Guaranteed Healthcare

In Honor of National Nurses Week, I thought I though I would investigate what Florence Nightingale faced when she began her quest to reform the British health care and along the way,  wound up challenging the very under-pinnings of English civil society. And like another valiant reformer, Fannie Lou Hamer,  who similarly struggled to over-come deeper issues of racism and sexism for equality. Like both these women, I am sick and tired of being sick and tired over so-called "health care reform". What it needs is no less than radical surgery not bandaides through individual mandates and more of the same insurance for all. What we need is a "Medicare for All, Single-Payer system, not in the future but now.  Too many lives are at stake.

"So long as a sick man, woman or child is considered administratively to be a pauper to be repressed, and nopt a fellow creature to be nursed into health, so long will these shameful disclosures have to be made.  They are not paupers, they are poor in affliction.  Society owes them every care for recovery. Sickness is general and human, and should be borne by ALL."

                                                                                 Florence Nightingale, 1863.

   In honor of National Nurses Week, which is celebrated the second week of May, I thought it fitting to quote Florence Nightingale to get a handle on what she would recommend I do in my own daily practice as a nurse trying to take care of my patients in an extremely difficult health care environment.  Born in 1820, when proper British women didn't work, let alone enter a training program for nurses, who were considered equivalent to char-women and servants, Florence would profoundly change her own health care system but the societal notion that viewed the poor, the working class and lastly, women as pre-conceived cogs in an industrial wheel that needed their labor but not the responsibility of their care especially, their health care needs.  The Industrial Revolution produced Britian's greatest wealth for the few at the expense of the health and well-being of it's poorest citizens who toiled away in its factories and mines.  Nightingale not only fought to improve the public and military hospitals through advances in nursing education but putting forth the radical idea that by improving the common people's environment, their health and well-being would improve.  Nurses were central to that cause.

     As a nurse and a nurse practitioner of over 16 years and the Joint Nursing Practice Commissioner in Public Health for CNA/NNOC (California Nurses Association/National Nurses Organizing Committee), I can relate to the struggle to improve patient care through improved nursing education and advocacy.  My colleagues and I, believe that one of the best solutions to our current crisis in health care financing would be to remove private health insurance out of the picture and replace it with a "Medicare for All, Single-Payer System" in which all are in with nobody left behind because of inability to pay.  It would be portable and easy to access.  Patients could truly choose their own providers based upon what they want and need, rather than where their insurance company tells them to go.  It would cover those with jobs and those without jobs.  It would stress preventative health care and encourage wellness as opposed to illness.  It would take care of the very old, the very young and everybody else in between.  It would put the "public" back into the "public health  care system" and would once and for all eliminate the worry patients have about paying medical bills or insurance costs if they are sick.  Small and large businesses wouldn't have to fear covering their employees due to rising costs of insurance because it would be public financing for all, creating the largest pool of patients. 

   As Fannie Lou Hamer said along time ago in the march for civil and voting rights for all, "I am sick and tired of being sick and tired".  As a nurse and a provider, I am sick and tired of trying to figure out who I can see and how I will pay for their visits.  I am sick and tired of being asked to tailor my care based on what the system of insurance, my patient's credit card or bank account allows for rather than what my training and education says medically they need.  I am sick and tired of watching staff cuts, hiring freezes and budget shuffles asking me and others to see more un-insured paitents with less resources to compete in this very sick system of cash before care. 

   You know you have a bad system of care delivery when we are spending more time and energy fiquring out how to pay for the visit rather than what the visit and the patient are for.  We currently have a system that asks for the cash, before the care.  That is wrong.  That is un-ethical. That isn't what nursing is all about. 

   The "Cash Now, Care Later" system of U.S. health care has got to go.  I want to start asking my patients what brings you into the clinic rather than what is your insurance and how will you pay for your visit today.  I am not a banker, an insurance sales person, nor a collection's agent.  I am a nurse in California with the strongest practice actis for nurses in the country.  And just as important, I am a CNA/NNOC nurse who understands what those practice acts would have me do in protecting my patients through advocacy when they are sick and need my help.

  If Florence and Fannie Lou were here today, I think they would be asking me to advocate for a truly just health care system that would leave no one out or behind.  They would be asking me to stand up and fight hard for the best blue-prints on single-payer to date.  HR676 in Congress and SB 840 in California are there, ready and waiting to be passed.  We need these bills sooner, rather than later.

Nancy Lewis, RN FNP MSN

CNA/NNOC, Joint Nursing Practice Commissioner.