As I write this, the Obama administration is releasing their recommendations for health care reform and the Affordable Health Choices Act has been introduced in the U.S. Senate. It is very clear that the time has come to make sweeping reforms of a health care system that is imploding upon itself. The costs of health care are skyrocketing, and yet, fewer Americans are insured. There are huge disparities in the care that is available to patients depending on the type of insurance they have.
Emergency departments have long provided the safety net for the entire health care system. Emergency departments function to provide not only life-saving emergency care, but after-hours care, care for patients who are too complex for other care venues, care for patients in communities with limited access to primary providers, care for patients with mental health conditions, and primary care for the uninsured and underinsured. Yet many policy makers mistakenly blamed the victim, painting emergency departments as the villain rather than a symptom of a broken system. Most agree that emergency departments are not the most effective place to provide primary care, and yet it could be a mistake of catastrophic proportions to restrict access to the safety net of emergency departments without thoroughly analyzing the unintended consequences.
It is essential that any health care reform must preserve the valuable service that our emergency departments provide. In order to do that, the health care system must ensure that there is adequate funding for the emergency-care system and that there are also resources to which patients can be referred so that they do not have to be boarded in the emergency department and do not end up bouncing back to the emergency department. These resources must include accessible and affordable primary, chronic, home, and mental health care. In many arenas, well educated licensed advanced practice nurses can help provide primary and preventive services that simply aren’t available to many patients now.
The Board of Directors of the Emergency Nurses Association (ENA) approved the Health Care Reform Platform for the association on June 25, 2008.1 This document spells out the Association’s position in 10 critical areas:
1.Emergency and trauma care systems
2.Health care workforce
3.Information technology
4.Insurance coverage
5.Insurance reform
6.Preventative health care: health promotion and injury prevention
7.Primary care
8.Reimbursement
9.Tort reform and medical errors
10.Utilization of the health care system
Each area spells out what the Association believes are key factors that must be present for effective change in the health care system.
Nurses are the largest group of health care providers in the United States and have the highest degree of honesty and trust of any profession. This places us in a unique position to advocate for our patients. There are no other health care professionals who are closer to patients than nurses. Policy makers need to hear our voices. In many instances, nurses can tell legislators what will work and what is doomed to fail.
As a nurse, you should be informed of the progress of health care reform and be able to add your opinions. Emergency nurses may be surprised to see just how informative, extensive, and in-depth ENA’s resources are and how quick and easy it is for nurses to make their voices heard. To access ENA’s Legislative Action Center, just go to the ENA home page at www.ena.org, and select Government Affairs from the menu on the left. Be sure to sign up for the e-mail alerts.
Many decisions in government are made rapidly, and a single phone call to a legislator or administrator at the right time can make a huge difference.
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