Occupy Health Care Portland

A giant pair of blue hands extended skyward as I ran through Portland’s Waterfront Park Saturday morning. Curious, I adjusted my route to get a closer look. A group of 50 or 60 people gathered around a 20 foot tall representation of a nurse. The giant blue, gloved hands were hers.

Giant Representation of a Nurse at Water Front Park, Portland, OR

The people carrying the towering nurse wore white lab coats. Interspersed among the crowd were men and women wearing scrubs.I counted four Portland Police officers talking amicably with several protestors.They wore regular uniforms. No riot gear in sight. I joined the crowd.

A young woman held a sign which read, Nurses for Single Payer Health Care. She explained the demonstration was part of the Occupy Portland movement, focusing on the need of single payer health care in the United States. She is a twenty-two year old nursing student working with a group of community health nurses promoting health care services for the under served. “I’m the youngest one in the group,” she told me, “but I feel this is really important.” 

I shot the above video on my iPhone. Following the presentation, demonstrators peacefully marched along Salmon Street to Pioneer Courthouse Square.

Nurses, doctors, and patients working together. Protestors and police officers sharing a city park peacefully. Everyone working together with a clear message and a focused goal. Hope and change, they begin here.

Occupy Portland Health Care photo: jparadisi 2011

I am a nurse. I am not Twenty feet tall, and my hands are not blue, but I raised them skyward too.

photo: jparadisi 2011

Health Care Reform: Stop Raining on the Parade

     The parade barely passed by and confetti was still strewn on the streets, when  insurance corporations went looking for loopholes in the Health Care Reform law, arguing about their responsibility to cover treatment of children with pre-existing conditions. Without a public option to compete against, private insurance companies tried to set the drumbeat the public marches to. Read this article by Robert Pear for the New York Times:   

Coverage Now for Sick Children? Check Fine Print   

However, the Department of Health and Human Services  intervened after the above article was published and Robert Pear wrote this follow-up article explaining insurance companies’ new stance on the issue.   

Insurers to Comply With Rules on Children   

       Stay informed at HealthReform.gov  

Spring Rain photo: JParadisi

If They Could See What Nurses See: Health Care Reform Passes

Opening Skies photo: JParadisi

     I wish declaring war on Iraq had stirred the same amount of energy which Health Care Reform has. Each endeavor involves spending huge sums of money and pivots on lives in the balance.

     The anger of those opposing Health Care Reform is vehement. Crowds shouting slurs at senators, threatening them with violence in voice messages for voting in favor of the bill, while prominent citizen and member of the opposition Sarah Palin tweets Don’t Retreat, instead RELOAD! to her followers demonstrates that no one is safe from bullying and workplace violence

     I would like Health Care Reform to go further, still, it’s a big step towards the betterment of the lives of our citizens. Its importance became real to me last week, just days after the bill’s passage, as I listened to young patients living with treatable, chronic illnesses tell me that they are enrolling in college, or taking the job offered to them, because they no longer have to plan their lives around qualifying for disability payments for their pre-existing conditions. Hearing young adult patients express how a future of independence has suddenly opened up for them, because Health Care Reform passed brought tears to my eyes. I wonder if those who oppose Health Care Reform are so blind that a tear could not escape from their eyes too, if they could see what nurses see.

Health Insurance Industry Appears Recession Proof in Today’s Economy

     Despite a projected staffing shortage, recent news reports suggest that nursing jobs aren’t as recession proof as originally thought. Apparently, ladies and gentlemen, nurses are working on the wrong end of the health care spectrum. We should be working for health care insurance companies, like Anthem Blue Cross, who raised their premium costs 39%, despite a $2.7 billion profit in just the last quarter of 2009. Spokesmen for the company say the monetary figure is misleading, as it represents only a 4% profit increase. Well, I feel better about that, don’t you? Read on in today’s New York Times.

NYT Well Blog Post: When the Patient Can’t Afford the Care

Dr. Pauline Chen posts about When the Patient Can’t Afford the Care on the New York Times Well Blog. Medical schools have added courses to educate physicians on insurance programs and coverage. Apparently,  patient noncompliance sometimes occurs because patients can’t afford their prescription medications and outpatient treatment. The comments from patients unable to afford their prescribed health care are most compelling. I posted a comment (#89).

Who’s Flying the Plane?

We've Gotten Off Track photo: JParadisi 2009

       Perhaps a change of nomenclature is needed in health care.  Physicians should be called Pilots, and nurses renamed First Officers, like in the airline industry, which the health care industry often compares itself to. The term doctor’s orders would change to instructions. Instead of a nurse requesting orders from a doctor, the First Officer would ask for further instructions from The Pilot. The name changes promote the team approach that more accurately describes patient care. 

     Gallup Poll: Power Elite Believes Nurses Should Have More Say in Policy, Management  posted by Shawn Kennedy on the American Journal of Nursing blog, Off The Charts  quotes that “69% of ‘people who run things in this country’ see nurses as having little influence on health reform.”  The poll ranks nurses at the very bottom of the list of groups influencing health reform, under patients, who lag behind physicians. Listed as the most influential  are  government, insurance and pharmaceutical executives. In other words, the people flying the plane do not control the plane. Decisions about health care policy are made by people who are not on the plane. Sometimes the decision makers aren’t even at the airport. 

         That’s not to say that physicians and nurses should dictate health care policy without thought or consideration of cost for treatment or alternative options. In the short story Voyagers, I write about recognizing the need for administrators, whose jobs keep hospitals solvent and regulated. However, demoting nurses, doctors, and the patients themselves to the bottom of the list of influential voices in health care policy, while allowing corporate administrators to have the most influence, seems a crippling case of the tail wagging the dog.

Off the Chart Gives Nod to Blog Post

JParadisi RN’s blog post, A Metaphor: Health Care Reform on Life Support, was mentioned yesterday on the American Journal of Nursing’s blog, Off the Chart.

Thanks AJN!


via http://ajnoffthecharts.wordpress.com/.

A Metaphor: Health Care Reform on Life Support

oil on wood (2008) artist: JParadisi

     The idea that the Health Care Reform bill is on life support is disappointing, but not surprising. It was admitted in a weakened state of health. It appears suspiciously a victim of domestic violence by special interest groups. The bruises on its body resemble the outline of handprints of the insurance companies it was created to protect our citizens from. Already, my patients are complaining of rising health insurance deductibles this year. It is estimated that 14 million people will still be uninsured if the Health Care Reform bill rallies and passes. It is a complex piece of legislation that confuses even those of us who strongly advocate for health care reform. I think that’s where the undecided get lost and fall to the wayside; afraid to support what they do not understand.

     In my grief over Health Care reform, I console myself  by remembering that at least it’s a step in the right direction. At least an estimated 34 million currently uninsured citizens will be insured, and people who are currently insured won’t lose their insurance if they change jobs or become ill. These are progressive and necessary improvements to the present situation. I tell myself that if we lose this moment in history, it won’t come again anytime soon. Something is better than nothing. Fight for the life of the Health Care Reform bill, don’t let it slip away.

     But I know, even if successfully resuscitated, it will not be the strong, idealistic super hero it once was. It is anemic. The bill has been bled by special interests groups and insurance companies. It’s vital organs have been damaged by poor perfusion (lack of blood supply). It is now being threatened with further leeching in order to get even a shadow of its former self passed into legislation.

     Health Care is a human rights issue. Human rights issues are intimately linked to economics. Historically, in most countries, including the United States, it is this link that causes resistance. It is the cause of resistance to Health Care Reform now. Until Health Care is recognized as a fundamental human right, and not a for- profit industry, our citizens will continue to suffer.

Health Care Reform? What the…..??????

     Senator Max Baucus  (D) Montana, along with five other “architects” is writing compromise legislature for Health Care Reform, which includes financially penalizing the uninsured for not having health care insurance.

Under the Baucus plan, all Americans would be required to carry health insurance. For taxpayers with incomes from 100 percent to 300 percent of the poverty level, the penalty for not having coverage would be $750 a year per person, with a maximum penalty of $1,500 for a family.

For taxpayers with incomes over 300 percent of the poverty level, the penalty would be $950 a person, with a maximum penalty of $3,800 for a family.

The poverty level is $10,830 for an individual and $22,050 for a family of four.

  We all know how well mandating automobile insurance works. The insured still pay for the uninsured. It must be a complex piece of legistature, because this piece doesn’t make sense. Will the uninsured receive the money to pay for their insurance? That’s not addressed in this article.

     Read the article in the NY Times:

Democrats Promise to Send Health Plan to Obama 


Drawing Lessons: Sideways Perspective,Dishwashers & Forks III

Forks Sideways (2009) JParadisi

Fork Sideways (2009) JParadisi

        A  doctor mentioned that if health care reform occurs, he will not make enough money to pay off his student loans. If this is true, he has a valid concern.

     I heard that 62% of personal bankruptcies in the United States are caused by debt incurred from a medical crisis. If this is true, it is also a valid concern.

    Everyone has a reason to be for or against Health Care Reform.  Fork tines upwards, or fork tines downwards.  We know that forks can also be placed in the dishwasher sideways, keeping the tines clean and free of entanglement in the basket. 

     Forks have to be washed after use. Health Care Reform is going to occur, one way or another, because our society can not afford the current system.  Some people fear  Health Care Reform will take away their Medicare benefits. At the current rate that health care costs are increasing, Medicare benefits may need to be cut. Why not change the system, and create a Medicare for all who need it? Medicare for everyone.

        The yelling and pictures of President Obama sporting a Hitler mustache at town hall meetings feels similar to the nurses venting their frustration, anger and distrust at each other and the administration during the intial phases of transition to nurse governance at a hospital, which I posted about on September 3rd. The force of opposition displayed at these meetings on the evening news is reminiscent of the energy surrounding the civil rights movement in the 1960’s and early 70’s. Historically, social change in our country occurs with dramatic labor pains. 

           Health Care Reform is a civil rights issue.

          Maybe, when all of the yelling has stopped, honest, respectful and productive conversation will begin at town hall meetings on the evening news.