Why You Need to Know about the Proposed Health Care Plan

Rep. Paul Ryan, Wisconsin/Flickr/Gage Skidmore

AHCA Release Ignites Concerns from Right and Left

The administration’s plan to replace the Affordable Care Act (ACA) was released earlier this week and has ignited a firestorm among Republicans and Democrats alike.

Democrats claim the American Health Care Act (AHCA) will create havoc and hardship for millions of the most vulnerable.

Many Republicans are worried about the plan’s effect on their constituents, while more conservative members of the GOP feel it doesn’t go far enough in repealing the ACA.

While there is a stated push by the new administration to “sell” the plan and implement it quickly to keep campaign promises, legislators in both parties are calling for time to examine the plan and analyze the cost of the plan, which has yet to be determined.

As almost everyone knows, finding a way to provide affordable health care in this country is very complicated and requires a delicate balance of funding by the federal government and states. It’s likely that there will be several changes before a final plan is in place.

What seems to be clear is that the changes coming down the road will have a direct impact on nurses, patients, and the institutions in which we work. Will staffing be cut if states lose federal reimbursements? […]

ANA’s Cipriano, AARP’s Reinhard Comment on ACA’s Undoing

President Obama signing the ACA in 2010/via Wikimedia Commons

Nurses and the Undoing of the ACA

Many in the nursing community supported the Affordable Care Act (ACA) when it was first introduced. This is understandable, given our firsthand experience of patients who didn’t seek care until they were gravely ill because they lacked health insurance. We know how disease management can change outcomes for those with chronic illness and how preventive care can make the difference between having a treatable cancer or a metastasis.

In the years since, as both supporters and detractors continued to argue over the law and its need to be improved (or scrapped, depending on your viewpoint), over 20 million people gained health insurance and access to care.

Now as Congress moves to repeal and replace the ACA with a yet-to-be-determined plan, many are concerned that major gains will be lost and once again it will be the poor and vulnerable who will suffer. (I touched on some of the concerns in my March editorial.)

To get a little more insight, I spoke with two very policy-smart nurses about what might happen and what they feel should happen.

What ANA president Pam Cipriano said:

I asked ANA president Pam Cipriano what she thought was the most critical aspect of the gains from the ACA that need to be preserved. Her answer:

“We must […]

Baby Boxes: Gifts Intended to Educate New Parents About Safe Sleeping

A Gift for Every New N.J. Parent

When I had my first child in New Jersey more than a decade ago, the hospital sent me home with a bag of product samples, including a few diapers, a package of wipes, two cans of formula, and an assortment of coupons. These items were helpful to varying extents—I was breastfeeding and unlikely to buy the products featured on the coupons, but the wipes and diapers certainly came in handy. So did the little hat a nurse put on my son’s head soon after birth. With its horizontal pink and blue stripes, this soft beanie that actually stayed in place was ever present during his first few weeks. It was the most useful and well-loved relic of our hospital stay.

The parents of infants in New Jersey are now given an even more practical item, one that also has the potential to reduce infant mortality rates: a baby box. This laminated, nontoxic cardboard box is packed with items that are essential during the early days of parenthood—including diapers, wipes, clothing, and breast pads—but it’s also a bed. The box, which includes a mattress and sheet, provides a safe place for infants to sleep during their first year. It’s free to all new and expectant parents in the state who watch a 20-minute educational video and take a quiz online. Upon completion, they receive a certificate that allows them to pick up the box at a local distribution center or order it by mail.

2017-02-24T09:44:54+00:00 February 24th, 2017|Nursing, Public health|0 Comments

An Oncology Nurse’s Perspective on the Health Insurance Situation

Money Bag/ by Julianna Paradisi/ all rights reserved

Costly Care

I was an oncology infusion nurse in a hospital-based ambulatory center for a number of years, many of them before the Affordable Care Act (ACA) was signed into law in 2010. Besides administering chemotherapy and blood products, I infused medications to patients with sickle cell anemia as well as chronic autoimmune disorders such as rheumatoid arthritis, lupus, and Crohn’s disease.

The common denominator among these diseases is the high cost of the medications used to treat them, at the time ranging from $3,000 to $10,000 per treatment. I know, because patients told me, their nurse.

I also know because uninsured patients were required to fill out paperwork declaring their lack of income, prior to receiving authorization for charitable treatment. If they were sick enough, they were admitted to the hospital for initial treatment, at more expense than outpatient infusion, until the paperwork was completed and approved.

These were particularly difficult times to be an infusion nurse.

Some patients lost their jobs during cancer treatment, because the cost of their cancer care increased their employer’s insurance coverage risk pool rates.

Other patients worked night shift before arriving, sleepless, for chemotherapy as soon as we opened in the morning. They couldn’t afford to lose their health […]

2017-02-22T14:53:49+00:00 February 22nd, 2017|health care policy, Nursing, Public health|1 Comment

The Role of Prevention and Standardized Care in Improving CKD Outcomes

Slowing Chronic Kidney Disease Progression

Most nurses have worked with patients with chronic kidney disease (CKD). Their condition may have been related to diabetes, high blood pressure, an acute infection, or other assaults on the kidney. I’ve tended to see a diagnosis of CKD as the beginning of an inevitable decline. Certainly, “prevention” didn’t seem a relevant concept at this point; my role was to assess and monitor, teach and support, and hope for the best.

Fig. 1. The Nephron. Blood flows into the nephron through the glomerulus. Filtrate from the glomerulus flows into Bowman’s capsule, then through the proximal tubule, the loop of Henle, and the distal tubule, a series of tubules that modifies the filtrate primarily by reabsorbing water and needed electrolytes into the bloodstream. The modified filtrate (urine) then flows into the collecting duct and eventually drains into the renal pelvis. Courtesy of National Kidney Disease Education Program and the NIDDK.

However, the authors of the February CE feature, “Improving Outcomes for Patients with Chronic Kidney Disease,” make it clear that many of us (nurses as well as physicians) aren’t up to date about what we can do to slow the progression of CKD. As authors Norton et al. note:

“The greatest opportunities to reduce the impact of CKD […]

2017-03-14T12:02:17+00:00 February 15th, 2017|Nursing, Public health|0 Comments