Health care for all

Nevada RNformation, Nov 2003 by Trossman, Susan

Nurses rally behind a campaign highlighting the uninsured.

Last year, paramedics brought a young, uninsured black man to a Chicago ED in full respiratory arrest. Despite their efforts, nurses and physicians could not revive him.

His death was a tragedy, compounded by the fact that it could have been prevented, according to Illinois Nurses Association (INA) president Mary Maryland, PhD, RN, APRN, BC. Nurses found prescriptions in his pocket for asthma medications he had received during an earlier visit to the same ED. Without insurance, he couldn't afford to fill them.

Like other nurses, Maryland has many stories about the uninsured, who number about 1.7 million in Illinois and 41.2 million in the United States. And at a Chicago town hall meeting March 10, the first day of Cover the Uninsured Week, she shared the story of the young man who frequented the ED for his care, as well as strategies she believes will ease this growing health care crisis.

The first Cover the Uninsured Week, which ran through March 16, consisted of a series of simultaneous events around the country aimed at building awareness among policymakers, the media, and the public on the issue of the uninsured. Some 875 events, which included town hall meetings, health fairs, and interfaith breakfasts, took place in more than 40 states.

This massive effort was sponsored by the Robert Wood Johnson Foundation (RWJF), the California Endowment, and the W. K. Kellogg Foundation, along with other national organizations, including the ANA. More than 20 of the ANA's constituent member associations also cosponsored or participated in events within their states to ensure nurses' voices were heard on this issue.

The background

The weeklong project was only part of a larger, ongoing campaign to raise public consciousness about the uninsured. For example, in January 2000 the RWJF and its national partners held a conference to present proposals they believed would improve Americans' access to health care. At that meeting, former ANA president Mary Foley, MS, RN, discussed the American Nurses Association's vision for a national insurance program in which everyone in the United States would be covered under an expanded, restructured Medicare.

Ongoing projects launched in February 2002 include national advertising and a Web site (www.covertheuninsuredweek.org) featuring information about grassroots and national activities focusing on the uninsured, as well as numerous fact sheets that focus on the problem.

The fact sheets detail several disturbing facts:

* Eight of 10 uninsured Americans come from working families who either have no health coverage through their employer or cannot afford insurance when it's offered.

* Nearly 25% of the uninsured are children, and those most likely to lack health care coverage are between 18 and 24 years old.

* Others most likely to be uninsured are Hispanics, low-wage earners, and people without high school diplomas.

* When examining coverage over a three-year period, three out of 10 people lacked health insurance for at least a month.

Around the nation

Several days before Cover the Uninsured Week began, the RWJF brought together leaders of its partner organizations at an event in Washington, DC, designed to spark media interest in upcoming activities. (Judging by media coverage throughout the week, the initiative was a success.)

"Every day, nurses see the human face of the uninsured," said American Nurses Association president Barbara Blakeney, MS, APRN,BC, ANP, at the kick-off event. "We hope to raise our voices in the message that 41 million uninsured people in this wealthy nation is not acceptable. We want to focus attention on the need to get these people covered."

Echoing her remarks was Karen Ballard, MA, RN, New York State Nurses Association (NYSNA) director of practice and governmental affairs. NYSNA cosponsored several of the events held throughout New York City, and more than 100 nurses participated.

"We're facing a societal issue here," Ballard said. "People either have to be so absolutely poor that they qualify for government programs to provide them with access to adequate health care, or they have to be so rich that they don't have to worry about affording health care."

In addition to sponsoring a town meeting March 10 in which Senator Hillary Clinton (D-NY) was the keynote speaker, NYSNA had a prominent role in coordinating a March 15 business and labor conference, as well as educational sessions held at local health care facilities and colleges of nursing.

At the labor conference, NYSNA's Economic and General Welfare program director Lorraine Seidel, RN, stressed the importance of health care coverage aimed at preventive care. She said that even employers in health care are resisting coverage for preventive services. And many are unwilling to provide retirees with health benefits - even though many of their employees have practiced within hospitals, nursing homes, or home care agencies for 40 years.

Advocating access and affordability of health care is also important to the Minnesota Nurses Association (MNA) and is part of its mission statement.