The challenges facing President Barack Obama and Congress are tremendous, but Americans are making it clear they want healthcare to be a high priority on the national agenda. In a national survey released Jan. 15 by Kaiser Family Foundation and the Harvard School of Public Health, 43% of respondents said they view reforming healthcare as a top concern, ranking it third behind improving the economy at 73% and fighting terrorism at 48%. We asked California nurses leaders what was one of the first issues related to healthcare the Obama administration should focus on and why.Patricia McFarland, RN
Thousands of individuals and families have lost and will continue to lose healthcare benefits as a result of the recession. The cost of COBRA is prohibitive for most people. Therefore, impacted workers will opt to feed their families and hope for the best. They will use the ED for primary care, thus creating more pressure on an already strained system. The Obama team needs to develop a plan to ensure healthcare coverage for individuals who have lost their jobs and their healthcare coverage during this recession.
— Patricia McFarland, RN, MS, FAAN, CEO, Association of California Nurse Leaders, Sacramento, Calif.Donna Kistler, RN
Our healthcare in the U.S. is fragmented, and information gaps stymie progress toward meaningful reform. It’s time to refocus our energies, attention, and funding on caring for the health of our citizens. In the past, decisions have been made without consulting key stakeholders, including nursing, in the care delivery system, resulting in inequities in care provision and apportionment. It is time for nursing to be included and present at the table for all discussions on healthcare reform.
— Donna Kistler, RN, MS, 2008 President, Association of California Nurse LeadersBeverly Jones, RN
I would recommend Obama address access to care. Most uninsured patients are forced to use EDs for primary care. The vicious cycle this produces, from overcrowding of EDs to high admission rates, often threatens the financial viability of the very organizations that are essential for their care.
— Beverly Jones, RN, MPS, CNAA, Sr VP, John Muir Medical Center, Walnut Creek, Calif.Marilyn Chow, RN
It’s all about access to affordable, high-quality healthcare coverage. The coverage should include prevention and services to help manage chronic conditions. Universal coverage will improve health outcomes, the efficiency of the system, and reduce current health disparities.
— Marilyn Chow, RN, DNSc, FAAN, VP, Patient Care Services, Kaiser Permanente Northern California, OaklandKathleen Harren, RN
Overcrowding of EDs and the significant number of hospitals that are economically unstable are examples of the fragility of the healthcare system. Public health access to the right level of healthcare has to be part of healthcare reform, and a redesign of the healthcare access system is needed.
— Kathleen Harren, RN, MHA, CNO, Little Co. of Mary Medical Center Torrance (Calif.)Pam Wells, RN
Employer-based insurance places too many patients and families at tremendous personal financial risk. Further, it places undue burden on hospitals that are already struggling with increasing expenses related to infrastructure, including implementation of electronic medical records and workforce shortages.
— Pam Wells, RN, VP, Patient Care, CNO, Packard Children’s Hospital, Palo Alto, Calif.Jennifer Jacoby, RN
Universal healthcare should be a right, not a privilege. Objections have centered around affordability. Meticulous re-evaluation of how our taxes are spent is essential to fund this endeavor. We need to balance our support of other nations with the needs of our children and elderly.
— Jennifer Jacoby, RN, MSN, CNAA-BC, CNO, Sharp Memorial Hospital, San DiegoSharon Steingass, RN
The Obama administration needs to include access as one of the first issues to be addressed. The administration needs to think broadly and include access to prevention and treatment, the most evidence-based information, as well as healthcare coverage.
— Sharon Steingass, RN, MSN, AOCN, VP, Ambulatory Services, City of Hope, Duarte, Calif.