National Health Service for the US. What’s in It for Nurses?
Nurses are in a unique profession. They care for the patient and act as his advocate yet they are seldom employed directly by the patient. A national health service will be good for nurses because they will be able to continue in this unique role. They will be able to serve for betterment of society. In the US, in the present system nurses are mainly employed to look after the insured thereby shoring up the profit margins of insurance companies and pharmaceutical firms. The author of has worked in Canada, Australia, UK and the US and offers his insights into probable changes which may come with the creation of a National Health Service.
I was born in India. I grew up in Malaysia where I completed my primary and secondary school education . I did my diploma in nursing at the Group School of Nursing for South Ayrshire located on Bellevue Road in the beautiful and wintery City of Ayr, Ayrshire. Then I moved to London, England to do my Intensive Care Course and my Oncology Nursing Certificate. I did these at the Lewisham District General Hospital and at the Royal Marsden Hospital respectively. At that time I did not feel that I had acquired sufficient knowledge about health and life in general so I went back to Scotland, Stirling University to be precise, to do my bachelor of Science Degree. This gave me a lot of satisfaction because I felt I learned a lot. However, it was also the driving force for me to do my Master’s Degree. I did this at Nottingham University and obtained an insight into the running of businesses and in particular Health Services.
Though I have a Master’s Degree in Business Administration I am above all an ordinary human being with very ordinary tastes and desires. My thinking and writing are inspired by Mr. Alister Kerr who was instrumental in motivating me to study hard and he always had a Scottish wink and a good word for me. When he noted that I was bored he invited me to attend his special lectures for third year student nurses who were preparing for their final examination. This gave a superior knowldege base when I was in my first year. All this happened in a National Health Care Service.
Myth: That another layer of beurecracy will be created. Reality: Many layers of beuracracy will disappear.
Many nurses who have not worked in a National Health System will be thinking that it will be the creation of another layer of burecracy. Yes, it is another layer of burecracy. I will be lying to you if I said that the system will be tailored to suite each and every patient at the national level. Individual tailoring and adjustments will be made by the bedside nurses not by the Administrators. So we as nurses will have professional responsibility and accountability to our managers etc. This will not change. What will change is that if we are not satisfied with our immediate superiors we will be able to take the issue all the way to Federal Politicians as opposed to the courts. However, the courts will also be available to resolve conflict issues.
A national Health Service is not as impersonal as many make it out to be. The impersonal nature is due to the behaviours of the employees. It is not a function of nationalization. Image via Wikipedia
The above is not the only change that will occur. Several job descriptions, profit centres, and many layers of beurecracy will disapper from hospitals.To begin with there will be no need to market the hospital’s services. Patients will seek out the hospital what best provides a service that the patient needs. Then the clerical staff which collects information about a patient’s insurance company and benefits will disappear. The folowing will agencies will not have useful roles in the National Helath Service:
- Debt collection and collection agencies will not be needed because no bills will be generated.
- Billing and invoicing will not be needed.
- Insurance Companies will not be needed. Every patinet has the right to health care.
- Book keeping departments will shrink because under the new system they will only need to keep records of purchases and inventory.
- Nurses will no longer need to scan and record all equipment used for patients.
- The need for endless consuantants will be reduced.
- Procedures which are not medically needed will not be performed or will be performed at the patient’s private cost.
- Doctors will not be all powerful. Nurses will receive more recognition. There are two reasons for this. First there are more of us. Second we are around longer i.e. when everyone goes home we dont.
Myth: That the National Health Service will be impersonal. Reality: The Health service will be patient centred, not money centred. Therefore it will be more friendly at the individual level.
Better Quality services can be performed when money is taken out of the equation. The dollar should not speak. Humanity, compassion, quality care will prevail in a National Health Care System. Image via Wikipedia
Myth: The National Health Service is about Income redistribution. Reality: It is about economies of scale.
A National Health Service can balance between the needs of the Rich and the Powerful and the needs of the poor and disabled. Image via Wikipedia
One of the funcions of a National Health Service is to help the disadvantaged. Many of us who have only worked in the US will be thingking that this smells of socialism. Yes, socialism is really bad. Yes, I mean it is really bad if you are filty rich, famous, and have lots of money. However it is really good if you are not a millionaire, are a Registered Nurse, a teacher, with slightly above average earnings of about $60 to 70,000, have a family, are old etc.
The term socialism has been villified in the US. Therefore I will not be going into a lengthy discussion about this. We as nurses are smart people. We should be able to address word sensitivities and we should be able to look past the needs of insurance and pharmaceutical companies. We need to look at human needs.
Many readers, particularly Americans think that a National Health Servicei is about income redistribution. A National Health Service is NOT about income redistribution. It is about ECONOMIES OF SCALE and provision of health services to the masses at a saving. Yes more people can be served with less money due to economies of scale. This is being done successfully in Australia, Canada, United Kingdom. I have already shown that these countries have lower infant mortalities, longer life expectancies and better quality of life indexes. We as nurses have a vested interes in provinding quality nursing care to more people.
Myth: Many nursing jobs will disappear. Reality: There will be more nursing jobs because there will be many more services provided to more people.
The number of nursing jobs will incrase as the number of services provided increase. Image via Wikipedia
I cannot remember the name of a united nations study but I know the study was presented at the ICIN conference in Perth, Australia. It showed that patient outcomes improved as the number of nurses increased. Countries which had more qualified nurses had better patient satisfaction and shorter discharge times.
In Australia, a country with both a Private and National (Public) Health Care systems Nurses were chosen to be the most trusted professionals.
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