Issue link: https://nnumagazine.uberflip.com/i/119584
Many Already on Board For Medicare For All On Jan. 25, Carolyn Trovao knew she was having a heart attack. Yet the 61-year-old Fresno, Calif. woman lay on her living room floor with crushing chest pain, afraid to go to the emergency room because she knew that, because she had no health insurance, getting medical help would ruin her financially and potentially kick her unemployed son out on the streets. ���I actually stayed at home for 16 hours suffering chest pains, praying that I would die because I was afraid that my son would be left homeless,��� said Trovao. ���I do have insurance to pay off my mortgage, so at least if I died, he would at least have a home.��� Passing in and out of consciousness, Trovao eventually couldn���t stand the pain anymore and her 23-year-old son, who lives with her, convinced her to go to the hospital. Trovao is still alive today, but now saddled with a $135,000 hospital bill that she has no resources to pay. The reason she didn���t have insurance coverage in the first place after she retired from her 15-year position with Aetna (yes, she used to work for a health insurer, advising brokers about Aetna policies no less) was because she could not afford the $1,300 per month COBRA premiums. ���That���s what happens to people,��� said Trovao. ���I never thought that I���d lay there and want to die, but I have to be honest with you, I���d have rather died than leave my son homeless.��� She said the hospital recently called about payment, but she has no idea how she will settle that debt. Trovao���s situation is just one of the many distressing stories that NNU nurses and staff members heard and documented during their threeweek bus tour across California this summer as part of NNU���s campaign to expand and improve the Medicare system to cover everybody. Dubbed the ���Healthcare Express,��� the bus left San Diego on June 19 and To see video interviews crisscrossed the state, making stops in from the Medicare for All more than 18 cities. At each stop, nursbus tour, please visit es offered basic health screenings to youtube.com/calnurses. the public, then hosted a town hall meeting to share healthcare stories, discuss the shortcomings of the Affordable Care Act and, alternatively, how a Medicare for all system would work to provide true universal healthcare, and explain how people can take action to pass such a reform. The town hall gatherings were often packed, and community members instinctively understood the need for Medicare to be expanded to cover everyone regardless of age. Registered nurses met all kinds of patients, from those who have lost their jobs and insurance so can no longer afford their medications, to those who had not seen a doctor or nurse in more than a decade. Many of the registered nurse volunteers had their own stories to tell. One RN is supporting 10 relatives on just her salary. Only her immediate family has health insurance. Another RN, Joan Potts, recently lost her insurance when she lost her job. Her husband, who is diabetic, depended on her coverage and is not able to get individual insurance because of his preexisting condition, so is not able to seek medical care. Based on her previous year���s salary, they make too much money to qualify for Medicaid. They are now considering a divorce so that he can access some kind of government aid. ���He suffers every day and I know there is medical help for him, but it���s unattainable. We just can���t afford it,��� said Potts. ���I���ve come to realize that healthcare shouldn���t be a luxury. There���s good people out there suffering needlessly and they���re dying needlessly. Unfortunately, it took something like this to happen to me to make me realize that this needs to stop. We need to have healthcare for everybody.��� Find out more about NNU���s Medicare for All campaign and what you can do to help at NursesHealAmerica.org. ���Lucia Hwang crackdowns on insurance abuses. For example, insurers can create new marketing techniques to cherry-pick whom they cover despite the ban on denials for people with preexisting conditions. The law also permits insurers to charge more based on age and for those who fail ���wellness��� programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions. Insurers will continue to be able to rescind coverage due to ���fraud or intentional misrepresentation��� - the main pretext they use now. The law also simply fails to provide universal coverage. Before the court decision, the non-partisan Congressional Budget Office estimated up to 27 million people would be left without health coverage under the ACA, mostly people who will still not be able to afford to buy private insurance. However, the court decision permitting states to reject the Medicaid expansion could cause the number left out to jump by as much as several million more. The principle of ���all the healthcare you can afford��� remains in effect, as the insurance market is divided into multiple risk pools and multiple plans offering different levels of coverage based on price. For the first time, the law will tax health benefits beginning in 2018. The main target is comprehensive coverage. The inevitable result will be fewer employers offering good health benefits, and far more people pushed into plans with reduced coverage and significantly higher co-pays, deductibles, and other large out-of-pocket costs. For registered nurses, the law promotes IT systems in healthcare, many of which are wasteful and have been used by many employers to erode RN clinical judgment and promote dubious standardized protocols and other efficiency measures. Budget pressures will drive these delivery system changes, under the guise of ���improving quality.��� The law also encourages the use of dubious ���patient satisfaction��� schemes, such as scripting and rounding, that typically undermine nursing practice by linking them to hospital reimbursements. For more on what���s wrong with these schemes, see the October 2010 issue of National Nurse. Ultimately, what the ACA accomplishes is create a windfall for health corporations: Billions of dollars in additional profits for insurance companies, through the individual mandate and taxpayer-funded subsidies to buy private insurance; for drug companies, whose support for the ACA was negotiated by blocking the ability of the federal government to negotiate bulk purchasing discounts; and hospitals, which will get millions of new customers and higher 16 N AT I O N A L N U R S E Carolyn Trovao told her story in Fresno, Calif. W W W. N A T I O N A L N U R S E S U N I T E D . O R G JUNE 2012