I love the Internet. It has a way of bringing people closer together. I saw Governor Howard Dean at a town hall meeting in Washington D.C earlier this month. He’s a dynamic speaker. I wanted to ask him some questions, but the place was packed, so I couldn’t get close to him. Not to be deterred, I emailed Governor Dean in hopes of getting a response to a couple of my questions. He not only responded to my email, he agreed to an interview for my blog. See, the Internet really can bring people closer together. I want to thank Governor Dean for stopping by Nurse Ratched’s Place to talk about healthcare reform.
Question: What is your take on the state of our healthcare system? What do you envision for our system, and how do we get there from here? Can America really afford a public option plan?
Answer: Our system is in disarray. We need a system in which the American consumer has real choices, including allowing people under 65 to sign up for Medicare, which is what the public option will look like. That way people can get affordable insurance which can never be taken away, which can’t be denied, and which will follow them through every job, every loss of job, and every move. We can’t afford NOT to have a public option.
Question: How flexible is the public option: will a person be able to move between the public option and private options as their needs and circumstances change?
Answer: People will be able to move back and forth between the public option and private insurance plans as they see fit, up to once a year.
Question: Given your unique perspective as a physician, can you tell us one aspect of the public option that you like and one aspect that you might not be happy with?
Answer: As a physician I would sign up for the public option at once if it is cheaper than what I have now. I would definitely sign my twenty something kids up; it would give them insurance for life at a reasonable cost no matter what they were doing and where they were living.
Question: One of my nursing coworkers wanted me to ask you this question. How will healthcare reform impact nursing workforce issues? Will we see mandated caps on salaries, and how will healthcare reform impact nurse to patient ratios?
Answer: Workforce issues are not addressed in any of the health care options being discussed in Congress. Most Democrats I know favor nurse/patient staff ratios to protect quality of care.
Question: Preventative healthcare is a key component in the healthcare reform debate. What are your thoughts on a proposal that would make the Chief Nurse Officer of the United States Public Health Service the National Nurse? In your opinion, would establishing the Office of the National Nurse have any impact on health promotion or on healthcare reform?
Answer: As a lot of people know, I am a huge supporter of the Office of National Nurse, and since Congress has been slow to act, I am hoping some changes can be made directly by HHS while we await more complete action by Congress.
“The doctor will see you now.” I’m hoping to hear those golden words soon because I’m sitting in my primary care physician’s office on my day off from work. I’m lucky that I have a primary care physician who is still taking new patients. Did you know that a lot of primary care doctors are struggling to keep their doors open? That was just one of the issues that healthcare bloggers were talking about last week in Washington, D.C.
I was honored to receive an invitation to serve as the official Twitter Reporter for Better Health’s Putting Patients First event. The summit on healthcare reform took place last week at the National Press Club in Washington, D.C. I sat under the Twitter Gallery sign (pictured above) during the conference. The experience was amazing, but I’d like to make two suggestions to the management of the National Press Club. First, please install more electric wall sockets in your building. There were no wall sockets to plug my computer into during the conference, so my battery almost went dead while I was tweeting. Next, please have Anderson Cooper onsite when I’m in the building. He’s hot.
I was happy to finally get to meet the people behind the blogs that I read everyday. I met Kim from Emergiblog, Dr. Wes, DrRich, Dr.Rob, Dr.Kevin, and Better Health contributors Dr. Alan Dappen, Valerie Tinley, NP and Dr. James Herndon. I sat in the Twitter Gallery with Kerri Morrone Sparling from Six Until Me , Dr. Edwin Leap, and Evan Falchuk from See First Blog. I also got to meet Lisa Emrich from Brass and Ivory, and Duncan Cross. I think Kim was a knockout in her new Calvin Klein suit. Note to Fox News: You need to hire Kim as one of your Sunday morning talking heads. She has a lot of good ideas about healthcare reform and she looked right at home at the National Press Club. She also comes complete with her own professional wardrobe.
Every blogger expressed their personal viewpoint about healthcare reform at the conference. The bloggers were not told what to say, and I was not told what to tweet, or what comments to make before, during, or after the conference. We came to D.C. to add our voices to the healthcare debate. No, I didn’t agree with everything that I heard during the conference. I thought a lot of the information presented by the keynote speakers was bunk. I’m in favor of a public option healthcare reform bill, and I don’t like the disinformation being spread via partisan politics about this important issue. I get infuriated when members of Congress from both sides of the aisle play partisan politics while my patients languish in a healthcare system that’s literally killing them. I’m really very frustrated, and I’m just like everyone else in this country that wants to give our politicians a good swift kick in the butt. What gives me hope is seeing good people from both sides of this debate coming together at a healthcare blogger conference in Washington, D.C. Healthcare providers truly want to put patients first.
My apologies to James Carville. I plagiarized his tagline because the insurance industry has forgotten about sick people during our national healthcare debate. I remember when nurses and insurance companies use to get along with each other. Back in the 1960s, these nurses even took time out of their busy schedules to pose for one of their ads. We took care of patients at the bedside, and the insurance companies paid the hospital bill. It was as simple as that, but then things started to change. It began with three little letters—HMO.
Insurance companies are spending a lot of time and money trying to scare people into opposing President Barack Obama’s ideas on health care reform. They are especially working hard to torpedo the public option plan. That plan would allow you to keep your own private health insurance policy or buy affordable health insurance through a public plan. Insurers are going all out to make you hate this idea by making claims that aren’t true. They are saying that the government is going to ration health care by dictating which doctor you can see, and by making you wait weeks to see a specialist. Ironic isn’t it? The insurance industry is already doing these things to patients everyday via their HMOs. We wouldn’t even be having this debate if they were playing fair in the first place.
Insurance companies make their money a couple of different ways. They rack in the bucks by not insuring people who are sick, a practice known as cherry picking, and by not paying out claims. They also make money by cutting out competition. This is the real reason why insurers are trying to muscle Uncle Sam out of the insurance business. Medicare administrative costs are equal to about 2 percent of what it pays out to providers. For private insurers the ratio over expenses to payments is typically over 15 percent. Why the big difference? Insurance companies have high overhead. Their CEOs take home mega-million dollar paychecks, they have to take care of their shareholders, and they have to pay for fancy ads that convince consumers that they will have health coverage when they really need it. They need those fancy ads. Insurance companies are always looking for ways to deny our claims, but I digress. Competition between private companies and a public plan would hit insurance companies right where it hurts—in their wallets. Fewer customers in private plans means less profits, and less profits, up to 20 to 30 percent by some estimates, means fewer martini lunches for those at the top of the corporate food chain. To make matters worse, those greedy folks who make money by NOT paying for care would have to lower their profit margin on the customers they do keep in order to compete with the government.
I’ll never forget the day that I learned about HMOs. I came into work and found red dots on the side of a few patient charts. My head nurse told me that the dots were put there to prompt doctors to discharge patients as soon as possible so that the hospital and the insurance company could make more money. That was twenty-five years ago and the system has been in freefall ever since. Year after year, nurses are voted as the most trusted profession in America in Gallup’s annual survey of professions for their honesty and ethical standards. We are patient advocates, and we never put anything above what’s best for our patients. That’s why I’m putting my seal of approval on President Obama’s public health insurance plan, and so are the American Nurses Association (ANA) and the SEIU. The insurance companies want your money. Nurses want to take care of their patients. We want all Americans to have affordable, high-quality healthcare.
Like most of you, I’m continuing to watch the events unfold in Iran via Twitter and YouTube. Not surprisingly, given the escalating violence, doctors and nurses are caught in the crossfire. This video was posted on YouTube on June 16th. One woman who I’m guessing is a nurse is showing a sign that says that 8 people were martyred. Toward the end of the clip the young man (whose voice breaks down many times) is saying that he witnessed the brutal beating of women and children. He speculates that the attackers were Lebanese Hezbollah. Hat tip to Andrew Sullivan, The Daily Dish.
This story really upset me because I work with medical students at UGH (Undisclosed Government Hospital), and because I have children who are the same age as these victims. The eye witnesses reports come from medical students who hid when Iranian militia and police raided a Tehran University dormitory in the middle of the night. Hat tip to Nico Pitney of the Huffington Post. As we witness history, we will continue to witness the murder of innocent people.
“At the same time, Iran’s Interior Ministry ordered a probe into an attack late Sunday night on Tehran University students in a dormitory reported to have left several students dead and many more injured or arrested. Students say it was carried out by Islamic militia and police. Iran’s English-language Press TV said the ministry urged Tehran’s governor’s office to identify those involved. Iran’s influential speaker of parliament, Ali Larijani, condemned the attack.
Students’ Web sites reported mass resignations by Tehran University professors outraged over the incident. One medical student said he and his roommate blocked their door with furniture and hid in the closet when they heard the militia’s motorcycles approaching. He heard the militia breaking down doors, and then screams of anguish as students were dragged from their beds and beaten violently.
When he came out after the militia had left, friends and classmates lay unconscious in dorm rooms and hallways, many with chest wounds from being stabbed or bloody faces from blows to their heads, he said. The staff of the hospital where the wounded students were taken, Hazrat Rasoul Hospital, was so shocked that they went on strike for two hours, standing silently outside the gate in their white medical uniforms.”
Do you remember this person? She is a bedside nurse. She walks up and down hospital hallways in her white nursing shoes all day long while caring for her patients. She is trained for active duty. I’m asking you this question because nursing researchers have had an epiphany. They believe that they have discovered something new in the field of bedside nursing.
Over the years I’ve observed that the more degrees and letters that a lot of academic nurses get behind their name, the more out of touch they become with bedside nursing. This came to light once again when I attended a mandatory inservice at work. I was told that we were going to talk about an innovative concept that was going to revolutionize patient care and the nursing profession. Imagine my surprise when the speaker talked about hourly rounds. Did you know that nursing researchers have discovered that patients are happiest when their nurses spend time with them at the bedside every hour, and anticipate their needs? Wow, what a concept. Academic nurses living in the ivory tower of higher learning have discovered through years of painstaking research that patients also want nurses to answer their call light promptly when they need help getting to the bathroom. Holy cow! Hourly rounds decreases the amount of time patients spend using their call lights, decreases injuries due to patient falls, and increases patient satisfaction while they are in the hospital.
Did I miss something? I remember learning all this stuff years ago when I was attending a lowly diploma nursing program. We were always walking up and down the halls in our nursing shoes. No one conducted studies on how to make patients happy back then. A little common sense goes a long ways. The formula to good patient care starts with clean bed sheets and a filled water pitcher, and ends with a connection to your patient. That’s not new. That’s nursing.
It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…
I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…
I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…
When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…
I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…
I love the Internet. It has a way of bringing people closer together. I saw Governor Howard Dean at a town hall meeting in Washington D.C earlier this month. He’s a dynamic speaker. I wanted to ask him some questions, but the place was packed, so I couldn’t get close to him. Not to be deterred, I emailed Governor Dean in hopes of getting a response to a couple of my questions. He not only responded to my email, he agreed to an interview for my blog. See, the Internet really can bring people closer together. I want to thank Governor Dean for stopping by Nurse Ratched’s Place to talk about healthcare reform.
