Posts Tagged ‘HCR’
March 8, 2011
Obama Speaks to Congress on Health Care/Image via Wikipedia
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 [health] system on the planet. Its fiscal future would be transformed if Congress passed reforms that emphasized control of costs as much as the expansion of coverage that Barack Obama rightly wants.”
Why should any of this matter to nurses? Here’s a post reminding us why nurses have a stake in health care reform.
But back to nursing proper, nursing in the trenches, nursing not in the abstract but in its inescapable dailiness. Read the rest of this entry ?
Posted in Uncategorized | Tagged Affordable Care Act, catastrophic illness, Donald Berwick, HCR, health care reform, medical bankruptcy | 1 Comment »
January 18, 2011
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 basic health services like well and ill baby care, immunizations, and health screenings; manage chronic conditions; care for the sick and dying using both technology and interpersonal techniques; and a multitude of other essential services that are well within our expertise. We want to educate our client and our communities and form a health care partnership with them. We are team players and are ready to try to make new systems work for consumers.”
If only nurses ruled the world . . .
Posted in from the archives, health care reform, nursing perspective, professional identity, Shawn Kennedy, AJN editor-in-chief | Tagged Affordable Care Act, American Nurses Association, HCR, scope of practice | Leave a Comment »
August 5, 2010
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 . . .”
By db*Photography/via Flick
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 some more time studying up on this as it affects us—as health care providers as well as citizens. How do you feel about this and what do you think could be done to clear up the confusion?
(More details about the poll results can be found here.)
Posted in health care reform | Tagged Affordable Care Act, HCR, health care reform, nurses | 1 Comment »
July 2, 2010
By Bob Jagendorf/via Flickr
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
Posted in Diana Mason, editor-in-chief emeritus, health care reform, nursing perspective, professional identity | Tagged HCR, health care reform, innovation, medical homes, nurses | 1 Comment »
April 26, 2010
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.
Posted in health care reform, health information technology (HIT), nursing innovations, Shawn Kennedy, AJN editor-in-chief | Tagged HCR, health care reform, health information technology, HIT, hospital CEOs, reimbursement | Leave a Comment »
March 22, 2010
By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
It’s interesting to have a firsthand encounter pertinent to the HCR story that is consuming the headlines. Recently, my son had a fall and dislocated his shoulder. He knew what had happened because he did it as a freshman in high school, some 10 years ago while playing sports. So he went to an ER and had the shoulder popped back in, saw an orthopedist as recommended, and went for physical therapy—all covered by his insurance plan. But all his claims for reimbursement were denied. The reason the company gave: his dislocated shoulder was considered a ‘preexisting condition.’
After my husband peeled me off the ceiling, we approached this methodically—we gathered forms, wrote letters, requested letters from the hospital, the orthopedist, the physical therapists—and appealed the ruling. After a bit, we received a response saying that they’d reconsidered and would cover the injury according to policy.
This is not a terribly compelling or poignant case, but it’s an example of the “first deny all claims” approach of some companies. Yes, it was resolved on appeal fairly easily, but why did it need appealing in the first place? I can’t imagine what patients and families with chronic illness must go through in trying to get treatment covered.
If the only thing health reform does is to eliminate the unjust use of preexisting conditions to deny coverage, it will get rid of one of the most critical obstacles to access to care.
Posted in health care reform, patient perspective, Shawn Kennedy, AJN editor-in-chief | Tagged chronic conditions, HCR, health care reform, nurses, preexisting conditions, why it matters | 6 Comments »
March 19, 2010
By Shawn Kennedy, AJN editorial director/interim editor-in-chief
The final push towards the staircase.../ caspermoller, via Flickr
Sometime in the next few days, Congress may bring the health care reform issue to a final vote and even a resolution of sorts, though one never knows what new twists may occur before then. I can’t even imagine what will occupy the news if it really does pass. (Philandering professional athletes and pilfering politicians better beware as newspapers seek new headlines.)
Many Americans are calling their legislators to tell them what they want and don’t want. At the same time, many remain confused by the complexity of the legislative process as well as the particulars of the legislation. The final push received a boost this week from projections by the Congressional Budget Office that the bill would cut the budget deficit by $1.2 trillion over the next two decades.
As nurses, we need to be knowledgeable and concerned with how health care will shape up—we’ll be delivering it. For information on the current bills under consideration, here’s two accessible sources: the Washington Post has a comparison of what the already passed Senate bill and the reconciliation version under consideration by the House include; the New York Times provides a pdf of the House bill.
Here’s a short list of provisions related to nursing likely to be in a final bill (as we noted in a post back in December about a useful ANA chart comparing House and Senate bills at the time):
- increased financial support for nursing recruitment and advanced education
- increased funding for graduate education for nursing faculty
- increased funding for education for students who will practice in underserved areas
- establishment of a Public Health Workforce Corps
- increased Medicare reimbursement rates for advanced practice nurses, including nurse–midwives
- pilot programs to provide reimbursement under Medicare for nurse practitioners to create or lead “medical homes”
- increased reimbursement to school-based health clinics under Medicaid
Posted in health care reform, nursing perspective, Shawn Kennedy, AJN editor-in-chief | Tagged HCR, health care reform, reconciliation, what does health care reform mean for nurses? | 5 Comments »
March 5, 2010
This week Not Nurse Ratched has an amusing, meandering, and thoughtful post about the uses of Facebook by patients in the hospital. There’s a short excerpt below, but read the whole thing here.
They update Facebook constantly. CONSTANTLY. They have us take photos of injuries they can’t reach so they can post the photos to Facebook. I am not making this up. “I want a photo of my hideously dislocated ankle/knee/shoulder but I can’t move, so would you mind using my phone to take a picture for me?” And they keep updating and updating. I have actually said, “I’m about to give you a medicine that is going to render you unconscious immediately, so you should set your phone down.”
How could we have a weekly Web roundup that doesn’t at least mention health insurance reform? The spotlight has been slowly turning toward the insurers themselves, a crucial part of the equation (along with cost control and many other factors). This week Secretary of Health and Human Services Kathleen Sebelius met with the top executives of insurance companies to demand an explanation for the steep increases in rates seen in the last year.
salmonella/via CDC
If you’re looking for yet another reason why processed food isn’t good for you (besides the frequent presence of high fructose corn syrup and massive doses of salt, and the inaccurate packaging claims that the foods are “healthy” and “lean”), this week the NY Times reported news of a widespread food recall, stating that “[t]housands of processed food products – from chilis to hot dogs to dips – contain an ingredient that federal food regulators say was contaminated with salmonella . . . “
Also this week: hopes were crushed for a pill thought promising for the treatment of Alzheimer’s. Garry Schwitzer of HealthNewsReview.org isn’t surprised, though–no one’s better at pointing out the way drugs are hyped by mainstream coverage, whether they work and are safe or not. Here’s the short take at his blog.
Lastly, for some widely varying provider-level perspectives on palliative care and end-of-life issues, there’s an excellent roundup of posts and links to blogs and Websites at the Palliative Care Grand Rounds hosted by Larry Beresford.
Posted in health care reform, nursing perspective, palliative care | Tagged corn syrup, end of life, Facebook, HCR, health care reform, insurance, palliative care, processed food, salmonella | 1 Comment »
March 2, 2010
By Shawn Kennedy, MA, RN, AJN interim editor-in-chief
In surfing the Web Monday, I came across this interesting tidbit on the blog run by Gary Schwitzer, creator of HealthNewsReview.org, a site devoted to assessing the accuracy of health news coverage. He quoted statistics from a report by the Center for Public Integrity, which claims that “there are eight lobbyists for every member of Congress.” The number of lobbyists went from about 1,400 in the first quarter of 2009 to nearly 3,700 by year’s end.
I see elderly people in the supermarket bagging groceries—some may like the company, but others are doing it to pay for medical care not covered under plans. My uncle—one of the “greatest generation”—used to cut his pills in half to make them last longer. Does this qualify as “rationing care”? Read the rest of this entry ?
Posted in health care reform, nursing perspective, Shawn Kennedy, AJN editor-in-chief | Tagged emergency rooms, HCR, health care reform, lobbyists | 5 Comments »
February 26, 2010
. . . . What really struck me about the meeting, however, was the inability of Republicans to explain how they propose dealing with the issue that, rightly, is at the emotional center of much health care debate: the plight of Americans who suffer from pre-existing medical conditions. In other advanced countries, everyone gets essential care whatever their medical history. But in America, a bout of cancer, an inherited genetic disorder, or even, in some states, having been a victim of domestic violence can make you uninsurable, and thus make adequate health care unaffordable.
One of the great virtues of the Democratic plan is that it would finally put an end to this unacceptable case of American exceptionalism. But what’s the Republican answer? Mr. Alexander was strangely inarticulate on the matter, saying only that “House Republicans have some ideas about how my friend in Tullahoma can continue to afford insurance for his wife who has had breast cancer.” He offered no clue about what those ideas might be.
That’s from “Afflicting the Afflicted,” Paul Krugman’s NY Times column about the health care reform summit that took place yesterday. It really is bewildering that so many elected officials can simply refuse to engage one of the major issues of our time. How can their supporters not begin to wonder at this as they themselves in ever greater numbers go into medical bankruptcy, are forced to choose between basic medications for chronic illnesses, and spend days on end struggling with insurance companies over every simple claim they make? Didn’t any of the naysayers notice the increases in insurance premiums announced this week, for example, with some major plans raising premiums by as much as 35%?
Nurses: Are your patients’ lives really improving? Are they getting any easier? Don’t they deserve a sincere effort to solve their problems, rather than more posturing designed to win votes in the next election cycle?
-Jacob Molyneux, senior editor/blog editor
Posted in ethical issues, health care reform | Tagged government takeover, HCR, Health Care Reform Summit, insurance premiums | 4 Comments »
