i suffer no illusions that this will be an easy process. it will be hard. but i also know that nearly a century after teddy roosevelt first called for reform, the cost of our health care has weighed down our economy and the conscience of our nation long enough. so let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year."
the president's american recovery and reinvestment act protects health coverage for 7 million americans who lose their jobs through a 65 percent cobra subsidy to make coverage affordable.
the recovery act also invests $19 billion in computerized medical records that will help to reduce costs and improve quality while ensuring patients' privacy.
$1 billion for prevention and wellness to improve america's health and help to reduce health care costs;
$1.1 billion for research to give doctors tools to make the best treatment decisions for their patients by providing objective information on the relative benefits of treatments; and
$500 million for health workforce to help train the next generation of doctors and nurses.
guiding principles
president obama is committed to working with congress to pass comprehensive health reform in his first year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all americans.
comprehensive health care reform can no longer wait. rapidly escalating health care costs are crushing family, business, and government budgets. employer-sponsored health insurance premiums have doubled in the last 9 years, a rate 3 times faster than cumulative wage increases. this forces families to sit around the kitchen table to make impossible choices between paying rent or paying health premiums. given all that we spend on health care, american families should not be presented with that choice. the united states spent approximately $2.2 trillion on health care in 2007, or $7,421 per person - nearly twice the average of other developed nations. americans spend more on health care than on housing or food. if rapid health cost growth persists, the congressional budget office estimates that by 2025, one out of every four dollars in our national economy will be tied up in the health system. this growing burden will limit other investments and priorities that are needed to grow our economy. rising health care costs also affect our economic competitiveness in the global economy, as american companies compete against companies in other countries that have dramatically lower health care costs.
the president has vowed that the health reform process will be different in his administration - an open, inclusive, and transparent process where all ideas are encouraged and all parties work together to find a solution to the health care crisis. working together with members of congress, doctors and hospitals, businesses and unions, and other key health care stakeholders, the president is committed to making sure we finally enact comprehensive health care reform.
the administration believes that comprehensive health reform should:
reduce long-term growth of health care costs for businesses and government
protect families from bankruptcy or debt because of health care costs
guarantee choice of doctors and health plans
invest in prevention and wellness
improve patient safety and quality of care
assure affordable, quality health coverage for all americans
maintain coverage when you change or lose your job
end barriers to coverage for people with pre-existing medical conditions
please visit www.healthreform.gov to learn more about the president's commitment to enacting comprehensive health reform this year.
maybe it's me but the word "reform" sparks more anxiety then it does hope for the future. i suppose only time will tell. though i must say i didn't appreciate that our president only included registered nurses in his estimation as "nurses" on the one video i have attached. perhaps i am just being too easily insulted but i worked to become a nurse as well even if that means i'm not a registered nurse. as well such is life...
Hitler and Stalin were great change agents as well. How about Hugo Chavez he has brought tremendous change to his country empty food shelves, shutting down the opposition he too is trying to build the country from the bottom up. This President is a failure and finally the AMerican people are starting to see it. I will entertain the thought of government run health care when Congress and the President give up there health care plans in favor of this one.
"Ignorance the most expensive commodity we pay for in this country" Rush Limbaugh
Like him or not, Barack Obama has done more positive things in the first six months in office than his predecessors did in the eight years prior. OK, so he's rocking the boat a bit for a few of the wealthy, self-contented people who have a thumb in the $$$ pie and don't want anyone messing with it. Insurance companies. Credit card companies. Banks. Hopefully, the "do-as-you-please" era is finally ending. More accountability. But we're spending too much money you say?? We seem to always have enough money for things like wars in Iraq (billions spent), grants for why kids fall of tricycles, "bridges to nowhwhere" in Alaska, but making sure everyone has access to healthcare without going bankrupt??????
Well, I hate to get back on topic, but the only real reform that will matter is a restructuring of the delivery system itself.
SInce we can't agree whether healthcare is a privilege or a right, why not start in the middle and make it a public utility, just like we did in the 1930's with electric power. Many similar issues: distribution, cost control, access.
The current system was designed in the 1940's and 1950's, for the problems then. We have new problems, and we need a new system.
Physicians as employees in the facilities, independent nurse practitioners, true community based healthcare systems, administrative accountability, on and on and on.
Seems these options are not on the table.
We also need a revenue stream to do all this, and I recommend taxing the number one cause of morbidity, junk food and fast food. This tax alone would pull every state out of the red.
I agree. I think the Mayo Clinic's delivery system that is focused on patient outcome, not how many procedures are done, is phenomenal. Physicians are paid a salary and so are not incentivized to rack up unnecessary procedures. The Data also backs this up; Mayo has one of the best statistics in terms of patient health.
I've tried every way I can think of to get this discussion going politically, but it seems no one really wants to listen to the data.
Too many special interests blocking the discussion. Taking on just the payment system is going to create a financial burden that will inevitably begin rationing, or worse yet, force wage controls or something even more drastic.
Too bad our nursing organizations don't really have a vision for healthcare. The AONE just parrots the AHA position, and the ANA can't even afford to have a healthcare summit to issue a white paper (that probably wouldn't get read anyway).
Letting the AHA, AMA, bigpharm, and the suppliers dictate the terms of the reform is like letting the tiger guard your livestock.
I agree. I think the Mayo Clinic's delivery system that is focused on patient outcome, not how many procedures are done, is phenomenal. Physicians are paid a salary and so are not incentivized to rack up unnecessary procedures. The Data also backs this up; Mayo has one of the best statistics in terms of patient health.
Hmmm....very interesting in that the Mayo Clinic doesn't favor Obama's healthcare plan. Maybe they are on to something....
Mayo Clinic's reaction to House Tri-Committee bill
Although there are some positive provisions in the current House Tri-Committee bill - including insurance for all and payment reform demonstration projects - the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.
In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever - a change in Medicare payment policy - to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.
Hmmm....very interesting in that the Mayo Clinic doesn't favor Obama's healthcare plan. Maybe they are on to something....
Mayo Clinic's reaction to House Tri-Committee bill
Although there are some positive provisions in the current House Tri-Committee bill - including insurance for all and payment reform demonstration projects - the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.
In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever - a change in Medicare payment policy - to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.
First of all, you know hes doing something right when no one's totally happy. They're happy about the House's plan to offer Pubic Option - Check.
Second, why don't you check your sources. You just posted someone's opinion on the Mayo Clinic's Public Policy BLOG. This is hardly commentary representative of the Mayo Clinic's Medical System. I mean, did you really think you could just sliiiide this in without me checking this? I at least cite my sources when I "copy & paste." Here...I'll do it for you.
People who oppose healthcare reform do not care about the American in the street. They are representing vested interest. Rush Limbaugh does not have to worry about health care. He is made. Ask joe blow who lost his job and his doctor in one pen stroke.
With one broad stroke, you condemn anyone who questions this "reform". Healthcare "reform" by politicians does not mean they care about the American in the street, either.
Visit the house bill: Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
I don't think I like that very much. NO APPEALS. So, you think "healthcare" is bad now, beware of the fine print of what you are backing.
With one broad stroke, you condemn anyone who questions this "reform". Healthcare "reform" by politicians does not mean they care about the American in the street, either.
Visit the house bill: Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
I don't think I like that very much. NO APPEALS. So, you think "healthcare" is bad now, beware of the fine print of what you are backing.
Specializes in Vents, Telemetry, Home Care, Home infusion.
too bad our nursing organizations don't really have a vision for healthcare. the aone just parrots the aha position, and the ana can't even afford to have a healthcare summit to issue a white paper (that probably wouldn't get read anyway).
guess you missed our 2002 reporting on ana nursing’s agenda for the future
nursing's agenda for the future is the result of an in-depth strategic planning process that involved leaders from 60-plus national nursing organizations. the organizations began their work at the call to the nursing profession summit in september 2001 and collectively developed a plan whereby they identified the profession's vision for the year 2010, and the key strategies to be actualized in the short term to achieve that vision. the plan is organized around 10 key domains, including: leadership and planning, economic value, delivery systems/nursing models, work environment, legislation/regulation/policy, public relations/communication, professional/nursing culture, education, recruitment/retention and diversity.
quality of care is of paramount importance to both patients and nurses. this article examines how the existing patient/nurse partnership is the result of a variety of clinical, political, and organisational power paradigm shifts over time. the significance of this partnership on the quality of care, particularly in terms of the necessary power base required, is then considered. next the education, health care systems, and diversity issues found in the uk and the us are compared and contrasted. the conclusion focuses on a transatlantic vision for the future in the consolidation of the patient/nurse transaction for the achievement of negotiated, competent, compassionate care and as a continuing force for quality at policy, strategic, and operational levels.
legitimate power emanates from an accepted ethical framework via our professional codes of conduct in which patients' rights are enshrined. nurses share more information (and vice versa) with patients than any other provider group. clinical, political, and organisational power are essential for nursing as a predominately female profession in a predominately male health leadership culture. nursing must have an opportunity to shape policies, as we are continually working at a disadvantage, waiting for others to make policy decisions that nurses are then expected to implement. nursing's arena for action has to stretch beyond the clinical setting and into the boardrooms of decision makers and policy shapers.
[color=#aa5522][color=#aa5522]the nhs and us health system
[color=#aa5522]the nhs began in 1948 and is generally viewed as a national treasure. created after world war ii, it represents more than just the delivery of health care for all, free at the point of delivery; it also represents social justice as a core principle in the uk health care. more than 350,000 nurses deliver services to in excess of one million patients per day. the nhs is the third largest organisation in the world following behind the chinese army. it is the largest employer in europe. it was created, and is managed centrally, by the government, which is striving to decentralise the management and policy making to local level as quickly as possible. it is a system in constant change, one which is much influenced by the political imperatives of the day. even with the chaos of change, nurses and other health providers take a reactive approach to government decisions and then frequently revolt against those decisions. this mode of behaviour on the part of health care professionals is detrimental to the effective use of power and is often described by government officials as the whining and moaning of the professions. this description is particularly disabling to a predominantly female nursing profession.
[color=#aa5522]to return to the rcn’s mission statement, as described above in discussing organisational power, the powerful phrase ‘shapes health policy’ speaks to a proactive mode of behaviour that has the potential to transform the image of nursing as well as the reality of nursing’s use of power. as the nhs continues to reform at, sometimes breakneck speed, the need for the strategic use of power by nurses is essential. the new structure of the nhs is based on local commissioning, which includes local organisations working closely with local authorities, within the framework of national, political imperatives. the desired outcome is for a locally negotiated health, social care, and well-being strategy (hodders et al., 2005). this completely fits with nursing’s belief system of transforming the nhs from an illness system to a health system. however, nurses are frequently excluded from the policy decision- making process. since policy centres on better expenditure control, greater productivity, and efficiency, nurses are not considered primary players in this strategic work. yet it is nurses, with their patient partners, who have the experience of safeguarding the deeply rooted moral imperatives of the nhs, which are to maintain universal access to care and equitable distribution of resources (hennessey, 2000). through strategic leadership and the use of power from a patient-centred approach, nurses must become essential in helping to create this new nhs that continues to maintain core values.
[color=#aa5522]the us system of health care is fragmented, private, and highly competitive. it is a system where bridges of collaboration and cooperation are frequently built only around economic gain, rather that national political imperatives as in the nhs. interestingly, however, this market-oriented system has pushed the rapid consolidation of health-care providers, i.e., hospitals, professional groups, and other health care delivery assets, into integrated systems of care. some of the integrated systems incorporate the old health insurance entity along with providers to create comprehensive systems of care. overall, the us system can be described as more integrated, intensively managed, evidence-based, and community-oriented, with both an emphasis on information/communication technology and on the psychosocial/behavioural dimensions of health care (o’neill, 1998). this description is a recipe in need of the nursing profession. nurses coordinate and facilitate the integration of services, manage patient services, are evidence and community-based, and emphasise information technology and psychosocial/behavioural care which illustrate the efficacy and level of patient (consumer) response, and satisfaction with health care interventions. to address these issues, another one million nurses are required for the us health market by the end of this decade.
while us nurses fight for inclusion in the board room and other policy-shaping venues, their political strategies and vehicles have been more fully developed over a longer period of time than their uk counterparts. having to challenge health care systems built on profit models, or at best, cost containment principles, us nurses have developed into strong, assertive advocates for patients and consumers. without the basic value of health care free for all, us nurses have within their professional and trade union bodies articulated and implemented strategies for working with government at both local, state, and national levels. with a greater emphasis on advanced education, many nurses in the us are educationally, as well as clinically, prepared to work as colleagues and leaders in health teams. career opportunities are more plentiful in the us than in the uk. with a centralised system of care and few top nursing posts available, the uk does not offer the range and extent of career growth that is possible in the us. for example, posts such as the cno for england and the general secretary of the rcn are few and far between in the uk. the reality is that there are too few opportunities for the vast numbers of excellent nurses throughout england.
whilst the emancipation of both nurses and patients in the us would appear to be well-advanced along the clinical, political, and organisational power continuum, the power position of nurses and patients in the uk is making great strides forward in a health care system that is currently free at the point of delivery. the two differing health care systems of the uk and the us are important variables in considering the emancipation and power base of nurses and patients in both countries.
sixty nursing organizations came together to develop nursing's agenda for the future as one voice for nursing and healthcare reform they felt needed to be obtained by 2010....ana and nursing organizations leaders are now implementing the groundwork laid out in this document and many meeting held over past 7 years.
those active in ana/ nursing healthcare activism understood the need to come together on consensus to envision a better health care system for our patients and ourselves as health care practitioners offering a clear message regarding needed quality and improved healthcare delivery than what has been established or proposed in current health leadership culture.
by being an active psna/ ana member attending district, state and national conventions over the years, i'm fully aware what ana has been working on nationally and via my state organization locally ---along with adding my voice to discussions and chiming in on policy & legislation proposed (and thwarting legislation negatively affecting nursing and patient care) ---along with pounding the pavement in state and nation's capital to effect change. kudos to former ana ceo linda j. stierle, msn, rn, nea-bc who took over in 2000 and helped lead this "call to the profession" and if memory is right, presented report at ana's 2002 convention in philadelphia.
(spent many hours assisting at this convention since hosted by psna and son's scout troop members helped stuff reports/goodies into bags for attendees.)
we are now at the golden hour to effect positive healthcare reform based on the above document... lets not blow this once in a lifetime chance.
Specializes in Vents, Telemetry, Home Care, Home infusion.
Visit the house bill: Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
I don't think I like that very much. NO APPEALS. So, you think "healthcare" is bad now, beware of the fine print of what you are backing.
At the current time YOUR EMPLOYER decides what treatments and benefits you get by their offering of health insurance plans--- some have a choice of plans, others only one plan --take it or leave it; often only available to fulltime employees working 40 hours. Insurance companies currently have their own criteria , often using INTERQUAL guidelines, to determine who gets to stay or be booted from hospital, which tests or procedures they will approve, who can get chemotherapy, Radiology, labwork and at what location, especially under HMO plans.
I get to listen to this message from insurance companies 100's of times a week when obtaining authorizations for homecare: "This authorization is not a guarantee of payment. Payment is based on plan enrollment, benefits, deductibles and exclusions along with medical necessity." You can appeal but most often appeal is denied on first round sending you into a vortex of paperwork.
Examples of homecare challenges this week include:
a. Patient readmitted for CHF --lost his medical assistance upon going back to work (self employed as electrician after laid off previous position) so without meds for 2 months. Ejection fraction now 27% from 40%.
b. Call from liaison @ Rehab unit to verify insurance home care benefits (I'd never heard of plan). I called insurance eligibility dept:
Homecare has $5,000 deductible. Pl/an became effective 2/13/09 --has 6 month window for pre-existing condition that is not covered ending 8/13/2009. "what is their diagnosis,if they lied on the application, it will not be covered" (refused to give a diagnosis despite reps 3 requests as I wasn't provided diagnosis by liaison.. didn't like reps denial tone of voice when calling about benefits, wouldn't have provided as eligibility clerk, without need to know under HIPAA!. Only has 100 benefits if use in-network provider; Deductible increases to $10,000 if choosing out of network provider. Unable to provide care as not a Great West provider. Fully expect patient to refuse any homecare because of deductible. Those patients who major carriers in my market: Aetna, Blue Cross PPO/HMO all have homecare benefit, most with 100% coverage with preauthorization.
c. Medicare Home Healthcare:
Medicare pays for 60 days care with set payment rate based on PPS OASIS grouper, no deductible copay.
Aetna Golden Medicare pays per visit with stingy preauthorization 2 visits each for SN and PT/ 2 week interval; most patients have $20,00/visit copay.
BC Keystone 65 pays per visit will preauthorize 6-8 visits each SN, PT for 4 week preauth interval -no copay.
We need a standardized system where everyone with same diagnosis and functional status eligible to receive same level of care....along with effective preventive care/immunizations provided age 0-23 (out of college).
guess you missed our 2002 reporting on ana nursing’s agenda for the future
yes, me and every politician in america as well. seriously, i did read all this, great rhetoric, short on action plan. just like most nursing "statements".
we are not in this discussion, and even where we are we are only minor players.
sure, they ask us about the nursing shortage, but when the discussion turns to hard reform measures, the aha, ama, insurance companies, and big pharm dominate the landscape. we are simply not in a position to compete with their resources to influence public policy.
we have one political strength...our numbers.
unfortunately, we are fractured. the ana can bring together 100 organizations...won't change a thing in terms of political reality.
Healthcare "reform" by politicians does not mean they care about the American in the street, either. 
AZ_LPN_8_26_13
462 Posts
Like him or not, Barack Obama has done more positive things in the first six months in office than his predecessors did in the eight years prior. OK, so he's rocking the boat a bit for a few of the wealthy, self-contented people who have a thumb in the $$$ pie and don't want anyone messing with it. Insurance companies. Credit card companies. Banks. Hopefully, the "do-as-you-please" era is finally ending. More accountability. But we're spending too much money you say?? We seem to always have enough money for things like wars in Iraq (billions spent), grants for why kids fall of tricycles, "bridges to nowhwhere" in Alaska, but making sure everyone has access to healthcare without going bankrupt??????
Rush Limbaugh???? Don't get me started :angryfire