National Nurses United

NewsBriefs.3:March alt 2 3/16/09 6:30 PM Page 7 Adopting Massachusetts Plan for Nation Would be Disastrous, Says Panel NATIONAL H ealthcare experts warned at a Feb. 25 hearing sponsored by the Leadership Conference for Guaranteed Healthcare, a pro-single-payer group of which CNA/NNOC is a key member, that extending Massachusetts-style health reform to the rest of the nation would not only fail to provide universal coverage, but harm Americans already struggling financially during the current economic crisis. The hearing findings are particularly important and timely because President Obama's administration and various Congressional legislators are modeling their national healthcare reform proposals after the Massachusetts plan, which was enacted in 2006. The controversial centerpiece of the Massachusetts plan is a requirement that every person in the state carries health insurance or else faces a fine. If people do not receive employer-sponsored insurance or qualify for public assistance in getting insurance, they must buy private health insurance on their own—a system called "individual mandate." Panelists at the Washington, D.C. hearing spoke about their experiences with the Massachusetts reform. Some 58 members of Congress attended or sent staff to learn from the expert panel, including Rep. John Conyers who has sponsored the single-payer bill HR 676. Speakers walked the briefing attendees through the economic and social difficulties associated with the state plan, which is known as Chapter 58 to the state's residents. The cost to the state has been hundreds of millions higher and the number of newly insured much lower than planners expected. The panel agreed that a fundamental flaw of the plan was continued reliance on a private insurance system which fails to control costs and has no incentive to provide healthcare, just collect insurance premiums. Sandy Eaton, an RN at Quincy Medical Center in Quincy, Mass. and a board member of the Massachusetts Nurses Association, explained that many residents who earn too much to qualify for public subsidies to buy insurance are spending a high percentage of their income for policies that they cannot afford to use. They MARCH 2009 cannot pay out of pocket for the expensive deductibles, doctor visit copays, drug prescription copays, lab charges, and coinsurance that many health plans charge. People are skipping medications and even limiting how much overtime they work for fear of making too much to qualify for government help. "Let me simply say that the system we have now in Massachusetts is not universal, not sustainable, and not fair," said Eaton. Even worse, the Massachusetts plan has further enriched private health insurance companies by providing them a captive market of customers while forcing the closure of many safety net programs and facilities. Government funds that had been going directly to many public hospitals to reimburse them for charity care were shifted to help subsidize the purchase of private insurance for residents. All of the panelists offered a straightforward solution to the stated healthcare reform goals of the Obama administration: expand Medicare to cover all Americans under a single-payer system. "We need to remember that our goal shouldn't be simply to have everyone insured, but rather to have everyone able to access the healthcare they need," said Massachusetts State Sen. Jamie Eldridge. Meanwhile, the citizens of Massachusetts are hurting. "We should not lose sight that real people are suffering," said David Himmelstein of Physicians for a National Health Program and Harvard Medical School at the hearing. "I have a patient right now who is refusing chemotherapy because the copays make chemo unaffordable for him. He is likely to die." —staff report Hospital Chain Giant Stirring Up Controversy TENNESSEE I n a stunning defeat for a giant healthcare corporation that normally bulldozes over community needs, a Tennessee state healthcare agency in February rejected HCA's request to move neonatal intensive care unit beds from one of its hospitals to another. The denial of HCA's bid was the result of CNA/ NNOC's intensive mobilization of Nashvillearea registered nurse members, as well as doctors and community activists. The healthcare advocates opposed HCA's application because the corporation abandoned labor and delivery and NICU services at Southern Hills Medical Center, which is located in a lower-income, largely Latino community, in favor of shifting those services over to StoneCrest Medical Center, a hospital in a more affluent area. The vote by the Tennessee Health Services and Development Agency does not compel HCA to restore services at Southern Hills, but RNs are calling on the chain to do so out of a duty to the mothers in the area who need a safe and close facility to deliver their babies. W W W. C A L N U R S E S . O R G "Patients still need those beds, and HCA has a moral and ethical obligation to reopen them at Southern Hills Hospital," said Malinda Markowitz, an RN who works at a California HCA hospital and is copresident of the CNA/NNOC Council of Presidents. "We want to thank the state for seeing through HCA's falsehoods in this application. Their real motive for abandoning Southern Hills was to hunt for higher-income, better-insured patients. What's good for HCA is bad for the public health of Tennessee." The Tennessee Health Services and Development Agency voted 5-4 during a Feb. 25 hearing against HCA's certificate of need application to move the NICU beds. Testimony by CNA/NNOC RNs and local obstetricians persuasively refuted HCA's assertion that it had notified the community and was forced to close down its labor and delivery unit because it was unable to find obstetricians to staff it despite "aggressive recruitment and retention efforts," according to Tom Ozburn, Southern Hills' CEO. In fact, doctors with Medicos Para La Familia, a bilingual teaching, research, and REGISTERED NURSE 7

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