Guaranteed Healthcare

Politicians and pundits forget that we still have a public health infrastructure that still fights to prevent preventable diseases like polio, measles, tuberculosis, HIV, std's and would be called upon in a city-wide disaster to provide care and comfort to traumatized citizens left high and dry by natural events.

We are still the safety net for now 48 million Americans without health insurance and even those with insurance  who cannot afford to pay the rising costs of their own care. We are the "white line" against disaster, communicable diseases and those with no real access to care.  But, because of cuts, especially here in California by Arnold Schwarzenegger, medicare and other state programs which for the Govenator has become the only way to ease our budget woes , this thin white line in the sand,  faces more strains than ever before.  We need to get serious about single-payer sooner rather than later.  The public's health is at risk without it.

I've worked in other systems before I entered the San Francisco Department of Public Health and I've met many doctors, public health nurses, and NP's who feel a great pride in the work we do everyday in preventing the spread of some pretty nasty communicable diseases.  From treating common colds to sti's, to pregnancy prevention and pre-natal care,  to children and teens with asthma, our patients are found everywhere in San Francisco including our city's streets. From Golden Gate Park to Ocean Beach and into the Tenderloin our patients are cared for despite great odds by our nurses and out-reach workers who hit the streets to find and treat patients who have missed appointments for their next INH dose for TB, their combavir for HIV or their next injection for Hepatitis B. 

   Recently, our own Board of Supervisors, put the meat back on budget bones for public health that was slated to slash funding from our community, non-profit clinics who treat mentally ill patients and those suffering from drug, alcohol or drug and alcohol abuse combined. We are often trying to be like the Betty Ford clinics without the frills and the funding. 

We provide emergency room and hosptialization for major trauma in the city at SFGH.  But repeated hiring freezes have taken its toll on nurses and nursing staff who are doing the best they can under extreme conditions.

The reason I decided to blog on stresses on our public health system today, is the serious problem related to more patients dumped into the safety net at a time our Govenator wants to cut spending on patients in the public programs by 10%.  This is no time, as if there is any time, to do so. Reliance on private health insurance with its rising costs to small and large business and to patient's and their families are going to be a thing of the past because whether it is mandated or not, we won't be able to pay for it on our own or at all. This factor and the sudden appearance of the group,  HCAN,  which is spending a  record 40 million dollars to tell us that health insurers are bad news for patients but fails miserably to include the single-payer solution in its tenets.  Patients already know that health insurance corporations have far too much power as it is in making our medical decisions based on their bottom line. This group uses our distrust of insurers but keeps them in control.  That is not a solution. That's a sell-out to keep the status quo and an insult to our patients who have been harmed by the system.  What we need is is a "Medicare for All" program that is portable from hospital to hospital, easy to access for all patients and their providers and totally cuts out insurance corporations.  Everybody in and nobody out.  Public health providers would see a dependable funding stream from all of our patients who would qualify under this one program.  We wouldn't have to be at the mercy of budgets cuts nor Governor's who use public health funding to make up the state's deficit in times of recession.  Without a fully funded public health system we're courting the next disaster.  It's time to stop playing Russian roulette with the public's health.

We need HR 676 to keep the public's health healthy. 

Nancy Lewis, RN FNP

HuckleBerry Cole Street Clinic

Hawkins Villiage Clinic

Joint Nursing Practice Commissioner, At Large, Public Health