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A Health Care System
        that Fits
   Nursing Values
    Barbara Qualley RN, BSN
        December 2010



               1
USA Health Care:
 60 Minute Report




        2
USA Health Care:
         60 Minute Report

‣Nursing Values and Health Care




                  2
USA Health Care:
             60 Minute Report

‣Nursing Values and Health Care
‣ Current Problems
  *How did we get here?




                          2
USA Health Care:
              60 Minute Report

‣Nursing Values and Health Care
‣ Current Problems
  *How did we get here?
  *Confusing, Complicated, Costly, Inefficient, Profits




                            2
USA Health Care:
              60 Minute Report

‣Nursing Values and Health Care
‣ Current Problems
  *How did we get here?
  *Confusing, Complicated, Costly, Inefficient, Profits
‣ Solution:
       Creating a Health Care System
       that Fits Nursing Values

                            2
Our Activist Roots:
                                                     Florence Nightingale




http://www.nightingaledeclaration.net/2010-international-year-nurse/
                                                                       3
Our Activist Roots:
                                                     Florence Nightingale




                         “You must inform public opinion…” Florence Nightingale, 1893

         She was an articulate public communicator, community and social activist, environmentalist and
                         ardent advocate for human rights and worldwide social reform.




http://www.nightingaledeclaration.net/2010-international-year-nurse/
                                                                       3
Our Activist Roots:
                                                     Florence Nightingale




                         “You must inform public opinion…” Florence Nightingale, 1893

         She was an articulate public communicator, community and social activist, environmentalist and
                         ardent advocate for human rights and worldwide social reform.


                                               She called all of this “nursing.”

http://www.nightingaledeclaration.net/2010-international-year-nurse/
                                                                       3
Nursing Values



      4
Code of Ethics for Nurses With
   Interpretive Statements




               5
Code of Ethics for Nurses With
       Interpretive Statements


•8.1 Health needs and concerns




                   5
Code of Ethics for Nurses With
       Interpretive Statements


•8.1 Health needs and concerns




                   5
Code of Ethics for Nurses With
        Interpretive Statements


•8.1 Health needs and concerns

•8.2 Responsibilities to the public




                     5
Code of Ethics for Nurses With
        Interpretive Statements


•8.1 Health needs and concerns

•8.2 Responsibilities to the public




                     5
Code of Ethics for Nurses With
        Interpretive Statements


•8.1 Health needs and concerns

•8.2 Responsibilities to the public

• Provision 9


                     5
Code of Ethics for Nurses With
        Interpretive Statements


•8.1 Health needs and concerns

•8.2 Responsibilities to the public

• Provision 9


                     5
Code of Ethics for Nurses With
        Interpretive Statements


•8.1 Health needs and concerns

•8.2 Responsibilities to the public

• Provision 9

•9.4 Social Reform
                     5
6
SUMMARY




   6
SUMMARY
Code of Ethics for Nurses




            6
SUMMARY
Code of Ethics for Nurses




            6
SUMMARY
                   Code of Ethics for Nurses

Nurses are concerned with:




                               6
SUMMARY
                   Code of Ethics for Nurses

Nurses are concerned with:




                               6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people




                                     6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people




                                     6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community

✴the lack of access to health services




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community

✴the lack of access to health services




                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community

✴the lack of access to health services

✴shaping social policy


                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community

✴the lack of access to health services

✴shaping social policy


                                      6
SUMMARY
                    Code of Ethics for Nurses

Nurses are concerned with:

✴promoting the health, welfare, and safety of all people

✴lack of access to health care, violation of human rights, and inequitable
distribution of nursing and health care resources

✴the health status of the community

✴the lack of access to health services

✴shaping social policy

✴bringing about social change
                                      6
Definitions



    7
Your Own Personal Definitions

  Using a quantity from 1 to 100,
           how many is:

             A few?
           Almost all?
             Most?

                 8
Definitions




    9
Definitions
 Universal health care




                   9
Definitions
 Universal health care
  Access for all to health care




                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
  or how good the coverage is




                     9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
   or how good the coverage is
  Ex: Insurance Mandate




                     9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System




                      9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered




                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered
   Improved Medicare-for-all




                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered
   Improved Medicare-for-all
   A type of national health insurance




                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered
   Improved Medicare-for-all
   A type of national health insurance
 Socialized Medicine




                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered
   Improved Medicare-for-all
   A type of national health insurance
 Socialized Medicine
   Publicly-financed, publicly owned



                       9
Definitions
 Universal health care
  Access for all to health care
  Doesn’t specify how they get coverage
    or how good the coverage is
   Ex: Insurance Mandate
 Single-Payer System
   Publicly-financed, privately delivered
   Improved Medicare-for-all
   A type of national health insurance
 Socialized Medicine
   Publicly-financed, publicly owned
   Payer also employs providers (Veterans Hospitals)


                       9
Definitions




    10
Definitions
 Health Insurance




                     10
Definitions
 Health Insurance
  Public




                     10
Definitions
 Health Insurance
  Public
  Medicare,   Medicaid, Veterans Admin.




                               10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.


 Health Care




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.


 Health Care
  Public




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.


 Health Care
  Public
   VA,   county hospitals



                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.


 Health Care
  Public
   VA,   county hospitals
  Private




                                10
Definitions
 Health Insurance
  Public
   Medicare,   Medicaid, Veterans Admin.
  Private
   BlueCross BlueShield, United Health
    Care, HealthPartners, Medica, Self-
    Insured businesses, etc.


 Health Care
  Public
   VA,   county hospitals
  Private
   Most hospitals, nursing homes, and
    doctor’s offices
                                10
History
Grassroots movements
have been successful!!!
But, not quickly.


Women’s suffrage >70 yrs




Civil Rights: Centuries
 (recently 1948-1971+)

                          11
History: Elusive Search for National
         Health Insurance




                 12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912




                                    12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912




                                    12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security




                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security

•Strategy was to enact a piece (Medicare) with the ultimate plan of
growing into National Health Insurance



                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security

•Strategy was to enact a piece (Medicare) with the ultimate plan of
growing into National Health Insurance



                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security

•Strategy was to enact a piece (Medicare) with the ultimate plan of
growing into National Health Insurance

•Elderly chosen because they had higher rates of poverty and less
insurance
                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security

•Strategy was to enact a piece (Medicare) with the ultimate plan of
growing into National Health Insurance

•Elderly chosen because they had higher rates of poverty and less
insurance
                                     12
History: Elusive Search for National
           Health Insurance
•Federal debate and interest began in 1912
•Initial attempts (1912-1952) involved legislating for National Health
Insurance (similar to other nations who covered all)

•Ideological divisions and special interest groups polarized initiatives
which prevented passage

•Officials in Truman Administration (1951) developed a plan to provide
federal health insurance only to aged on Social Security

•Strategy was to enact a piece (Medicare) with the ultimate plan of
growing into National Health Insurance

•Elderly chosen because they had higher rates of poverty and less
insurance
                              (Oberlander,12
                                           2003, p 15-25)
The United
                     States
                     is the

          ONLY
    Industrialized Nation
without Universal Health Care
              13
Statistics




    14
Statistics



       55,000 American deaths in 2008
due to lack of money/insurance for health care




                      14
Statistics



       55,000 American deaths in 2008
due to lack of money/insurance for health care

  50.7 million Americans are now uninsured
       and even more are underinsured




                      14
So, where are we now?
What are the problems?




          15
So, where are we now?
What are the problems?




          15
Current bureaucracy




         16
Current bureaucracy

➡ Rations health care by: health status and ability to pay




                             16
Current bureaucracy

➡ Rations health care by: health status and ability to pay
➡ Costly: highest cost per person in the world




                             16
Current bureaucracy

➡ Rations health care by: health status and ability to pay
➡ Costly: highest cost per person in the world
➡ Health outcomes: mediocre




                             16
Current bureaucracy

➡   Rations health care by: health status and ability to pay
➡   Costly: highest cost per person in the world
➡   Health outcomes: mediocre
➡   Profit making: health care not seen as a right, but as a
-   commodity




                              16
Current bureaucracy

➡   Rations health care by: health status and ability to pay
➡   Costly: highest cost per person in the world
➡   Health outcomes: mediocre
➡   Profit making: health care not seen as a right, but as a
-   commodity
➡   Wasteful: inefficient use of time, money, resources




                              16
Current bureaucracy

➡   Rations health care by: health status and ability to pay
➡   Costly: highest cost per person in the world
➡   Health outcomes: mediocre
➡   Profit making: health care not seen as a right, but as a
-   commodity
➡   Wasteful: inefficient use of time, money, resources
➡   User UNFRIENDLY: confusing and stressful




                              16
Current bureaucracy

➡   Rations health care by: health status and ability to pay
➡   Costly: highest cost per person in the world
➡   Health outcomes: mediocre
➡   Profit making: health care not seen as a right, but as a
-   commodity
➡   Wasteful: inefficient use of time, money, resources
➡   User UNFRIENDLY: confusing and stressful
➡   Mysterious: never know what will be covered



                              16
Current bureaucracy

➡   Rations health care by: health status and ability to pay
➡   Costly: highest cost per person in the world
➡   Health outcomes: mediocre
➡   Profit making: health care not seen as a right, but as a
-   commodity
➡   Wasteful: inefficient use of time, money, resources
➡   User UNFRIENDLY: confusing and stressful
➡   Mysterious: never know what will be covered
➡   Complicated: impossible for average person to
-    understand, especially when sick

                              16
Health Care Spending per Person,
             2007




                Sources: OECD, 2009
        Health Affairs, 2002 – Data from 2006
                          17
The Insured




Source: American Journal of Medicine, 2009

                     18
The Insured




Source: American Journal of Medicine, 2009

                     18
The Insured

           62% of personal bankruptcies
             due to medical expenses (2007)




Source: American Journal of Medicine, 2009

                     18
The Insured

           62% of personal bankruptcies
             due to medical expenses (2007)




Source: American Journal of Medicine, 2009

                     18
The Insured

           62% of personal bankruptcies
             due to medical expenses (2007)




Source: American Journal of Medicine, 2009

                     18
The Insured

           62% of personal bankruptcies
             due to medical expenses (2007)

           78% of people with medical
             bankruptcies had health
             insurance when they got sick


Source: American Journal of Medicine, 2009

                     18
Life Expectancy




    Source: OECD, 2009
            19
Administrative
(In)Efficiency




      20
21
Text




   22
How did we get into this mess?




Employer Based Health Insurance/Care
Market Driven Approach
   Pharmaceutical Companies
   Insurance Companies
   Privatization of Hospitals & Doctors
                       23
24
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-

                   COST-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-

                   COST-




                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-

                   COST-

                  ACCESS-



                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-

                   COST-

                  ACCESS-



                     25
CONCERNS RE:
          NEW FEDERAL PLAN
THE PATIENT PROTECTION AND AFFORDABILITY ACT
                 MARCH 2010

               COMPLEXITY-

                  WASTE-

                   COST-

                  ACCESS-

                 INEQUITY-

                     25
The Solution:
        Single-Payer,
Universal Health Care System
  (Improved MEDICARE for ALL)




 Sources: New England Journal of Medicine, 2003
                  PNHP, 2009
                       26
The Solution:
                   Single-Payer,
           Universal Health Care System
              (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:




            Sources: New England Journal of Medicine, 2003
                             PNHP, 2009
                                  26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
  Reduce    administrative waste (US wastes 31%)




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
  Reduce administrative waste (US wastes 31%)
  Negotiate drug prices (VA spends 40% less on medications)




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
  Reduce  administrative waste (US wastes 31%)
  Negotiate drug prices (VA spends 40% less on medications)
  All other cost control methods easier to implement




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
  Reduce  administrative waste (US wastes 31%)
  Negotiate drug prices (VA spends 40% less on medications)
  All other cost control methods easier to implement
  Cover   everyone




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
  Reduce  administrative waste (US wastes 31%)
  Negotiate drug prices (VA spends 40% less on medications)
  All other cost control methods easier to implement
  Covereveryone
  Improve our health




                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
   Reduce  administrative waste (US wastes 31%)
   Negotiate drug prices (VA spends 40% less on medications)
   All other cost control methods easier to implement
  Cover everyone
  Improve our health
  Protect against financial ruin



                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
The Solution:
                      Single-Payer,
              Universal Health Care System
                    (Improved MEDICARE for ALL)
 Single-payer, universal health care has been shown to:
  Reduce   costs
   Reduce  administrative waste (US wastes 31%)
   Negotiate drug prices (VA spends 40% less on medications)
   All other cost control methods easier to implement
  Cover everyone
  Improve our health
  Protect against financial ruin
  Provide real choice


                Sources: New England Journal of Medicine, 2003
                                 PNHP, 2009
                                      26
27
SINGLE PAYER
      HEALTHCARE FINANCING
                             Rx
  MEDICARE
                             EYE CARE
  MEDICAID
              SINGLE PAYER
 EMPLOYER     HEALTHCARE
  PAYROLL         FUND
  TAX- 5.8%
               $$$$$$$$$$     DOCTOR
 EMPLOYEE
  PAYROLL
  TAX- 2.9%
                  28
Lewin 2001
29
MN Health Plan for All
   Minnesotans




          30
MN Health Plan for All
                Minnesotans

Simple, Direct System




                        30
MN Health Plan for All
                Minnesotans

Simple, Direct System
Pre-existing conditions covered




                                  30
MN Health Plan for All
                Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable




                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care




                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care
Universal




                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care
Universal
Single payer




                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care
Universal
Single payer
Comprehensive




                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care
Universal
Single payer
Comprehensive
Choice of doctors, NP, PA,
hospitals and clinics


                                  30
MN Health Plan for All
                  Minnesotans

Simple, Direct System
Pre-existing conditions covered
Affordable
Quality Care
Universal
Single payer
Comprehensive
Choice of doctors, NP, PA,
hospitals and clinics
Guaranteed for life

                                  30
Proposal for Legislation:
The Minnesota Health Plan




             31
Proposal for Legislation:
      The Minnesota Health Plan
The Minnesota Health Plan would provide
affordable health care for all Minnesotans.




                     31
Proposal for Legislation:
      The Minnesota Health Plan
The Minnesota Health Plan would provide
affordable health care for all Minnesotans.




                     31
Proposal for Legislation:
       The Minnesota Health Plan
The Minnesota Health Plan would provide
 affordable health care for all Minnesotans.

It would costs less and cover more.
 Minnesotans would choose the doctor they
 trust and get the care they need when they
 need it.




                      31
Proposal for Legislation:
       The Minnesota Health Plan
The Minnesota Health Plan would provide
 affordable health care for all Minnesotans.

It would costs less and cover more.
 Minnesotans would choose the doctor they
 trust and get the care they need when they
 need it.




                      31
Proposal for Legislation:
       The Minnesota Health Plan
The Minnesota Health Plan would provide
 affordable health care for all Minnesotans.

It would costs less and cover more.
 Minnesotans would choose the doctor they
 trust and get the care they need when they
 need it.

And they would have peace of mind
 knowing their coverage couldn’t be taken
 away.
                      31
Obstacles
Universal single-payer healthcare system




          32
Obstacles
            Universal single-payer healthcare system

•   Profit




                      32
Obstacles
               Universal single-payer healthcare system

•    Profit
•   Politics




                         32
Obstacles
             Universal single-payer healthcare system

•     Profit
•    Politics
•   Perception




                       32
Obstacles
             Universal single-payer healthcare system

•     Profit
•    Politics
•   Perception
•    Paranoia



                       32
Nurses are trusted
Gallup Poll Votes
Nurses Most Trusted
Profession (Dec 2010)

  For 11 years!


  83% of Americans believe nurses'
  honesty and ethical standards are
  either "high" or "very high”




                                  33
You can make a difference




            34
You can make a difference
•Learn more




              34
You can make a difference
•Learn more
• Join other nurses




                      34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators




                           34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators
• Join an advocacy group




                           34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators
• Join an advocacy group
•Organize locally



                           34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators
• Join an advocacy group
•Organize locally
•Talk to your friends, neighbors...



                           34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators
• Join an advocacy group
•Organize locally
•Talk to your friends, neighbors...
•Host a teach-in, movie night, book club...


                           34
You can make a difference
•Learn more
• Join other nurses
•Write letters to the editors, candidates, legislators
• Join an advocacy group
•Organize locally
•Talk to your friends, neighbors...
•Host a teach-in, movie night, book club...
•Vote

                           34
35
You can make a difference




            36
You can make a difference




            36
You can make a difference
• Join Nurses




                36
You can make a difference
• Join Nurses
•Learn more




                36
You can make a difference
• Join Nurses
•Learn more
•Talk to other nurses




                        36
You can make a difference
• Join Nurses
•Learn more
•Talk to other nurses
•Connect us with other nurses



                        36
IN OTHER WORDS:
IN OTHER WORDS:
   ★Educate
IN OTHER WORDS:
   ★Educate
   ★Organize
IN OTHER WORDS:
   ★Educate
   ★Organize
   ★Mobilize
38
38
Plant the
  Seed




and it will grow!
        39
Credits:
Rebekah Smith, Santwana Dasgupta, Minnesota
Universal Health Care Coalition, Minnesota Health
Reform Caucus


Amy Lange, RN, MS, Minnesota Universal Health
Care Coalition (MUHCC) www.muhcc.org


David Mair, MD, Physicians for a National Health
Program-Minnesota


Deborah Richter, www.vthca.org, Montpelier, VT
                        40
THANK YOU FOR YOUR
ATTENTION AND INTEREST


QUESTIONS AND COMMENTS?




           41

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A health care system that fits nursing values dec 9, 2010 1 ceu

  • 1. A Health Care System that Fits Nursing Values Barbara Qualley RN, BSN December 2010 1
  • 2. USA Health Care: 60 Minute Report 2
  • 3. USA Health Care: 60 Minute Report ‣Nursing Values and Health Care 2
  • 4. USA Health Care: 60 Minute Report ‣Nursing Values and Health Care ‣ Current Problems *How did we get here? 2
  • 5. USA Health Care: 60 Minute Report ‣Nursing Values and Health Care ‣ Current Problems *How did we get here? *Confusing, Complicated, Costly, Inefficient, Profits 2
  • 6. USA Health Care: 60 Minute Report ‣Nursing Values and Health Care ‣ Current Problems *How did we get here? *Confusing, Complicated, Costly, Inefficient, Profits ‣ Solution: Creating a Health Care System that Fits Nursing Values 2
  • 7. Our Activist Roots: Florence Nightingale http://www.nightingaledeclaration.net/2010-international-year-nurse/ 3
  • 8. Our Activist Roots: Florence Nightingale “You must inform public opinion…” Florence Nightingale, 1893 She was an articulate public communicator, community and social activist, environmentalist and ardent advocate for human rights and worldwide social reform. http://www.nightingaledeclaration.net/2010-international-year-nurse/ 3
  • 9. Our Activist Roots: Florence Nightingale “You must inform public opinion…” Florence Nightingale, 1893 She was an articulate public communicator, community and social activist, environmentalist and ardent advocate for human rights and worldwide social reform. She called all of this “nursing.” http://www.nightingaledeclaration.net/2010-international-year-nurse/ 3
  • 11. Code of Ethics for Nurses With Interpretive Statements 5
  • 12. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns 5
  • 13. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns 5
  • 14. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns •8.2 Responsibilities to the public 5
  • 15. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns •8.2 Responsibilities to the public 5
  • 16. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns •8.2 Responsibilities to the public • Provision 9 5
  • 17. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns •8.2 Responsibilities to the public • Provision 9 5
  • 18. Code of Ethics for Nurses With Interpretive Statements •8.1 Health needs and concerns •8.2 Responsibilities to the public • Provision 9 •9.4 Social Reform 5
  • 19. 6
  • 20. SUMMARY 6
  • 21. SUMMARY Code of Ethics for Nurses 6
  • 22. SUMMARY Code of Ethics for Nurses 6
  • 23. SUMMARY Code of Ethics for Nurses Nurses are concerned with: 6
  • 24. SUMMARY Code of Ethics for Nurses Nurses are concerned with: 6
  • 25. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people 6
  • 26. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people 6
  • 27. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources 6
  • 28. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources 6
  • 29. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community 6
  • 30. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community 6
  • 31. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community ✴the lack of access to health services 6
  • 32. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community ✴the lack of access to health services 6
  • 33. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community ✴the lack of access to health services ✴shaping social policy 6
  • 34. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community ✴the lack of access to health services ✴shaping social policy 6
  • 35. SUMMARY Code of Ethics for Nurses Nurses are concerned with: ✴promoting the health, welfare, and safety of all people ✴lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources ✴the health status of the community ✴the lack of access to health services ✴shaping social policy ✴bringing about social change 6
  • 37. Your Own Personal Definitions Using a quantity from 1 to 100, how many is: A few? Almost all? Most? 8
  • 40. Definitions  Universal health care  Access for all to health care 9
  • 41. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is 9
  • 42. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate 9
  • 43. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System 9
  • 44. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered 9
  • 45. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered  Improved Medicare-for-all 9
  • 46. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered  Improved Medicare-for-all  A type of national health insurance 9
  • 47. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered  Improved Medicare-for-all  A type of national health insurance  Socialized Medicine 9
  • 48. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered  Improved Medicare-for-all  A type of national health insurance  Socialized Medicine  Publicly-financed, publicly owned 9
  • 49. Definitions  Universal health care  Access for all to health care  Doesn’t specify how they get coverage or how good the coverage is  Ex: Insurance Mandate  Single-Payer System  Publicly-financed, privately delivered  Improved Medicare-for-all  A type of national health insurance  Socialized Medicine  Publicly-financed, publicly owned  Payer also employs providers (Veterans Hospitals) 9
  • 53. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin. 10
  • 54. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private 10
  • 55. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc. 10
  • 56. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc. 10
  • 57. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc.  Health Care 10
  • 58. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc.  Health Care  Public 10
  • 59. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc.  Health Care  Public VA, county hospitals 10
  • 60. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc.  Health Care  Public VA, county hospitals  Private 10
  • 61. Definitions  Health Insurance  Public Medicare, Medicaid, Veterans Admin.  Private BlueCross BlueShield, United Health Care, HealthPartners, Medica, Self- Insured businesses, etc.  Health Care  Public VA, county hospitals  Private Most hospitals, nursing homes, and doctor’s offices 10
  • 62. History Grassroots movements have been successful!!! But, not quickly. Women’s suffrage >70 yrs Civil Rights: Centuries (recently 1948-1971+) 11
  • 63. History: Elusive Search for National Health Insurance 12
  • 64. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 12
  • 65. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 12
  • 66. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) 12
  • 67. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) 12
  • 68. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage 12
  • 69. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage 12
  • 70. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security 12
  • 71. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security 12
  • 72. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security •Strategy was to enact a piece (Medicare) with the ultimate plan of growing into National Health Insurance 12
  • 73. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security •Strategy was to enact a piece (Medicare) with the ultimate plan of growing into National Health Insurance 12
  • 74. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security •Strategy was to enact a piece (Medicare) with the ultimate plan of growing into National Health Insurance •Elderly chosen because they had higher rates of poverty and less insurance 12
  • 75. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security •Strategy was to enact a piece (Medicare) with the ultimate plan of growing into National Health Insurance •Elderly chosen because they had higher rates of poverty and less insurance 12
  • 76. History: Elusive Search for National Health Insurance •Federal debate and interest began in 1912 •Initial attempts (1912-1952) involved legislating for National Health Insurance (similar to other nations who covered all) •Ideological divisions and special interest groups polarized initiatives which prevented passage •Officials in Truman Administration (1951) developed a plan to provide federal health insurance only to aged on Social Security •Strategy was to enact a piece (Medicare) with the ultimate plan of growing into National Health Insurance •Elderly chosen because they had higher rates of poverty and less insurance (Oberlander,12 2003, p 15-25)
  • 77. The United States is the ONLY Industrialized Nation without Universal Health Care 13
  • 79. Statistics 55,000 American deaths in 2008 due to lack of money/insurance for health care 14
  • 80. Statistics 55,000 American deaths in 2008 due to lack of money/insurance for health care 50.7 million Americans are now uninsured and even more are underinsured 14
  • 81. So, where are we now? What are the problems? 15
  • 82. So, where are we now? What are the problems? 15
  • 84. Current bureaucracy ➡ Rations health care by: health status and ability to pay 16
  • 85. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world 16
  • 86. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre 16
  • 87. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre ➡ Profit making: health care not seen as a right, but as a - commodity 16
  • 88. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre ➡ Profit making: health care not seen as a right, but as a - commodity ➡ Wasteful: inefficient use of time, money, resources 16
  • 89. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre ➡ Profit making: health care not seen as a right, but as a - commodity ➡ Wasteful: inefficient use of time, money, resources ➡ User UNFRIENDLY: confusing and stressful 16
  • 90. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre ➡ Profit making: health care not seen as a right, but as a - commodity ➡ Wasteful: inefficient use of time, money, resources ➡ User UNFRIENDLY: confusing and stressful ➡ Mysterious: never know what will be covered 16
  • 91. Current bureaucracy ➡ Rations health care by: health status and ability to pay ➡ Costly: highest cost per person in the world ➡ Health outcomes: mediocre ➡ Profit making: health care not seen as a right, but as a - commodity ➡ Wasteful: inefficient use of time, money, resources ➡ User UNFRIENDLY: confusing and stressful ➡ Mysterious: never know what will be covered ➡ Complicated: impossible for average person to - understand, especially when sick 16
  • 92. Health Care Spending per Person, 2007 Sources: OECD, 2009 Health Affairs, 2002 – Data from 2006 17
  • 93. The Insured Source: American Journal of Medicine, 2009 18
  • 94. The Insured Source: American Journal of Medicine, 2009 18
  • 95. The Insured 62% of personal bankruptcies due to medical expenses (2007) Source: American Journal of Medicine, 2009 18
  • 96. The Insured 62% of personal bankruptcies due to medical expenses (2007) Source: American Journal of Medicine, 2009 18
  • 97. The Insured 62% of personal bankruptcies due to medical expenses (2007) Source: American Journal of Medicine, 2009 18
  • 98. The Insured 62% of personal bankruptcies due to medical expenses (2007) 78% of people with medical bankruptcies had health insurance when they got sick Source: American Journal of Medicine, 2009 18
  • 99. Life Expectancy Source: OECD, 2009 19
  • 101. 21
  • 102. Text 22
  • 103. How did we get into this mess? Employer Based Health Insurance/Care Market Driven Approach Pharmaceutical Companies Insurance Companies Privatization of Hospitals & Doctors 23
  • 104. 24
  • 105. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 25
  • 106. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- 25
  • 107. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- 25
  • 108. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- 25
  • 109. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- 25
  • 110. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- COST- 25
  • 111. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- COST- 25
  • 112. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- COST- ACCESS- 25
  • 113. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- COST- ACCESS- 25
  • 114. CONCERNS RE: NEW FEDERAL PLAN THE PATIENT PROTECTION AND AFFORDABILITY ACT MARCH 2010 COMPLEXITY- WASTE- COST- ACCESS- INEQUITY- 25
  • 115. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL) Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 116. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to: Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 117. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 118. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 119. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 120. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) All other cost control methods easier to implement Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 121. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) All other cost control methods easier to implement  Cover everyone Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 122. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) All other cost control methods easier to implement  Covereveryone  Improve our health Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 123. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) All other cost control methods easier to implement  Cover everyone  Improve our health  Protect against financial ruin Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 124. The Solution: Single-Payer, Universal Health Care System (Improved MEDICARE for ALL)  Single-payer, universal health care has been shown to:  Reduce costs Reduce administrative waste (US wastes 31%) Negotiate drug prices (VA spends 40% less on medications) All other cost control methods easier to implement  Cover everyone  Improve our health  Protect against financial ruin  Provide real choice Sources: New England Journal of Medicine, 2003 PNHP, 2009 26
  • 125. 27
  • 126. SINGLE PAYER HEALTHCARE FINANCING Rx MEDICARE EYE CARE MEDICAID SINGLE PAYER EMPLOYER HEALTHCARE PAYROLL FUND TAX- 5.8% $$$$$$$$$$ DOCTOR EMPLOYEE PAYROLL TAX- 2.9% 28 Lewin 2001
  • 127. 29
  • 128. MN Health Plan for All Minnesotans 30
  • 129. MN Health Plan for All Minnesotans Simple, Direct System 30
  • 130. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered 30
  • 131. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable 30
  • 132. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care 30
  • 133. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care Universal 30
  • 134. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care Universal Single payer 30
  • 135. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care Universal Single payer Comprehensive 30
  • 136. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care Universal Single payer Comprehensive Choice of doctors, NP, PA, hospitals and clinics 30
  • 137. MN Health Plan for All Minnesotans Simple, Direct System Pre-existing conditions covered Affordable Quality Care Universal Single payer Comprehensive Choice of doctors, NP, PA, hospitals and clinics Guaranteed for life 30
  • 138. Proposal for Legislation: The Minnesota Health Plan 31
  • 139. Proposal for Legislation: The Minnesota Health Plan The Minnesota Health Plan would provide affordable health care for all Minnesotans. 31
  • 140. Proposal for Legislation: The Minnesota Health Plan The Minnesota Health Plan would provide affordable health care for all Minnesotans. 31
  • 141. Proposal for Legislation: The Minnesota Health Plan The Minnesota Health Plan would provide affordable health care for all Minnesotans. It would costs less and cover more. Minnesotans would choose the doctor they trust and get the care they need when they need it. 31
  • 142. Proposal for Legislation: The Minnesota Health Plan The Minnesota Health Plan would provide affordable health care for all Minnesotans. It would costs less and cover more. Minnesotans would choose the doctor they trust and get the care they need when they need it. 31
  • 143. Proposal for Legislation: The Minnesota Health Plan The Minnesota Health Plan would provide affordable health care for all Minnesotans. It would costs less and cover more. Minnesotans would choose the doctor they trust and get the care they need when they need it. And they would have peace of mind knowing their coverage couldn’t be taken away. 31
  • 145. Obstacles Universal single-payer healthcare system • Profit 32
  • 146. Obstacles Universal single-payer healthcare system • Profit • Politics 32
  • 147. Obstacles Universal single-payer healthcare system • Profit • Politics • Perception 32
  • 148. Obstacles Universal single-payer healthcare system • Profit • Politics • Perception • Paranoia 32
  • 149. Nurses are trusted Gallup Poll Votes Nurses Most Trusted Profession (Dec 2010) For 11 years! 83% of Americans believe nurses' honesty and ethical standards are either "high" or "very high” 33
  • 150. You can make a difference 34
  • 151. You can make a difference •Learn more 34
  • 152. You can make a difference •Learn more • Join other nurses 34
  • 153. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators 34
  • 154. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators • Join an advocacy group 34
  • 155. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators • Join an advocacy group •Organize locally 34
  • 156. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators • Join an advocacy group •Organize locally •Talk to your friends, neighbors... 34
  • 157. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators • Join an advocacy group •Organize locally •Talk to your friends, neighbors... •Host a teach-in, movie night, book club... 34
  • 158. You can make a difference •Learn more • Join other nurses •Write letters to the editors, candidates, legislators • Join an advocacy group •Organize locally •Talk to your friends, neighbors... •Host a teach-in, movie night, book club... •Vote 34
  • 159. 35
  • 160. You can make a difference 36
  • 161. You can make a difference 36
  • 162. You can make a difference • Join Nurses 36
  • 163. You can make a difference • Join Nurses •Learn more 36
  • 164. You can make a difference • Join Nurses •Learn more •Talk to other nurses 36
  • 165. You can make a difference • Join Nurses •Learn more •Talk to other nurses •Connect us with other nurses 36
  • 167. IN OTHER WORDS: ★Educate
  • 168. IN OTHER WORDS: ★Educate ★Organize
  • 169. IN OTHER WORDS: ★Educate ★Organize ★Mobilize
  • 170. 38
  • 171. 38
  • 172. Plant the Seed and it will grow! 39
  • 173. Credits: Rebekah Smith, Santwana Dasgupta, Minnesota Universal Health Care Coalition, Minnesota Health Reform Caucus Amy Lange, RN, MS, Minnesota Universal Health Care Coalition (MUHCC) www.muhcc.org David Mair, MD, Physicians for a National Health Program-Minnesota Deborah Richter, www.vthca.org, Montpelier, VT 40
  • 174. THANK YOU FOR YOUR ATTENTION AND INTEREST QUESTIONS AND COMMENTS? 41

Editor's Notes

  1. I am Barbara, the Nurse. I’m delighted to be here tonight and I thank you for coming out on this wintery afternoon. I’ve been a registered nurse for over 30 years. Since I was a teenager, I have had an intense interest and passion for supporting the creation of a simplified, cost effective, community centered health care system covering everyone. I even went door knocking at age 15! \n\nRecently, I spent four years learning about the mess we are currently in. I read dry, boring books on health care reform to build a knowledge base. I read websites and attended presentations devoted to health care reform and found conflicting information. I read research and knowing that numbers can be manipulated, I questioned the results. And, I talked with people. All of this required a lot of time and energy to understand all that was being presented, yet I felt compelled to educate myself and become active. \n\nI struggled to understand the confusing ideas being presented. So complicated! Who was right? Who was wrong? I asked myself many questions and searched out answers. Does our Health Care bureaucracy need to change in incremental steps? Do we continue to cater to the powerful people representing the insurance and pharmaceutical businesses? Or, do we need to create and agree on the goal of covering every American through a humane, cost effective system and then develop the plan based on that? \n\nI did not start out thinking we could have a process where the all the billing for health care expenses went through a single payer system or that the government should be involved with this. I wondered if we did create a system where every American was covered by a National Health Plan, would people abuse it. Would they continue risky behavior and be irresponsible, causing those of us who try to be responsible to pay for those who are not? Would people become lazy? Would it be socialized medicine? Would there be rationing of care? Would choice of care and doctor be taking away? How would it be paid for? What impact would it have on the stakeholders? \n\nNow that I’ve done this research, listened to and joined other people, and worked on health care reform, it’s clear to me that our nursing values can guide us in creating and supporting plans for a new health care system.\n\n
  2. \n
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  6.  “You must inform public opinion…” Florence Nightingale, 1893 She was an articulate public communicator, community and social activist, environmentalist and ardent advocate for human rights and worldwide social reform. She influenced local, national, and international leaders and fought to keep the issues related to health in the public eye. She call all of this “nursing.” http://www.nightingaledeclaration.net/2010-international-year-nurse/Today, in our 21st century ‘global village’, these broader insights from Nightingale can become innovative approaches developed by nurses who seek to impact and influence the factors which will determine and sustain the health of humanity in our time. http://www.2010iynurse.net/Florence_Nightingale.aspx \n
  7.  “You must inform public opinion…” Florence Nightingale, 1893 She was an articulate public communicator, community and social activist, environmentalist and ardent advocate for human rights and worldwide social reform. She influenced local, national, and international leaders and fought to keep the issues related to health in the public eye. She call all of this “nursing.” http://www.nightingaledeclaration.net/2010-international-year-nurse/Today, in our 21st century ‘global village’, these broader insights from Nightingale can become innovative approaches developed by nurses who seek to impact and influence the factors which will determine and sustain the health of humanity in our time. http://www.2010iynurse.net/Florence_Nightingale.aspx \n
  8. \n
  9. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  10. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  11. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  12. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  13. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  14. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
  15. 8.1 Health needs and concerns-The nursing profession is committed to promoting the health, welfare, and safety of all people. The nurse has a responsibility to be aware not only of specific health needs of individual patients but also of broader health concerns such as world hunger, environmental pollution, lack of access to health care, violation of human rights, and inequitable distribution of nursing and health care resources. The availability and accessibility of high quality health services to all people require both interdisciplinary planning and collaborative partnerships among health professionals and others at the community, national, and international levels. \n8.2 Responsibilities to the public-\nNurses, individually and collectively, have a responsibility to be knowledgeable about the health status of the community and existing threats to health and safety. ... In addition, the nurse supports initiatives to address barriers to health, such as poverty, homelessness, unsafe living conditions, abuse and violence, and lack of access to health services. \nProvision 9 \nThe profession of nursing,... as represented by associations and their members, is responsible for articulating nursing values, and for maintaining the integrity of the profession and its practice, and for shaping social policy. \n\n9.4 Social Reform- Nurses can work individually as citizens or collectively through political action to bring about social change.\n
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  32. The definition of communication is: From the mind of one to the mind of another--with understanding. Without understanding there is no communication. So, we must use shared definitions to have true communication. But, that is not as easy as it sounds. We constantly hear words and phrases being spoken. And, We each have our own definitions of what they mean. What is socialism to you? What does single payer health care mean to you? What does universal health care mean to you? How do you define Medicare? \n
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  34. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  35. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  36. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  37. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  38. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  39. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  40. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  41. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  42. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  43. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
  44. Now, there are a few states who are actively working for a Universal, Single Payer System. MN is one of the states who is very actively seeking this. I guess I should say people in MN are actively seeking a USP system. So is California, Vermont, and Hawaii. And, I’d like to share what I think is exciting news. Vermont may be the first state to pass legislation... Elected Governor is an outspoken advocate and members of the VT Senate and House also support it. I’ll talk about MN a little later. \n
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  71. It’s hard to get our heads around this statistic unless it is your child, dear friend, spouse, or you. 150 deaths per day.\n
  72. It’s hard to get our heads around this statistic unless it is your child, dear friend, spouse, or you. 150 deaths per day.\n
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  74. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  75. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  76. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  77. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  78. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  79. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  80. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  81. There is a Widespread belief that because we spend the most and because we believe we must be the best, most Americans believe we have the best quality of care in the world. But the UsA is in the bottom 1/4 of all industrial countries for health indicators such as life expectancy and infant mortality. In 2000, the World Health Organization ranked us as 1st in expenditures (spending) and 37th overall in health system performance! \n
  82. In the United States, we pay over $7,000 PER PERSON for health care! As you can see on this graph, we pay way more than other other country. And, all those countries cover every one of their citizens. We do not even come close, even though we are paying so much more. In other words, we are already paying enough for health care for all--we just don’t get it. So, obviously something is wrong! What’s going on? Are we paying more because we have superior care? Are our people healthier than the other countries? Are we paying for and getting amazing new drugs and medical devices? As I mentioned the answers to those questions are “no”. Obviously, change is absolutely necessary.\n
  83. Health Insurance is a faulty product. Many people have insurance plans that don’t really cover expenses if they get sick. When you think about it, what value do we get from insurance companies? I’ve been asking this question now for awhile and I haven’t heard a good answer yet. \n
  84. Health Insurance is a faulty product. Many people have insurance plans that don’t really cover expenses if they get sick. When you think about it, what value do we get from insurance companies? I’ve been asking this question now for awhile and I haven’t heard a good answer yet. \n
  85. Health Insurance is a faulty product. Many people have insurance plans that don’t really cover expenses if they get sick. When you think about it, what value do we get from insurance companies? I’ve been asking this question now for awhile and I haven’t heard a good answer yet. \n
  86. Health Insurance is a faulty product. Many people have insurance plans that don’t really cover expenses if they get sick. When you think about it, what value do we get from insurance companies? I’ve been asking this question now for awhile and I haven’t heard a good answer yet. \n
  87. Health Insurance is a faulty product. Many people have insurance plans that don’t really cover expenses if they get sick. When you think about it, what value do we get from insurance companies? I’ve been asking this question now for awhile and I haven’t heard a good answer yet. \n
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  89. This clearly shows where we are spending (wasting) health care dollars. While the growth in number of providers matches population growth, the numbers of insurance administrators, health business administrators and paper pushers is exploding.\n
  90. And, here’s the graph for the growth of nurses compared to administrators. Do we really need that many administrators making decisions on healthcare and the administration of health care? \n
  91. Here’s a chart created by someone who attempted to show the “system” we have now. What this chart is missing are the countless hours and hours wasted on the phone and correspondence. Frustration, anger, heartbreak, exhaustion. People, who have an illness or injury, are having to spend their Life Time trying to get the care they need. So what is an alternative? We’ll talk about it in the next few minutes. \n
  92. Historically and today, Americans are in conflict in our society. It started with the founding fathers of this country and continues to this day. \n\n Bitter battles based on principle of whether health care is an individual responsibility (no government involvement) or societal responsibility (state, federal, or charity involvement)\n\n\n
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  94. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  95. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  96. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  97. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  98. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  99. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  100. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  101. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
  102. The bill will expand access and will address some insurance company abuses. But it isn’t an adequate solution. \nComplexity\n hundreds of plans \n new layers of rules \n lots of verification of eligibility, income, compliance\nWaste\n increases administrative burden to insurers, families, and providers \n leaves in place a fragmented system where 31% of health care spending goes to administrative overhead\nCost\n People forced to buy a product they can’t afford \n Doesn’t control rate hikes, doesn’t guarantee claims will be paid\n Imposes a fine if you don’t comply\n Healthy people may chose the fine, raising costs to people with insurance. \n Doesn’t use proven methods of cost containment: bulk purchasing, administrative simplicity, global budgeting.\n ACCESS-\n Leaves people out- 23 million estimated to be uninsured in 2019 \n INEQUITY- \n Leaves in place a system where the quality and security of your coverage is largely determined by your wealth\n \n\n
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  113. This is ONE example to show that it can be done in Vermont and for no more money than we are spending now, we can pay for comprehensive care for all Vermonters including Dr, hospital, prescriptions, eye care, dental care, mental health, rehab. It could be financed with lump sum Medicare, Medicaid, and a 5.8% payroll tax on employers and 2.9% payroll tax on employees. Keep in mind that this is just one example of a universal health care investment plan.\n
  114. \n
  115. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  116. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  117. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  118. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  119. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  120. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  121. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  122. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
  123. Right now: Real life American Story\n\nYou find a job that has HI-->Relief. 3 life needs ($, work, HI) met\nNow, comes the crazy part. It’s New Year’s eve and you decide to take a walk with some friends. You fall and fracture your neck (or you have a stroke). You really need all your resources for healing and adjusting to your new life. You are here in the US of American. So what happens next? What happens next is appalling. \nAren’t able to work for who knows how long. You know you won’t be able to go back to your current job.\nYou are not able to work. No income. Your HI will change. COBRA-18 months, but how will you pay for it? You could go on MCHA, but how will you pay for it? You do not qualify for Medicaid because you’re over 21 and not certified as disabled. You do not qualify for MN Care because you have to be without insurance for 4 months and then it only covers up to $10,000 per year.\nYou’re not over 65, so you don’t qualify for Medicare. You spent enormous amounts of time and energy and will end up stressed beyond belief...Losing your home, losing everything, bankruptcy is a real possibility. \n
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  129. You mean to tell me that we could pay for everyone’s care, for less money than we are currently spending now in total? If it is so good, then why don’t we have it.?\nProfit: Special interest groups spend enormous amounts of money to block this. They do it by lobbying our legislators and spending millions of dollars feeding us fear messages constantly.\nPolitics and politicians: Influenced by big money. Influenced by supporting those bills that will assist in getting them $ for election and get them re-elected.\nPerception: Belief systems; blocking possibilities, lack of understanding, misinformation, against govt involvement\nParanoia: Fear, stress, hopelessness, the hell we know is better than the unknown\n
  130. You mean to tell me that we could pay for everyone’s care, for less money than we are currently spending now in total? If it is so good, then why don’t we have it.?\nProfit: Special interest groups spend enormous amounts of money to block this. They do it by lobbying our legislators and spending millions of dollars feeding us fear messages constantly.\nPolitics and politicians: Influenced by big money. Influenced by supporting those bills that will assist in getting them $ for election and get them re-elected.\nPerception: Belief systems; blocking possibilities, lack of understanding, misinformation, against govt involvement\nParanoia: Fear, stress, hopelessness, the hell we know is better than the unknown\n
  131. You mean to tell me that we could pay for everyone’s care, for less money than we are currently spending now in total? If it is so good, then why don’t we have it.?\nProfit: Special interest groups spend enormous amounts of money to block this. They do it by lobbying our legislators and spending millions of dollars feeding us fear messages constantly.\nPolitics and politicians: Influenced by big money. Influenced by supporting those bills that will assist in getting them $ for election and get them re-elected.\nPerception: Belief systems; blocking possibilities, lack of understanding, misinformation, against govt involvement\nParanoia: Fear, stress, hopelessness, the hell we know is better than the unknown\n
  132. You mean to tell me that we could pay for everyone’s care, for less money than we are currently spending now in total? If it is so good, then why don’t we have it.?\nProfit: Special interest groups spend enormous amounts of money to block this. They do it by lobbying our legislators and spending millions of dollars feeding us fear messages constantly.\nPolitics and politicians: Influenced by big money. Influenced by supporting those bills that will assist in getting them $ for election and get them re-elected.\nPerception: Belief systems; blocking possibilities, lack of understanding, misinformation, against govt involvement\nParanoia: Fear, stress, hopelessness, the hell we know is better than the unknown\n
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  152. I hope I am planting a seed tonight. A seed in you that will germinate and grow when the time is right. That may be now or it may be in the future. \nRight now though, you are probably spending your energy on learning information, developing skills, focusing on tasks, and studying for tests! All important!\nBut, I can see past this. You will shift and become a professional nurse- not a student. As you gain knowledge, skills, and wisdom, you will be accumulating real life stories. I’m hoping you will be aware. Aware of the inequities and needless frustrations and suffering caused by our current health care mess. And, Aware that you can contribute to making changes. Changes based on nursing values. \nAll the graphs and statistics are difficult to grasp unless you are one of those affected. Then you know first hand how horrific and frustrating our health care mess is. Statistics dilute the problem; they separate us from the personal impact they represent. Statistics seem remote. But, as a nurse, you will see first hand how the statistics do really contain real life people. You will participate in people’s lives and experience the real pain, suffering, and devastation created by our current system. I hope you will be aware and that you will have a deeper understanding and sense of outrage and responsibility to work for change and justice. \nYou can make a difference. So, I hope when you have the energy to participate, you’ll join other nurses in becoming actively involved to create a health care system that fits the nursing values we and the people in our nation believe in and hold dear. I know as nurses, you will be impacting lives and making a difference in our world.\n
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