January 28, 2007, 1:03 am

Health Care is NOT an Entitlement


The “Fun-Tier”?

Were they serious?

Baylor actually sent out this paper “tower” of information on Texas!

They sent out a toy as a recruitment tool!

And it’s free for the asking! Just mail in the coupon!

As Will Smith said in “Independence Day”: “I gotta get me one of these!”


Notice that this particular nurse is suffering from the dreaded “occipital slip” of her cap.

Probably too busy playing with her toy to care!


Health care is not a right. Health care is a need, like water or food. And like water or food, it isn’t free.

Everybody should have health coverage, and each individual should have the opportunity to choose the health care they want from the provider they want.

Every individual needs to be responsible for purchasing their own health care and making sure their children are covered.

What follows is what I would consider a “best case scenario”. I don’t have all the answers and I may border on living in La-La land but this is what I would like to see.


What should a Health Care Insurance company be required to offer in their plans in return for premiums?

  • Full coverage for “Well Care” without deductibles
    • Yearly physical, well-baby checks and immunizations
    • Screening tests (mammograms, PSA levels)
    • Labs (liver function testing for statin use, A1C levels for diabetes)
    • Classes for patient education: smoking cessation, hypertension information, diabetes, diet and nutrition
  • Medications without a co-pay and without restrictions to a “formulary”.
  • Mental health care covered – including counseling and hospitalization as necessary.
  • Emergency and Hospital Care
    • Here is where any deductibles would come into play
      • The individual can choose the amount of their deductible for emergency care.
      • The individual can choose the amount of their deductible for hospital care.

The amount of the premium would be based on the number of people covered and the deductibles chosen. The maximum amount of the hospital deductible would be $10,000.

There should be no exclusion of pre-existing conditions and no lifetime maximum, thereby protecting people from catastrophic illness. Cosmetic surgery would not be covered unless required as the result of accident.

Each person is able to pick their own provider of health services, be it physician, nurse practitioner, chiropractor.

Health care decisions are made by the patient and their health care provider, free of outside influence.


Okay, there’s the foundation.

Now we need to pay for it.

I do not believe it is the government’s responsibility to actually purchase and provide health care, but there are things them government can do to facilitate the ability of individuals to do so.

In fact, I thought the recent proposals in the State of the Union message were a definite step in the right direction (hang in there with me, readers of the Democratic persuasion!). As I understood it:

  • Tax breaks for both individual and families to purchase health insurance offset by
  • Actually taxing employer-sponsored health benefits as income

Personally, I want the government involved as minimally as possible in my health care decisions. However, there are some situations where the government may be able to provide a “safety net” by providing a system of basic care, including mental health coverage to:

  • Those who are unable to work due to disability and therefore unable to receive the tax breaks, including children of the family affected.
  • The elderly who are unemployed or disabled.
    • Not every elderly person is poor or needs to have government health care, especially if they are receiving tax benefits that allow them to purchase private plans.
    • Not every older adult aged 65 needs Medicare, again if they are receiving tax breaks to purchase private plans.
  • Health care should be provided to all Veterans through the VA system as a benefit for having served their country in the armed forces.

I’m talking citizens of the United States, by the way. Children should never suffer, even if their parents are illegal aliens and should have access to immunization and health care. If you are an adult from another country in the US illegally, you shouldn’t be receiving one dime in benefits from this country. Access to health care, yes. But you pay for it.


This all means the health care insurance industry will now have to compete for the health care dollar.

If an individual has the ability the choose their health plan, the industry will have to become competitive. People will spend their health care dollars where the plans are competitive and the premiums reasonable.

Individuals can decide the amount of coverage they want and how much to spend on it. Younger people may choose a higher deductible as they are relatively healthier. They can add coverage as they get older and depend more on the health care system.

Individuals who (irresponsibly)choose not to have health insurance of any kind will pay the price in the form of what is popularly known as ” a bill” from the provider of the service.


In terms of how to spend the money obtained, I’ve said it before and I’ll say it again: the majority of the money should be spent at the level of primary care: Family practitioners, Internists, Pediatricians. Think prevention. Think basic care. Deal with potential health care problems BEFORE they become problems and money will be saved in the long run.

Make private practice attractive again by making it feasible to run a practice by paying what the service is worth and not a portion of what some bureaucrat thinks it is worth. Enact legislation to stop exorbant/frivolous lawsuits so malpractice premiums will drop.


As you have probably ascertained, I am not for a single-payer health plan. Frankly, I’ve never seen one that works. There’s the NHS in Great Britian, but I direct you to the NHS Blog Doctor for a good look at how THAT system works. Canada has national health care, but if I’m not mistaken there are waiting lists for procedures and surgeries.

Can’t imagine that would go over big here in the US, where people get upset if they have to wait an hour in the ER.

We have universal access. All you have to do is go into an ER and you MUST be treated whether you have insurance or not or whether you can pay or not. You cannot be turned away.

Most of the nursing organizations (and most of the readings in my Leadership and Management class) all promote the idea of a single payer system.

I don’t think it’s the government’s responsibility to care for a citizen from cradle to grave. I believe it is the government’s responsibility to help facilitate the individual citizen in obtaining needed services.

I believe that individuals citizens and their respective states need to take on at least some of the onus of paying for and maintaining a viable health care system that assists citizens with purchasing the health care of their choice.

Maybe someday it will be possible to do away with the employer-paid health care altogether. I’d rather have the money and be able to choose my own plan with my own provider.

Minimal government interference and individual responsibility.

That’s what I believe is the way to address health care in this country.

Because health care is not an entitlement.

(Let the bashing begin………)


  • Dmitriy Kruglyak

    January 28, 2007 at 2:22 am

    You hit a nail on the head by drawing the distinction between a “right” and a “need”.


  • Rachel

    January 28, 2007 at 5:53 am

    I would love for health insurance to be “untied” from any employment. Under today’s standards, my husband and I would be paying through the roof for private health insurance, giving our chronic illnesses. Right now, all we need is the usual lab work (A1C, liver/kidney function, etc) in addition to physicals and eye exams. We shouldn’t be punished for taking care of ourselves despite diabetes being a part of our health records.

  • #1 Dinosaur

    January 28, 2007 at 6:21 am

    I too appreciate the distinction between “right” and “need.” Well enunciated.

    Unfortunately (not intended as bashing) your enumeration of how it *should* work (including payment models) is kind of Pollyanna/pie-in-the-sky. Bummer; I agree with you and wish it could happen.


    January 28, 2007 at 9:24 am

    The entitlement mentality in this country to my mind is the root of most evil. Thank you for saying exactly what many of us think on a daily basis. Eloquently stated.

  • Mel

    January 28, 2007 at 11:00 am

    Right on, Kim!

  • Bardiac

    January 28, 2007 at 11:48 am

    I’m not sure that basic health care plans need to cover physicals and stuff. If we were to untie health insurance from employment, then I’d want to be able to choose a plan that would truly cover catastrophic stuff, and let me handle the basics. If we think in terms of car insurance, we pay to cover serious stuff, and not to cover oil changes, new tires, and so forth.

    I think cutting the middle man out of the basic stuff would likely save money on a basic level. We’d have to be able to get up front information about the costs of basic physicals and such, though, and that seems pretty rare under current conditions.

  • Marie

    January 28, 2007 at 1:02 pm

    Love your thoughts on our healthcare system. I would like to include in the system some kind of “reward” for those people who are compliant with their medical care. They attend all medical appointments, compliant with their med regimen, eat appropriately for their particular disease process. Their are many objective methods such as blood pressure and various labs to track a person’s health. It places the responsiblity for what the individual pays in $$ to their cooperation in maintaining their health. I also would like to tie “compliance” with “access”, if that were even possible. As an ED RN, I am constantly frustrated by our “frequent fliers” who are non-compliant and take time and $$ away from those people who are compliant and want to do what they can to make themselves well and healthy. I get tired of trying to help those, over and over, who don’t want to help themselves – but that’s another story. First time to this blog. Love It! Thanks!!

  • difficultpt

    January 28, 2007 at 3:13 pm

    Amen (oh, I feel an insurance rant coming on over at my blog in the near future . . .)

  • Widget

    January 28, 2007 at 6:59 pm

    Marie, please note that most cases of hypertension (high blood pressure) are asymptomatic and of genetic origin. Drug companies may hype hypertension into “the silent killer” but the reality is that only in a small percentage of patients is hypertension a serious concern. The trouble is that we can’t identify who those patients are (besides the obvious high-risk categories such as diabetics).

    I am in favor of encouraging patient compliance, but tying patient compliance to “metrics of health” serves only to hurt those who are already unhealthy.

  • Angry Male (student) Nurse

    January 28, 2007 at 8:19 pm

    Sing it sister! Let’s take responsibility for ourselves, our children. If you work full time, you should have access to affordable insurance and you shouldn’t mind paying a bit for it.

    How about we start out by annhilating the medical insurance lobby?
    A sprained back shouldn’t render one uninsurable.

  • S. R.

    January 29, 2007 at 2:06 am

    Makes good sense. I think kids should be helped no matter what, for no matter what. If a kid comes to this country with cleft palate deformity, the least this nation can do (for its karma) is to fix it for the kid.

    Even losers who foul up their health deserve some support. They are losers arent they?

  • Candy

    January 29, 2007 at 7:34 am

    OK, let’s do it! I admit to a little Pollyanna streak and I think this can work. I’d add one little caveat…no more primary doctoring through the ER.

    Oh, and this: “those who choose not to have health insurance” will likely choose not to pay the bill, either.

  • Candy

    January 29, 2007 at 7:40 am

    Talk about timing: read this for a peek into that world…right now the insurance industry is holding all the cards. That MUST be changed before anything close to true healthcare equality is achieved.


  • TC

    January 29, 2007 at 9:31 am

    A man once told me, “you can have anything you want, you just can’t have everything.” I think health care is so expensive because everyone wants everything done, regardless of the cost. I think at times tough decisions need to be made, but who makes them? Right now, the insurance companies make them with caps on coverage, denying or dropping people w/various chronic illnesses and just creating a quagmire of what they cover. I don’t particularly want the government making decisions for me, but I want big business doing it even less

    We DO have universal access through the ER. It’s the most inefficient, costly universal health care there is. As someone who was once on medicaid, it is IMPOSSIBLE to find a provider who takes it because they pay so little. Many elders are finding that out w/medicare as well.

    I don’t think we should look at Britain when it comes to national healthcare-they have too many issues. People in Scandinavia have wonderful social insurance. And don’t say, “well, they pay 50% in taxes.” Cause right now I pay over a third of my income in taxes and what do I get for it? A measly 6 weeks maternity leave at poverty level reimbursement.

    I don’t know what the answer is either but it’s going to require a solution that A. thinks outside the box and B. isn’t catering to insurance co’s, pharmaceutical co’s and other big business. I sometimes wonder if it wouldn’t be better to do away w/all insurance and let it become a true free market-then maybe people could afford to pay for a doctor’s visit out of their own pocket.

  • Mother Jones RN

    January 29, 2007 at 9:57 am

    I think you should run from president. Hey, why not? Every other Tom, Dick, and Hillary are running for office:-)


  • Teresa

    January 29, 2007 at 11:08 am

    Agree that healthcare should be untied from employment, but who can afford to pay out of pocket?

    Why not single payor? We have all kinds of insurance companies and all competition has done is make more money for the CEOs.

    Work for minimum wage, spend half your paycheck on insurance with a huge deductible and low lifetime cap. Have a child or other family member with a catastrophic illness and go bankrupt. The child might get Medicaid then, but what about parents?

    Waiting lists? I work for a state/federal program for low income adults (many of them do work). They wait an average of 4 months for a new patient primary care appointment and just as long for some types of specialty care.

    I see patients who haven’t had healthcare for years. 46 y/o with no previous mammogram now has mets to liver and bone. Was she supposed to access the ER for that?

    Rant over. Ready for flames.

  • Liana

    January 29, 2007 at 11:31 am

    Canadian here, so perhaps a bit biased… but I’m pretty happy with the way the system works. Long waiting lists are always an issue, but I’ve yet to see someone who emergently needed a procedure but was forced to wait. If you go to stats canada, in 2005, 40% of people waited less than a month for elective surgery, and 80% waited less than 3 months. Waiting a bit seems like a small price to pay for knowing that I won’t have to fear bankruptcy should I get catastrophically ill.

    Conversely, the U.S. spends more than just about any other country (as a % of GDP) on healthcare, and yet fares worse than many countries on basic indicators of population health such as life expectancy and infant mortality.

    Something’s not right here. I don’t know what the answer is, but something’s clearly not right.

  • Deacon Barry

    January 29, 2007 at 11:44 am

    What I like about the NHS is that it provides universal cover. Nobody faces large medical bills through having a condition that renders them uninsurable. The risk is spread out over the whole population. Now I pay a percentage of my salary in National Insurance, and I’m a very low user of the Health Service – I last saw a doctor eight years ago, and that was for indigestion. Paying National Insurance gives me peace of mind. It’s a win-win situation. If I do need treatment, I’ll get it (eventually): If I don’t need treatment I still win.

  • missb

    January 29, 2007 at 1:39 pm

    it makes me crazy that we’ve set up a system where the access itself has helped skyrocket the cost of healthcare for everyone. I work in a public hospital and our ER is beyond cluttered with people who simply need a band-aid or an anitbiotic but since they don’t have a PCP because they either can’t find one who takes medicaid or they don’t know how to navigate through the system to get one. The system is brutal and paper-heavy and corrupt. The fact that we (as a country) have allowed emergency rooms to become doctor’s offices and allowed ambulances to become free taxi rides infuriates me. It also makes me feel so hopeless: we’re so far gone that I don’t know how we can dig ourselves out. A trip to the ER is so ingrained…it’s almost cultural here in NYC. Got a cold? Head for the ER. “Prevention” isn’t how this generation was raised and it sucks.

    And someone up there in the comments mentioned that part of the reason treatments (and therefore insurance) are so expensive is that people want EVERYTHING! This is so very true. We want the biggest, brightest and best and we want it immediately! Personally I don’t think waiting 4 months for an elective non-life-threatening procedure is a big deal, but I don’t want my gov’t determining what is and isn’t life-threatening, THAT’S for sure! I believe these high costs are a direct reflection of our own fears of death and dying. We have the wildly expensive medical ability to prolong the lives of our most premature infants and our oldest comatose patients. But should we? It may seem like simply a moral issue, but it’s not. It’s inexorably tied to healthcare costs. Arguing about it can get super-ugly.

    I will certainly not bash you! You’ve got so many good ideas in here! But…

    (there’s always “buts!”)

    Although tax breaks for privately purchased insurance is certainly a step in the right direction (or a least “a” direction), they are, as currently proposed, so miniscule as to be ridiculous. Several hundred dollars is meaningless when you have a deductible, co-pays and a monthly family insurance pay-out upwards of $1500.

    And what are the inevitable illegals going to pay for their care WITH, exactly? I agree that the access should be there and that subsidizing their benefits 100% is not the way to go, but…then, what? We can’t simply say “well, they shouldn’t be here anyway” because they ARE here and we need to deal with it.

    Thinking about our healthcare system gives me a rockin’ headache. I want’ so badly for it to change, but I have no idea how we can manage it without changes so drastic that an entire generation may suffer while we get out act together.

  • JenCarroll

    January 29, 2007 at 2:30 pm

    Hey Kim

    Thanks for identifying that Canada’s system is a single payer one and not “free”–common misconception. However, reports of wait-lists have been grossly overblown south of the border while Americans have weirdly minimised the wait times in their own country as someone else addressed.

    Also, the UN doesn’t agree with you on needs not equalling rights. From the Universal Declaration of Human Rights, Article 25:

    (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

    Things can be both rights and needs (check out the rest of the list for a bunch of examples: http://www.un.org/Overview/rights.html) . In fact, I’d argue (and here I go:) that the very characteristic of being a need is what makes something a right.


  • Barbara

    January 29, 2007 at 3:01 pm

    Wonderful discussion. We do need to do something about our illness-care system in the USA. It is “broke.”
    I have worked in two different government systems…the military and Indian Health Care…both completely run by government bureaucracy in its finest. That wasn’t working either. We “reward” illnesses in this kind of system.
    We need to find a way to “reward” wellness and responsibility. And to understand that compliance is a choice, also. We were just talking about this at work…the chronic COPD patient who refuses to quit smoking or even attempt to and we keep “fixing” them to return to unhealthy behaviors (and pay for them as citizens). Who goes without health/illness care because the resources are no longer available because the COPD patient “used” more than their share of the budget. Money is a limited resource no matter where it comes from.
    I’ve also had some limited experience in a developing country and working with their “system” and we, in both the USA and Canadian, have so much more than they do, at its worse, than most of the rest of the world, we need to be careful what we are asking for.
    Again, resources are limited.
    I’ve worked in everykind of “system” you can think of now…after over 30 yrs of nursing. I don’t have an answer either. It does appear that people want something with strings attached and without taking responsibility for themselves and their choices…either with their health and/or their money/payment plan/taxes.
    Keep up the dialog….


  • Barbara

    January 29, 2007 at 3:25 pm

    Sorry, I mean without strings attached!

  • […] Some proponents of consumerism are opposed to single-payer healthcare. This is because they believe government mandated-coverage will wrest control from consumers. In addition, many supporters of single-payer believe that healthcare is an inalienable right. Others say it is not. However, the debate is far from black and white. In this post, Kim of Emergiblog argues that healthcare is a right, but it is not free. On the other hand, Kevin MD contends that “healthcare is absolutely not a right.” […]

  • Levi

    January 29, 2007 at 6:46 pm

    There are some point I agree with you, but the frivolous lawsuits will not drop the cost of health care.
    Part of the problem is people using the ER as their primary care physicians. I am kind of gulity of doing this myself because I was 100 miles from home and my PCP couldn’t squeeze me in until Tuesday(this happened on a Friday. I had a severe UTI and would have spread to my kidneys if I had waited until Tuesday. Usually I have to be forced to go to the doctor. When I had pneumonia and no insurance at the time, I totally refused to go until my wife and mother-in-law forced me to go. Then even threatened to tell the ER staff I was suicidial just to get treatment for me.
    Insurance companies need to be held liable to pay for the services they promise to deliver. That is problem number #1. I am fighting with my own insurance company to pay for PCP bills that my insurance refuses to pay. I paid my $15 co-pay, but the insurance refuses to pay the rest.
    Health insurance, like you posted needs standards in what they should provide. Although I am not a supporter of Welfare and other safety net programs, no one tax dollars should not go to anyone that doesn’t want to work, unless they are disabled. The exception is medicaid and medicare. If it weren’t for these programs, we would not have a shortage of nurses, but rather an overabundance of nurses looking for work. On average 50%-75% of a hospitals income comes from Federal and State funded programs.
    i do not mind seeing my tax money go to a hospital that I may not need. We should not pay for illegal aliens either, but how can anyone collect on someone who doesn’t have a permanent address in the US and lives in a foriegn country.
    There are many free clinics for the uninsured, but their resources are so limited, that anything more severe than a cold, or something like a Cholesterol check required a trip to the ER/hospital.
    There are no easy solutions. Not everyone is insurable because of pre-existing medical conditions. They can range from being diabetic to mental illness, which in a way is not fair to those people.

  • Anne

    January 29, 2007 at 9:18 pm

    Great post Kim! Finally a moderate voice in the debate. I think a lot of those objectives could be covered by government providing the funding through tax dollars.

    It seems to me to come down to this:

    Americans pay trillions of dollars to let the government wage wars, but get freaked out about the government providing some basic healthcare for all of its citizens. If government regulation is so evil, why not get rid of the FDA? Why not get rid of all government for that matter?

    Don’t you agree that some government involvement could wrest at least some of the control the insurance companies have?

    There seems to be a great ideological divide here. Those who value a life based on their ability to pay and those who value life regardless.

  • DisappearingJohn

    January 30, 2007 at 6:04 am

    I don’t favor a single-payor system, either (and I consider myself of the democratic persuasion) but I think the problem that needs addressed is the cost of healthcare in America, and that sadly starts with tort reform.

    When people can win the lottery because of getting a heart attack from eating fast food, and doctors order every test under the sun to ensure they aren’t going to get sued, cost are going to stay sky high..

  • Anne

    January 30, 2007 at 9:16 am

    Or maybe instead of thinking of it as “those people think they’re entitled?!” think of it as “hmm, I guess it would be nice if everyone could had basic coverage”.

    I guess I don’t mind that some of my tax dollars goes to pay for healthcare for all. Maybe it’s just irrationally ingrained in Canadian culture, but the vast majority of us believe that we should all just chip in for the health of all.

  • Jo

    January 30, 2007 at 12:22 pm

    Here Here! Aye Aye! Yes! I concur! I agree!
    You said it just the way I would’ve and I agree with you 100%

  • JenCarroll

    January 30, 2007 at 2:06 pm

    Good post Anne.

    One big reason that single payer health will never fly in the US is that the average American sees red (literally) when they hear the word “socialized” medicine. Socialized and socialism do not equal communism.

    However, a huge difference between Canadian and American culture is the relative weight/value given to individual rights and freedoms versus collective good. Single payer system would require a huge paradigm shift on the part of the US society that would undermine what it means to be American. (Bearing in mind that my understanding of what it means to be American is determined by TV/movies/news/books and only occasional visits)


  • Anne

    January 30, 2007 at 7:30 pm

    You know what though? I don’t see any of these extra freedoms that Americans have that other developed nations don’t also. It seems that a lot of individual freedoms that we have up here, they don’t have down there. I guess maybe we have more social freedoms while they have more economic freedoms?

  • Cosmetic surgeryWeblog

    January 31, 2007 at 1:39 am

    […] “>Health Care is NOT an Entitlement The #8220FunTier#8221 Were they serious Baylor actually sent out this paper #8220tower#8221 of information on Texas! They sent out a toy as a recruitment tool! And it#8217s free for the asking! Just mail in the coupon! As Will Smith said in #8220Independence Day#8221: #8220I gotta…out:2 sent:2Orig article […]

  • JenCarroll

    January 31, 2007 at 3:04 am

    Yeah, I agree lots of places have all of the same freedoms (and more, same-sex marriage springs to mind) but it’s that libertarian streak that runs through it that wants govt intervention limited.

    We can bear arms too (although it’s not listed as right) but there are more hoops to jump through and a slightly more limited selection of guns to choose from. We have a free press that is subject to market forces just like theirs, but it is also subject to the occasional (temporary and well-justified) press ban on high-profile cases that would never fly south of the border. Similar levels of govt intervention in health would make some heads spin.


  • FHT

    January 31, 2007 at 2:56 pm

    I’m with the UN on this one.

    As you said, we already have universal health care. It’s the most expensive, least effective model (the ER.) In some places in the world, if you can’t pay up front, you stay home to die. Americans would, I hope, never go for that. So let’s be real about it. I mean, this is just pure fantasy:

    “If you are an adult from another country in the US illegally, you shouldn’t be receiving one dime in benefits from this country. Access to health care, yes. But you pay for it.”

    Pay for it with what? All that money they are spending on luxury items like rent and food?

    As the spouse of a US Marine, I am grateful that everyone gets health care. The system is far, far, far from perfect but it also does not force people to choose between health care and rent.

  • KarenMoeller

    January 31, 2007 at 7:21 pm

    A timely discussion topic; thanks for giving it the attention it deserves in your blog.

    We already have socialized medicine in this country and it’s called Medicare. For the last five years or so, I’ve asked older folks if they or anyone they know have declined coverage due to the philosophical reason of not wishing to participate in socialized medicine. Haven’t found one soul yet! Anyone know of a person who has done this? In fact, most of the seniors I know are happy with their Medicare arrangements.

    Another take on other countries’ medical coverage for their citizens: let’s look at their programs, toss out what isn’t working and copy what is for our own system. Don’t just diss the whole Canadian system or the UK’s; pick it apart.

    Last year we traveled with an Australian family and medical coverage was a conversation topic. They were quite happy with their medical care (25+ years experience). Also had a Norwegian girlfriend visit. She detailed their system and said it had worked very well for her family of five. Both of them expressed how far behind they believe the US to be in handling this problem.

    I’ve always had employer medical coverage. I’d like not to have it tied to my job. My auto insurance, life insurance and disability policies are not connected to my employer and health insurance shouldn’t be either.

    KarenM in NC

  • Anne

    February 1, 2007 at 9:25 am

    The main thing that I think is wrong with the Canadian system is that the government has been slowly cutting funding for the past 10 years. The lack of funding for nurse positions is a contributing factor. If the funding was restored **in the proper places!** I think a lot of the wait times would be reduced.
    I also want to point out that the government doesn’t have a monopoly on healthcare here. Most doctors have for-profit private practices (unless they’re in a publicly-funded hospital), and we are starting to see more private clinics popping up all the time. The difference is that these clinics bill the government instead of individuals, and the government pays via our tax dollars.

    I know France is not a very popular country to many Americans right now, but maybe you guys should be looking at their system instead of ours or the UK’s. France has got a more even mix of public and private.

  • […] Recent debate has asked whether health care was a right or entitlement. Emergiblog joins the fray: Health care is not a right. Health care is a need, like water or food. And like water or food, it isn’t free. […]

  • Carolyn

    February 2, 2007 at 9:58 am

    What a great post! I am with you on the need for change and a need for insurance co’s to compete. I want to add that when a person chooses to privately pay, as in no insurance, that the bill can only reflect what the lowest negotiated price is for insurance companies. I have seen outrageous bills to people without insurance, when the provider has “negotiated” much lower rates with groups. For instance, in Alaska, large groups of insured (the state employees, the union employee’s group) have negotiated discounts at the two large hospitals.

    An individual who has no insurance should be billed at what the other groups are billed at.

    Sure everyone can be seen in an ER, HOWEVER, the ER will charge that person outrageous fees to cover all the losses from providing care to the indigent. And they collect some. That system is not right or fair and outlines the problems that consumers who are seeking the lowest costs will run into.

    Adam Smith’s “invisible hand” in the market place
    Does Not Work For Health/Illness care. We are a capitalistic society that is tring to make an economic philosophy work to a vulnerable(when ill) group.

  • GJhvl

    February 3, 2007 at 10:47 am

    Wow, the power of the internet! The ability to learn about other points of view! Unfortunately I just can’t wrap my head round the idea of medical care not being a right. I literally cannot imagine anyone thinking that it is not one of the basic protections to expect from a government. The fact that people like you think that even your fellow Americans are not entitled to basics of life like food, water and health care does help to explain what looks like blindness to suffering in New Orleans and Baghdad, but it also may explain why the rest of the world isn’t entirely convinced that the US is totally totally wonderful.

  • Kim.R

    February 7, 2007 at 3:36 pm

    Good thoughts Kim and every one else. I have been on all three sides of the health care street. I’ve been on public assistance,employer subsidized, and private pay. I am now a private pay individual with a chronic illness. I am not able to work and the only reason I am receiving appropriate health care is because my husband works his fanny off to provide for both of us. With that said I am in favor of Private co-op insurance companys that are a non-profit base. Yes they do exist and are becomming more popular for obvious reasons. I am also in favor of just about anything that takes the joy stick out of the hands of greedy insurance company’s that have been responsible for destroying lives, as I have witnessed. Not to say there isn’t anything good about insurance company’s. My former insurance company forked out thousands upon thousands of dollars during my pre-diagnosis stage and initial treatment after diagnosis. I am very grateful!!! I live in Alaska and there are no HMOs, thank the Lord above, so there is quite a bit of freedome to choose a provider that best suites the patient and their needs. HMOs, another dark subject. They seem to be the worst offenders of white nuckle joy stick greed. I believe that families and churches need to take care of their own which in short puts some responsibility on the local community of individuals to kick in and take care of each other, elderly, widows, and children, instead of shurking it all off onto the government. By the way my health is gradually improving and I am a BSN student and should graduate within 16 mo. It has taken ten years to get this far. I love health care and am minoring in Gerontology/Geriatrics. We will take care of our ailing population whether we like it or not because it’s within our own homes..the question is, like mentioned above, are we willing to give up a little life style to make sure our family and friends are cared for or is it always going to be some one elses problem?

  • […] Back in January, I wrote a piece entitled “Health Care is NOT an Entitlement“. […]

  • drdisaia

    February 22, 2007 at 7:03 am

    You might want to add that health care insurance companies should not have the right to pay whatever they want on a bill (like their usual 30% or less). If they paid anywhere close to what we bill, I might be doing more reconstruction (breast cancer, trauma, etc).

    As it is, taking health insurance in my practice is a “break even” proposition at best. I need to limit my exposure to make a living.

  • Pete

    February 8, 2008 at 6:42 am

    A novel concept!!. We, (the people) start a not for profit health care company. We apply rules for the use of the insurance.
    We cover preventive visits and diagnostic test to determine underlying health issues. If we find one we do not drop the person from the plan and we do not try and bilk them out of more money. But we do hold them accountable for their health.
    The insurance plan could cover medications. When medications are prescribed for HTN, diabetes and other chronic problems the plan monitors prescription refills to ensure compliance. If you are not taking your medications then we advise you that if you continue to be noncompliant you will be removed from the plan.
    If you abuse the system going to the ED for a runny nose or others non emergent problems you get a warning the first time and subsequent trips for frivolous conditions would result in your being finically responsible for your visit or eventually being dropped from the plan.
    We need to hold people accountable for their health. The government is NOT the answer, look at where this country is with MEDICADE and MEDICARE.
    The last thing we need to do is make federal decision makers utilize the same system that the common people do. The politicians have no idea and never will have any idea what the average person goes through the provide health coverage for their families.

  • Healthcare As A Right « WhiteCoat Rants

    November 7, 2008 at 1:03 pm

    […] I don’t believe that healthcare is a “right.” Instead, I believe that people should look upon good health and the ability to receive health care as a privilege. I won’t argue the point because I don’t think that I can do better at illustrating it than other bloggers have done. For example, see Shadowfax, Maggie Mahar, and Kim at Emergiblog. […]

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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