I've worked in healthcare since eary kidhood when I helped take care of old folks in my grandma's nursing home, then later as a Nurses Aid, then 40 more years as an RN working mostly with low income populations in psych and rehab and medical settings. The changes I have observed from the inside over all these years, and the personal experiences of my own and family members, have had this outcome, for me: even if I could AFFORD frequent medical care, I'd forgo it for all except acute illness or surgical necessity.

I find todays medical care mostly untrustworthy, disempowering, and based primarily on treatment of symptoms, rather than diagnosing and treating the root causes of illness.

I long ago assumed full charge of my own health issues. Whatever I did not know, I made sure I learned, so as to be skilled enough to monitor my own chronic health porblems. I seek out family practice docs who are willing to work with me this way, rather than assume they know more than I do about my body, and who have the ability to write prescriptions when I need them. I make sure to have a good working relatonship with one at all times, should I become acutely ill and need more of their services and expertise, so they know me in advance..and that I am a full partner here, not just a "consumer of their skill."

After enough negative experiences, I made it my business to learn all I could about, and to utilize alternative health care techniques so as to minimize or remove the need for prescription medication as much as possible. (In the last nursing home I worked at, the average number of drugs each resident took daily was 15. Fifteen different drugs, most of which were prrescribed to counteract each others side effects. The poor elderly and disabled have become, in my opinion, a cash crop for the pharmaceutical companies: a rich, never ending harvest. Drugs are often the ONLY treatment they get.)

No one close to me ever enters a hospital without me on deck at bedside 24/7 if they have to have surgery, are on any miind altering drugs or are vulnerable in any way at all. I know way too much about how bad interal communication is in most hospitals, and that they are often short staffed or staffed with float nurses who don't even have time to glance at a chart becore doing hands on cares. (not so much so in specialty units like critical care..etc.) Level of expertise holds little reassurance to me, when delivery of care is rushed and communication channels leak like seives.

I think the America people have been brainwashed to the core about thier need to depend totally and completely on doctors and drugs for every ache or pain or sleepless night. I believe we have become totally "disempowered" and encouraged to turn all out personal power and responsibility for our own wellness, over to what has been turned into a profit based industry. Marketers play doctor on TV every five freakin minutes, scaring the hell out of people day in and day out, and manufacturing new "disorders" as they go, so as to sell the latest designer drug, many of which are just the old ones with one new ingredient, so as to be able to retain patent, and keep it from generic status.

What we need even more than quanty of health care, is QUALITY health care, such as I was trained to give many years ago, back when medicine was still a profession and an art. Back when you had time to take a decent history. When you actually were SUPPOSED to come to know your patient, so as to factor in ALL thier parts..thier mind and emotions as well as the body, because all of these parts are connected with illness. You can't just treat the body and the pnysical symptoms, ignoring everything else, and help a person truly get well and stay that way.

Medicine ..(note: my experience is in medicne as practiced on the second tier..not the top pier of medical care where the rich go for care)... as I know it today, is not medicine. It is an assembly line process of treating symptomology only. Get 'em in and out as fast as possible so as to serve the bottom line, and that's usually done by writing a script. (Unless of ocurse, you can order tests that ARE covered by insurance or medicare/medicaid..then you can refer them to specialists when needed.)

As a poor person myself, I promise you this: you will NEVER see me in the kind of nursing home I would be allowed to go to. I am fully prepared to decide the when and where of my own exit from this world.

Now I remember why I avoid writing on this topic. It unleashes all the bitternes amd anger.

I was so proud to get that degree I worked so hard to get back in 1972. I was SO proud to be a Registered Nurse.

When I retired, I was only expensive overhead, and I couldn't stand to watch any of it anymore.

I became disabled in the early 90's and having issues with health and money gave me the same sense of the care system. The safety net Americans think the poor have access to is a myth. It just isn't there. If I didn't have family I could rely on, I'd be homeless or dead now, and that is not an exaggeration.

I appreciate nurses more than I can say after seeing how they handled my mom when she had two brain surgeries a couple of years ago, but the system itself is broken. We pay more than any other developed country and receive less effective care. We are the only developed nation whose infant mortality rate is going up. And I have to agree that I'll probably take myself out before I'll go to a home of any kind.

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