The Power of No

. . . . 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, […]

Notes from the Web

Here are a few items of interest on today’s Web as these huge wet snowflakes actually start to accumulate on rooftops here in NYC and the horizon (New Jersey, that is, across the thin wedge of the Hudson River you can see from AJN offices) closes steadily in:

Kim at Emergiblog has a nice post dealing with changing her mind about whether or not she wanted to get a BSN.

And this post by Anne Dabrow Woods at In the Round (excerpted below) got our attention for its honesty about the difference between treating a condition in the hospital and treating it at home in a family member—and also because it put a human face on an article we ran in our February issue about ostomy complications and management.

My oldest daughter was diagnosed with ulcerative colitis when she was 7 years old and despite aggressive treatment for her disease; she required a total colectomy, temporary ileostomy, and an ileo-anal anastamosis when she was 12. As a nurse I thought I was equipped to care for her ileostomy; was I ever wrong. I had experience taking care of hospitalized patients with ostomies, but I quickly learned caring for someone who is active is a totally different story.

In his most recent post, Anonymous Doc is as usual thoughtful and honest (except for that anonymity thing, of course . . . which does, whatever its drawbacks, kind of free him up as a writer). He moves from […]

If Health Care Reform Were an ICU Patient . . .

The idea that the Health Care Reform bill is on life support is disappointing, but not surprising. It was admitted in a weakened state of health. It appears suspiciously a victim of domestic violence by special interest groups. The bruises on its body resemble the outline of handprints of the insurance companies it was created to protect our citizens from.

So writes nurse-artist-blogger JParadisi RN in a recent post, which (whatever your beliefs about whether we should do something major soon about the increasing numbers of uninsured Americans and the skyrocketing costs of health care) has particular resonance as President Obama prepares to address the nation tonight about this and other issues.


(Full disclosure: Paradisi’s artwork appeared on the October 2009 cover of AJN.)

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Gallup Poll: Power Elite Believes Nurses Should Have More Say in Policy, Management

Shawn Kennedy, MA, RN, AJN interim editor-in-chief

Last week I attended a press conference in Washington, D.C., where the Robert Wood Johnson Foundation (RWJF) released a Gallup poll it had commissioned to find out what 1,500 opinion leaders (or as Gallup editor-in-chief Frank Newport put it, “the people who run things in this country”) think about nursing leadership and nurses’ influence on health care reform. 

It’s no surprise that most (69%) see nurses as having little influence on health reform. Nurses ranked at the very bottom—immediately below patients, who were below physicians in the rankings. Mary Naylor, an innovative leader from the University of Pennsylvania and part of a reaction panel, hit the nail on the head: “Everyone should be concerned that the largest group of health care providers and the consumers are the least influential.” (Those seen as having the greatest influence are government officials and insurance executives—no surprise there, either.)

In identifying what impedes nurses’ ability to be in leadership roles, here’s how the opinion leaders weighed-in:

And You Thought PE Was Another Name for Gym Class

By Jacob Molyneux, senior editor

The template goes something like this: Start with a legitimate quality-of-life issue — like fitful sleep or shyness — that does not yet have its own prescription medication and is debilitating to a few people a lot of the time. Next, position the quality-of-life issue as a medical condition with symptoms so common it covers vast numbers of people who had previously not identified themselves as having a health problem, or who thought they were just experiencing an occasional and normal annoyance.

According to the rest of this article in the NY Times, the latest disorder about to enter our dictionary of accepted medical conditions is premature ejaculation (PE). Several companies are developing treatments in the form of pills or aerosol sprays. The net of nonspecific symptoms seems to have been cast fairly wide—a representative of one drug company is quoted as saying that one in three men have this condition. 

Celebrities may soon be confessing that the anxiety occasioned by PE has led to ruined marriages, depression, drug use, and even the use of prostitutes. The ironies of the media campaign to push the term PE into our medical lexicon are worth considering as our legislators debate health care reform provisions and the crisis of rising costs. Medical bankruptcy is on the rise. Many cannot afford medications they need for serious conditions like heart disease and diabetes.

It may be premature to suggest it, but it seems likely the pharmaceutical companies expect health care reform legislation […]

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