Health Care Reform, Politics and the Impact on Nursing

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Health Care Reform, Politics and the Impact on
Nursing

• Tina C. Gordon, MPA, CAE
• Chief Executive Officer
• North Carolina Nurses Association

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Background

• Why the significant interest in
• health care reform?
• Rising cost of health care
• Rising cost of and decreasing access to insurance
  coverage
• National leadership/political agenda

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Background

• Within 10 years, if the health system is not
  reformed
• The number of people without insurance will
  increase by more then 30 in 29 states and by at
  least 10 in all 50
• Uncompensated care will more than double in 45
  states
• Businesses will see premiums increase more than
  doubling in 27 states
• Every state will see spending for Medicaid/CHIP
  rise by at least 75
• Urban Institute

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Background

• Under current system, around half of all
  Americans under 65 will lose their health
  coverage at some point over next ten years.
• In the last 12 months, six million more Americans
  lost their health insurance.
• Harvard researchers found that 62 of all U.S.
  personal bankruptcies were caused by health
  problems 78 of those had insurance.

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Background
Economic Impact Health care spending represented
17 of the GDP in 2008. 2.37 Trillion Costs
are expected to increase 6.2 annually through
2018 (20 of GDP) Health Care provides over 14
million jobs 3 million new jobs over the next
decade
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Political Environment

• The politics of health care reform
• Top priority for President Obama and
  Congressional Democrats
• Political Opportunity Democrats control White
  House and Congress (60 seats in Senate)
• Major stakeholders supporting reform
• Spending lobbying and advertising

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Nursings Position

• Goals of Health Care Reform
• Bring Stability and Improved Care to Americans by
  offering new consumer protections
• Reduce Costs to make health care affordable
• Protect a Patients Choice of Providers,
  hospitals and insurance plans
• Assure Quality, Affordable Health Care for all
  patients

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Reasons to Support Health Care Reform

• Ends Discrimination for Pre-existing Condition
• Ends Exorbitant Out-of-Pocket Expenses,
  deductibles or Co-pays
• Ends Cost-Sharing for Preventive Care
• Ends Dropping of Coverage for Seriously Ill.

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Reasons to Support Health Care Reform

• Ends Gender Discrimination
• Ends Annual or Lifetime Caps on Coverage
• Extends Coverage for Young Adults
• Guarantees Insurance Renewal

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Key Hang-ups

• Public Plan
• Employer Mandate
• Cost/How to Pay for Reform

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Public Plan

• SUPPORTERS (including ANA)
• Broader choice for patients
• Increase affordability
• Foster marketplace competition
• Ensure access to services.
• OPPONENTS
• Will drive private insurers out of business
• Will increase cost-shifting to private insurance
• Back Door to single payer system

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Impact on Nursing

• House Resolution 3200 Americans Affordable
  Health Choices Act of 2009
• HR 3200 focuses on community-based
  multidisciplinary teams to support primary care
  through the medical home model (NPs are
  recognized as primary care providers and
  authorized to lead medical homes)

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Impact on Nursing

• HR 3200 would bolster the nursing profession and
  foster full integration, coordination and
  collaboration at all levels among our nations
  healthcare workforce
• HR 3200 seeks to improve maternal and infant
  health. This bill increases reimbursement to
  100 for midwifery services (CNMs currently
  reimbursed at 65)

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HR 3200 Common Myths

• Myth 1 Hospitals will receive less money and
  will be forced to decrease nursing staff.
• Myth 2 Health care will be rationed.
• Myth 3 All non-US citizens, illegal or not,
  will be provided with free health care services.

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Common Myths (cont.)

• Myth 4 The government mandates a program for
  orders for end-of-life the government will have
  a say in how your life ends. The government will
  specify which doctors can write an end of life
  order and will decide what level of treatment you
  will have during end-of-life care.

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Nursing Workforce

• Coverage Does Not Equal Access
• The supply of nurses must be sufficient in order
  for health care reform to be successful

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Current Status

• An update from Capitol Hill

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Next Steps

• What can you do to get involved?

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Nurses Make a Difference

• Do your part -- nurses, you guys have a lot of
  credibility touch a lot of people's lives
  people trust you -- if you're out there saying
  it's time for us to act...America will finally
  join the ranks of every other advanced nation by
  providing quality, affordable health insurance to
  all of its citizens.
• President Barack Obama , addressing nurses after
  being introduced by ANAs President Patton,
  September 10, 2009

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For More Information

• North Carolina Nurses Association
• www.ncnurses.org
• 1-800-626-2153
• rns_at_ncnurses.org
• American Nurses Association
• www.RNaction.org/healthcare