John D. Shier, RN, PhD

John Shier is a Registered Nurse and Doctor of Philosophy who entered the profession of nursing at the young age of sixty and after having two prior successful careers.

Prior to his nursing career and his work as "ThatGuyNurse," John was an Assistant Professor of Philosophy at the University of Wisconsin - Green Bay for fourteen years. John also served eighteen years as the Executive Director of the Lake Michigan Area Agency on Aging as well as providing leadership as the Executive Director of the United Way of Brown County.

Contact John…

John D. Shier RN, Ph.D.
2790 Elm Tree Hill
Apt. 330
Green Bay, WI 54313
920.489.8763
jshier1@new.rr.com

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A Parable About Insurance

Once upon a time there was a society with a very interesting way of providing automobile insurance. Nobody purchased automobile insurance until they were involved in an accident. Then they contacted the nearest insurance company and were compensated for their losses. Insurance companies of course were not happy with this arrangement because it meant that they were required to make payments to people who made no premium payments to them.

The patient care and affordability act proposes that universal health insurance would be achieved through combining the requirement that employers provide insurance to their employees or, alternatively make payments to states insurance rolls and that individuals either purchase insurance or be fine. Persons eligible for Medicare and Medicaid would continue those coverages

A number of states have challenged the constitutionality of the individual mandate; the requirement that persons not eligible for Medicare or Medicaid and not insured by their employers must purchase their own medical insurance.

It seems clear that individuals, largely those relatively young and healthy, would not, without a legal requirement purchase medical insurance. Since under the patient care and affordability act insurance companies are forbidden to disallow applicants on the basis of pre–existing conditions, there would be created a situation identical to that of the insurance parable. People who had made no payments into the insurance system would be entitled to make claims against that system when, for any reason, they became sick or were injured.

So it would seem that either insurance companies must be allowed to disallow claimants based upon pre-existing conditions or there must be a requirement that every person be covered by medical insurance either through a but, to age or disability or through a mandate such services be purchased.

Comments and criticisms of this argument are welcomed.

From, “Notes From thatguynurse: Choose Now, Live Later”

“A Common Hospice Experience:
Tuesday afternoon.  My hospice social work partner and I head out of town to a rural nursing home to do an admission assessment.  We arrive and find that our patient is already in the process of active dying.  She is unresponsive.  Her legs are mottled.  Her forehead is burning with fever and her hands and feet are icy cold.  We hear the death rattles in her lungs which have filled with fluid.
We proceed to do our assessment and fill in the necessary paperwork to accomplish admission to hospice.  All the while we are doing this, we glance at each other and shake our heads over the thought that had we been called weeks or even months before so much suffering for both our patient and for her family could have been averted.  However, the family had kept holding out hope that her situation might improve.  It was only when it was completely clear that death was close was hospice called.
We finished our work, packed up and headed back to the car.  A voice called, “Nurse, come back.”  We returned.  Our patient was dead.  I then did the last work of hospice.  I prepared the body to be delivered to the funeral home.  l called her doctor to pronounced the death.  I called the coroner.  I inventoried her medications to return them to the hospice offices for disposal.   I gave what consolation I could to her family.
We left.”

From, “Notes From thatguynurse; Choose Now, Live Later:”

“A Common Hospice Experience:
Tuesday afternoon.  My hospice social work partner and I head out of town to a rural nursing home to do an admission assessment.  We arrive and find that our patient is already in the process of active dying.  She is unresponsive.  Her legs are mottled.  Her forehead is burning with fever and her hands and feet are icy cold.  We hear the death rattles in her lungs which have filled with fluid.
We proceed to do our assessment and fill in the necessary paperwork to accomplish admission to hospice.  All the while we are doing this, we glance at each other and shake our heads over the thought that had we been called weeks or even months before so much suffering for both our patient and for her family could have been averted.  However, the family had kept holding out hope that her situation might improve.  It was only when it was completely clear that death was close was hospice called.
We finished our work, packed up and headed back to the car.  A voice called, “Nurse, come back.”  We returned.  Our patient was dead.  I then did the last work of hospice.  I prepared the body to be delivered to the funeral home.  l called her doctor to pronounced the death.  I called the coroner.  I inventoried her medications to return them to the hospice offices for disposal.   I gave what consolation I could to her family.
We left.”