I work with a nurse who was diagnosed with breast cancer about two and a half years ago. After a lumpectomy and chemotherapy, she spent time researching radiation treatments. What she found was a type of radiation therapy called IMRT, or Intensity Modulated Radiation Therapy. It directs the radiation to the immediate tumor area, thus decreasing the amount of damage to the surrounding tissues, in her case, her heart, her lungs, and her other breast. With a family history of heart problems, she felt that it would be important to her future health to have IMRT, rather than the traditional treatment.
What she also found was that her insurance company would not pay for this particular treatment, stating that it was â€œstill experimental,â€? despite the fact that it was already approved and reimbursable treatment for prostate cancer and cancers of the head and neck. Not only would they not pay for it, they also refused to deduct the cost of the traditional treatment that they would pay for (about $15,000 to $20,000) and allow her to just pay the difference for the safer treatment.
After much frustration and angst (imagine having to deal with this scenario while trying to cope with the effects of chemotherapy and healing from cancer), she and her husband refinanced their home so that they could pay the $30,000 cost of this treatment completely out of pocket.
This is just one example of the many sad and unjust scenarios of our broken healthcare system. Because healthcare is considered a marketplace commodity, the concern for profit is paramount; the provision of healthcare itself is secondary. Much of healthcare money is siphoned away from patient care into huge corporate salaries and shareholder profits, which leads to administrative decisions to ignore laws regarding staffing by ratio and acuity and to reductions in ancillary staff, both of which greatly affect the quality and safety of care we can provide.
Because RNs believe that patient needs are paramount, because state law in the form of the California Nurse Practice Act requires us to be advocates for our patients or risk losing our licenses, because we actually care about the health and welfare of human beings, because weâ€™re unableâ€”due to administrative decisions to limit resourcesâ€”to provide the quality of care that we feel is the right of all of our patients, frustrated and stymied RNs leave/are driven from acute care, exacerbating the current shortage of nurses at the bedside.
Who makes up the healthcare industry? Hospital corporations that are more concerned with market share and CEO compensation than in providing care to patients. Pharmaceutical corporations that care about the same, and that spend millions of dollars to keep the costs of their drugs and their profits as high as possible, even if it means forcing people to choose between paying for food or rent or buying their medications. Insurance corporations that wonâ€™t cover you if you have preexisting conditions, will drop you if you develop a costly condition, and that refuse to pay for a safer treatment for a woman with breast cancer. These corporations are the largest part of our healthcare industry, an industry that, due to its millions of dollars spent on campaign contributions and lobbying, owns our elected officials, the very people we should be able to rely upon in order to improve things.
Examples of this are big campaign contributors who get policy paybacks at great public cost: In the national healthcare arena, more than 50 Bush fundraisers who raised $100,000 or $200,000 each for the presidentâ€™s campaigns are employed by the healthcare industry. Among them is William McGuire, CEO of United Health Group, which is benefiting handsomely from the new Medicare law. Administration appointee Daniel Troy, who became Food and Drug Administration counsel in 2001, made his career in private practice representing pharmaceutical industries and pursued policies at the FDA in the interest of this industry.
The lead sponsor of the Medicare house legislation, Rep. Dennis Hastert (R-IL) ranks sixth in the House for lifetime contributions from pharmaceutical manufacturers; in the Senate, the lead sponsor of this same legislation, Senator Bill Frist, ranks 15th. Representative Bill Thomas (R-CA), who ranks third among his colleagues for campaign contributions from the health sector, receiving $1.9 million over the course of his career in Congress, is a champion of including Health Savings Accounts (HSAs) in the new Medicare law; policy experts say HSAs are a boon to the wealthy and will actually contribute to an increase in the number of uninsured Americans.
This is why the California Nurses Association is working to put the California Nurses Clean Money and Fair Elections Act on the ballot this November. This initiative provides for public funds for candidates who voluntarily agree not to accept private and/or corporate contributions, bans contributions to candidates from lobbyists and state contractors, and limits corporate contributions to ballot measures.
The intended result is that elected officials are not beholden to wealthy or corporate donors, but answer to the public, i.e., regular citizens who have voted them into office. In Arizona and Maine, where this type of election reform has already been instituted, there has been a surge in the number of women, minorities and working people who are able to run for office and win. Voter turnout has increased.
Arizona now has prescription drug subsidies for seniors, and â€œMaine Rxâ€? is a heralded prescription drug program that saves patients as much as 60% of market prices for medications. Meanwhile, 6.5 million Californians, including 1.6 million children, are uninsured, with nearly 80% of uninsured Californians from working families. Nationally, medical expenses cause half of all personal bankruptcies. And lack of health insurance is the 7th leading cause of death in the United States. â€
Under the current political system, we cannot take care of patients the way they deserve, the way we were taught to, the way our governing board requires us to. As patients ourselves, we will not be given the best care possible, as long as corporate interests run the show. Not everyone has a house he or she can mortgage to pay for health care. And no one should have to. With 94% of Congressional races going to the candidate who spends the most money, it is time to take our democracy back.
The first step to returning democracy to Americans and cleaning up the health and welfare of the citizens of this state is clean money elections. And, as Bill Moyers so aptly put it, this is â€œthe reform that makes the other reforms finally possible.â€? âˆ†
Sherri Stoddard is on the Board of Directors of the California Nurses Association covering the Central Coast region. You can reach her at firstname.lastname@example.org