NEW YORK NURSE: May 2009
by Nancy Webber
Has the time for healthcare reform finally arrived?
Reform proposals are being discussed in Washington and legislation is expected to be introduced later this year. There seems to be agreement that something must be done about the way health care is funded in the United States.
But proponents of a single-payer national health plan are finding it difficult to be heard.
Single-payer supporters at first were not invited to a March forum on healthcare reform hosted by President Barack Obama at the White House. Two individuals did attend the event after they raised an outcry in the press.
Congressional leaders have been blunt about their opposition. House Speaker Nancy Pelosi recently told a group of reporters, “As our members came back from their recess, a great deal of what they heard out there was public options. In our caucus, over and over again, we hear single-payer, single-payer, single-payer. Well, it’s not going to be a single-payer.”
In a February 2009 New York Times/CBS poll of American taxpayers, 59% said the government should provide national health insurance. “The public increasingly wants a national health plan. While it is clear that a single-payer system saves the most money, the government seems determined not to consider it,” said Karen Ballard, NYSNA president-elect.
A single-payer national health plan is often described as “Medicare for all.” With the successful Medicare program as a model, the government would fund and administer a health insurance plan for all Americans.
Contrary to statements made by for-profit health insurers and their supporters, a single-payer plan is not “nationalized medicine” or “socialized medicine.” Patients would choose their providers, as they do now.
Legislation to create a national health plan (H.R.676) has 72 co-sponsors in Congress. It has been endorsed by more than 520 state and local unions, including NYSNA. A similar bill (S703) has been introduced in the U.S. Senate.
H.R.676 calls for a modest increase in personal income tax and employer payroll taxes. For individuals, the tax would be offset by the elimination of co-pays, deductibles, and other out-of-pocket expenses. Employers would realize savings from no longer having to pay high premium costs for employer-based health coverage.
The reform proposals receiving the most support in Washington involve offering public insurance as an option, in addition to the private plans. This would be similar to conventional Medicare, but it would compete with private insurance plans. There is concern that this will not fix the patchwork system we have now and might make it worse.
“A public plan option could work only if everyone is automatically enrolled,” said Ballard. “Individuals would have to opt out if they preferred a private plan. It also would have to include those 55 and over and provide comprehensive coverage for children/young adults up to age 25.”
Any system based on a combination of public and private insurance plans must address the problem that more than 30% of each dollar spent on health care in the U.S. covers administrative costs, twice the percentage of countries with national health plans.
“A government-supported national health plan would make a major difference in the way nursing is practiced,” said Ballard. “It would remove many obstacles to quality nursing care that we have almost come to accept as normal.” Some examples:
Emergency room visits would decline, allowing practitioners to focus on genuine emergencies.
Universal preventive care would eventually reduce hospital admittance rates and have an impact on chronic understaffing.
Patients’ length of stay would be appropriate to their medical condition rather than dictated by their insurance plan.
Community follow-up would be covered for everyone, reducing the currently high rate of rehospitalization.
Complementary and alternative therapies would be more readily available; many of which are provided by nurses – massage, biofeedback, hypnosis, acupressure, aromatherapy, guided imagery, meditation, relaxation and therapeutic touch/healing touch.
While single-payer health coverage is being discussed at the national level, some states are considering healthcare reform within their own borders.
On May 5, Assemblyman Richard N. Gottfried and State Senator Thomas Duane announced the introduction of New York Health Plus (A7854/S4884). The bill is supported by NYSNA.
New York Health Plus builds on the Family Health Plus and Child Health Plus programs to provide a full benefit package that is more comprehensive than most commercial health insurance programs. All New Yorkers would be eligible, regardless of income. Individuals would choose from among participating health plans, as they do now under Family Health Plus and Child Health Plus.
Can New York implement such a plan on its own? Supporters say that laws creating workers compensation, senior citizen drug benefits, and Child Health Plus were enacted in New York long before they were adopted at the national level. Expansion of Family Health Plus and Child Health Plus would not require changes in federal legislation.
At least 10 states have legislation under consideration this year, including New York. Supporters point to the Canadian experience, where Saskatchewan had single-payer health coverage nearly 20 years before the system was adopted by the nation as a whole.
Starting during Nurses Week, a new feature at nysna.org will give you the tools you need to inform yourself and others about the need for healthcare reform and a single-payer national health plan.
This section will also be updated with events and lobbying activities for reform at both the state and national levels. It won’t take much time to get involved, and your voice will make a difference!