leadsag
Joined: 31 Oct 2002
Posts: 263
Posted: Mon Apr 28, 2003 11:54 pm Post subject: ...
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Reply to aprnjam....Look at corporations finanacial statements - they DO make money on EPO. And I totally agree with you on the Dr. visit in the hospital...it is an extra $28 per day he makes if he gets you into the hospital!!! If you are not hospitalized he doesn't make it so to his advantage to have you in hospital(translates to sicker).
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aprnjam
Joined: 28 Apr 2003
Posts: 85
Posted: Tue Apr 29, 2003 1:11 am Post subject: reply to ledsag
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I won't deny that large corporations do make money on Epo, but I can tell you from personal experience that I have spent hours on the phone getting Epo donated to patients who can't afford it. I am a gerontological nurse practitioner, and the population that I cared for was entirely Medicare/Medicaid. I had a few private pay, but they were few and far between. In order to keep my head above the water and just barely meet expenses I had to work 18 hour days. When CMS reduced NP reimbursement by 7%, it just made it even worse. You make NO profit on Medicare/Medicaid patients. CMS is reducing benefits so much that in effect they are rationing health care. If this is the population you care for, you can't pay your office expenses, and pay yourself a salary. I almost went
oke. I saw 30 patients day, including hospital patients (average reimbursement for a patient's hospital stay was $400 for a 5 day stay). For that hospital stay, it took me an hour to do the admission paperwork, another 45 minutes to do the admission history and physical, then the daily visits, orders, progress notes, then 30-45 minutes per patient to do the discharge summary. It averages out to about $10/hour. In my office, my office expenses (rent, utilities, insurance, employee expenses, supplies, etc) ran an average of $180K year, last year I grossed $220K. So after working 16-18 hour days, being on call 24 hours day/7 days a week, one week of vacation and one week for continuing education, I made a salary of $40,000. That may sound like a lot, but I still owe $40K on my student loans. I figured it out and I was making an average of $6.00/hour. Not much for 8 years of school, plus all the responsibility and liability. But I loved my patients, loved by job and cried the day I had to close the doors. Besides going into renal failure, the first quarter of the year, because of the CMS cuts, I was in the hole. I just couldn't financially survive anymore.<
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>I've been on both sides, and it's not as rosy as it seems. The mounds of paperwork takes hours to complete or you won't get paid the small amount they allow, and I get frustrated when I get a denial because some piece of information is missing and I have to deal with the insurance company as a patient.<
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>What Mr. Bush is doing for us, is leading us toward rationing of care for everyone with chronic illnesses and the elders. If you don't have a large amount of cash, then you are SOL as they say. Which leaves a lot of people out in the cold. Many of my patients were having to make a choice between paying their rent, buying food, or paying for their medication which was half of their income. Most made the choice not to fill the prescription. Then they become labled as non-compliant. No one bothers to check into the fact that they can't afford it. Now many of the larger corporations are refusing to take the samples that the drug companies pass out, because they feel it is unethical and they are cutting off the only route to needed medication for millions. Think about it, you may soon be in that position, or someone you know may be in that position.
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plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Tue Apr 29, 2003 2:41 am Post subject: it does make my blood boil
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How we can afford to blow the beejeebys out of a third world country (I'm not going to argue if it necessary or not), but can't afford to take care of our own citizens. It seems more a lack of will and the case of a small amount of individuals making a big pile of money, but contributing nothing or very little to the actual care of patients (it does sound like you got the work, but not the money Aprnjam).<
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>I believe if we made our healthcare system a shining example to the world, we would make more friends than heading overseas and knocking the crap out of other people's relatives and friends. (Sorry if I got a little off subject, just had to get off a little steam)
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plugger
Joined: 11 Jan 2003
Posts: 258
Posted: Tue Apr 29, 2003 3:16 am Post subject: P.S.
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Welcome to the board, Aprnjam and LuLu. It is always good to some fresh perspective.
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Lin
Joined: 28 Oct 2002
Posts: 337
Posted: Wed Apr 30, 2003 1:12 am Post subject: Salary
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APRN, I mean no disrespect but 40k a year is NOTHING for someone with your education and experience! Just wanted to point out there are men with only a high school diploma that are making as much and more! Didn't mean to make you feel bad, just telling it like it is!<
>There are people benefitting from healthcare costs, but it's not the caregivers! Lin.
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Patient2
Joined: 30 Apr 2003
Posts: 10
Posted: Wed Apr 30, 2003 6:15 pm Post subject: APRN
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You had my attention until the little Bush Dig! Are you aware that the Lovely and caring Clinton Family was in office on their Second term when the Senate hearings on Aging - Dialysis a Population at Risk were held. Every dirtily little secret was exposed about the Dialysis community and the Honorable Billery Clinton's turned a complete Blind eye to it because it would expose to many People with deep pockets.<
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>My Doctor got paid $320.00 per month, I never saw him and when I finally needed to I was given an appointment two months later. The nurses at the D - down right, C - crappy, I - institute were making 75,000 to 85,000 a year using a Clorox based cleaner for my catheter. Also finding the cheapest band aids I have ever seen. Old Chairs, One TV per four patients, labs once a month. Epo by the tons and lets not for get the Fortaz. If your eyes watered from the Clorox and IV solution of Fortaz (sp?) was immediately given. By the way this was a not for profit unit. But it was a definite for greed unit.<
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>There are definitely places and people making money! So you will have to for give my bluntness but it is really hard to hear how hard it is on the workers when we sit there day after day being abused by care givers who are making a living off of our misery and going along with the inadequate care while
inging down that kind of money!
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