By Diana J. Mason, RN, PhD, editor-in-chief emeritus
Fuzzy cell phone image from West Wing, 9/10/09
I was pleased to represent the American Academy of Nursing yesterday at President Obama’s speech on health care reform to an audience of nurses (including new Administrator of the Health Resources and Services Administration or HRSA, nurse Mary Wakefield) in the West Wing of the White House. His remarks summarized his powerful presentation to Congress and the nation on Wednesday evening, with one exception: he used the word “nurses” in Thursday morning’s speech. In fact, in that follow-up speech, he talked a lot about nurses, noting that nurses know too well the problems with our health care system, see the impact of its failings on the lives of their patients every day, are trusted by the public, and are key to reforming health care.
The President’s speech was introduced by Rebecca Patton, president of the American Nurses Association (ANA). He spoke about his own family’s experiences with health care and the essential work of nurses in helping his family members come into this world, leave it gently, and cope with illness. He then summarized some of the major points of the plan he laid out on Wednesday night:
• People won’t have to worry about being dropped from their health insurance plans if they become ill.
• His plan would not force people or employers to change their coverage or choice of physician (and I hope he soon learns that this language should be “provider,” since many of us get our health care from a range of health care providers who may or may not be physicians).
• His plan would forbid insurers from dropping you or refusing to cover you because of a preexisting condition, would limit out-of-pocket expenses, and would provide the uninsured and others with access to an insurance exchange that would promote competition and lower costs. (I’m hoping that this exchange would include a public plan option to spur more competition.)
He’s right. Nurses do know the importance of these elements of health care reform. He shared the example of a posting on the New York Times blog by nurse blogger Theresa Brown, about treating an insurance salesman with cancer. He asked for nurses’ help in talking with people about the importance of health care reform. We can help by talking with patients, friends, and families about the importance of actively supporting health care reform now. As the President said, “We aren’t the first to take up this course, but we’re going to be the last.”
Like several others on this post I do not want another screwed up government run program. Yes, health care need adjustments but not at the expense of everything else. It matters not about how much money one has because who ever makes the least is poor… so it is all a relative issue. The proposed reforms are not the needed ones, as we all know politicians seldom have any clue what the world around them is doing and this is no different!
Many of you setting in your political action committees are right there with them, as you haven’t performed bedside care for years. You are but a few who profess to speak for all and you are wrong! This is NOT utopia as much as we would all like it to be. Got real people and stop selling a bill of goods.
Many of us have seen that major illnesses and conditions strike people every day. It haws ever been thus. This bill will not ease suffering or make care any more accessible than it already is. It will mandate higher costs, lower quality of care and will begin to ration care. Already scarce hospital beds will be in even greater shortage. Adding 50 million more patients to insurance rolls will not accomplish anything in the way of reform.
The reforms that are needed are much more fundamental than that. In home health we teach patients to be independent and manage their own disease or condition. WE need to start allowing people to start their own health savings accounts that are funded with pre-tax dollars.
We need tort reform, many nurses will not come back to the practice of nursing with out it. A grave yard shift nurse on a med surg floor should not have to carry 16-20 patients and many will refuse to do that and with good reason. With liability issues limited maybe health care costs can come down.
The last obstacle is to get government out of health care. The government is the main driver of health care costs. Between competing for health care services and insurance mandates, the cost of insurance and treatment has become very expensive, even with people you would consider will off.
The House BILL HR3200 is 11-1300 pages long and much of what is said by the administration is incorrect. Yes, you will be driven to the Public option, or fined if you do not have “adequate coverage”. Yes we do need some health care reform and the biggest reform would be to get government out of health care.
Use your critical reasoning skills and truely look at our health care system and see if HR3200 is really an improvement. I think you will find it is not.
As a nurse I want what is best for my clients, but they are the final arbiters of what is best for them at the time. AS nurses we know that many people will not hear or take our advice, that is not our problem. Many maladies afflict us and it will ever be thus, and no law, or good intention can change that.
http://well.blogs.nytimes.com/2009/09/16/nurse-brown-goes-to-washington/
Please read Theresa Brown’s latest post. She is a nurse to be proud of and I agree with her!
“Every day nurses see just how inhumane disease and illness can be, and we all hope for a more humane system of health insurance coverage. The President was smart to come to nurses for support. Making life better for patients in this country — what could be more natural for a nurse?”
I’m proud to be a nurse and believe that we, as a profession have a view of this issue that others do not. Let’s keep open minds and hearts so we can help in the reform process that is coming and so very needed.
Becky,
You are so right on. I am hearing this from people every day. He who walks on water doesn’t care about the American people. He is a narcissist and he is going to ruin this country!
[EDITOR’S NOTE: This kind of ominous and vague ad hominem insult of an elected official from either party is both nonsensical and inappropriate. Also inappropriate are comments insulting others who have written posts or comments. This is a forum in which we invite people to feel safe to engage each other’s ideas, not to fall back on insults and known untruths that degrade us all as they reduce the value of language, fact, and the possibility of the meaningful exchange of ideas. Whatever our beliefs, fears, hopes, doubts, questions, frustrations, it is time to begin acting like adults when we talk to each other. We depend on and value the exchange of contrary ideas among respectful and even passionate equals; unfortunately, this is not what we have seen in several highly inappropriate comments we’ve had to delete on this thread. No one has all the answers, but solutions do not come out of fear, hatred, intimidation, or rhetorical strategies based on deliberate use of known lies and the invocation of words like “communist,” “fascist,” “socialist,” “narcissist,” and various other words that have actual and very specific meanings with little to do with the way they are being used.]
Insurance Company run health care is not working either. Too much money and time wasted for paperwork, preapprovals etc. We do need preventative initiatives. Cut Medicaid Medicare fraud. Some Dr’s here in Fl are real crooks. We need to get this done step by step. If something doesn’t work, fix or fine tune it. Consumers need to get more pro-active with their health. Dr Oz has a good new television show that encourages this. PS, I can’t talk, didn’t go for my walk today. As for addictions in this country??? What a tradgedy!!!
The most recent evolution of the Baucus Bill coutesy of the Associated Press.
http://www.newser.com/article/d9an1r280/baucus-health-care-plan-raises-plenty-of-concerns-despite-major-concessions-to-industry.html
To the writer above, universal health care was not a tenet I subscribed to when deciding on my chosen profession. I am first and foremost, an American, not a socialist.
We should be proud as nurses that the President made an effort to speak directly to us about issues that we understand. Too many folks, including writers on this blog, are stuck on one aspect of the proposed plans (of which there are now two, and a third to be submitted by the Senate Finance Committee). The public option was proposed as a way to create competition in the private marketplace for those folks at a low income level, unable to purchase private insurance. However it is not likely to be in a final bill.
Senator Baucus today announced the Senate Finance Committee’s plan which will instead have a not-for-private cooperative to compete with private insurers.
More importantly all the plans provide that most Americans will have access to health care. Right now only those on Medicare, veterans, active military and Native Americans have such a right. And as nurses, the moral principle that has formed the basis for all of our advocacy efforts around health reform, has been to have a system of universal health care. This will be the first time in America, that this will occur.
Judith K. Leavitt, MEd, RN, FAAN
This health care reform bill is nothing more than a power grab for upwards of 17% of our nation’s GDP. As to what’s in the bill, it’s true, if anything at all changes in your private insurance you get automatically flipped to the public option. Please READ IT for yourself if you can understand it.
Did you know that neither the TARP bill nor the health care reform bill were written by general members of the House? Do you wonder why no one seems to have read the bill or if they have read it, they don’t understand it. It was written by attorneys who buried the language in such sophisticated legalese, no one but a high functioning attorney can understand it.
The reason Joe Wilson declared that the President was lying is because he was. Do Americans know anything at all about our current president, read his books? understand his upbringing and ideology?
Many of the appointed czars are self avowed communists. But, I digress.
Read the health care bill and the two separate amendments proposed by House Republicans to give enforcement capabilities to the bill. The first was for language stating abortions would not be funded by tax payer dollars and the second was an amendment enforcing verification of people receiving care under the plan were legal citizens, both were soundly defeated by the Democratic majority and the president knew this. How is it that socialism, communism, and marxism were real when our men fought and died to keep it at bay in other countries and our own citizens do not recognize it when it comes home to roost? Ask yourself why big labor (unions) are exempt and why Congress is exempt.
I dont care if people think I’m an alarmist because I know something many others don’t know, I knew before the election where Barak Obama would lead this country. When one considers the government is daily spending twice as much money as it takes in, that it wishes to cripple us with Cap and Trade, and then insure the health care needs of every person in this country, legal or not, and then claim it will be deficit neutral … a rational thinking person might conclude we’ve been duped.
The words of Ronald Reagan are more relevant today than ever. If you appeal to people for basic human compassion for others, they will be reluctant to say no. It’s a great and wonderful socialist tool. Please I appeal to you, don’t be duped.
http://www.usatoday.com/news/health/2009-09-09-saving-money-hospitals_N.htm
For those of you that are overwhelmed by the idea of cutting waste to meet savings goals. If hospital CEO’s feel they are up to the challenge then let’s encourage them. Please read the article.
The same principals can be applied to many processes in our healthcare system, including Medicare and Medicaid, with great success!
Let’s think positive and work together.
Also, that YouTube video is in reponse to one of the early bills introduced. Here is the most recent bill. I encourage everyone to read it.
http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf
There is already tremendous waste in both the Medicare and the Medicaid programs currently managed by the federal government. Why do they think they can possible manage healthcare for all. Without rationing or major tax increases, the price would be enormous. We have too much government involvment in our lives and we need LESS!
I agree with Diana. Here is the current bill just introduced. Before making any decisions to fear it, read it!
http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf
A majority of physicians support some type of public option as noted in a recent survey (http://www.rwjf.org/healthreform/product.jsp?id=48408).
Another survey noted that physicians ranked Medicare highly among other payors on many key points (http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/heal-claims-process/national-health-insurer-report-card.shtml). I read a negative comment about the first survey, saying “docs just want to get paid.”
I for one, like to get paid fairly for my services- don’t you?
If we nurse’s weekly pay was based on what the patients we cared for actually reimbursed the hospital that week we would be up in arms for change!! Truly, no one would take the job.
I’m tired of people saying how “terrible” government run healthcare is when our seniors on Medicare are the ones fighting to keep it! If it were so bad, I would expect them to happily exchange it. You can argue that the elderly are fearful of change, which is true on some levels, but even the ones toting anti-ObamaCare signs chant, “leave my Medicare alone!”
Our healthcare system is broken. Let’s all pitch in and help fix it instead of fearing the change that must come.
I totally agree barbara, to read is a very good thing!
Wow! These comments are disturbing. They demonstrate a superficial understanding of the health care system, a misinterpretation of the public option that is being discussed, and a reflexive lock step with Fox News. Maybe watch PBS or C-Span once in a while? Maybe read instead of watch TV? Really, this is depressing.
I encourage all to actually read the current bill. Don’t believe what the administration or Congress says- believe what they write. If you like your plan-you can keep it-WRONG, the current bill specifies that should anything about your plan change you will be placed on the public option-that is not choice, but a government mandate over what should be your private decision. Please, read the bill and let your Congressional representative hear from you.
For those who believe that government can’t do a good job of providing health care, look beyone the rhetoric at the facts:
1. The government would not be running health care. It would be ensuring that people have access to health care coverage. This can be private or a public plan, if that makes it into the legislation in the Senate. Remember, the president and Congress already have what is being proposed by the president for the nation. They have a choice of health plans and are well covered. That’s what health care reform will do for the nation.
2. The government had done a stellar job of actually running health care. Look at what is provided by the military–all branches. And the VA health system has been leading the way on electronic health records and standards of care.
3. If you’re a nurse or a physician or have had health care in recent years, you know that the system is broken. Care is not safe. Outcomes are not what they ought to be. Promoting health and wellness is not a priority (acute care is). And most health care providers would insist on having frank end-of-life discussions when it’s their turn to face life’s last transition.
So move beyond the rhetoric and look at the facts. We might disagree on how to get there, but the federal government must lead the effort to reform health care in this country.
Government has become too large and self-serving. The current Congress and administration are seeking total control and involvement in every aspect of our lives and this must stop. I have traveled to most major healthcare centers in the United States and I have seen people from literally all over the world come here specifically for our healthcare, because it is the best. We can streamline inefficienices. The most effective way government can help the healthcare system is to bring about tort reform.
Before we allow Congress and this administration to touch our healthcare system, the best in the world, tell them to streamline themselves and cut the waste they have created first!
I agree with much that is written above. If we go with a government plan, then based on our Constitiution ALL will be covered, including those not hear legally. But I also can not help but wonder if they are even considering looking into all the changes that we face that make us take time away from the bedside to complie with other government run regulations. The days of old fashion nursing care have gone away, I for one miss them!
Representative Mike Rogers of the 8th Congressional District presents arguments against a public option.
There are ways to fix this that are more effective and less radical. Destroying the 85% that have earned health care for the 15% who do not is madness. There are other options to reform that need to be heard. Please view the video and hear a review by an elected official who has read the bill. American citizens who know the Constitution know that we remain free only when we limit the size of government. Ask yourself what level of privacy the HIPAA laws will provide when the government has all your health records.
http://www.youtube.com/watch?v=G44NCvNDLfc
As a disease management health educator I understand the importance and hurdles of teaching people how to handle their already existing chronic conditions and preventing further costly complications. It is my experience that most individuals do not take a proactive part in learning and managing their disease. I talk to these people daily and most of them can not tell me their medications, blood pressure, lab results, etc. They rely on their health care provider to “take care of them”. I do not know of a doctor that has the time it take to manage or teach these people how to take monitor and control their condition. We don’t have time to hold your hands. We have paperwork, mandated goals, people to see and bills to pay. The American people need to wake up and take better care of themselves!! It’s our health, our life, our taxes, our co-pays, our insurance premiums! It needs to be OUR individual effort as well. Health care providers are trained to offer a service to people. If the people do not accept it than they are at fault if there health fails. They need to pay the consequences. Obesity, smoking, drug and alcohol abuses are draining our health care system. That’s were the change needs to occur. It’s the people, not just the system. The system has developed because of the people. Take a deeper look Washington!!
I just can’t understand how he will fund a new government program with the savings from eliminating “waste” from another government program. If medicare is that bad why can’t we just fix it?
Hooray for nurses! We can become a force like no other within healthcare and assist in this needed transformation. As nurses let’s focus on what we do best and bring that to the table. I didn’t hear the president talk about the government “running” anything the other night. I heard about an option for low cost, non-profit insurance that is covered by it’s members- only for those without insurance. I heard a focus on promoting the things we already are doing well and expanding these ideas. I heard a call to action, and I for one, am ready to help in whatever way I can. Our president encouraged personal responsibility. This is truly the key to success in this endeavor. I personally don’t have a big problem with government putting some checks in place to help promote responsibility. Just like wearing a seatbelt, which is proven to save lives and minimize injury, had to be mandated by law to engage the public; so will mandating that everyone carry some type of health insurance. It is sad that it takes laws to do this but if someone has another idea, give it to our leaders. I heard someone mention- “the door is open!”
Reform is needed as a nurse I see this, but not the government run anything. HELP those that need it and leave the rest alone and try to fix what we have running by limiting lawsuits and high costs. Teach patients to be cooperative in their care and to LISTEN and do what the doctors order and Nurses TEACH. A lot of patients are non-compliant and need to be compliant! STOP SMOKING even if you have cancer, why get treatment if you don’t stop the cause??? It’s not a good thing! We waste money and time and paitents don’t follow through!!!