Healthcare Reform: A Nurse Practitioner's Perspective
Most of my spare time is spent listening to and watching the healthcare reform debate. I know that I favor a single payer system but I also know many people do not. My intent is not to get in a debate about this, as I don't think it will happen. What I do think has a chance is a public insurance option. That is if everyone is not scared to death about things that are not going to happen.
I don't know about others but when I hear how bad healthcare will become under a public plan, I get insulted. There are lazy people and there are dumb people and unethical people, unfortunately, already in healthcare. But just because the government is a payer, all of the sudden, the majority of us who are ethical, smart and not so lazy will suddenly change? That is insulting and not true. Maybe everything a person wants will not be covered. So what, everything I want my insurance to cover doesn't always work out now. My hope is that with corporate revenue not being the bottom line, patient care can be what it is all about. Funny to say, seeing as how I work in a retail clinic, but I hope "retail" says more about our location than just profit. Not that I don't want my company and others to be viable and make a profit. I want to keep my job. But just adding another source of revenue with a public option doesn't seem bad.
I have wondered how we would function with a public option. I don't think it would be very different from how it works now, at least for the next few years. If our companies choose to be a provider and if the public option chooses to use retail clinics, I think it would add much to healthcare reform and especially to healthcare cost reduction. Our business should increase when people, who had once had no insurance, would options other than ERs. And as these people come to have medical homes, there is more room for preventive care. Preventive and wellness care is something I think we will have to offer working with a person's medical home. As our scope of practice expands, I think the healthcare system will see more savings. At least that is my hope. One of the reasons I do this is I want to be part of the solutions to the mess we call a healthcare system.
So that is what I think will happen if we do have health insurance reform and a public option. How this committee to oversee Medicare works will be interesting. I believe in following evidenced-based guidelines, however, I truly believe we need to treat our patients not the tests or the guidelines. And a lot of how much these guidelines work will be determined by how much room we have to be clinician-chefs and not just cooks following recipes.
I support the ANA's stand on reform and I am writing to both my representatives in the Congress and the Senate. I think, it is probably a waste to write my senators. They have never voted for anything I support and I doubt they ever will. I just like to keep them aware that one person is working to get them out of office.
Again, what do we have to fear? Right now we have insurance company bureaucrats telling us what to do in order to keep their profits. Isn't it time for a health care system more concerned about care than profit?