On the Web: A Tragic Choice, Wasting Berwick, Cost Control, A Nurse’s Comfort Zone

President Barack Obama speaks to a joint sessi...

An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured.

Read the rest of this troubling post at The Health Care Blog by surgeon John Maa if you doubt that we need health care reform in this country.

A measure of how unserious we are about fixing the problem of health care quality and costs in the U.S. can be found in reports that Don Berwick, President Obama’s choice to run the Centers for Medicare and Medicaid Services (CMS), continues to have an uphill battle for confirmation, despite being widely acknowledged within the medical community as the best choice for the challenging job.

Since we’re talking policy, there’s an incisive post at the Health Affairs Blog on where our energies should—and should not—be going in controlling costs. Here’s an excerpt:

The current cry to reduce Federal deficits and debt growth by reducing Medicare and Medicaid entitlements is totally missing the key issue: the need to moderate all health care inflation. This should be the time for a national debate on how to best tackle the underlying cost problem, for the sake of our future, the economy, and access to health care.

The June 13-19, 2009 Economist editorialized: “America has the most wasteful […]

2016-11-21T13:13:54-05:00March 8th, 2011|Nursing|1 Comment
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HCR: Been There, Done That

By Maureen ‘Shawn’ Kennedy, AJN editor in chief

I was doing some research in the AJN archives and came across an editorial written in November 1993 by Virginia Trotter Betts, then-president of the American Nurses Association. “The Best Buy in Health Care” (click through to the PDF option; article will be free until July 18) reads like it was written with the Institute of Medicine’s Future of Nursing report in mind. Here’s an excerpt for those who don’t have access to the AJN archives (a shameless plug: subscribers have full access to ALL the issues of AJN, back to the very first issue in 1900—a treasure trove of nursing history):

“But we must also face the fact that such reform will require significant changes in nursing. Nurses will have to operate with greater autonomy and deliver care to a broader clientele. To foster enhanced roles for nurses as case managers and team leaders, nursing administrators must alert the work environment to offer a continuum of care on site and off site. Nurse educators will need to offer innovative programs, curricula, and clinical placements that prepare nurses for careers characterized by critical thinking and maximum flexibility. Nurse researchers will need to add more health care system, economic and policy studies to their repertoire.”

And another:

“Nurses want to do more in a reformed system to facilitate access at a reasonable cost.  We want to do what we are educated to do – provide […]

2016-11-21T13:14:18-05:00January 18th, 2011|career, health care policy, nursing perspective|0 Comments
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Still Confused About Health Care Reform? Welcome to the Club

By Peggy McDaniel, BSN, RN. Peggy is an infusion practice manager who occasionally writes for this blog.

I admit that I’ve been a bit overwhelmed with the ongoing discussions around health care reform. It sounds like I’m not the only one. FierceHealthcare.com recently reported that the results of a Harris Poll suggest many Americans remain befuddled about the implications of the Affordable Care Act passed in March:

“Here are some areas [w]here a general cluelessness among those polled prevailed:

  • 82 percent think the bill will result in rationing of healthcare or that it might (it won’t);
  • 79 percent don’t know or aren’t sure if drug companies will pay an annual fee (they will);
  • 73 percent don’t know the law establishes a new tax on the sale of medical devices;
  • 66 percent don’t know or aren’t sure if the legislation will result in insurance exchanges where people can shop for insurance (it will); and
  • 63 percent either aren’t sure or don’t know if the new law will increase the number of people elibible for Medicaid (it will).

The chairman of the Harris Poll is quoted in the article: “It seems people are still reacting to the rhetoric, not the substance of what is in the bill . . .”

Considering the results of this poll, what do you think it would take to get the public up to speed on the facts? Do Americans not care, or is it too overwhelming? As a nurse, I feel I should be more informed about the law. And I’m going to spend […]

2016-11-21T13:16:17-05:00August 5th, 2010|health care policy|1 Comment
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Health Care Reform: What’s In It for Nurses?

A relaxing and safe Fourth of July weekend from the AJN editors to all nurses in the U.S., whether you’re taking it easy or on the job!

A recent poll conducted by the Kaiser Family Foundation shows rising popularity for the health care reform law. Many hard decisions still need to be made; innovation is more crucial than ever. Nurses who’d like a clearer sense of how the health care reform law may affect them in the coming years should have a look at “Health Care Reform: What’s In It for Nursing?” in our July edition. Written by AJN‘s emeritus editor-in-chief Diana Mason, it points out some of the new models of care the law promotes, models in which nurses play an increasingly important and vital role at every level. As often in the dynamic history of this country, there will be new kinds of opportunities for those who are ready for them.—JM, blog editor

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2016-11-21T13:16:55-05:00July 2nd, 2010|career, health care policy, nursing perspective|1 Comment
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Hospital Execs Assert They’re ‘Scared to Death’ by Reform Measures

By Shawn Kennedy, AJN interim editor-in-chief

On Friday, at the Association of Health Care Journalists (AHCJ) meeting in Chicago, I attended a session in which a panel of hospital executives discussed how their facilities would be affected by health care reform. They weren’t really sure of anything except that they’d probably lose money.

The panel included Richard Gamelli of Stritch School of Medicine and the Loyola University Health System, Jeffrey Hillebrand from NorthShore University HealthSystem, and Jim Skogsbergh from Advocate Health Care.

Skogsbergh was the most dire: “I’m scared to death about health care reform and I’m not sure how it will all shake out. The only thing I do expect is to that I’m going to get paid a lot less.” An attendee asked if hospitals would do better now that patients they cared for as charity patients would have health insurance under the new law. Gamelli answered that that depended on the insurance. Currently, he said, his facility is only reimbursed for 90% of costs incurred by Medicaid patients and 50% of those incurred by Medicare patients.

Where’s the innovation? The session was disappointing in that it was mostly about how these megahospital systems would deal with the financial implications. It would have been interesting to have a perspective from a small community hospital. And other than a program mentioned by Hillebrand to try to reduce hospital readmissions among patients with chronic disease, there seemed to be little focus on finding new approaches to cutting costs through improving quality.

2016-11-21T13:18:03-05:00April 26th, 2010|health care policy|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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