them, we LISTEN to their complaints and try to help them find solutions to their problems, and not only their medical problems, but the problems that they have with their basic needs. Sometimes it's a matter of helping them get food stamps, or helping them get into a shelter, or finding someone to come in a stay with them when their family has abandoned them because they don't want to deal with them anymore. They've become too much work. Yes, I said Mr. Bush, because Mr. Bush signed the Bill, and he has to take responsibility for signing the Bill. I don't care who started it, Republican's or Democrats, he signed it, therefore he is responsible. I personally think that our entire government needs a complete overhaul, more people need to get involved in grass roots movements to change things. We need to put pressure on our senators and congressmen. They work for US, we put them in office, but they seem to forget that, because, we, the people who put them in office, don't bug them enough. We have to stay on their backs, tell them what our issues are. The more we hound them, eventually they will pay attention. We, as a nation, as a group of people, have to make the changes. We can't rely on them to make it for us, because they sure are screwing up and cutting dollars from where it is needed. When they are finally out of office, do you know where they get their health care for the rest of their lives? They are allowed to go to any military facility in the area and receive "priority" treatment, while the retired military person and his family, take last place for everything, and get their care on a space available basis. Where is the fairness in that? My husband spent 12
years in the Army and was medically retired. It takes us up to 8 weeks to get a "routine" appointment at a military facility. A follow-up appointment can be another 6-8 weeks out. On the first day of the month, we have to start calling at 7:30 AM. We sit there and hit re-dial for as long as an hour before we get through, only to be told that all the appointments for retired personnel for the month are gone. Tri Care sucks...Medicare pays better. And forget getting any other insurance, we both have pre-existing conditions, so there is a 2 year waiting period. The last one I checked on wanted $780/month for both of us, 2 year pre-existing clause, which means essentially no health care for 2 years. Take $780 from a $2000/month income and you have nothing left. That doesn't include the high costs of medications. Now, we're in the same position as my former patients. Yes, I am severely ticked off about all of this. Now, I've been on both sides of the issue and being on this side sucks.<
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>I agree, there are people with a lot less education, who work a lot less hours, who make a lot more money than I did as a NP. But, I loved my job, I loved caring for my patients, I loved helping them. One particular patient comes to mind. She came into my office, with a walker, complaining of leg weakness. She said that she had been complaining to her physician about her leg weakness for over two years. She said that she had heard from a friend that I had helped her tremendously and she thought she would give me a try. I did a complete H&P on her, including a med review and I immediately saw her problem. She was taking Procardia for her hypertension. One of the big side effects of Procardia is muscle weakness. She had been on the medication for 2 years, which is how long she had been complaining of muscle weakness. When I got her records, her physician had her coming in every week, had documented that she had somatoform disorder (means that nothing is wrong, the complaints are psychosomatic), had sent her to physical therapy, and even gave her a referral to mental health for counseling for her somatform disorder, which she was faithfully attending every two weeks. I discontinued the Procardia, changed her Norvasc and had her come back in one week to assess how the change in meds was working. She walked in with no walker! No more leg weakness! It was a simple side effect of a medication that the physician ignored. I cared for this lady for another 4 years until her death of gastic cancer. I cared, and I searched for the answer. That is the difference between someone who is in the health care field because they love it, and someone who is in it for money.<
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>Sorry for the "preaching" but it really touches a nerve when I know that they are rationing health care to those of us who desperately need it, provide us with inferior care, inferior products and medications. I have always been a patient advocate, and now that I'm on the other side, I don't intend to stop now. If anything, I will probably be more of an advocate. I know that I have a lot of opinons, and many have been formed because I have been on the health care provider side. So bear with me, I'll listen to you're opinions. I firmly believe that we can all learn from each other and that we are all in this together and we can all help each other!!!!<
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LuLuW
Joined: 27 Apr 2003
Posts: 46
Posted: Thu May 01, 2003 2:53 am Post subject: Clinton had 8, Bush Sr. had 8, and now Bush Jr's had 3
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Where does it end? I say it ends HERE and NOW! Plugger, you said<
>Quote:I have to admit, the Bush administration seems to be following in the same tradition. <
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>Um, yeah, I'd say so. Just as APRN has pointed out above, rather than moving toward more accessible and better healthcare, the current administration has despicably moved toward the further rationing of healthcare. That is disgraceful and goes against everything DEO stands for. And as for this statementQuote:We seem to be trying the great liberal solution of throwing a lot of money at it, but it doesn't seem to be getting better. Everyone knows that there are only two places this current administration has thrown any money. 1) toward tax cuts for the richest 1% of our population, and 2) for the Iraq war effort <
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>I can guarantee, yes guarantee, that the current adminstration in particular and conservatives in general are not going to help our efforts willingly. I will be willing to bet that they'll fight everything we stand for tooth and nail with their "pull yourselves up by your own bootstraps" mentality. Because, after all, the government owes us nothing, right? That's their platform. We are going to have to force them to first listen to us, and second to actually do something. I'm telling you, if you want dialysis reform, you're going to have to find some of those chastized bleeding heart liberals, or at least someone who does, in fact, have a heart.
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