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I'm a conservative, and i went to an alexandria ocasio-cortez rally

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You are reading page 6 of I'm a conservative, and i went to an alexandria ocasio-cortez rally. If you want to start from the beginning Go to First Page.

Yes, it is a large bureaucratic entity. What do you think Medicare is?

You know, I am unaware of problems with the department overseeing Medicare, as compared to VA.

The VA has a well documented toxic culture in which whistleblowers are retaliated against.

Just last week the Washington Post had a lengthy piece on how those who speak out are silenced or pushed out of the VA.

Then there are the NPR stories.

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It's easy for things to be worse.

Imagine your your understaffed unit with one less nurse, or CNA, or no unit secretary, or fewer patient transporters, fewer phlebotomists and respiratory therapists, housekeepers, etc. Or, they can pay you less. Or, both.

I work in a non-union state, worked for non-profit and for one of the top ten most profitable hospitals in the country. I'll never work there again, but it wasn't as bad as other places I hear about on AN. So, at least in my neck of the woods it good get much much worse.

Geez, Dude. I have worked under those conditions, minus the pay example.

On Sunday, my unit had NO tech. And that was because the faculty has short of them.

I have worked short-staffed many times, during my two-year nursing career.

The facility where I work demands forced OT.

Quality of care? I don't think it is so great now.

Your arguments are similar to what the folks who didn't want expanded Medicaid in KY used.

Heard it all before.

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I work at a physical rehab hospital, and daily, I care for patients who have no business in rehab, as they are non-rehabable.

One such patient is leaving us today, for SNF. He was with us a little over week, and it was clear to me, and others, that he wasn't capable of three hours of therapy a day.

I have many such examples.

Is this poor quality of care, or unethical use of government resources?

Perhaps both. But that is a different philosophical discussion.

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So you have no source? You just wrote down what seemed like a plausible idea to you, threw it out there, and waited to see if it would stick?

As the reader, it isn't my responsibility to look up sources for others ideas that I don't agree with.

You are better than that, Dude.

It's not my responsibility to spoon feed information to people who disagree with me.

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I think we established that it is possible quality may suffer under a Medicare for all plan. Back to the question...if it would, is it worth it?

Based upon speculation, you have convinced yourself that it's possible that quality may suffer.

Maybe.

Or maybe our quality and health outcomes would improve when we follow a path similar to those countries which enjoy better access at less cost per person, than does the USA.

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.kff.org/slideshow/health-spending-in-the-u-s-as-compared-to-other-countries-slideshow/&ved=2ahUKEwijjvn3587cAhXKIDQIHTXQDcQQFjAaegQIBhAB&usg=AOvVaw2Sl2Cyfusy1sdy1iN1rIro

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It's not my responsibility to spoon feed information to people who disagree with me.

Nobody is asking you to do that.

You are expected to provide sources, background, whatever you would like to call it, to back up your ideas or suggestions.

For instance, I don't simply post, Trump is an idiot.

I always provide sources examples of his idiotic behavior.

And God knows, I have many to choose from.

Again, you are better than this, Dude.

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Yes, it is a large bureaucratic entity. What do you think Medicare is?

They're both government run, but that's pretty much the extent of the similarities, and what makes the VA bad apply at least much to the private insurance sector if not more.

The main problem with the VA is that it's way too cheap, for a patient that medicare would pay for about $60,000 of care per year, the VA only pays for about $5,000 per year. The VA does this by restricting access to care by requiring patients only use designated services and facilities, which is also what private insurers do and we see the same reduced access to care as a result.

The VA is also government run healthcare delivery which is problematic in any situation where the insurer is also the one delivering care, medicare and medicare-for-all still utilize competitive, separately operated healthcare delivery and even still utilizes private insurers, but where the profit motive is to provide the most effective and efficient care, currently the profit motive for private insurers is to provide as little care as possible, much like the VA.

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I think we established that it is possible quality may suffer under a Medicare for all plan. Back to the question...if it would, is it worth it?

While there could potentially be a short term strain, it's not clear that quality would suffer, and it's far better than the alternative.

There seems to be a misconception that if everyone had healthcare coverage, there would suddenly be an increase in people receiving healthcare, which is only partly true.

Currently, everyone has healthcare, it's just a matter of what point in a disease process or illness that they get healthcare. For instance, under our current system we're legally required to provide treatment to someone with heart failure, but only once it's progressed to the point where they require acute, ongoing care, which is extremely expensive. What they don't have access to is the care that reduces the likelihood we'll be on the hook for the cost of the hospitalizations, ICU stays, VADs, nursing homes, etc that will be required because we chose not to provide the much cheaper preventative care disease management.

When we look at why we pay astronomically more for the same care compared to other countries, there are two main culprits; the excessive overhead costs we pay for our private insurance system, and probably the biggest cause of our higher healthcare costs is that we provide about 2/3 of our healthcare in acute hospitalizations and about 1/3 in preventative care and disease management, whereas in other countries it's the opposite, which greatly reduces the overall cost since the per patient cost of caring for patients in hospitals because they didn't get adequate preventative care or management is much higher.

So initially we would hopefully see the demand for preventative care and disease management go up, while still dealing with those who didn't have adequate access to these things and are still requiring frequent acute hospitalizations, but eventually that should go down, leaving us with a far more sustainable system that prioritizes reducing costs by reducing illness severity.

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I work at a physical rehab hospital, and daily, I care for patients who have no business in rehab, as they are non-rehabable.

One such patient is leaving us today, for SNF. He was with us a little over week, and it was clear to me, and others, that he wasn't capable of three hours of therapy a day.

I have many such examples.

Is this poor quality of care, or unethical use of government resources?

Perhaps both. But that is a different philosophical discussion.

Or neither. What's the point of your little anecdote?

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Or neither. What's the point of your little anecdote?

Testy, Testy, Dude.

The point of my little anecdote was to illustrate that quality of medical care in the US already oftentimes sucks.

I was responding to your fear of a lowering quality of care if there is Medicare for all.

Munro was simply responding to the pasta you threw up against the wall, Dude.

Again, testy, testy, Dude.

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Or neither. What's the point of your little anecdote?

It wasn't a test question, Dude.

Here's another little anecdote.

We recently had an ALS patient. She was sent out for a trach and feeding tube.

Is she rehabable? No.

Can she do three hours of therapy a day? Maybe.

Is this quality or ethical care? No.

So long as profit is a motive, there will always be examples of subpar and unethical care.

Those things will still exist with Medicare for all. But which system will bring the greater good?

Another philosophical discussion.

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