Thursday, September 17, 2009


Would it surprise anyone if newFNP were to say that she is a supporter of a public option for health care coverage?  Because she is.

NewFNP does not understand the arguments against public health coverage.  NewFNP thinks that Medicare is a pretty cool program -- certainly preferable to elderly people dying in the streets left and right.  And although the reimbursement isn't great and the prescription drug coverage leaves something to be desired, if newFNP's 94-year old grandma needs to go to the emergency room, it's covered.  If she needs to be evaluated for her hypertension, her doctor accepts her insurance -- her public insurance.

Another thing that oftentimes stumps newFNP is this vitriolic opposition to coverage for illegal immigrants.  Um, sorry to be the one to tell you, but this country spends a shitload of money on the medical care of illegal immigrants.  Lest anyone thinks that newFNP's clinic is full of native born Americans down on their luck, think the hell again.  A large proportion of newFNP's adult patients are living here illegally.  Some are applying for green cards and citizenship.  Others are ineligible.  For many, their children were born here.  By and large, the parents were not.

NewFNP is very mindful that she is spending taxpayer money when she is ordering tests, referring to specialists and trying her damnedest to take good care of her patient's complaint within the walls of her clinic.  But newFNP's time is well compensated -- those visits may be free to the patient but they are far from free.

In the absence of comprehensive and - let's be frank - rather harshly defined immigration reform, what exactly is the alternative?  

Not treating someone's active TB because they are illegal residents?  That makes little sense from a public health perspective as that adult living here illegally may spread TB to his child, who will in all likelihood go to a public school classroom where 30 other children may be exposed.  

Or not treating someone's diabetes so that they can present to the emergency room in DKA or blind or with a necrotic Charcot?  That's not going to save anyone any money and it sure as hell isn't going to prevent any suffering.

NewFNP doesn't know the answer.  But she knows that bankruptcy due to medical debt is fucked.  She knows that her patient today, a 40-something year old status post metastatic choriocarcinoma and a citizen, is scared to go to the emergency room for severe abdominal pain because she is already receiving daily phone calls over a $1500 outstanding debt.  

And she sure as hell knows that preventing an illness is far, far superior a plan from an economic, an emotional and a future-oriented perspective than is treating a chronic illness, amputating a leg, tracking down an outbreak of communicable disease or treating anything other than an emergency in an emergency department.  

Is there anyone at all protesting this plan who is uninsured?  Seriously -- anyone?  Have those who oppose a public option - even if it is only for citizens - ever met someone who suffered as a result of lack of insurance?  Are they utterly lacking in empathy?  

Not to be overly dramatic, but is this the America in which we want to live?  


Anonymous said...

You go girl! Couldn't agree with you more.

From, "Applying to NP school"

Julia said...

I agree 100%. What is frightening to me is how little logic and how much vitriol is behind the opposition. Yet, somehow comparing the administration to Hitler seems to be the news, not the people going bankrupt daily because they don't have health insurance, or found out that their health insurance won't cover whatever expensive treatments they just required.

Anonymous said...

A knee jerk reaction such as kick'm out just reeks of ignorence. We are trying to fix healthcare not imigration law. Thanks for verbalizing my feelings.

Anonymous said...

you put into words exactly what I have been feeling, as an ER nurse I know illegal immigrants and the uninsured get health care in the most expensive form, providing them with ongoing basic care can only save money

BostonFNP said...

I have started to question the empathy of my fellow citizens also. I feel that the intellecutal arguements regarding bankrupcy, national debt, health outcomes and the fact that we are all bearing the cost for the un- and underinsured have been made over and over. To fight against health care reform at this point, seems to me, to only be from a protectionist standpoint. I.e.- I have it, you don't. Too bad for you. *Sigh*

Barbara said...

Well, I guess I'll have to be the first nurse to disagree, in a respectful and less vitriolic way.

I attended a tea party today, I am against Gov. run health care, cap and tax, unlimited unvetted czars, and acorn funded community organizing and all of the political sleeze that continues from Washington.

Does health care need reform? You betcha.

Do I want the bloated, incompetent federal government to run it? No way. Open up health care to all, across state lines. Allow large groups of people to pool the risk.

My hubby is a Realtor and a self employed contractor with limited access to affordable health care. My job provides health benefits. But if all Realtors could pool together it would be affordable.
Where is the tort reform? That alone would stop unnecessary tests and CYA procedures.

Keep abortion out of the plan, it is an offense to those of us who truly feel its murder and don't want to fund it,

I could go on. Call me racist, heartless and ill informed but I work for the county in a mental health facility and I am not naive. I just want to stop the socialization of America. We can fix health care without the government option.

Anonymous said...

I disagree also. I do not agree with covering the people who are here illegally. They have not paid taxes to benefit from universal health care. And no it is not a knee jerk reaction. If and when immigration reform is corrected (yea right)then that drastically reduces the uninsured population by 50%, which is significant. We must also look at welfare reform because i have seen too many able bodied people come in to my clinic with Medicaid. Health care reform needs to start and immigration and welfare reform in my opinion

Anonymous said...

Correction to last post from anonymous--health care reform needs to start with immigration and welfare reform.

Anonymous said...

I support healthcare reform--in fact, I would love to see single payer insurance for everyone. And let's be honest--we are never going to "kick out" all the undocumented workers in the U.S., so we might as well be proactive and cover people's basic healthcare needs BEFORE they end up in the ER.

(Just to cement my card-carrying liberal status here, I support abortion and birth control coverage as part of health care reform)

Karen said...

Yes NewFNP, I totally agree. To me it seems outrageous that so many people are so whipped up into a frenzy. Many may understnad the facts, but many just seem to be spitting garbage they heard on cable news. It is sad that so many politicians without a basic understanding of public health or health care in general are the one making these decisions. If America's healthcare providers were making these decisions. I assure you they would be different.

Le Sigh. I live in the Deep South and generally mind my own business about these things so as not to get shot. Sometime I was to shake them and tell them America was a socialist nation long before Obama came along. We are just trying to make it work as opposed to the current situation.

sarah said...

hi new FNP....brand new canadian NP here! it's mind boggling to me how this issue has so divided the US....public health care is the way of all industrialized nations; and all members of the G9 with the exception of the US. it works amazingly well in canada (despite the nut who famously starred in an american political advertisement!). i agree with all your sentiments. it must be so frustrating, it's nice to know there are american colleagues of like mind.

Anonymous said...

If the immigration system is broken, and the health care system is broken, fix the immigration system and cure both.
More money is not the answer, especially when you money being spent has not been earned by those who are spending it.

Lisa said...

Right on, NewFNP!
The idea that this may pass without a public option that is available to all (Medicare for All) is mind boggling to me. Without that provision, it is really a joke because it will force everyone to get over-priced insurance with no alternative - Now tell me how that is going to encourage the insurance companies to lower their prices???
Very sad that so many of our Senators are bought and paid for by pharma and insurance companies, very sad.

I am a NewFNP finally myself, starting my very own HRSA job next week at an urban free clinic. Hope someone up there likes me:)

thanks for all your great blog posts and insights.