Rx: Empower Doctors, Reduce Costs
1. Reduce the power of insurance companies to deny coverage. You pay for your insurance, you should get care covered, especially when needed to save the patient's life.
2. Reduce costs of medication. Stop annoying medication ads by pharmaceutical companies to help reduce the cost.
3. Return power to the doctors. They should be the ones to decide what is medically necessary.4. Make insurance affordable for everyone.
Brenda Morales
Lancaster, PA
Rx: Keep Nurse-to-Patient Ratios Reasonable
Undoubtedly we love being nurses or we wouldn't do it! We could give ultimate care if we had ratios within a normal range, wages comparable for our education, and respect for what we actually do. Nurses used to be revered as "Angels". I, for one, still feel that that is my purpose - to be an "Angel of Mercy" and I believe I am just that. Our job is not meant to be easy, but less stress would be nice. Please, allow me to continue to do what I have done for the past 27 years and love doing.
Mary Anne Pittman
Rinard, IL
Rx: Empower Doctors to Make Decisions
"Stop the insurance [companies] from making the decisions for the doctors. Only the doctors know what is good for the patients. I am so sick and tired of the insurance [companies] telling the doctors what is good for the patients. Let's put the care-taking back into the doctors' hands. Also, let's start making the insurance [companies] pay more to the doctors than they have been. We pay out the nose for health care and the doctors don't see any of this."
Jeannie Misener
North Olmsted, OH
Rx: Focus on Primary Care
"After practicing internal medicine in Denver for 35 years, I was forced to close my office due to inadequate reimbursement from MCR, MCD, HMOs,etc. I could no longer pay the overhead."
"Primary Care is fast disappearing. Our entire healthcare system is broken beyond repair unless Congress makes drastic changes in payments to primary care docs. Many of us retired docs would still be practicing medicine if the system was changed."
David Claassen
Denver, CO
Rx: Focus on Health Care, Not Sick Care
"Our country focuses on a sick care system, instead of a health care system. We need to emphasize health promotion and prevention and who better than our nation's 2.9 million nurses to help in this endeavor?"
"Our recommendation is to create an Office of the National Nurse to:
- Elevate the Chief Nurse Officer of the USPHS to full time status within the Office of the Surgeon General to enhance prevention efforts in all communities.
- Complement the work of the US Surgeon General.
- Encourage participation in the Medical Reserve Corps to improve the health and safety within every community.
- Incorporate proven evidence based interventions.
We have heard all the reports and studies about the need for prevention, we have the diagnosis, now we need a pragmatic action plan and solution-please join and support our efforts. Thank you Healthcare United!"
Teri Mills
Tualatin, OR
Rx: Encourage Preventative Care
"I am a nurse practitioner. Insurance companies MUST be reigned in; CEOs are making obscene bonuses at the expense of patient care. They must not be allowed to refuse coverage for pre-existing conditions, and deductibles must be brought down to more affordable levels. People continue to avoid seeking care until too late when it will be much more expensive because many people cannot afford to meet their deductibles."
"We are not doing nearly enough to encourage true preventative care - we have a badly broken system that thrives on symptom treatment and illness care, instead of empowering people to take charge of their own health care and outcomes."
"It is immoral for a country such as this to allow its citizens to end up bankrupt or even homeless because they cannot pay ridiculously expensive medical bills. We have the knowledge and the wherewithall; we need to override the desires of the insurance industry to continue to 'cherry pick' and profit from the suffering of our populace."
Gail Jett
Bend, OR
Rx: Think Outside the Box
So many ideas!
First of all look at where the real high costs are coming from--look at the pay of administration, needless construction costs (I have seen new untis being built or reconstructed only to close or never open),look at the cost of what pharmaceutical companies are charging for medication, continue to reinforce the non payment of never events and the need to have adequate staff and technology in place to keep patients safe and receive good and safe patient care,pay nurse and support staff more that a factory line worker to make this a profession that the upcoming youth would be interested in. Encourage hospitals to look outside the box on how to staff creatively to again make this an attractive profession to pursue. There really should be some type of ruling/law in place regarding mandating staff for multiple shifts in a row-again patient safely is at risk. Laws need to be set in place as to the insurance companies dictating the care that physicians and hospitals can provide to a patient-what make them think they are more knowledgeable than a Physician in ordering the care for a patient---again big safely risk for patients!
Thank you Dr. Lewis for advocating for all if healthcare-especially the patients!
Laurie Grothman RN, BSN, CWOCN
Mequon, WI
Rx: Provide 8-Hour Shift Options
"Provide eight hour shift options. In the health care industry, many, many mistakes are made by tired health care professionals. It should be against the law to provide life saving medical services by overtaxed, overworked, mentally tired nurses. We make on-the-spot decisions that often make the difference in life or death. Our ability to assess a situation and make correct decisions directly affects the quality of medical care."
"A sick, injured patient deserves the best of care. There is something wrong with our system [when] we can't do that."
Rhonda Howell
Waycross, GA
Rx: Fix the Skewed Payer System
1. Develop a single payer system, either through the government or through government working with industry (HMO's. Big Pharm, AMA, ANA). Make sure that the goal of reducing administrative costs is adhered to in the plan. Bring people that will lose their jobs in private industry onto the government payroll. Use Medicare as a model. There are many things that Medicare gets right.
2. Establish national tort reform. Take a look at ideas that some states have adopted, such as Texas, to see if a viable national program can be implemented. (I have not seen the Texas program, only read that they have one).
3. As part of the single payer plan help establish Healthy People 2010 as a goal while looking at Healthy People 2020 as a way to implement proactive health care reform by implementing preventative strategies for all Americans. More emphasis needs to be paid to reimbursing at a higher rate for primary care providers that would include ARNP's. Health care ain't rocket science and many conditions can be diagnosed by nurses and doctors, but they don't get the same reimbursement as the specialties. Many preventative strategies can be implemented if we catch diseases before they become critical. Include an increase number of scholarships to folks who want to go into medicine or nursing, but tie the scholarships to a 2-3 year committment to government service in rural areas, as primary care providers.
4. Fix the skewed payer system, which could happen with a single payer. Right now Medicare will pay a hospital $17,000 for an amputation of a diabetic patients leg, but won't pay the $150/visit that the same patient could have done to help prevent the leg from going bad in the first place. All focus should be on prevention.
5. Stop NIH funding of Big Pharm's research projects unless it is for a medication that would actually be of benefit. Reduce the amount of time drug companies can keep drugs patented.
Just some random thoughts. I am a Registered Nurse in Florida with a Master's degree in nursing and 30 years in clinical and management positions.
Phil Rowe
Lutz, FL
Rx: Insurance Companies Should Pay for Physician-Requested Meds
When a physician prescribes medication, equipment, supplies or other services and that physician determines that it is medically necessary, the insurance company should pay for what the physician that is treating the patient thinks is necessary. Sitting behind a desk looking at papers doesn't qualify the insurance companies staff to determine what is best for patients. Patients should not have to do without their needed medications because there insurance company won't approve it and they are unable to afford to pay the hundreds it costs to pay out of pocket. I work for an agency that provides for children with special health care needs and there are countless episodes of children with cancer, cardiac defects, diabetics going without their medication because there insurance company will not pay for it and they have us working for them and advocating for them.
Michelle Pack
Swoope, VA
Rx: Focus on Prevention
It is time for a paradigm shift in health care with an innovative educational program that would start in public schools at a young age about diet, posture, exercise, self-care, relaxation and movement studies. Insurance companies need to pay for prevention and insurance needs to be available for all at an affordable cost regardless of past medical history. Currently people's life choices and potentiality are held back because of the constraints caused by lack of insurance coverage options. The change also needs to happen within the health care field as individual pratitioners take responsibility for their actions or lack of action. I have observed within my own profession of physical therapy, a lack of quality care being provided at very high costs to medicare and insurance companies. It is not so much about giving more services but about all parties beginning to take responsibility... individuals for their own health, providers for the services they provide, and insurers for the benefits they provide. Throwing federal monies at this broken system with not manifest any true or significant change. As with so many issues it is a void of personal responsibility on all behalfs and the failure of leadership to promote the idea of self-responsibility for all.
Denise Deig, MS, PT, GCFP, BFLT/T
Fishers, IN
Rx: Treat Mental Health Illness as Physical Illness
"More extensive coverage for mental health problems. I have lived and worked in the mental health field in New Orleans before and after Katrina. The needs for mental health services has dramatically increased without accompanying providers. After Katrina, the suicide rate jumped three times the rate that it was before Katrina. In general, mental health services are woefully lacking throughout the U.S. With the influx of service men and women coming home from Iraq and Afghanastan, the mental health system will be pushed to the limits, if not past them. Mental health illnesses are as real as any physical illnesses. They cost our country untold money in lost wages, lost production, strains on Emergency Room services, population strains on our jails and prisons and disrupts our school systems in the education of our children."
Peter Yuslum
Gonzales, LA
Rx: A Clinical Psychologists's Three Point Plan to Reform Healthcare
"As a clinical psychologist in private practice, my concerns are mainly in the mental health fields.
1) I continually see the need for those with middle and lower incomes to have access to psychotherapy that they cannot pay for themselves. Overall tremendous amounts of work hours, medical bills, legal bills, and personal tragedy (over generations!) could be prevented if access to menal health education and treatment was adequately supported.
2) Providing some basic education in our schools on relationship building; partner/marriage possibilities, expectations, and skills; and parenting seems increasingly important as more and more people see the relationships around them fail.
3)And for those who struggle on a daily basis with mental illness there is a distressing lack of humane, dignified, and supportive options for living arrangements that promote a safe as well as growth enhancing. Too often I see people lost to an existence of living alone and isolated or living in and out of locked hospital units away from any opportunity for increasing daily functioning and growing interrelationships. Living facilities and/or communities that allow for graduated levels of assistance, structure, oversight, and productive work, as well as the development of trusted, respectful relationships are terribly needed.
Thanks so much for grappling with the difficult issues of healthcare for Americans"
Sarah Orth
Marengo, IL
Rx: The "Working Poor" Needs Primary Care
"As a person who works for a major health care institution, I volunteer my time serving on community health care agencies to offer my expertise in educating the community about various health conditions. One of the major problems I see is the lack of health care to persons considered the "WORKING POOR". These are people who work everyday but their company does not provide health care coverage. As a result they are often times so ill when they come to see a provider that many times hospitalization is needed. If these individuals had a means to get low cost primary prevention or wellness care, their overall outcomes would be better for them and their families. Please, let's reform health care!"
Trudy Gaillard
Columbus, OH