Testifying in Albany in support of the New York Health Act, a bill before the New York State Legislature to implement a single payer system, I shared overview from the perspective of an RN on this essential proposal. Here are some of those remarks:
Nurses are uniquely situated on the front lines of healthcare delivery. We see, hear, care for and suffer with our patients, at times intimately, as they navigate the system. Often we are the first voice a baby hears when she leaves the protection of her mother’s womb. We’re the last eyes into which a patient looks as he takes his final breath. We’re the reassuring voice and ear before surgery, and the reliever of pain afterwards. We’re the interpreter of medical jargon for people too shy to ask for an explanation. We’re the motivator when patients think they just cannot take another treatment.
Taken off track
We are there for patients with our hearts and souls, and our patients know they can count on us to not only care for them, but to be there for them.
But we can’t do it adequately in a dysfunctional healthcare system. The system is in such a state of chaos that we can hardly call it a system.
Instead of directing our care towards patients and families, we are forced to accommodate private insurers and multiple and muddled reimbursement systems. We spend an inappropriate amount of time maneuvering within these obstacles to care in order to give our patients a chance to thrive. Much of what we are directed to do now is to engage in activities that allow private and for-profit insurers, marketing and accounting firms, consultants and analysts to make profits on the misfortunes of our patients.
A healthcare system should be designed to provide the means for society to prevent illness to the extent possible, provide prompt care and interventions when necessary, facilitate access to the resources needed for healthy behaviors and to support research that discovers causes of disease, as well as best treatments and cures.
The bottom line
Healthcare in our state now caters to the mushrooming insurance industry, burgeoning big Pharma, litigators of all stripes, and a marketing industry that serves as an umbrella for all of these. Bottom line: an indecent portion of healthcare dollars line the pockets of individuals who don’t care FOR people and don’t care ABOUT people.
Healthier, happier, more productive
The components constitute an irrational payer system that has stealthily transformed healthcare into a cross between WalMart, an auto parts factory, and a casino.
Why WalMart? Because to “capture the market” in this industry we see an age of unprecedented mega-mergers, with sharks throwing the little fish out of the pond. No more community hospitals, where you know who you are dealing with. Instead, we see more “one size fits all,” as merged healthcare entities takeover, often without regard to meeting community health needs.
A factory? Because caregivers are on a treadmill of ever-increasing productivity requirements (the competition is out there!), rushing from patient to patient to meet quotas that Henry Ford would be shocked by.
A casino? Because a majority of the population has to “bet” on whether or not they will need care. Deductibles, premiums, co-pays and co-insurance are so high that they actually provide a disincentive to seek medical insurance. By the time some people meet their deductibles, they find themselves choosing between bankruptcy and follow up.
All of these indignities, and worse, could be avoided. Our healthcare system could save money in the long run if you do the math. Our society would be better off, healthier, happier, more productive and peaceful.
The New York Health Act would not be a panacea — nothing is. But it would be a firm and critically necessary beginning for a healthier New York. As nurses, we’re staunchly committed to tackle whatever challenges such a change in care delivery might present.