This morning, as I listened to NPR's coverage of yesterday's momentous override vote, I was struck by the significance of this moment for U.S. healthcare.

If you have ever doubted the idea that healthcare workers can build power to elect the next President and Congress—and win healthcare reform in 2009—yesterday's override of Bush's veto should leave no doubt in your mind of just how powerful an organized movement can be.  In the past month, healthcare workers rallied together and sent their message to Congress—that enough was enough, that a Medicare bill rewarding insurance companies while short-changing patient care is unacceptable. 

In the end, Congress listened to healthcare workers—not the insurance industry—with droves of Republicans in both the House and Senate reversing their earlier votes to join in on yesterday's override.  Thanks to all of you (more than 800 total!) who took part in our action to contact Sen. McCain and other members of Congress.

As I travel the country speaking to nurses, doctors, personal care assistants, pharmacists, acupuncturists and countless others, I'll be reflecting on what each of us, as part of Healthcare United, can achieve in the weeks and months ahead.

Summertime in the Twin Cities is off to a busy start for Healthcare United volunteers. We held our first meet-up over coffee in early June, where myself and another RN hosted a film screening and discussed how transparency and accountability are necessary in reforming our healthcare system. This would impact caregivers from a variety of backgrounds, including RNs, dental hygienists, physical therapists, doctors and pharmacists. We acknowledges that while we all work in a different healthcare areas, we are all healthcare workers.

On June 19th, during a visit by Sen. John McCain to the Twin Cities, I represented Healthcare United at a morning press conference. As an RN and a healthcare reform activist, I stressed that we healthcare workers are the ones we've been waiting for. It's our job to see to it that the broken healthcare system gets fixed. A recent online survey by the Healthcare United campaign demonstrated that healthcare workers are ready to act for change, they're just not sure how. One positive step in that direction is to do all we can to encourage Minnesota healthcare workers to register and vote for change.

In the afternoon of June 19th, I participated in a peaceful demonstration of healthcare workers, peace workers, unions and other activists in front of McCain's hotel. I was able to deliver Healthcare United's survey results on healthcare reform to one of McCain's aides. When I joined together in chanting with other demonstrators, I kicked off the chant: "Patients--before Profits-Healthcare Reform NOW!"

If we all register and vote on Election Day, I know our newly elected officials will hear this chant loud and clear!

After President Bush’s defiant veto this afternoon, the Senate is poised for an override vote. According the Majority Leader Harry Reid, the vote will take place at around 5:30pm.
 
Sen. Ted Kennedy whose return to the Senate floor last week helped usher in a great victory for patients and doctors alike, is currently undergoing treatment for his cancer and is not expected to vote today.
 
Sen. Reid is confident that Kennedy’s participation will not be needed since many GOP lawmakers reinforced their continued support for the bill.
 
Sen. John McCain is still nowhere to be found.
 
For the complete article from Roll Call, please click here (subscription required).

First off, let me say THANK YOU. You joined with thousands of others in participating in a nationwide survey this spring on how we can best improve our nation's healthcare system.
 
The collective response was overwhelming! 8,300 of you spoke out on your concerns and priorities this election year.  
 
Here's a quick snapshot of how the results broke down (for more detailed results, visit this page):

• 95.7% of you are concerned with the state of the healthcare system in this country.
• Most participants feel that the 2008 presidential candidates do not share their concerns, with 85% stating that the candidates do not talk enough about healthcare reform.  
• Most importantly, the study found that nearly 9 in 10 doctors, nurses and caregivers would be willing to advocate on behalf of the changes that they'd like to see implemented, but are unsure of how to do so.

It's clear that healthcare professionals in this country demand wholesale change--both for our patients, our profession, and most of all, our families. Many of you are eager to advocate for these changes, but are unsure of how best to participate.
 
That's why, on Saturday, July 19th at 1:00pm EDT,  Healthcare United is holding our first-ever national healthcare conference call for our members--and you're invited. On the call, we'll hear reports from several members on what's happening in their state, and how we can help. We'll also hear from a leading research firm on a recent survey of caregivers and what matters most to us this election year. To view the agenda for the call, click here.
 
If you can join us, please take a moment to RSVP for this call. I'll be sending around more details next week, including a conference call number and information.

Thanks for helping make healthcare reform happen!

Thousands of Healthcare United activists clearly recognized what President Bush did not, that the Medicare reform bill that the House and Senate approved shores up vital healthcare services for millions of seniors and military families and allows doctors to do the work they were meant to do - care for their patients.

Senator John McCain didn't seem to grasp this either, but your message reached his desk loud and clear.

Bush's decision was based in part because the bill would reduce payments to private Medicare Advantage plans offered by insurance companies. And as many of those companies are staunch supporters of the Bush administration, the president chose to side with them rather than Medicare patients.

When our Congress gathers to vote on the override of the president's veto, he'll find out once again not to underestimate the power of concerned activists like Healthcare United and others who are standing together to ensure that Medicare keeps working for seniors, the disabled and military families.

Speaking at a Health Reform Summit in Washington DC, Federal Reserve Chairman Ben Bernake shared some of his thoughts on healthcare costs and his prognosis was quite gloomy. The National Coalition on Health Care estimates that by the year 2016 spending on healthcare will consume 20% of the nations’ gross domestic product -- approximately $4.2 trillion.

According to Chairman Bernake, “Per capita health care spending in the United States has increased at a faster rate that per capita income for a number of decades.”

So what does it all mean? Well, if you're a healthcare worker and have a family of four, it means that you spent nearly $3,300 per year for healthcare coverage in 2007.  That's 10% more than you spent in 2006, according to the National Coalition on Health Care.
 
With out of pocket healthcare costs going up 10% in one year, how are families supposed to get ahead?

Sources:

1) http://www.voanews.com/english/2008-06-17-voa39.cfm <http://www.voanews.com/english/2008-06-17-voa39.cfm
2) http://www.nchc.org/facts/cost.shtml

The Senate floor exploded in a roar of bipartisan cheering yesterday as Senator Ted Kennedy (D-MA) returned to cast his vote on the much anticipated Medicare bill that would block a 10% cut in payments to doctors, support community hospitals, and expand access to primary care services. The Senator’s vote was among 9 that helped secure a veto-proof margin of (69-30) for one of the most critical pieces of healthcare legislation this year.

The warm reception Senator Kennedy received speaks volumes about the character of a man that has dedicated his life to improving the quality of our healthcare system over a distinguished 46 year career.

"I return today to keep a promise to our senior citizens, and that is to protect Medicare. Win, lose or draw, I wasn't going to take the chance that my vote would make a difference," Kennedy said in statement released from his office.

Here's some footage from his return:

In stark contrast to Senator Kennedy, Republican presidential candidate Senator John McCain talks often about his commitment to improving the healthcare system, but didn't make it to DC to vote on the bill or the previous vote that came to the floor on June 26th.

For more news on Senator Kennedy’s vital Medicare vote, click here!

I came across a recent report by The Commonwealth Fund that talked about underinsurance. Underinsurance is when you have insurance but it covers very little with high co-pays and even higher deductibles. For those who have not heard of it, consider yourself very lucky because 25 million patients in our healthcare system have to deal with this problem each time they seek care. And sadly, this number is growing.
 
On average, if you’re underinsured you pay anywhere upwards of 10% of your income on out-of-pocket medical expenses – and that’s on top of paying a premium for your health insurance. The result of this is that those who are underinsured regularly go without needed care such as doctor visits, filling prescriptions, and following up on recommended tests or treatment.
 
A troubling finding of this report is that among families earning over $40,000 per year, rates of being underinsured have nearly tripled since 2003.
 
The topic of underinsurance isn’t getting as much attention as it should in the national healthcare debate, but it further highlights the problem that the healthcare system in this country needs to be fixed -- yesterday.
 
You can read the full article here.

I was sitting on a bench in the pharmacy, across the street from the retirement community where I worked-still wearing my R.N. badge, but technically off duty. It was one hour and 15 minutes since I'd given report and handed over the keys to the evening supervisor.  My husband and I had symphony tickets. Once I made it home, there'd be just enough time for me to change out of my uniform. I'd already given up on the leisurely dinner. 

All afternoon I'd been working my way down the list of residents for whom I provided help with medication management.  It was an aspect of my job that was increasingly fraught with complications. Whereas it used to be that all the residents on my list had their prescriptions filled locally (by pharmacists I knew by name and by familiar phone number), now it seemed certain residents wanted to switch to mail-order systems. The challenge was that of helping elderly residents to get their medications at the best going rate - and to get those medications in hand, on time. Sometimes I felt more like a consumer advocate than a nurse.    

But the nursing aspect of my job (the caring part) was still connected to the on time part. And so it came to pass that late in the day on which I had symphony tickets, a certain resident - Mrs. A on the third floor - called me in a panic. It seemed that (for reasons she didn't quite understand) she had exactly one Lanoxin left in the bottle, and yet the mail-order people had just informed her that she couldn't have another order sent for another week.  
And so it was that I was sitting on the bench in the pharmacy across the street, waiting for Mrs. A's emergency prescription to be filled.

But in the end, this isn't a story about a mail-order glitch or even about my personal frustrations. In the end, it's a little drama, one that I witnessed as I sat glaring at the clock in the pharmacy.

There was an elderly woman leaning on the counter.  She was arguing with the young man waiting on her. "It can't be that much," she was saying. Her color was ashen. She was short of breath.

"Here," the young man said, showing her the paper attached to her prescription bag. I could tell he was a nice kid, but it was clear he had his script. "They called your insurance company. This prescription isn't covered."

The woman didn't even look at the paper. "It has to be covered," she said.  

"I'm sorry, ma'am.  They say it's not."

"Well you can just keep it then."  She said this with so much venom that anyone in earshot would just naturally sympathize with the poor kid trying to do his job. "You can just take it yourself," she said. "I sure don't have that kind of money."  And she turned on her heel and walked away-short of breath, her color ashen.  

Sitting on the counter was the bag holding the prescription medications that a doctor had ordered, and a pharmacist had duly filled-the prescription she'd didn't have that kind of money to pay for. And so here is the dark ending to the story about the day I ended up sitting in the pharmacy after work, and was almost late for the symphony: 

This elderly woman gets a prescription.
This elderly woman gets none.
Another story about a healthcare system that seems to have come undone

 

Healthcare workers in Maine continue to step up and spread the word about Healthcare United. The next house party will be on Sunday July 20th at 4 p.m. in Raymond Maine, northwest of the Portland area. To RSVP, please go here.

A Southern Maine Election 2008 Planning meeting will be held on Sat. July 19th at noon at the HCU office at 574 Congress, 2nd floor (above Wild Burrito). Healthcare workers will talk about strategies for making health care reform a top issue this election year and how health care workers are making that happen. This is also an opportunity to learn more about Healthcare United if you're supportive but still have questions. Refreshments will be served. To RSVP, please click here.

Come join us for our first planning meeting on August 9th at 10:30 AM in Bozeman during the exciting lead up to the November elections. You'll find us in the Bozeman Public Library on 626 E Main St.!

We will discuss many facets of our plans to achieve wide-spread health care reform in our country. There will be a review of a national poll of health care workers that analyzes their views on the need for change. We will also explore how you can help bring about the change that you want. This is an exciting time for health care reform, and this is your chance to be a part of an historic movement!

As caregivers, we are true witnesses to the healthcare crisis. Every day—on the job—we see firsthand the costs and hardships caused by the gaps within our healthcare system. Often we ourselves, and members of our families too, have stumbled and fallen into these gaps.  It is time now for us to get involved and speak up.  

For me personally, speaking up has always meant voting on issues related to healthcare reform, and encouraging my friends and co-workers to do the same. But in order to vote, one must be registered to vote.

Recently I was surprised to learn that almost one in four caregivers is not yet registered to vote. I believe that this year’s presidential election could very well be close once again, and I know that the votes of concerned caregivers could truly make a difference in the outcome. But only if those caregivers have registered to vote!

Last week, Healthcare United activists launched their largest effort to register caregivers to vote. The effort has now extended into eleven states, with the goal of making “every voice heard" on the issue of national healthcare reform.  Local activists have joined with elected officials and fellow healthcare advocates to register their coworkers and colleagues at hospitals, nursing homes and community centers.
 
To learn more about the number of unregistered caregivers in your state, and to learn what you can do to make a difference at the local level, please visit your state’s page here.

Healthcare United was featured in an article published yesterday by the Shepherd Express of Milwaukee.  The piece covers our efforts to mark Juneteenth through our new voter registration drive.

An excerpt:

Juneteenth 2008 celebrated, as it always does, the day in 1865 on which slaves in Texas learned that they had been emancipated. But this year's Juneteenth celebration also was a day of action for Milwaukee's African-American residents and health care professionals who want the next president and elected officials to address the wide racial disparities in health care.

Service Employees International Union (SEIU), Healthcare United and their allies were at the Juneteenth gathering on June 19, where they registered voters and urged Milwaukeeans to make health care an important electoral issue. "We have to actively engage in the political process," said Clarene Anderson of the Black Health Coalition of Wisconsin. "We have to force the change that needs to occur."

Before the event, national SEIU representatives stopped in Milwaukee as part of a national "Road to Health Care" bus tour aimed at drawing attention to how members of racial and ethnic minorities are disproportionately disadvantaged by America's broken health care system.

Click here to read the full article.

From the [Alabama] Press-Register:

MONTGOMERY - The Christian Coalition of Alabama teamed up with a Democratic lawmaker on Tuesday to call for better health care for the state's uninsured. The event may defy conventional wisdom about Christian Coalition priorities and partnerships, but it is only the latest example of what the group's leader says is an effort to expand its focus.

"Yes, we're ardently pro-life. Yes, we're ardently for marriage," said Dr. Randy Brinson, chairman of the state Christian Coalition. "But beyond just that, there's other moral failings that are having (an) impact. ... Not enough emphasis is put on that."

One such problem is the number of people who lack medical care because they are uninsured or underinsured, said Brinson, a Montgomery physician and lifelong Republican, during a news conference with state Sen. Linda Coleman, D-Birmingham. Brinson and Coleman said the rising cost of gas and food exacerbate the plight of the uninsured, forcing them to choose between transportation, sustenance and basic medical care. The problem could be solved through partnerships between public and private organizations and an effort to let people know what health care options are already available to them, he said.

This just in: doctors are fed up with insurance companies' failures to pay doctors on time and in full for the services they provide. So doctors, in response to the insurance companies frequent ratings and rankings of medical professionals, have developed their own report cards to rate the companies right back!

According to the American Medical Association's press release, physicians spend as much as 14 percent of their total revenue trying to ensure accurate payments for their services from insurance companies. Additional findings from their report include:

• We waste $210 billion every year because of how inefficiently and unpredictably the insurance companies process medical claims. Just imagine what medical services we could provide with $210 billion!
• Insurance companies pay nothing in response to physician claims as much as 7 percent of the time.
• Insurers are not consistent in how they explain denials to doctors, which means that physicians must spend inordinate amounts of time and money figuring out how to appeal.

Get ratings of individual insurance companies and find out more about the study here.